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Does the perception that stress affects health matter? The association with health and mortality.

Keller A1, Litzelman K, Wisk LE, Maddox T, Cheng ER, Creswell PD, Witt WP.
Author information
Abstract
OBJECTIVE:
This study sought to examine the relationship among the amount of stress, the perception that stress affects health, and health and mortality outcomes in a nationally representative sample of U.S. adults.
METHODS:
Data from the 1998 National Health Interview Survey were linked to prospective National Death Index mortality data through 2006. Separate logistic regression models were used to examine the factors associated with current health status and psychological distress. Cox proportional hazard models were used to determine the impact of perceiving that stress affects health on all-cause mortality. Each model specifically examined the interaction between the amount of stress and the perception that stress affects health, controlling for sociodemographic, health behavior, and access to health care factors.
RESULTS:
33.7% of nearly 186 million (unweighted n = 28,753) U.S. adults perceived that stress affected their health a lot or to some extent. Both higher levels of reported stress and the perception that stress affects health were independently associated with an increased likelihood of worse health and mental health outcomes. The amount of stress and the perception that stress affects health interacted such that those who reported a lot of stress and that stress impacted their health a lot had a 43% increased risk of premature death (HR = 1.43, 95% CI [1.2, 1.7]).
CONCLUSIONS:
High amounts of stress and the perception that stress impacts health are each associated with poor health and mental health. Individuals who perceived that stress affects their health and reported a large amount of stress had an increased risk of premature death.
PsycINFO Database Record (c) 2012 APA, all rights reserved

b) – This is the result of a research study by Dr. Genelle Sawyer:
Stressors Among 9-1-1 Telecommunicators
Survey Results

Study conducted by Dr. Genelle Sawyer
The Citadel, Department of Psychology

Data collection process:
Participants were obtained from multiple 9-1-1 Call Center locations in the Southeast as well as through a posting on the Association of Public-Safety Communications Officials (APCO) open forum page for employees and members.

Participants completed an on-line survey through SurveyMonkey where they provided informed consent and answered multiple prompts to obtain information about their daily experience as a 9-1-1 telecommunicator, including exposure to traumatic experiences, emotional reactions and symptoms, and coping strategies.

Results:

A total of 567 participants gained access to the study with 529 completing all or portions of the study. Specific completion rates are provided for each prompt.

Participant Demographics

• Gender (N = 529)
o Male 32.7% (n = 173)
o Female 67.3% (n = 356)
• Age (N = 493)
o Mean age of 41.0 (range 21 to 67)
• Ethnicity/Race (N = 526)
o White/Caucasian 84.0% (n=442)
o Black 7.4% (n=39)
o Hispanic/Latino 2.9% (n=15)
o Asian 0.6% (n=3)
o Native American 0.6% (n=3)
o Bi- or multi-racial 4.4% (n=23)
o Other 0.2% (n=1)
• Employment Role (N = 526)
o Call-taker 7.56% (n=40)
o Dispatcher 7.75% (n=41)
o Call-taker and dispatcher 52.17% (n=276)
o Shift/working supervisor 21.74% (n=115)
o Training coordinator 3.97% (n=21)
o Other 6.81% (n=36)
• Marital Status (N = 526)
o Single 23.19% (n=122)
o Cohabitation without marriage 7.98% (n=42)
o Married 54.37% (n=286)
o Separated 2.66% (n=14)
o Divorced 10.45% (n=55)
o Widowed 1.33% (n=7)
• Education Level (N = 529)
o High school 16.07% (n=85)
o Some college 42.91% (n=227)
o Associate degree 15.12% (n=80)
o Bachelor’s degree 22.68% (n=120)
o Master’s degree 2.84% (n=15)
o Doctoral degree 0.38% (n=2)

• How many hours have you worked in the past 7 days? (N = 528)
o Mean of 49.55 hours (range of 0 to 96 hours)
 Note that some indicated abnormal hours due to vacation
• How long have you been a telecommunicator? (N = 528)
o Mean of 12.37 years (range of less than 6 months to 40 years)

