Online Program

Psychological Impact of Deploying in Support of the U.S. Response to Ebola: A Systematic Review and Meta-Analysis of Past Outbreaks

Tuesday, November 3, 2015

Kartavya Vyas, MA, Department of Sociology, Anthropology, and Social Work, Creighton University, Omaha, NE
Eileen Delaney, PhD, Naval Center for Combat & Operational Stress Control, San Diego, CA
Jennifer Webb-Murphy, PhD, Naval Center for Combat & Operational Stress Control, San Diego, CA
Scott Johnston, PhD, Naval Center for Combat & Operational Stress Control, San Diego, CA
Purpose: To examine the potential psychological impact of deploying in support of Operation United Assistance (OUA), the U.S. response to Ebola in West Africa, by systematic review and meta-analysis.

Methods: Peer-reviewed articles published between January 1, 2000 and December 31, 2014 were identified using PubMed, PsycINFO, and Web of Science. Inclusion criteria for the systematic review included: based on original research, event defined as an infectious disease outbreak/exposure, included uninfected healthcare workers, and assessed mental health outcomes. Additional inclusion criteria for the meta-analysis included: a control group, continuous measurement of outcomes, and extractable data. Thirty-two studies involving 26,869 persons were included in the systematic review; 13 studies involving 7,785 persons were included in the meta-analysis. For the meta-analysis, a random effects model was used; pooled standardized mean differences (SMD) and 95% confidence intervals (CI) were calculated.

Findings: Reflecting the sociodemographics of the military, those who are younger, single, not living with family, have fewer years of work experience, lower education, and lower household income are at significant risk for psychological distress, alcohol/drug misuse, PTSD, depression, and/or anxiety as a result of their perceived risk of infection. Effect sizes for PTSD, depressive, and anxiety symptoms were considered small (SMD=.12, 95% CI=-.23-.47, I2=79%), moderate (SMD=.40, 95% CI=.24-.51, I2=93%), and small (SMD=.08, 95% CI=-.09-.25, I2=68%), respectively.

Implications: Deployed OUA service members may return with clinically significant problems; most notably depression. Delivering resilience training, issuing clear instructions and directives, and fostering altruistic acceptance may protect service members from developing mental health disorders.

Learning Areas:

Occupational health and safety
Other professions or practice related to public health
Protection of the public in relation to communicable diseases including prevention or control
Provision of health care to the public
Public health or related public policy

Learning Objectives:
Describe how and why military service members deploying to West Africa in support of the U.S. response to Ebola may return with mental health problems; List the types of mental health conditions that are associated with perceiving oneself at risk of infection; Differentiate between mental health disorders that have minimal, moderate, and high probabilities of occurrence due to perceiving oneself at risk of infection; Identify methods for the prevention of mental health problems associated with perceiving oneself at risk of infection.

Keyword(s): International Health, Occupational Health and Safety

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I will receive my master's degree in medical anthropology from Creighton University in a few months. I have worked in the fields of HIV and mental health clinical research, both in academia and in the military, for nearly 10 years. I have presented numerous abstracts at international and national conferences and have published several first-author, peer-reviewed articles.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

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