ABSTRACT The present study investigated the association between ACE and deviant behaviour among students, with moderating roles of self‐regulation and age. In a cross‐sectional design, 420 students were surveyed using ACE, deviant behaviour, and self‐regulation scales. The study revealed that ACE predicted deviant behaviour (β = 0.26, p < 0.001), but age did not. Furthermore, age (β = −0.18, p = 0.0049) and self‐regulation (β = −0.60, p = 0.003) moderated ACE on deviance behaviour. That is, students with high self‐regulation reported less deviance when exposed to high ACE. However, the effect sizes were modest, with ACE alone explaining 6.8% of the variance in deviant behaviour and the moderation model explaining 10.0%. Given the nature of the study, the findings should be interpreted as evidence of statistical association rather than causation. The study highlights the relevance of trauma‐informed, culturally responsive, and developmentally sensitive student‐support services that strengthen self‐regulatory skills and address the psychosocial needs of students with histories of adversity.
ABSTRACT Digital interventions implemented in schools to help youth manage stress and regulate emotions have rapidly increased with the advancement of digital technology. However, the evidence synthesis for digital interventions implemented in school settings to improve emotion regulation is not yet available. This systematic review aimed to synthesize the effects of existing school‐based digital interventions designed to improve youth emotion regulation. Adhering to the Systematic Review and Meta‐Analysis (PRISMA) guideline, Cochrane Library, EMBASE, PsychINFO, PubMed, and Web of Science were searched for articles. Of the total 196 abstracts screened, 27 articles that met the inclusion and exclusion criteria were selected for the full review. This paper reports the systematic review of school‐based digital interventions organized by delivery method (mobile app, tablet app, hybrid, and internet‐based), outcome measures used, effects on youth emotion regulation and other emotional and mental health outcomes, and implementation outcomes. Implications based on the systematic review are addressed.
ABSTRACT In India, adolescent poor mental health is a significant concern, with suicide being a leading cause of adolescent death. The Indian government is responding through policies and initiatives. Such actions to protect adolescent emotional well‐being could be enhanced by Indian adolescents' own accounts of what helps and harms their well‐being, and by drawing on culturally relevant theories of youth well‐being. This study aimed to elicit the perspectives of a community sample of Indian adolescents on factors that affect their emotional well‐being and to identify which well‐being theories best capture their experiences. Focus groups were conducted with participants (n = 50) aged 13−16 years in schools in Karnataka, India. Participants were from both urban (40%) and rural (58%) locations, and all attended government‐aided schools. Data was analyzed using a form of inductive framework analysis. Dominant theories of well‐being were examined for the best fit to the data. Fifteen factors were identified as positively influencing adolescent emotional well‐being. Significant factors were “connections with others,” “engaging in hobbies,” and “feeling valued.” Dominant theories of well‐being do not fully account for all of the influential factors reported by adolescents. The Basic Psychological Needs Theory was the best fit to the data. These findings add to the growing body of research suggesting that culture significantly influences well‐being, highlighting the need for a localized approach, alongside furthering well‐being knowledge relating to adolescents in India. How findings can be used to drive policy and interventions in India is discussed.
ABSTRACT The negative impact of low levels of physical activity upon global health and wellbeing has been consistently observed and emphasized. These negative impacts are magnified for individuals with mental ill‐health, resulting in a higher prevalence of physical comorbidities and reduced life expectancy compared to the general population (Chan et al. 2023). An approach to supporting the promotion of physical activity for people with mental ill‐health is physical activity in the natural environment (e.g., Barton and Rogerson 2017; White et al. 2019). Previous research has demonstrated the associated benefits of physical activity in nature (e.g., Barton and Rogerson 2017; Jimenez et al. 2021), however, to date there are no published applied guidelines to support the inclusion of physical activity in nature as a restorative and preventative measure for people with mental ill‐health. Thus, in this study we aimed to identify current practical recommendations for physical activity in nature for enhancing mental health and wellbeing. To achieve the aim, a scoping review of reviews was conducted, from which 919 manuscripts were identified, 54 full‐texts screened, and 18 full‐texts reviewed. Following analysis, six recommendations were developed relating to: natural environment, activity type, program duration, session duration, social interaction, and target populations. The developed set of recommendations can be used as a guide to support physical activity in nature and acts as a foundation for future guidelines and applied interventions into nature‐based physical activity for restorative and preventative approaches to enhance the mental health and wellbeing of people with mental ill‐health.
