Singleton, David (2024) An investigation into compassion, moral injury, burnout and psychological distress in first responders. University of Southampton, Doctoral Thesis, 210pp.
Abstract
The first chapter details a systematic review of studies that investigate the relationship between self-compassion (SC) and depression, anxiety and post-traumatic stress disorder (PTSD) in first responders (FR). Searches were conducted using five databases: PsychINFO, MEDLINE, Web of Science, Scopus and Google Scholar. Seven studies met the inclusion criteria and were included in this review; four correlation-based studies and three intervention-based studies. A narrative synthesis indicated a potential relationship with higher SC being associated with lower symptoms of depression, anxiety and PTSD. Secondly, interventions incorporating SC can have positive effects in increasing SC and reducing symptoms of depression, anxiety and PTSD in FR. Future research should employ higher methodological quality and robust randomised control trials in order to provide a better understanding of the relationship between SC and depression, anxiety and PTSD in FR, alongside understanding what interventions can and/or will be effective.
The second chapter is an empirical paper exploring the relationship between psychological difficulties (PD), PTSD, alcohol use, the inhibitors of compassion and the facilitators of compassion on moral injury (MI) and burnout in police officers and firefighters in the United Kingdom (UK). A total of 125 participants completed online measures of MI, burnout, PD, PTSD, alcohol use, shame, fears of compassion, self-criticisms and self-reassurance and the three flows of compassion. Bivariate correlations and a hierarchal multiple regression revealed the relationships between the aforesaid variables, alongside whether these predicted MI amongst police officers and firefighters. Years in service, PD, burnout, shame, self-criticisms, fears of compassion and the three flows of compassion were all significantly associated with MI. PTSD, self-criticisms, SC and compassion from others (CfO) were all significantly associated with burnout. Compassion to others (CtO) and CfO significantly predicted MI after accounting for the aforementioned variables, with PD being revealed as the biggest predictor of MI, followed by years in service. The findings indicate strong relationships between MI, PD and the facets of compassion in UK police officers and firefighters. Results highlight the clinical importance of screening for MI, PD and the facets of compassion, alongside the consideration of using compassion-based treatments.
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