Predictors of posttraumatic stress symptoms, COVID-related functional impairment, and burnout among medical professionals during the COVID-19 pandemic

ABSTRACT

Physicians are particularly vulnerable to mental health symptoms during global stressors such as the COVID-19 pandemic. Such stressors can increase death anxiety, which is a vulnerability factor for psychological dysfunction. Thus, exposure to COVID-related death may play a unique role in physicians’ mental health during the pandemic. This cross-sectional study collected self-reported data from 485 resident physicians and fellows. Participants reported mental health symptoms, including posttraumatic stress symptoms (PTSS), burnout, and functional impairment due to the pandemic. Participants also reported death anxiety, COVID-19 anxiety, cognitive accessibility of death-related thoughts (DTA), and workplace exposure to COVID-19. Death anxiety, COVID-19 anxiety, DTA, and workplace COVID-19 exposure all independently predicted PTSS. Furthermore, COVID-19 anxiety and DTA interacted to predict PTSS, such that high levels of COVID-19 anxiety predicted higher PTSS, regardless of DTA level. Death anxiety and COVID-19 workplace exposure interacted to predict PTSS as well, such that death anxiety predicted PTSS only when COVID-19 exposure was high. Burnout was predicted by COVID-19 anxiety and workplace exposure, and COVID-related functional impairment was predicted by death anxiety and COVID anxiety. These findings demonstrate that death-related and COVID-related concerns, independently and in interaction with each other, play an important role in psychological distress among physicians.

KEYWORDS:

• Physician mental health
• resident mental health
• death anxiety

Disclosure statement

No potential conflict of interest was reported by the author(s).

Notes

1. We initially sought to test the effect of experimentally manipulating awareness (or salience) of death and COVID in our study. However, we anticipated the possibility that the high levels of exposure to COVID-19, and death resulting from it, among medical professionals at the height of the pandemic would make it impossible to increase the salience of these threats above their current levels; thus, we anticipated this may make it difficult to test our initial hypotheses regarding the experimentally increasing salience of these threats. We therefore designed the study to include measures of levels of anxiety about death and COVID-19 and the accessibility of death-related thoughts, so that we could explore the predictors of the mental health symptoms presented in the present paper. Because no effects of the manipulations were found, we do not present those data here, but they are available from the first author on request. Please see our pre-registration with our initial hypotheses as well as our justification for the secondary analyses here: https://osf.io/r5xs9.

Additional information

Funding

The author(s) reported there is no funding associated with the work featured in this article.