Isolation, self-blame and perceived invalidation in aid personnel: identifying humanitarian-specific distress using the PostAID/Q

Abstract

Humanitarian-specific psychological distress following deployment can elude detection using contemporary measures of trauma-related stress. This study assesses the unidimensional structure and convergent validity of the Post-deployment Altruistic Identity Disruption Questionnaire (PostAID/Q), an 18-item questionnaire underpinned by the construct Altruistic Identity/Disruption (AI/AID). Humanitarian aid personnel (N=108) completed an online web survey, inclusive of the Moral Injury Questionnaire (MIQ), Posttraumatic Distress Disorder Checklist (PCL-5), Psychological Well-Being Posttraumatic Changes Questionnaire (PWB-PTCQ) and Social Provisions Scale (SPS). A confirmatory factor analysis suggested a single factor structure providing further support for the conception of AI/AID as a unidimensional construct. Convergent validity was demonstrated through (1) utility for predicting a posttraumatic stress disorder (PTSD) diagnosis assessed by the PCL-5, and (2) moral injury assessed by the MIQ. The PostAID/Q was further moderately and negatively associated with the availability of social support (assessed by the SPS) and lower self-reports of psychological well-being post trauma (assessed by the PWB-PCTQ). Finally, the PostAID/Q demonstrated evidence of incremental validity in predicting humanitarian specific psychological distress over and above the PCL-5. Specifically, the PostAID/Q predicted increased moral injury on the MIQ, and decreased psychological well-being post trauma. The PostAID/Q can assist in identifying humanitarian specific psychological responses post deployment guiding support for personnel, over and above more traditional measures of posttraumatic stress.