ABSTRACT
Background: Employees and volunteers at national socialism related memorial sites in Germany (MemoS) are confronted with severely aversive documents of German history on a regular basis.
Objective: Enhance knowledge on mental health in MemoS.
Method: In an online study, mental distress, secondary traumatisation as well as potential risk and protective factors were assessed in MemoS and a control group.
Results: 40.9% of MemoS reported at least one kind of secondary traumatic event experienced in the context of their work. Depression and general mental distress were higher in the MemoS than in controls, and symptoms of secondary traumatisation were significantly more common.
Conclusions: Our results give clear evidence for mental distress and symptoms of secondary traumatisation in the MemoS group. This finding shows secondary traumatisation symptoms based on documents of atrocities that happened more than 70 years ago. Further, the high mental burden in the MemoS suggests the necessity of supervision for people dedicating their work life to assuring remembrance of the crimes of the Nazi era.
HIGHLIGHTS
first systematic examination of mental health and trauma in employees and volunteers at national socialism related memorial sites in Germany.
mental distress and secondary traumatisation symptom load significantly higher in people working at the memorial sites than in controls.
findings indicate a need for support of the people working at the memorial sites.
Antecedentes: Los empleados y voluntarios de los sitios conmemorativos relacionados con el socialismo nacional en Alemania (MemoS) se enfrentan periódicamente a documentos de la historia alemana severamente aversivos.
Objetivo: Mejorar el conocimiento sobre la salud mental de los MemoS.
Método: En un estudio en línea, se evaluaron el malestar mental, la traumatización secundaria, así como los posibles factores de riesgo y de protección en los MemoS y en un grupo control.
Resultados: El 40.9% de los MemoS refirió haber experimentado en el contexto de su trabajo, al menos un tipo de evento traumático secundario. La depresión y el malestar mental general fueron mayores en los MemoS que en los controles y los síntomas de traumatización secundaria fueron significativamente más comunes.
Conclusiones: Nuestros resultados brindan una evidencia clara de malestar mental y síntomas de traumatización secundaria en el grupo MemoS. Este hallazgo muestra síntomas de traumatización secundaria basados en documentos de atrocidades ocurridas hace más de 70 años. Además, la elevada carga mental de los MemoS sugiere la necesidad de supervisión de las personas que dedican su vida laboral en asegurar el recuerdo de los crímenes de la era Nazi.
背景：德国国家社会主义相关纪念场所（ MemoS ）的员工和志愿者经常面对严重令人厌恶的德国历史文件。
目的：提高 MemoS 心理健康知识。
方法：在一项在线研究中，在 MemoS 组和对照组中评估了心理痛苦，二次创伤以及潜在的风险和保护因素。
结果： MemoS 组中40.9%报告了在工作环境中至少经历过一种二次创伤事件。 MemoS 中的抑郁和一般心理痛苦高于对照组，二次创伤的症状显著更常见。
结论：我们的研究结果为 MemoS 组的心理痛苦和二次创伤症状提供了明确的证据。这一发现展现出基于 70 多年前发生的暴行记录的二次创伤症状。此外， MemoS 组中的高心理负担表明，有必要对那些致力于确保纳粹时代罪行得到记录的人进行监管。
1. Introduction
Secondary traumatisation is devoid of direct impressions of the original trauma, occurs later in time via reports of witnesses or documentations and results in symptoms comparable to post-traumatic stress disorder (PTSD). Evidence for secondary traumatisation has been found in a number of professions (Kindermann et al., Citation2017, Citation2019; Leuteritz et al., Citation2019; Maguire & Byrne, Citation2017; Vrklevski & Franklin, Citation2008; Whitt-Woosley & Sprang, Citation2018; Wichmann et al., Citation2018). Employees and volunteers at national socialism related memorial sites in Germany (MemoS) are faced with artefacts of some the most atrocious crimes in human history on a daily basis. First evidence for secondary traumatisation in people working with documents of past traumatic events comes from Sloan et al. (Citation2019), investigating archivists, and Jegodtka (Citation2013) interviewing people from different professional backgrounds related to national socialism related memorial site work in Germany. However, a systematic examination of general symptom and trauma load in MemoS is lacking.
We conducted an online study, recruiting MemoS from all over Germany. We hypothesised secondary traumatisation, general mental distress and depression to be higher in the MemoS group compared to a control group.
2. Methods
2.1. Sample characteristics
In the MemoS group, 44 participants (30 women) from 11 different German federal states responded. 23 of them were aged 18–39 years, 19 were 40–59 years old and two older than 60. 79% had Abitur (the highest German school diploma after 12 years of education). Work experience at memorial sites or comparable work places ranged from less than one to 36 years (M = 13.3 ± 11.0).
Demographics were similar in the control group (n = 47, 32 women). 21 participants were aged 18–39 years and 26 were 40–59 years old. Abitur was more common at 96% (X2(1, N = 81) = 5.57, p = .02). Work experience ranged from one to 37 years (M = 11.8 ± 8.5) and did not differ significantly from the MemoS group (z = −0.17, p > .05).