ABSTRACT The Australian construction industry is characterized by elevated suicide risk and widespread exposure to psychosocial hazards. The Northern Territory (NT) presents a particularly high‐risk context, with the highest suicide rates nationally and a geographically dispersed, highly mobile workforce. This study examines mental health outcomes in the NT construction workforce and evaluates a workplace mental health accreditation model implemented across construction sites. A mixed‐methods quasi‐experimental design was employed. Quantitative data were collected from 12 construction sites at different stages of the accreditation (accredited, partially accredited, and non‐accredited) across two time points. Qualitative data were obtained from a focus group and semi‐structured interviews with 14 industry stakeholders and workers. Baseline findings indicate that NT construction workers experience higher psychological distress and suicidal ideation, and lower help‐seeking, relative to interstate comparison samples. Quantitative analyses across accreditation stages showed no statistically significant differences between groups over the study period, likely reflecting limited statistical power. In contrast, qualitative findings indicate perceived improvements in mental health awareness, peer support, and workplace culture among participants at sites engaged in the accreditation process. The findings indicate a high burden of mental health risk in the NT construction workforce and provide limited quantitative evidence of short‐term accreditation effects. Qualitative insights, however, indicate perceived changes in awareness, support, and cultural change. Together, the results highlight the need for sustained, context‐specific strategies and more robust longitudinal evaluation of workplace mental health interventions in remote construction settings.
ABSTRACT Objectives This study explored the feasibility and potential efficacy of an online psychological coaching programme for white‐collar corporate workers (M‐REBC), based on a combined mindfulness and rational emotive behaviour therapy (REBT) approach. Methods The M‐REBC programme was delivered one‐to‐one to participants (n = 14), over six 60‐min virtual sessions, amounting to over 80 h of psychological coaching across the cohort. Integrating best practice, feasibility was assessed based on the recruitment process, attrition, adherence, and satisfaction with the intervention. Reflexive thematic analysis of debrief interview data also contributed to the feasibility assessment. Supplementary intervention effects were explored quantitatively using a within‐subjects repeated measures experimental design which captured pre, mid‐and‐post‐intervention changes on reliable mental wellbeing, resilience, perceived stress, mindfulness and irrational performance belief measures. Results Participants reported high satisfaction with the M‐REBC programme, with several linking benefits to the integrative mindfulness and REBT approach. Low attrition rates and strong adherence to the programme components were also recorded. Significant main effects were observed for mental wellbeing, perceived stress, mindfulness, resilience, and irrational performance beliefs. Conclusions Overall, data indicate M‐REBC feasibility among corporate employees. To build on this feasibility exploration, we recommend that future researchers trial M‐REBC among larger samples, using a randomised controlled design. M‐REBC may be considered in other high‐performance settings such as sport and the military and/or among groups.
To assess the impact of the COVID-19 pandemic on suicide deaths in Mexico between 2020 and 2022. Data were obtained from the Mexican Ministry of Health website, covering national mortality data from 2015 to 2022. Suicide rates were analyzed across different age groups using time series data, and excess mortality during the pandemic years (2020–2022) was calculated. Using the endemic channels technique, we determined the expected number of suicides for the period 2014–2019. Subsequently, the number of observed deaths in each week is compared with the expected number. Between 2015 and 2019, Mexico reported an annual median of 6274 suicide deaths, with a rate of 5.12 per 100,000 inhabitants. During the pandemic years, 81.3% of suicide deaths occurred in men, and this proportion was similar before the pandemic. In general, suicide deaths increased by 26.1%, with significant variations across age groups. The age group 18–39 exhibited the highest excess mortality rate, followed by the 40–49 and 50–59 age groups. Weekly suicide deaths showed a continuous upward trend throughout the pandemic years. In performing a regional level analysis, the higher excess of suicides includes several Norteast and one Central states of Coahuila, Nuevo Leon, Tamaulipas, and San Luis Potosí (excess rate of 6.01). The COVID-19 pandemic increased the suicide mortality rates in Mexico, with notable increases observed across all studied age groups.
