Addressing Posttraumatic Stress during the COVID-19 Pandemic: A Systematic Scoping Review

Background:

Available research suggests that posttraumatic stress has been exacerbated by the COVID-19 pandemic (Du et al., 2020). Existing psychological trauma has been rekindled by recent threats to stability and COVID-related post-traumatic stress, or that which has developed since the onset of the pandemic, which is on the rise (Okom et al., 2020). Yet, research is still emerging on the unique ways the pandemic has impacted existing trauma and has been linked with new trauma, as well as on current needs for intervention, particularly among at-risk non-dominant populations and communities (González-Sanguino, 2020). Thus, a systematic scoping review was conducted to explore the following research questions: (a) What is known about new and existing posttraumatic stress since the outbreak of the COVID-19 pandemic, and (b) what needs remain for prevention and intervention, particularly with at-risk non-dominant populations and communities?

Methods:

A systematic scoping review took place to explore posttraumatic stress since the onset of the COVID-19 pandemic and current needs for prevention and intervention, particularly among at-risk non-dominant populations, which included: (a) peer-reviewed and grey sources (b) published in English, (c) supported by primary qualitative and quantitative research, on (d) posttraumatic stress since the pandemic and needs for intervention among at-risk populations. Excluded sources consisted of those focused on (a) physical trauma rather than psychological trauma (b) posttraumatic stress prior to the pandemic, or (c) sources that were not supported by primary research.

An eight database search returned 71 potentially relevant sources, all of which were fully read. Of these, 47 were excluded upon full text reading, resulting in 24 articles for thematic analysis, to uncover themes from extant research.

Findings:

Seven overarching themes were identified from the 25 studies, with regard to what is known about trauma and current needs for prevention and intervention. These surrounded (a) worsening symptoms of posttraumatic stress since the pandemic, (b) links between trauma and perceptions, knowledge and awareness surrounding COVID-19, and needs for (c) timely and accurate knowledge and awareness on COVID-19, (d) more research, and (e) multi-level policy development, (f) integrated and targeted mental health interventions for at-risk groups (e.g., primarily among women, members of non-dominant populations, adolescents, individuals with lower socio-economic status and those with limited education), (g) further promotion of safe spaces for socialization, physical wellness and sleep hygiene.

Implications:

Several implications for practice, research, policy, and education were identified. For example, further advancements are urgently recommended for brief and accessible telehealth interventions targeted to the needs of at-risk groups, policies to increase wages and opportunities for employment can help to decrease posttraumatic stress, further longitudinal and trauma-informed research is needed, and educators should be mindful of adolescents being a key at-risk group. Further implications will be discussed.