1. Study suggests food may affect mood – and differently depending on age

    December 25, 2017 by Ashley

    From the Binghamton University press release:

    Diet and dietary practices differentially affect mental health in young adults versus older adults, according to new research from Binghamton University, State University of New York.

    Lina Begdache, assistant professor of health and wellness studies at Binghamton University, along with fellow Binghamton researchers, conducted an anonymous internet survey, asking people around the world to complete the Food-Mood Questionnaire (FMQ), which includes questions on food groups that have been associated with neurochemistry and neurobiology. Analyzing the data, Begdache and Assistant Professor of Systems Science and Industrial Engineering Nasim Sabounchi found that mood in young adults (18-29) seems to be dependent on food that increases availability of neurotransmitter precursors and concentrations in the brain (meat). However, mood in mature adults (over 30 years) may be more reliant on food that increases availability of antioxidants (fruits) and abstinence of food that inappropriately activates the sympathetic nervous system (coffee, high glycemic index and skipping breakfast).

    “One of the major findings of this paper is that diet and dietary practices differentially affect mental health in young adults versus mature adults,” said Begdache. “Another noteworthy finding is that young adult mood appears to be sensitive to build-up of brain chemicals. Regular consumption of meat leads to build-up of two brain chemicals (serotonin and dopamine) known to promote mood. Regular exercise leads to build-up of these and other neurotransmitters as well. In other words, young adults who ate meat (red or white) less than three times a week and exercised less than three times week showed a significant mental distress.”

    “Conversely, mature adult mood seems to be more sensitive to regular consumption of sources of antioxidants and abstinence of food that inappropriately activates the innate fight-or-flight response (commonly known as the stress response),” added Begdache. “With aging, there is an increase in free radical formation (oxidants), so our need for antioxidants increases. Free radicals cause disturbances in the brain, which increases the risk for mental distress. Also, our ability to regulate stress decreases, so if we consume food that activates the stress response (such as coffee and too much carbohydrates), we are more likely to experience mental distress.”

    Begdache and her team are interested in comparing dietary intake between men and women in relation to mental distress. There is a gender difference in brain morphology which may be also sensitive to dietary components, and may potentially explain some the documented gender-specific mental distress risk, said Begdache.


  2. Study suggests eating together as a family helps children feel better, physically and mentally

    by Ashley

    From the University of Montreal press release:

    Children who routinely eat their meals together with their family are more likely to experience long-term physical and mental health benefits, a new Canadian study shows.

    Université de Montréal doctoral student Marie-Josée Harbec and her supervisor, pyschoeducation professor Linda Pagani, made the finding after following a cohort of Quebec children born between 1997 and 1998.

    The study is published today in the Journal of Developmental & Behavioral Pediatrics.

    “There is a handful of research suggesting positive links between eating family meals together frequently and child and adolescent health,” Pagani said. “In the past, researchers were unclear on whether families that ate together were simply healthier to begin with. And measuring how often families eat together and how children are doing at that very moment may not capture the complexity of the environmental experience.”

    The study looked at children who had been followed by researchers since they were 5 months old as part of the Quebec Longitudinal Study of Child Development. At age 6, their parents started reporting on whether or not they had family meals together. At age 10, parents, teachers and the children themselves provided information on the children’s lifestyle habits and their psycho-social well-being.

    “We decided to look at the long-term influence of sharing meals as an early childhood family environment experience in a sample of children born the same year,” Pagani said, “and we followed-up regularly as they grew up. Using a birth cohort, this study examines the prospective associations between the environmental quality of the family meal experience at age 6 and child well-being at age 10.”

    When the family meal environment quality was better at age 6, higher levels of general fitness and lower levels of soft-drink consumption were observed at age 10. These children also seemed to have more social skills, as they were less likely to self-report being physical aggressive, oppositional or delinquent at age 10.

    “Because we had a lot of information about the children before age 6 — such as their temperament and cognitive abilities, their mother’s education and psychological characteristics, and prior family configuration and functioning — we were able to eliminate any pre-existing conditions of the children or families that could throw a different light on our results,” said Harbec. “It was really ideal as a situation.”