ABSTRACT Introduction Digital self‐help interventions for mental health can improve symptoms of common mental disorders such as depression and anxiety. However, such online interventions remain inaccessible to the majority of people in LMICs due to a lack of smartphone access, internet signal and/or affordability of data. However, radio persists as a key form of information and entertainment, and remains the most popular form of mass media in Africa. This study aimed to improve the accessibility of a well‐evidenced online self‐help intervention (WHO's Step‐by‐Step) by adapting it for delivery over radio. The objectives were to a) explore the feasibility of adapting the intervention to radio and b) evaluate impacts on mental health symptoms in adults with mild‐moderate depression and/or anxiety. Methods The Lumuno radio campaign was adapted from WHO's Step‐by‐Step intervention using formative research with mental health researchers, clinical professionals, community groups and people with lived experience of mental illness. The resulting radio campaign was broadcast daily, at high intensity, for 26 weeks. A mixed‐methods pilot study, including a pre‐post panel of 440 individuals recruited from Mazabuka town, Zambia, was used to evaluate the campaign's impact on depression and anxiety levels. Results Mean depression score (PHQ‐9) decreased by 19.7% (effect size −0.65, p < 0.001) and mean anxiety score (GAD‐7) dropped by 10.7% (effect size −0.22, p < 0.05). At endline, 41% and 54% respectively of those who had moderate to moderately severe depression, or moderate anxiety at baseline achieved a clinically significant reduction in symptoms. Conclusions This is the first study to indicate that a radio campaign promoting self‐help for depression and anxiety is feasible and may significantly improve mental health outcomes, however, a more rigorous trial is needed to confirm these promising pilot results. Radio may provide an accessible and cost‐effective platform for delivering mental health support in Zambia and, potentially, other LMIC contexts where radio listenership is high.
Physician suicide is a significant public health problem, as previous research shows physicians are at increased risk of dying by suicide compared to the general population. We aim to focus on the recent trends in physician suicide death rates, risk factors and preventive measures related to physicians in the US. We adhered to the PRISMA guidelines for systematic reviews. A search of PubMed, Embase, and PsycINFO resulted in 5139 records. We included 5 studies that provide a sex-specific examination of physician suicide death rates, related risk factors, or preventive measures. We used the Newcastle-Ottawa Scale for quality assessment and employed a thematic approach to interpret data. Our qualitative analysis revealed that female physicians have an elevated risk of suicide in comparison to their female non-physician counterparts, whereas male physicians exhibit lower risk relative to male non-physicians. Our findings show that male risk factors for suicide include job and legal stressors, while females were affected by mental health issues. Depression was a direct contributor to suicidal thoughts, while burnout was indirectly involved. Distinguishing between burnout and depression is essential for the implementation of successful preventative methods. Future research must investigate intersectional elements, as well as longitudinal post-pandemic trends, to inform the formulation of fair policy. These findings underscore the critical need for supportive workplace conditions to mitigate suicide risk among physicians. Enhancing awareness of the stigma associated with mental health care access and prioritizing support networks are crucial measures for cultivating a culture of psychological well-being within the medical profession.
ABSTRACT Attention‐deficit/hyperactivity disorder (ADHD) is associated with disordered eating habits, and individuals with eating disorders show more ADHD symptoms. Little is known about the underlying mechanism of this association. In this scoping review, we aim to provide an overview of researched mediators in adults and discuss implications for future research. We followed the Preferred Reporting Items for Systematic Reviews and Meta‐Analyses extension for Scoping Reviews Checklist. A literature search was conducted on PubMed, Ovid, and PubPsych. We included studies written in English or German and conducted on adults (18+ years). Of the 884 search results, 22 studies were included. N = 11 studies examined hyperactivity/impulsivity as a mediator, n = 8 inattention, n = 5 emotion dysregulation/emotional eating, n = 7 depression, negative mood, and/or anxiety, n = 6 general genetics and genetics in dopamine signaling pathways, n = 3 attractiveness of food, n = 4 interoceptive awareness/sensitivity, n = 2 general psychopathological symptoms and personality factors, and n = 1 circadian rhythm disruption. Inattention, hyperactivity, and impulsivity are cross‐sectionally well‐researched mediators but do not seem to mediate either a total or a causal relationship. Emotion dysregulation as well as the role of the dopaminergic reward system, including addictive‐like behavior, seem to be involved as mediators and should receive more attention. Future research should not only focus on investigating one mediator while controlling for comorbidities and confounding factors but should also include prospective longitudinal study designs.
