Traumatic Stress Symptom Expression Following Indirect Exposure: A Multidisciplinary Investigation

Some researchers and theorists have posited that the biopsychosocial response to indirect trauma exposure that occurs during the course of one's professional trauma work may be qualitatively different than traumatic stress symptoms that occur following a primary exposure. This study investigates the ways trauma symptoms subsequent to indirect exposure are expressed and the domains and domain-specific symptoms that predict membership in different diagnostic outcome categories. A multidisciplinary group of 181 professionals was interviewed using the Secondary Traumatic Stress Clinical Algorithm as a guide and the Clinician-Administered PTSD Scale-5 to establish symptom profiles. Multinomial logistic regression analysis was used to assess the relationship between secondary traumatic stress domains and symptoms, and outcomes, with age, sex, age-sex interaction, and profession used as covariates. The analysis suggests that symptoms of intrusion and arousal/reactivity have the strongest effect on all outcomes when all other terms in the model are held constant. Age, sex, and profession predicted membership in various symptomatic categories. The results of the study illustrate how secondary trauma symptoms manifest, the covariates that moderate the professional's response to indirect trauma, and highlight potential areas of focus for intervention that can be preventative or treatment-oriented.