    Added Pagani: “The presence of parents during mealtimes likely provides young children with firsthand social interaction, discussions of social issues and day-to-day concerns, and vicarious learning of prosocial interactions in a familiar and emotionally secure setting. Experiencing positive forms of communication may likely help the child engage in better communication skills with people outside of the family unit. Our findings suggest that family meals are not solely markers of home environment quality, but are also easy targets for parent education about improving children’s well-being.”

    “From a population-health perspective, our findings suggest that family meals have long-term influences on children’s physical and mental well-being,” said Harbec.

    At a time when fewer families in Western countries are having meals together, it would be especially opportune now for psycho-social workers to encourage the practice at home — indeed, even make it a priority, the researchers believe. And family meals could be touted as advantageous in public-information campaigns that aim to optimize child development.


  3. Study suggests rates of psychosis vary internationally

    December 16, 2017 by Ashley

    From the University College London press release:

    Rates of psychosis can be close to eight times higher in some regions compared to others, finds a new study led by researchers at UCL, King’s College London and the University of Cambridge.

    The study, published today in JAMA Psychiatry, was the biggest international comparison of incidence of psychotic disorders, and the first major study of its kind in more than 25 years.

    “It’s well-established that psychotic disorders, such as schizophrenia, are highly heritable, but genetics don’t tell the whole story. Our findings suggest that environmental factors can also play a big role,” said the study’s lead author, Dr James Kirkbride (UCL Psychiatry). “We need more in-depth research to understand why people in some areas may be at greater risk of developing a psychotic disorder, which could help us understand the roots of the condition and guide health care planning,” he said.

    The authors estimated the incidence of psychotic disorders across 17 areas in six countries — the UK, France, Italy, the Netherlands, Spain and Brazil — using comparable methodology. Their data was drawn from people aged 18-64 who contacted mental health services after a suspected first psychotic episode, which included 2,774 incident cases in total.

    They found the overall incidence of psychotic disorders to be 21.4 per 100,000 person-years, but discovered wide variations between different areas, from a low of 6.0 per 100,000 person-years in the rural area around Santiago (Spain), to a high of over 45 in inner-city Paris and Southeast London. This variation could not be explained by differences in the age, sex and ethnic composition of the population across these areas.

    To reduce the likelihood that differences in treatment-seeking behaviour between regions skewed the results, the researchers encouraged case detection in the survey areas to be as comprehensive as possible.

    Among the contributing factors under consideration, they found that the strongest area-level predictor of high rates of psychotic disorders was a low rate of owner-occupied housing. The researchers used owner-occupied housing as an indicator of socio-economic affluence and stability.

    “Areas with higher rates of owner-occupied housing have lower rates of psychosis, which may be linked to social deprivation. People in areas that are socially deprived may have more social stresses, which could predict psychosis incidence, as suggested by other studies. An alternative explanation could be that owner-occupied housing is an indicator of social stability and cohesiveness, relating to stronger support networks,” said the study’s first author, Hannah Jongsma (University of Cambridge).

    In line with previous research, higher incidence of psychosis was also associated with younger age (although the authors also identified a secondary peak in middle age among women), males, and ethnic minorities. A related paper investigating psychosis incidence in a rural region of England, also led by Dr Kirkbride and published last week in JAMA Psychiatry, found that while people from ethnic minorities are more likely to experience a psychotic disorder, these rates become lower in areas with a high degree of ethnic diversity — both for the majority- and minority-ethnic individuals, potentially suggesting that greater social connections between individuals from different backgrounds is protective against some mental health issues.

    The researchers say their findings can be used to help plan mental health services, by identifying which regions could expect greater incidence of psychosis. Some of the researchers have developed a predictive model that is already being put to use by health agencies. “We can predict with an increasing degree of accuracy what the incidence rates are in a given region based on readily-available demographic data. This can help policy makers plan where to focus resources for the treatment and prevention of psychotic disorders,” said co-author Professor Jim van Os (University Medical Center Utrecht).