ABSTRACT Suicide rates among Black women and girls have been rising, with depression being a major precursor to suicide attempts. Implementing evidence‐based treatments for depression could significantly help in reducing these suicide rates. As such, the aim of the study was to review treatment effects of depression intervention on young Black girls and women (YBGW) across treatment settings. Studies that used Randomized Controlled Trials (RCT) to reduce depressive symptomatology in Black girls and women ages 12–29 were eligible for inclusion. Following the review of 715 abstracts and 68 full‐text articles, 12 studies were ultimately selected. The RCT articles were then organized into four categories based on the intervention methods used in the study. Notably, only two studies specifically targeted YBGW, and only one provided treatment effect sizes for this group. The remaining RCTs did not include data specific to YBGW, limiting the ability to draw robust conclusions regarding treatment effects on depression. Despite these limitation, the study highlights the critical need for targeted depression interventions to address the rising suicide rates among Black women and girls.
ABSTRACT Behavioral avoidance exacerbates anxiety symptoms. Capturing and identifying maladaptive avoidance patterns holds clinical utility. However, effective assessment tools which provide unique information on behavior beyond self‐report are needed. Here, we assess the replicability of an interactive game to distinguish between clinically anxious and healthy youth's behavioral avoidance. One hundred and fifteen youth (8–17 years old) completed the Yale Interactive Kinect Environment Software (YIKES) paradigm, whereby behavioral avoidance of aversive and non‐aversive faces is captured. Our primary, preregistered analyses used mixed ANOVA models to test differences in behavioral avoidance by diagnostic status, clinician‐reported avoidance, and self‐reported social anxiety symptoms. Secondary, non‐preregistered analyses pooled data across two published studies (n = 189 youth). Primary analyses found no association between clinician‐rated anxiety symptoms and avoidance (ps > 0.296). A secondary, pooled analysis with additional data indicated a positive association between self‐reported social anxiety symptom severity and avoidance of aversive faces (r = 0.25, p < 0.001). A positive association also emerged between overall self‐reported anxiety symptoms and avoidance of aversive faces (r = 0.18, p = 0.014). Here, we provide evidence that a naturalistic interactive game is effective for capturing avoidance patterns. While no associations with clinician‐rated measures emerged, behavioral avoidance was correlated with self‐reported anxiety. This appeared stronger for social anxiety compared to overall anxiety symptom severity. Our results suggest that self‐report may be more sensitive to capturing behavioral patterns of avoidance than clinician‐report, although replication and further work building on this paradigm is warranted.
Therapists with lived experience of mental ill health (MIH) bring unique insights and empathy to their practice. However, this dual identity creates significant challenges as they balance personal wellbeing with professional responsibilities. This systematic review explores coping strategies and resilience factors to support therapists with MIH. The review adhered to PRISMA guidelines and included studies using qualitative, quantitative, and mixed-methods approaches. Eligible studies focused on coping strategies and resilience mechanisms for therapists with MIH. Databases searched included Web of Science, MEDLINE, ASSIA, CINAHL, Embase, and APA PsycINFO, with additional forward and backward citation searches. Data synthesis employed a thematic narrative approach to identify recurring themes. The search and screening process resulted in 14 eligible studies of various designs. Key coping strategies identified were personal therapy, support systems, self-care practices, and reflective techniques. Personal therapy provided a safe space for therapists to process challenges and enhance their professional empathy. Support systems, including peer networks and nonjudgmental supervision, fostered resilience, although stigma and systemic barriers often reduced their accessibility. Reflective practices, such as journaling and supervision, were essential for promoting self-awareness and professional growth. Despite these strategies, therapists faced challenges in managing dual identities and navigating workplace stigma. The studies highlighted the professional value of lived experience in enhancing therapeutic relationships, but systemic support and organizational change were often lacking. This review emphasises the importance of systemic and institutional support in fostering resilience for therapists with MIH. Addressing stigma, providing resources for self-care and supervision, and integrating lived experiences into professional practice are critical. Future research should explore diverse populations and longitudinal perspectives to deepen understanding and inform inclusive practices. Enhancing support for therapists with MIH will ensure their sustained contributions to the mental health field.
Childhood emotional maltreatment is related to an increase in negative psychological outcomes in adulthood, such as psychopathology; however, less research has examined how emotional maltreatment leads to a decrease in positive outcomes, such as flourishing. This study examines psychological flexibility, which is operationalized as the ability to overcome negative emotions to accomplish valued goals, as a potential mediator and moderator in the relationship between emotional maltreatment in childhood and flourishing. College student participants ( N = 262) were given the Personalized Psychological Flexibility Index (PPFI), the emotional abuse and neglect subscales of the Childhood Trauma Questionnaire (CTQ), and the Flourishing Scale (FS). Psychological flexibility was found to be a mediator and moderator in the relationship between emotional maltreatment and flourishing. The specific subscales of the PPFI were examined and acceptance and lack of avoidance were significant moderators in the relationship between emotional maltreatment and flourishing, while harnessing was not. Identified goals were examined but did not have a significant effect on flourishing. Therapies that emphasize psychological flexibility, such as Acceptance and Commitment Therapy (ACT), can be an effective treatment to reduce the effect of emotional maltreatment on an individual's ability to flourish.