Exposure to Traumatic Calls

• Traffic accident with fatality(-ies) (N = 484)
o Yes 93.18%
o No 6.82%
• Natural disaster/severe weather (N = 484)
o Yes 90.70%
o No 9.30%
• Suicidal caller (N = 484)
o Yes 95.04%
o No 4.96%
• Homicide (N = 479)
o Yes 75.37%
o No 24.63%
• Line of duty death (N=481)
o Yes 32.02%
o No 67.98%
• Death of a child (N = 484)
o Yes 82.85%
o No 17.36%
• Death of an adult (N = 485)
o Yes 98.56%
o No 1.44%
• Officer shot (N = 482)
o Yes 35.06%
o No 65.15%
• Officer, firefighter, EMT injured (N = 484)
o Yes 76.45%
o No 23.97%
• Pursuits (N = 484)
o Yes 84.50%
o No 15.91%
• Calls involving children with severe injury (N = 481)
o Yes 90.44%
o No 9.56%
• Armed robbery (N = 484)
o Yes 84.50%
o No 15.50%
• Assault and battery (N = 485)
o Yes 96.49%
o No 3.71%
• Sexual assault of a child (N = 482)
o Yes 81.54%
o No 18.46%
• Sexual assault of an adult (N = 479)
o Yes 92.07%
o No 8.98%
• Calls involving your family/friends (N = 485)
o Yes 69.69%
o No 30.72%
• Hostage situation (N = 486)
o Yes 52.06%
o No 48.15%
• Bomb threat situation (N = 485)
o Yes 74.43%
o No 26.19%
• Domestics (N = 487)
o Yes 98.56%
o No 1.44%
• Riots/mob action (N = 483)
o Yes 37.47%
o No 62.94%
• Plane crash (N = 483)
o Yes 46.79%
o No 54.04%
• Shots fired (N = 483)
o Yes 90.48%
o No 9.52%
• Structure fire (N = 485)
o Yes 97.94%
o No 2.47%
• Barricaded subject (police stand-off with suspect) (N = 486)
o Yes 74.49%
o No 25.93%
• Active shooter situation (N = 484)
o Yes 27.07%
o No 73.35%
• Other highly disturbing calls (N = 463)
o Yes 88.34%
o No 12.74%

• Most common responses for “top three most difficult/traumatic calls” (N = 470)
o Child death or injury 69.15% (n=325)
o Officer shot, injured or killed 41.91% (n=197)
o Suicide related calls 28.93% (n=136)
o Death or homicide of adult 20.64% (n=97)
o Sexual assault/abuse of child 20.41% (n=96)
o Calls involving family or friend 11.70% (n=55)
o Domestic situations 10.41% (n=49)

Usage of and Satisfaction with Support Services

• Usage of support services in response to traumatic calls (N = 420)
o Mental health services (private) 9.50% (n=40)
o Mental health services (work-related service) 10.48% (n=44)
o Peer support/counseling 45.00% (n=189)
o Chaplin or other religious support 13.81% (n=58)

• If you received mental health treatment or support, how helpful was the treatment (N = 173)
o Mean of 3.03

Not helpful Moderately Very helpful
1 2 3 4 5
13.87% 17.34% 32.37% 24.28% 12.14%

• How concerned are you that receiving mental health treatment would result in you being judged or viewed as “weak” by your supervisors? (N = 420)
o Mean of 2.18

Not concerned Moderately Very concerned
1 2 3 4 5
46.90% 14.29% 20.71% 10.24% 7.86%

• How concerned are you that receiving mental health treatment would result in you being judged or viewed as “weak” by your peers? (N = 422)
o Mean of 2.19

Not concerned Moderately Very concerned
1 2 3 4 5
47.39% 13.51% 20.38% 9.48% 9.24%

• How concerned are you that receiving mental health treatment would impact your job security or ability to receive a promotion? (N = 421)
o Mean of 2.21

Not concerned Moderately Very concerned
1 2 3 4 5
47.03% 16.39% 17.58% 6.89% 12.11%

Job Stress and Satisfaction

• How satisfied are you with your current job? (N = 473)
o Mean of 4.55

Very Dissatisfied Dissatisfied Moderately Dissatisfied Neutral Moderately Satisfied Satisfied Very Satisfied
4.23% 5.50% 10.15% 7.61% 23.47% 33.19% 15.86%

• Do you feel like you are always on the job? (N = 473)
o Yes 48.63%
o No 51.37%

• Are you able to leave the stress of work at work when you go home? (N = 473)
o Yes 58.35%
o No 41.65%

• Do you have a difficult time managing your social life outside of work? (N = 472)
o Yes 47.03%
o No 52.97%

Use of Coping Strategies

• Typical weekly consumption of alcohol (N = 474)
o 0 drinks 48.10%
o 1-5 drinks 38.82%
o 6-11 drinks 7.60%
o 12 or more drinks 5.49%