    The findings add weight to previous evidence that environmental factors could play a larger role in causing psychotic disorders than previously believed.

    “In the past couple decades, researchers have made a lot of progress in identifying how genes are linked to psychotic disorder. We suggest that we now need to devote more time to researching how environmental and genetic factors can both contribute to psychosis,” said joint senior author Professor Craig Morgan (King’s College London).

    The researchers say that more research is needed to identify causal mechanisms, investigate other risk factors, and study psychosis incidence in other environments such as lower-income countries.

    The study was funded by the European Community’s Seventh Framework Programme, alongside support from the São Paulo Research Foundation, Wellcome, the Royal Society, and the National Institute for Health Research.


  4. Study suggests lack of sleep could cause mood disorders in teens

    December 14, 2017 by Ashley

    From the American College of Neuropsychopharmacology press release:

    Chronic sleep deprivation — which can involve staying up late, and waking up early for work or school — has become a way of life for both kids and adults, especially with the increasing use of phones and tablets late into the night. But this social jet lag poses some serious health and mental health risks: new research finds that for teenagers, even a short period of sleep restriction could, over the long-term, raise their risk for depression and addiction.

    University of Pittsburgh’s Peter Franzen and Erika Forbes invited 35 participants, aged 11.5-15 years, into a sleep lab for two nights. Half the participants slept for 10 hours, while the other half slept only four hours. A week later, they came back to the lab for another two nights and adopted the opposite sleep schedule from their initial visit.

    Each time they visited the lab, the participants underwent brain scans while playing a game that involved receiving monetary rewards of $10 and $1. At the end of each visit, the teens answered questions that measured their emotional functioning, as well as depression symptoms.

    The researchers found that sleep deprivation affected the putamen, an area of the brain that plays a role in goal-based movements and learning from rewards. When participants were sleep-deprived and the reward in the game they played was larger, the putamen was less responsive. In the rested condition, the brain region didn’t show any difference between high- and low-reward conditions.

    Franzen and Forbes also found connections between sleep restriction and mood: after a night of restricted sleep, the participants who experienced less activation in the putamen also reported more symptoms of depression. This is consistent with findings, from a large literature of studies on depression and reward circuitry, that depression is characterized by less activity in the brain’s reward system.

    The results suggest that sleep deprivation in the tween and teen years may interfere with how the brain processes rewards, which could disrupt mood and put a person at risk of depression, as well as risk-taking behavior and addiction.


  5. NIH study of WWII evacuees suggests mental illness may be passed to offspring

    December 11, 2017 by Ashley

    From the NIH/Eunice Kennedy Shriver National Institute of Child Health and Human Development press release:

    Mental illness associated with early childhood adversity may be passed from generation to generation, according to a study of adults whose parents evacuated Finland as children during World War II. The study was conducted by researchers at the National Institutes of Health, Uppsala University in Sweden, and Helsinki University in Finland. It appears in JAMA Psychiatry.

    The research team found that daughters of female evacuees had the same high risk for mental health disorders as their mothers, even though they did not experience the same adversity. The study could not determine why the higher risk for mental illness persisted across generations. Possible explanations include changes in the evacuees’ parenting behavior stemming from their childhood experience or epigenetic changes — chemical alterations in gene expression, without any changes to underlying DNA.

    “Many studies have shown that traumatic exposures during pregnancy can have negative effects on offspring,” said study author Stephen Gilman, Sc.D., of the Division of Intramural Population Health Research at the Eunice Kennedy Shriver National Institute of Child Health and Human Development. “Here, we found evidence that a mother’s childhood traumatic exposure — in this case separation from family members during war — may have long-lasting health consequences for her daughters.”

    From 1941 to 1945, roughly 49,000 Finish children were evacuated from their homes to protect them from bombings, malnutrition and other hazards during the country’s wars with the Soviet Union. The children, many of them only preschoolers, were placed with foster families in Sweden. In addition to separation from their families, the children faced the stresses of adapting to their foster families, and in many cases, learning a new language. Upon their return, many children experienced the additional stress of readjusting to Finnish society.