ABSTRACT Online psychological therapy practices have increased in frequency in recent years, especially since the onset of the COVID‐19 pandemic. Recent research has proven their effectiveness; however, mental health clinicians' attitudes toward their use have been less explored. This is important as these attitudes can influence patient outcomes and the implementation of evidence‐based interventions. As such, we aimed to explore mental health clinicians' attitudes toward online therapy through a systematic review. Four electronic databases (MEDLINE, PsycINFO, Web of Science, and Scopus) were searched, as well as gray literature (PsycEXTRA and ProQuest) and manual searches of Overton, charity websites, Google Scholar, and reference lists. Themes were identified from the resulting qualitative studies, and quantitative and mixed methods studies were mapped onto these themes using a matrix. The synthesis followed a narrative approach. Thirteen themes were discovered from the 28 included studies, which highlight a range of clinicians' attitudes toward online therapy, both positive and negative. Themes consist of the therapeutic relationship, communication and relational aspects, time and space, technical aspects, professional self‐doubt, individual differences, practical aspects, patient privacy, risk, perception of patient experience, transition to online therapy, change in attitude with the pandemic, and general attitudes/future intentions. Clinicians generally had somewhat positive attitudes toward online therapy, especially since the COVID‐19 pandemic; however, they also identified key limitations. Training clinicians to use technology and online modalities might be a key direction for future clinical practice and research to improve clinicians' confidence and attitudes toward online therapy.
Racial discrimination is a common and potentially chronic psychosocial stressor that influences affective processing. Prior research suggests experiences of discrimination (EOD) can enhance anterior cingulate cortex (ACC) and amygdala reactivity to negative stimuli. It is unclear if frequent discrimination influences positive emotional processing especially during passive engagement with emotionally salient stimuli. This study explored EOD's influence on neural processing of positive stimuli, predicting a positive association with ACC response to rewarding images. 59 Black women, ages 18–65, from a community-based sample were enrolled in a study assessing trauma and its influence on mental health. Participants completed fMRI scans viewing positive, negative, and neutral images. They reported subjective emotional responses to the affective images. Participants completed the Experiences of Discrimination interview, measuring frequency of racial discrimination, as well as reporting on nondiscrimination-related traumatic events. EOD frequency was not associated with subjective ratings of emotional arousal or valence, nor amygdala, nucleus accumbens (NAc) or ACC responses to negative or positive stimuli. There was a significant positive association between EOD and the ventral lateral prefrontal cortex response to positive scenes, p = 0.04, but this did not withstand false discovery rate correction. Whole-brain analyses revealed EOD frequency predicted lower right fusiform gyrus responses to positive > neutral images (p FDR 0.05). Findings suggest that greater racial discrimination frequency was associated with lower response in the fusiform gyrus- which is involved with processing of face stimuli and specifically sensitive to race- in response to positive images. Results indicate that past EOD influences visual sensitivity to positively valenced visual stimuli.
Acceptability is a vital component of psychosocial interventions, separate from (but related to) efficacy, and includes the attitudes, feelings, and thoughts of clients and therapists about the appropriateness of (and anticipated response to) an intervention. This systematic review summarized the evidence regarding acceptability of psychosocial interventions for people adults seeking refuge (i.e., refugees, asylum seekers, and internally displaced people who were at least 18 years old). We conducted a mixed-methods systematic review of acceptability, measured quantitatively (e.g., dropout, attendance) and qualitatively (e.g., client and therapist attitudes, cultural appropriateness). Cochrane procedures were utilized for conducting the systematic review, meta-analysis, and thematic analysis. The search strategy resulted in the identification of 102 studies ( n > 8983 participants). Meta-analyses of quantitative data revealed a mean dropout rate of 16.9% and a mean attendance rate of 84.1% from a variety of psychosocial interventions. Thematic analysis of qualitative data generated seven themes; (a) openness and closeness , (b) presence and care , (c) somatic focus , (d) flexibility , (e) sensitivity towards gender and culture , (f) limiting discussion of trauma , and (g) conflicting priorities (i.e., relocation, work demands, transport difficulties, health issues, etc.). This review synthesized available data and highlighted important findings related to acceptability. These findings may be utilized in the provision of interventions for refugees and will aid in therapists adjusting their practice to improve its acceptability for this part of our population.