2.2. Measures
The study was conducted as a Qualtrics online survey (https://www.qualtrics.com/) with the following questionnaires: Global Severity Index (GSI T) of the Brief Symptom Inventory (BSI; Franke, Citation2000), Beck Depression Inventory (Beck et al., Citation2009), Life Events Checklist (LEC; Krüger-Gottschalk et al., Citation2017), PCL-5 (Krüger-Gottschalk et al., Citation2017), Professional Quality of Life (Stamm, Citation2009), RS-11 (Schumacher et al., Citation2005) and Z-Skala (Huber, Citation2008). Where applicable, measures were adapted to target MemoS’ work-related experiences.
We also examined potential protective (work experience, Professional Quality of Life, resilience, centrality), and risk factors (direct contact with contemporary witnesses or their descendants). Correlations of mental health with risk and protective factors, results on the BSI subscales, as well as further descriptions on PCL-5 adaptation and data handling, are presented in the supplementary material.
2.3. Statistical analysis
For between group comparisons, t- or Wilcoxon tests were used. PCL-5 scores from three MemoS had to be excluded from analysis (personal instead of work-related reports). No Criterion A work-related traumatic events reported by the control group qualified as such (i.e. not a traumatic event or not work-related).
3. Results
3.1. Mental distress
GSI T scores (z = −2.81, p = .005) and BDI-II scores (z = −2.89, p = .004) were significantly higher in the MemoS group than in the controls.
3.2. Secondary traumatisation
In the MemoS group, 18 participants reported at least one kind of work-related secondary traumatic event in the LEC (40.9%). On average, MemoS reported 5.2 different kinds of work-related secondary traumatic events (SD = 5.2). Reports ranged from 0 to 14 kinds of events.
Neither in MemoS (M = 7.7, SD = 7.5) nor in the control group (M = 1.7, SD = 3.6) the average PCL-5 score met the cut-off for PTSD (Bovin et al., Citation2016).
On the ProQOL subscale secondary traumatic stress (STS), the MemoS group (M = 22.9, SD = 6.3) scored significantly higher than the control group (M = 17.5, SD = 4.9; z = −4.54, p < .001).
4. Discussion
Confrontation with traumatic material lies at the core of national socialism related memorial site work. Our results of elevated mental distress (GSI T), depression scores and secondary traumatic symptoms in MemoS demonstrate that repeated confrontation with aversive materials more than half a century old can cause symptoms of secondary traumatisation.
We used the PCL-5 and its DSM-5 criteria (American Psychiatric Association, Citation2013) for (primary) PTSD to measure symptoms of secondary traumatisation. The scores were in a subclinical range in the MemoS. Although it remains undisputed that secondary traumatisation symptomatology parallels that of (primary) PTSD (Breslau et al., Citation2004), symptom profiles of primary and secondary traumatisation may differ (Sprang & Steckler, Citation2023). Furthermore, some features of secondary traumatisation may extend beyond the domains of PTSD, e.g. moral distress or empathic over-involvement (Sprang et al., Citation2019). This could have led to an underestimation of secondary traumatisation. Future studies and measurements are needed that allow a more precise assessment of secondary traumatisation.
Comparing our findings to other studies on secondary traumatisation (Kindermann et al., Citation2019; Leuteritz et al., Citation2019; Vrklevski & Franklin, Citation2008; Whitt-Woosley & Sprang, Citation2018), it is striking that the great amount of time that elapsed since the primary traumatic events seems not to alleviate their potential to cause secondary trauma. Thus, in agreement with the reports of Jegodtka (Citation2013) and Sloan et al. (Citation2019), our findings clearly indicate that events that happened long ago can nevertheless result in secondary traumatisation symptoms. More research is needed to investigate whether this is generally the case, or whether it can be explained by the particular horrific dimension of the investigated contexts and eventual singularity. In any case, memorial sites appear as workplaces with a significant risk of secondary traumatisation.
5. Conclusion
Working at a national socialism related memorial site goes along with enhanced levels of mental distress, depression and secondary traumatisation symptoms. Sloan et al. (Citation2019) describe a phenomenon among people working with traumatic records ‘that as witnesses to trauma experienced firsthand by others, they were not entitled to experience trauma themselves’ (Sloan et al., Citation2019, p. 13). Caring for the mental health of MemoS does not entail disrespect toward the original trauma and its victims and survivors, but enables MemoS to continue to validate and acknowledge survivors’ experiences (Sloan et al., Citation2019). Given the great societal relevance, the allocation of resources for the mental health of MemoS seems imperative.
Transparency and openness
This study was not preregistered. The processed data is available at https://osf.io/kqj3n/. We report how we determined our sample size, all data exclusions, all manipulations, and all measures in the study. We do not have any previously published or currently in press works stemming from this dataset. The study was approved by the local ethics board of the University of Konstanz and participants gave written informed consent on the survey start page.
Acknowledgements
We are grateful to the memorial site employees and volunteers who participated in the study, and who helped us to improve our understanding by sharing personal experiences and ideas and by asking critical questions. In particular we are indebted to Matthias Heyl for his great support. We are also grateful to the members of the University of Konstanz for their participation. Finally, we are thanking Dr Thomas Müller from the ZfP Südwürttemberg for his careful and important comments on a previous version of the manuscript.
Disclosure statement
No potential conflict of interest was reported by the author(s).
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