Hensel Jennifer M, Ruiz Carlos, Finney Caitlin, Dewa Carolyn S
Centre for Research on Employment and Workplace Health, Centre for Addiction and Mental Health, Toronto, Ontario, Canada; Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada; Department of Psychiatry at Women's College Hospital, Toronto, Ontario, Canada.
J Trauma Stress. 2015 Apr;28(2):83-91. doi: 10.1002/jts.21998.
Revisions to the posttraumatic stress disorder (PTSD) diagnostic criteria in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5; American Psychiatric Association, 2013) clarify that secondary exposure can lead to the development of impairing symptoms requiring treatment. Historically known as secondary traumatic stress (STS), this reaction occurs through repeatedly hearing the details of traumatic events experienced by others. Professionals who work therapeutically with trauma victims may be at particular risk for this exposure. This meta-analysis of 38 published studies examines 17 risk factors for STS among professionals indirectly exposed to trauma through their therapeutic work with trauma victims. Small significant effect sizes were found for trauma caseload volume (r = .16), caseload frequency (r = .12), caseload ratio (r = .19), and having a personal trauma history (r = .19). Small negative effect sizes were found for work support (r = -.17) and social support (r = -.26). Demographic variables appear to be less implicated although more work is needed that examines the role of gender in the context of particular personal traumas. Caseload frequency and personal trauma effect sizes were moderated by year of publication. Future work should examine the measurement of STS and associated impairment, understudied risk factors, and effective interventions.
《精神疾病诊断与统计手册》第五版（DSM - 5；美国精神病学协会，2013年）中创伤后应激障碍（PTSD）诊断标准的修订明确指出，二次暴露可导致出现需要治疗的损害性症状。这种反应在历史上被称为二次创伤应激（STS），它是通过反复听闻他人经历的创伤事件细节而发生的。从事创伤受害者治疗工作的专业人员可能特别容易受到这种暴露的影响。这项对38项已发表研究的荟萃分析，考察了专业人员通过与创伤受害者的治疗工作间接接触创伤后发生STS的17个风险因素。发现创伤病例数量（r = 0.16）、病例频率（r = 0.12）、病例比例（r = 0.19）以及有个人创伤史（r = 0.19）的效应量有小的显著差异。发现工作支持（r = -0.17）和社会支持（r = -0.26）的效应量有小的负差异。人口统计学变量似乎关联较小，不过还需要更多研究来考察性别在特定个人创伤背景下的作用。病例频率和个人创伤效应量受发表年份的影响。未来的工作应考察STS及相关损害的测量、研究不足的风险因素以及有效的干预措施。