    During the same time, thousands of Finnish families chose not to evacuate all their children and often kept some at home, but little information exists on the rationale for their decisions. The researchers compared the risk of being hospitalized for a psychiatric (mental health) disorder among offspring of the evacuees to the risks of psychiatric hospitalization among the offspring of the siblings who remained with their parents. Studying the two groups — cousins to each other — allowed the researchers to compensate for family-based factors that can contribute to mental health problems and to focus instead on the evacuees’ wartime experience.

    In a previous study, the researchers found that women evacuated as children were more than twice as likely to be hospitalized for a psychiatric disorder than their female siblings who remained at home. For the current study, the researchers linked records from this generation — more than 46,000 siblings born between 1933 and 1944 — to those of their offspring, more than 93,000 individuals born after 1950. Of these, nearly 3,000 were offspring of parents who had been evacuated to Sweden as children, and more than 90,000 were offspring of parents who remained in Finland during the war.

    The researchers found that female evacuees and their daughters were at the greatest risk for being hospitalized for mood disorders, such as depression and bipolar disorder. In fact, the evacuees’ daughters had more than four times the risk of hospitalization for a mood disorder, compared to the daughters of mothers who stayed home — regardless of whether their mothers were hospitalized for a mood disorder.

    The researchers did not find any increase in psychiatric hospitalizations for the sons or daughters of males who had been evacuated as children.

    The study could not determine why the daughters of female evacuees had a higher risk of mental illness. One possibility is that the stresses of the evacuees’ experience affected their psychological development in ways that influenced their parenting style. Another possibility is that the evacuee experience resulted in epigenetic changes. For example, the researchers cited an earlier finding that Holocaust survivors have higher levels of compounds known as methyl groups bound to the gene FKBP5 and have passed this change on to their children. This higher level of methyl groups appears to alter the production of cortisol, a hormone that regulates the stress response.

    “The Finnish evacuation was intended to protect children from the many harms associated with the country’s wars with the Soviet Union,” said study co-author Torsten Santavirta, Ph.D., of Uppsala University. “Our observation of long-term psychiatric risk that reached into the next generation is concerning and underscores the need to weigh benefits as well as potential risks when designing policies for child protection.”

    The authors concluded that future studies are needed to understand how the experience of war affects the mental health of parents and their offspring and to develop interventions to help families affected by armed conflict.


  6. Study suggests school exacerbates feelings of being ‘different’ in pupils with Autism Spectrum Conditions

    November 28, 2017 by Ashley

    From the University of Surrey press release:

    autism_stairsNegative school experiences can have harmful long term effects on pupils with Autism Spectrum Conditions, a new study in the journal Autism reports.

    Researchers from the University of Surrey have discovered that experiences of social and emotional exclusion in mainstream schools can adversely affect how pupils with autism view themselves, increasing their risk of developing low self-esteem, a poor sense of self-worth and mental health problems.

    Examining 17 previous studies in the area, researchers discovered that how pupils with autism view themselves is closely linked to their perceptions of how other’s treat and interact with them. They found that a tendency of many pupils with the condition to internalise the negative attitudes and reactions of others toward them, combined with unfavourable social comparisons to classmates, leads to a sense of being ‘different’ and more limited than peers.

    Negative self-perception can lead to increased isolation and low self-esteem making pupils with autism more susceptible to mental health problems.

    It was discovered that the physical environment of schools can impact on children’s ability to interact with other pupils. Sensory sensitivity, which is a common characteristic of autism and can magnify sounds to an intolerable level, can lead to everyday classroom and playground noises such as shrieks and chatter being a source of anxiety and distraction. This impacts on a pupil’s ability to concentrate in the classroom and to socialise with others, further increasing isolation and a sense of being ‘different.’

    It was also found that pupils with autism who developed supportive friendships and felt accepted by classmates said this helped alleviate their social difficulties and made them feel good about themselves.

