Secondary Traumatic Stress, Vicarious Posttraumatic Growth, and Rumination Among Healthcare Professionals: Examining Conditional Indirect Effect of Secondary Exposure to Trauma

Objective: Rumination is considered to be a key factor that determines whether a person would develop pathogenic or salutogenic posttraumatic psychological changes. Much of the previous research in this direction has focused on primary victims of trauma, and there is a paucity of research on secondary victims of trauma. The present study is one of the first to examine simultaneously the indirect effects of secondary exposure to armed conflict (SEAC) on secondary traumatic stress (STS) and vicarious posttraumatic growth (VPTG) via rumination, and also determine whether these indirect effects are moderated by time since SEAC. Method: A cross-sectional research design was employed and a sample of 337 healthcare professionals who worked with primary victims of armed conflict was selected from secondary and tertiary healthcare units in Kashmir. Results: After adjusting for potential confounding variables, the results revealed that SEAC has a significant indirect effect on STS and VPTG via rumination; while SEAC had a positive indirect effect on STS via intrusive rumination, the indirect effect of SEAC positively predicted VPTG via deliberate rumination. Furthermore, the indirect effect of SEAC on STS via intrusive rumination was strong soon after SEAC, but the magnitude of the relationship decreases over time. The indirect effect of SEAC via deliberate rumination, on the other hand, was not influenced by times since SEAC. Conclusion: These results suggest that STS and VPTG are influenced by different cognitive mechanisms, and unlike VPTG, the cognitive mechanism influencing STS is conditional on time since SEAC.