• Typical weekly engagement in health promoting behaviors (e.g., exercise, yoga) (N = 474)
o 0 35.02%
o 1-2 31.86%
o 3-4 33.36%
o 5 or more 10.70%

• Do you use tobacco products? (N = 473)
o Yes 25.16%
o No 74.84%

Mental Health Outcomes

• Rates of potential Post-traumatic Stress Disorder (as measured by the PCL-5 with cut-off of 33; N = 422)
o Likely diagnosis of PTSD 21.3% (n = 90)
o Unlikely diagnosis of PTSD 78.7% (n = 332)

• Rates of potential depression (as measured by the CES-D with cut-off of 16; N = 407)
o Likely diagnosis of depression 43.2% (n = 176)
o Unlikely diagnosis of depression 56.8% (n = 231)

b. FROM ANECDOTAL TO HARD DATA – By Audrey Fraizer
The subject of stress in the 911 center surfaced repeatedly during Dr. Genelle Sawyer’s research into the effect of traumatic incidents on police, fire, and ambulance field personnel. – https://iaedjournal.org/from-anecdotal-to-hard-data/

c. Does the Perception That Stress Affects Health Matter? The Association with Health and Mortality.
Keller A1, Litzelman K, Wisk LE, Maddox T, Cheng ER, Creswell PD, Witt WP.
Author information
Abstract
OBJECTIVE:
This study sought to examine the relationship among the amount of stress, the perception that stress affects health, and health and mortality outcomes in a nationally representative sample of U.S. adults.
METHODS:
Data from the 1998 National Health Interview Survey were linked to prospective National Death Index mortality data through 2006. Separate logistic regression models were used to examine the factors associated with current health status and psychological distress. Cox proportional hazard models were used to determine the impact of perceiving that stress affects health on all-cause mortality. Each model specifically examined the interaction between the amount of stress and the perception that stress affects health, controlling for sociodemographic, health behavior, and access to health care factors.
RESULTS:
33.7% of nearly 186 million (unweighted n = 28,753) U.S. adults perceived that stress affected their health a lot or to some extent. Both higher levels of reported stress and the perception that stress affects health were independently associated with an increased likelihood of worse health and mental health outcomes. The amount of stress and the perception that stress affects health interacted such that those who reported a lot of stress and that stress impacted their health a lot had a 43% increased risk of premature death (HR = 1.43, 95% CI [1.2, 1.7]).
CONCLUSIONS:
High amounts of stress and the perception that stress impacts health are each associated with poor health and mental health. Individuals who perceived that stress affects their health and reported a large amount of stress had an increased risk of premature death.
PsycINFO Database Record (c) 2012 APA, all rights reserved – https://www.ncbi.nlm.nih.gov/pubmed/22201278

d. Dispatcher Trauma: The Unique Stress of the Job (And How to Overcome It)
Just because dispatchers don’t witness trauma first-hand doesn’t mean they are not potentially to the stressful aftermath. – https://www.policeone.com/health-fitness/articles/171323006-Dispatcher-trauma-The-unique-stress-of-the-job-and-how-to-overcome-it/

e. Stress and the 911 Dispatcher
The 911 Dispatcher is the first “First Responder.” The dispatcher is the vital link, ensuring clear communication between all responders, affecting the safety of both the citizen in need and the police, fire and emergency medical personnel responding. Through our actions, we help save lives, protect property, and assist the public in their time of need. In this blog, I will share articles and other things of interest that may help dispatchers do their job more effectively. https://www.msfa.org/content/chaplains/Stress_and_the_Dispatcher.pdf

f. PTSD AND EMERGENCY TELECOMMUNICATORS – by Anna Raskin
(This interview first ran in “The Call,” the official publication of NENA: The 9-1-1 Association) Dr. Michelle Lilly published a groundbreaking study on 911 telecommunicators in the Journal of Traumatic Stress in April 2012 titled “Duty-Related Trauma Exposure in 911 Telecommunicators: Considering the Risk for Post-traumatic Stress.” Bringing to light the PTSD symptomatology in telecommunicators, the study has been instrumental in showing that dispatchers are at risk for PTSD in a similar way as police officers. Dr. Lilly has been at Northern Illinois University since the fall of 2009 and is an Associate Professor of Clinical Psychology. She has a wealth of experience studying victims of intimate partner violence, survivors of sexual and physical assaults, and other survivors of traumatic stress. – https://iaedjournal.org/ptsd-in-911-communications-qa/