    These findings suggest it is crucial for schools to create a culture of acceptance for all pupils to ensure the long term wellbeing of pupils with autism in mainstream settings.

    Lead author of the paper Dr Emma Williams, from the University of Surrey, said: “Inclusive mainstream education settings may inadvertently accentuate the sense of being ‘different’ in a negative way to classmates.

    “We are not saying that mainstream schools are ‘bad’ for pupils with autism, as other evidence suggests they have a number of positive effects, including increasing academic performance and social skills.

    “Rather, we are suggesting that by cultivating a culture of acceptance of all and making small changes, such as creating non-distracting places to socialise, and listening to their pupils’ needs, schools can help these pupils think and feel more positively about themselves.

    “With over 100,000 children in the UK diagnosed with autism, it is important that we get this right to ensure that pupils with autism get the education they deserve and leave school feeling accepted, loved and valued, rather than with additional mental health issues.”


  7. Study links teenage depression to father’s depression

    by Ashley

    From the University College London press release:

    Adolescents whose fathers have depressive symptoms are more likely to experience symptoms of depression themselves, finds a new study led by UCL researchers.

    While the link between mothers’ depression and depression in their children is well-established, the new Lancet Psychiatry study is the first to find an association between depression in fathers and their teenaged children, independent of whether the mother has depression, in a large sample in the general population. The effects of fathers’ and mothers’ depression on their children’s symptoms were similar in magnitude.

    “There’s a common misconception that mothers are more responsible for their children’s mental health, while fathers are less influential — we found that the link between parent and teen depression is not related to gender,” said the study’s lead author, Dr Gemma Lewis (UCL Psychiatry).

    “Family-focused interventions to prevent depression often focus more on mothers, but our findings suggest we should be just as focused on fathers,” she said.

    The researchers drew on two large longitudinal studies of children: Growing up in Ireland, and the Millennium Cohort Study in England and Wales, using data from 6070 and 7768 families from the two studies, respectively. Parental depressive symptoms were assessed using a questionnaire when the children were 9 and 7 years old in the two cohorts, and then adolescent depressive symptoms were assessed when the children were 13 and 14 years old. The study samples were population-based, meaning they included people who experienced symptoms of depression but had not sought treatment.

    After adjusting for confounding factors such as maternal depression, family income and parental alcohol use, the researchers found that for every 3-point (one standard deviation) increase on the Mood and Feelings Questionnaire (MFQ; a commonly-used measure of depressive symptoms) on the part of fathers, there was an associated 0.2-point increase in the adolescent’s MFQ score. The findings were replicated in both independent study samples.

    Incidence of depression increases markedly at the beginning of adolescence, so the researchers say that understanding the risk factors at that age can be key to preventing depression later in life.

    “Men are less likely to seek treatment for depression. If you’re a father who hasn’t sought treatment for your depression, it could have an impact on your child. We hope that our findings could encourage men who experience depressive symptoms to speak to their doctor about it,” said Dr Lewis.

    Previous studies have shown links between paternal depression and poor behavioural and emotional outcomes in their children, but no large study in the general population (as opposed to a clinical population) has looked at the link with adolescent depression while taking into account maternal depression as well.

    “The mental health of both parents should be a priority for preventing depression among adolescents. There has been far too much emphasis on mothers but fathers are important as well,” said the study’s senior author, Professor Glyn Lewis (UCL Psychiatry).


  8. Study examines health risks of energy drinks

    November 26, 2017 by Ashley

    From the Frontiers press release:

    A new review of current scientific knowledge on energy drinks finds their advertised short-term benefits can be outweighed by serious health risks — which include risk-seeking behavior, mental health problems, increased blood pressure, obesity and kidney damage. The study, published in Frontiers in Public Health, also highlights the worrying trend of mixing energy drinks with alcohol. The authors recommend restricted sales to children and adolescents and setting evidence-based caffeine limits.

    As energy drink consumption continues to grow worldwide, there is a need to thoroughly examine their advertised benefits, nutritional content and any negative effects on public health.

