PTSD symptoms among health workers and public service providers during the COVID-19 outbreak
Open accessAbstract
In the frontline of the pandemic stand healthcare workers and public service providers, occupations which have proven to be associated with increased mental health problems during pandemic crises. This cross-sectional, survey-based study collected data from 1773 healthcare workers and public service providers throughout Norway between March 31, 2020 and April 7, 2020, which encompasses a timeframe where all non-pharmacological interventions (NPIs) were held constant. Post-traumatic stress disorder (PTSD), anxiety and depression were assessed by the Norwegian version of the PTSD checklist (PCL-5), General Anxiety Disorder –7, and Patient Health Questionnaire-9 (PHQ-9), respectively. Health anxiety and specific predictors were assessed with specific items. Multiple regression analysis was used for predictor analysis. A total of 28.9% of the sample had clinical or subclinical symptoms of PTSD, and 21.2% and 20.5% were above the established cut-offs for anxiety and depression. Those working directly in contrast to indirectly with COVID-19 patients had significantly higher PTSD symptoms. Worries about job and economy, negative metacognitions, burnout, health anxiety and emotional support were significantly associated with PTSD symptoms, after controlling for demographic variables and psychological symptoms. Health workers and public service providers are experiencing high levels of PTSD symptoms, anxiety and depression during the COVID-19 pandemic. Health workers working directly with COVID-19 patients have significantly higher levels of PTSD symptoms and depression compared to those working indirectly. Appropriate action to monitor and reduce PTSD, anxiety, and depression among these groups of individuals working in the frontline of pandemic with crucial societal roles should be taken immediately.
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Maladaptive coping such as rumination and catastrophizing, commonly triggered during a crisis, is positively associated with PTSS.
“maladaptive coping such as rumination and catastrophizing thoughts, which is commonly triggered during a crisis (e.g., COVID-19), was positively associated with PTSS [18].”
From Associations between COVID-19 Work-Related Stressors and Posttraumatic Stress Symptoms among Chinese Doctors and Nurses: Application of Stress-Coping Theory (2022) · cites this paper as [18]
The Introduction links worry and rumination to prolonged distress, and ‘Other predictors of PTSD symptoms’ reports positive associations between PTSD symptoms and worries about work and the economy and negative metacognitions (page numbers unavailable). The copy does not establish an association specifically for catastrophizing thoughts, or that these coping responses are commonly triggered by a crisis. (LLM, conf=0.87)
Experimental — accuracy not yet measuredIn previous pre-COVID studies, maladaptive coping was associated with PTSS.
“and maladaptive coping was associated with PTSS [18].”
From Associations between COVID-19 Work-Related Stressors and Posttraumatic Stress Symptoms among Chinese Doctors and Nurses: Application of Stress-Coping Theory (2022) · cites this paper as [18]
The Introduction (page unavailable) says previous studies identified worry and metacognitive beliefs as predictors of PTSD symptoms, and describes worry and rumination as ways of coping that prolong distress. This supports an association for specific coping-related patterns, but the paper does not report a pre-COVID finding for maladaptive coping as a general construct. (LLM, conf=0.78)
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- Authors
- Johnson, S. U., Ebrahimi, O. V., & Hoffart, A.
- Affiliations
- University of Oslo (NO)
- Corresponding author
- Johnson, Sverre Urnes
- Venue
- PLoS ONE
- Publisher
- Center for Open Science
- Published
- 2020-05-20
- Volume
- 15
- Issue
- 10
- Pages
- e0241032-e0241032
- ISSN
- 1932-6203 (ISSN-L)
- PMC
- PMC7577493
- OpenAlex
- W3094239751
- Cited by
- 273
- References
- 42
- Citations by year
- 2026: 9 · 2025: 6 · 2024: 29 · 2023: 51 · 2022: 109 · 2021: 65 · 2020: 4
- FWCI
- 22.88
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Locations
- PLoS ONE (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- PsyArXiv (OSF Preprints) (submittedVersion, cc-by)
- PsyArXiv (OSF Preprints) (submittedVersion)
- NORA - Norwegian Open Research Archives (submittedVersion, cc-by)
- Funders
- Universitetet i Oslo
- Topics
- Social Sciences › Psychology › Clinical Psychology › COVID-19 and Mental Health
- Social Sciences › Psychology › Clinical Psychology › Posttraumatic Stress Disorder Research
- Health Sciences › Health Professions › General Health Professions › Healthcare professionals’ stress and burnout
- Keywords
- post-traumatic stress disorder, COVID-19 pandemic, healthcare workers, public service providers, anxiety, depression, health anxiety, burnout, metacognition, frontline workers, workplace mental health, non-pharmacological treatment
- MeSH terms
- Social Workers, Patient Health Questionnaire, Betacoronavirus, COVID-19, SARS-CoV-2, Adolescent, Adult, Anxiety, Burnout, Professional, Cross-Sectional Studies, Depression, Female, Health Personnel, Humans, Male, Middle Aged, Norway, Pneumonia, Viral, Stress Disorders, Post-Traumatic, Coronavirus Infections, Young Adult, Pandemics
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