Schizophrenia remains one of the most stigmatized psychiatric diagnoses. It has been argued that the condition requires renaming. Psychosis is often used as an alternative term in UK clinical practice. We explored the prevalence of stigmatizing attitudes towards schizophrenia and psychosis using Twitter. Quantitative content analysis was used to analyze Tweets ( n = 423) containing the terms “psychosis,” “psychotic,” “schizophrenia,” or “schizophrenic.” Tweets were categorized according to the presence and type of stigma. Both schizophrenia and psychosis were frequently stigmatized on Twitter. However, Tweets using the terms psychosis/tic were significantly more likely to contain stigmatizing attitudes (70.9%, n = 151) than Tweets using the terms schizophrenia/c (42.4%, n = 89; p < 0.001). Adjective terms were significantly more commonly stigmatized (76.6%, n = 164) than nouns (36.4%, n = 76; p < 0.001). The term “psychotic” was frequently used pejoratively. Both “schizophrenia” and “psychosis” are associated with high levels of stigma on Twitter. If schizophrenia is to be renamed, psychosis may not be a suitable replacement.
ABSTRACT Suicidal behavior is a critical mental health problem in the United States, and this is particularly true for youth with social identities that are historically minoritized and discriminated against. There is also a growing awareness of the influence of social determinants of health (SDOH) on mental health. The current study examines links between one's own thoughts of suicide and the dose of exposure to other people's suicidal thoughts, often labeled contagion, within the context of different minoritized identity groups and SDOH deficits. Project Lift Up is a national longitudinal study of youth aged 13–22 years designed to understand exposure to suicidal thoughts and behaviors in social networks. A cohort of 4981 adolescents and young adults was recruited online via social media between June 13, 2022, and October 30, 2023. Youth who knew one person with suicidal thoughts were 1.75 times ( p = 0.002) more likely than those without such exposure to self‐report recent thought of suicide and those who knew between 2 and 4 people were 1.81 times more likely ( p < 0.001). These odds increased to 3.47 ( p < 0.001) if the youth knew five or more people with thoughts of suicide. Youth who identified with a social identity group that experiences marginalization and systemic oppression (based on race, ethnicity, disability status, gender, and sexual identity) and exposure to suicidal thoughts had higher odds of recent thoughts of suicide compared to non‐minoritized and non‐exposed youth. SDOH also explained unique variance in self‐reported ideation. Exposure to other people's suicidal thoughts is associated with one's own thoughts of suicide and the number of people exposed to amplifies this effect, especially for individuals also experiencing adversity burden from SDOH. Results add to the extant literature documenting the higher odds of suicidal ideation that minoritized youth face.
ABSTRACT This cross‐sectional study aims to explore the exposure to sexual harassment and assaults, coping, and posttraumatic stress disorder (PTSD) and their associations among Australian ambulance personnel. The study was conducted on 492 stratified and randomly selected ambulance personnel across three Australian states in 2017. A telephone interview administered questionnaire was used to collect data on exposure to sexual harassment and assault (Life Event Checklist for the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM‐5)), coping (Brief Coping Orientations to Problems Experienced (Brief COPE)), and PTSD (PTSD checklist for DSM‐5). Descriptive and bivariate statistics were used for data analysis. The study found that female ambulance personnel were more likely to be exposed to sexual harassment and assault directly and to sexual harassment as part of their jobs than their male colleagues. Female staff were more likely to use religious, emotional and instrumental support, and self‐blame as their coping strategies. Frequent exposure to sexual harassment was significantly associated with an increased risk of PTSD. Greater use of maladaptive coping strategies was significantly associated with an increased risk of PTSD. Greater use of adaptive coping strategies was not significantly associated with a reduced risk of PTSD. Findings from this study suggest that strategies to manage frequent exposures to sexual harassment and its impacts, especially for female ambulance personnel, should be implemented to reduce the risk of PTSD. Further investigation into the effective use of adaptive coping strategies may provide explanations for the insignificant associations between a greater use of adaptive coping strategies and PTSD.