    “We summarize the consequences of energy drink consumption, which include heart, kidney, and dental problems, as well as risk-seeking behavior and poor mental health,” says Dr. Josiemer Mattei, Assistant Professor of Nutrition based at the Harvard T.H. Chan School of Public Health, Boston, USA, who published this study along with a team of graduate researchers.

    “The evidence suggests they are harmful to health and should be limited through more stringent regulation by restricting their sales to children and adolescents, as well as setting an evidence-based upper limit on the amount of caffeine.”

    Most energy drinks consist of similar ingredients — water, sugar, caffeine, certain vitamins, minerals and non-nutritive stimulants such as guarana, taurine and ginseng. Some can contain up to 100 mg caffeine per fluid ounce, eight times more than a regular coffee at 12 mg. A moderate daily caffeine intake of up to 400 mg is recommended for adults, but little research exists on tolerable levels for adolescents and children.

    “The energy drink industry has grown dramatically in the past 20 years, culminating in a nearly $10 billion per year industry in the United States. They are often marketed as a healthy beverage that people can adopt to improve their energy, stamina, athletic performance and concentration, but our review shows there are important health consequences, and little is known about many of their non-nutritive stimulants such as guarana and taurine,” says Dr. Mattei.

    The health risks associated with energy drinks are mostly attributed to their high sugar and caffeine levels. They range from risk-seeking behavior, such as substance misuse and aggression, mental health problems in the form of anxiety and stress, to increased blood pressure, obesity, kidney damage, fatigue, stomachaches and irritation.

    The review also highlights another worrying trend of mixing energy drinks with alcohol. Individuals who do this consume more alcohol than if they were drinking alcohol alone. It is thought energy drinks can mask the signs of alcohol inebriation, enabling an individual to consume more, increasing the likelihood of dehydration and alcohol poisoning.

    Dr. Mattei and her colleagues hope that by highlighting our current knowledge about the health consequences of energy drinks, policy and interventions can be put in place to reduce negative effects on public health. In addition, the review can be used to target research to fill the gaps in our knowledge.

    “Our review is limited because there are a small number of studies in this area and they primarily focus on healthy young adults, assessed at one point in time. Future research should explore the effects of the energy drink constituents we know less about, such as taurine, and consider long-term assessments across a broader range of the population to examine the effects of energy drink consumption over time,” she explains.

    “However, we conclude that there is currently enough evidence to suggest that the negative health consequences of drinking energy drinks outweigh any potential short-term benefits.”


  9. Study looks at mental health risks of too much screen time

    November 24, 2017 by Ashley

    From the San Diego State University press release:

    Increased time spent in front of a screen — in the form of computers, cell phones and tablets — might have contributed to an uptick in symptoms of depression and suicide-related behaviors and thoughts in American young people, especially girls, according to a new study by San Diego State University professor of psychology Jean Twenge. The findings point to the need for parents to monitor how much time their children are spending in front of media screens.

    “These increases in mental health issues among teens are very alarming,” Twenge said. “Teens are telling us they are struggling, and we need to take that very seriously.”

    Twenge, along with SDSU graduate student Gabrielle Martin and colleagues Thomas Joiner and Megan Rogers at Florida State University, looked at questionnaire data from more than 500,000 U.S. teens found in two anonymous, nationally representative surveys that have been conducted since 1991. They also looked at data suicide statistics kept by the U.S. Centers for Disease Control and Prevention.

    They found that the suicide rate for girls aged 13-18 increased by 65 percent between 2010 and 2015, and the number of girls experiencing so-called suicide-related outcomes — feeling hopeless, thinking about suicide, planning for suicide or attempting suicide — rose by 12 percent. The number of teen girls reporting symptoms of severe depression increased by 58 percent.

    “When I first saw these sudden increases in mental health issues, I wasn’t sure what was causing them,” said Twenge, author of iGen: Why Today’s Super-Connected Kids Are Growing Up Less Rebellious, More Tolerant, Less Happy — And Completely Unprepared for Adulthood. “But these same surveys ask teens how they spend their leisure time, and between 2010 and 2015, teens increasingly spent more time with screens and less time on other activities. That was by far the largest change in their lives during this five-year period, and it’s not a good formula for mental health.”

    The researchers returned to the data and looked to see if there was a statistical correlation between screen-time and depressive symptoms and suicide-related outcomes. They found that 48 percent of teens who spent five or more hours per day on electronic devices reported at least one suicide-related outcome, compared to only 28 percent of those who spent less than an hour a day on devices. Depressive symptoms were more common in teens who spent a lot of time on their devices, as well.

    The findings fit with previous studies that have linked spending more time on social media to unhappiness.

    On the positive side, the researchers found that spending time away from screen and engaging in in-person social interaction, sports and exercise, doing homework, attending religious services, etc., was linked to having fewer depressive symptoms and suicide-related outcomes. The researchers reported their findings today in the journal Clinical Psychological Science.

    While economic struggles are generally thought to be linked to depression and suicide, the U.S. economy was improving between 2010 and 2015, so that is unlikely to be the primary driver of these increases, Twenge noted.

    “Although we can’t say for sure that the growing use of smartphones caused the increase in mental health issues, that was by far the biggest change in teens’ lives between 2010 and 2015,” she said.

    The good news? You don’t have to totally give up on electronic devices to lower your risk for depression and suicide-relayed outcomes. Twenge said that limiting screen-time to one or two hours per day would statistically fall into the safe zone for device usage.


  10. Study suggests stress faced by emergency call handlers damaging to long term health

    November 23, 2017 by Ashley

    From the University of Surrey press release:

    During this innovative study, researchers from the University of Surrey, University of Dundee, Anglia Ruskin University and Kingston University/St George’s, University of London investigated areas that impacted on the psychological health of call handlers.

    Previous research on how stress affects healthcare workers is largely focused on frontline staff i.e. paramedics and firefighters, however little is known on the impact on call handlers who make critical decisions in assessing what type of emergency response is required.

    Examining 16 studies from across the world, researchers identified key factors which cause operatives stress and potentially impact on their psychological health. Exposure to traumatic and abusive calls was found to negatively affect call handlers, because although they are not physically exposed to emergency situations, evidence demonstrated that they experienced trauma vicariously. In one study, participants reported experiencing fear, helplessness or horror in reaction to 32 per cent of the different types of calls that they received.

    A key stressor for call handlers was a lack of control over their workload due to the unpredictability of calls and a lack of organisational recognition of the demands of managing their assignments. One study reported that ambulance call handlers felt out of control of their workload after returning from rest breaks, which led them not taking scheduled breaks, leading to exhaustion. A lack of high quality training in dealing with pressurised calls was identified by some handlers as contributing to stress levels, with police call handlers in one study showing concern about their performance in handling fluid situations such as robberies in progress or suicidal callers, in case they did not make the correct decisions.

    Co-author of the paper Mark Cropley, Professor in Health Psychology at the University of Surrey, said:

    “Call handlers across different emergency services consistently reported their job as highly stressful, which in turn affects their psychological health. This undoubtedly impacts on their overall wellbeing, leading to increased sickness and time away from work, putting additional strain on the service and their colleagues.

    “Although handlers are not experiencing trauma first-hand the stress that they experience when responding to such calls should not be overlooked.”

    Co-author Professor Patricia Schofield, of Anglia Ruskin University, said: “Call handlers are the front line of emergency care but are often overlooked when it comes to studies about stress affecting the police, fire and ambulance services. This study finds evidence that staff are at risk of burnout, due to high workload, inadequate training and a lack of control.

    “It’s important that these staff are considered and interventions made to ensure that they can cope with their workload — these people make vital decisions which affect lives.”

    Co-author Professor Tom Quinn from Kingston University & St George’s, University of London, said:

    “Most people probably don’t recognise the stressful conditions under which emergency call centre staff work. Now that we have explored and summarised the evidence to identify the challenges these important staff face, we plan to develop and test interventions to reduce the burden on them and improve their wellbeing.”