Lisa J. Merlo

Background Resilience, a person’s ability to adapt to adverse events, is associated with positive outcomes, especially in the field of healthcare. Research into the effects of the COVID-19 pandemic may help to understand and combat the long-term mental health burden for trainees in health care. Objective This cross-sectional study aimed to assess the impact of the pandemic on health profession students’ educational experiences, determine the association between their self-reported resilience and psychological distress and assess group differences between students from different graduate health profession programs in an academic medical center. Methods Graduate health profession students completed a 44-question online survey and the 10-item Connor Davidson Resilience Scale (CD-RISC-10) during the COVID-19 pandemic period between January-March 2021. We used descriptive statistics, independent samples t test, Related-samples Wilcoxon signed rank test, Pearson correlations test and Analysis of variance (ANOVA) to analyze the data. Results Majority of respondents reported that COVID-19 had a negative impact on their education and caused a reduction in educational opportunities (76.6% and 73% respectively). Majority also reported feeling burned out, lonely/isolated, or frustrated by COVID-19 restrictions (70.0%, 67.4%, and 61.8% respectively). Students reported increased use of both avoidant and adaptive coping strategies during the pandemic. Higher resilience scores were associated with higher self-reported stress, fewer burnout symptoms, and better overall well-being. Conclusion The COVID-19 pandemic significantly affected students in graduate health profession programs. Instructional quality, educational opportunities, institutional trust, peer socialization, and personal health and wellbeing were perceived to be negatively impacted. Students may require additional support and resources from their training programs to mitigate these concerns. Future studies should evaluate the long-term impact of the COVID-19 pandemic among pandemic-era graduate health profession students.

Background and Objectives Adverse events during childhood increase the risk for the development of substance use disorders (SUDs). This study examined the association between adverse childhood experiences (ACEs) and SUD treatment response. Methods This cohort analysis included data from longitudinal clinical assessments extracted from the records of 438 consenting individuals undergoing SUD treatment (63% male; 88.8% White). Mixed effects models evaluated the relationship between scores on the ACE questionnaire and indicators of treatment response (i.e., alcohol and drug abstinence self‐efficacy; symptoms of depression, anxiety, and posttraumatic stress disorder) for individuals with alcohol‐related ( n = 332) and other drug‐related ( n = 275) diagnoses, with some participants included in both groups. Results Treatment response varied as a function of ACEs, with the magnitude of differences varying across time in treatment. Relative to those with no ACE history, those who experienced ≥2 ACEs reported worse depression, anxiety, PTSD symptoms, and alcohol/drug abstinence self‐efficacy at baseline, with many differences remaining at the 30‐day assessment. All differences abated by discharge, with the exception of PTSD symptoms among those in the drug use group with a history of ≥4 ACEs. Male gender and older age were generally associated with lower symptomology and higher abstinence self‐efficacy. Discussion and Conclusions Assessing ACE history early in SUD treatment may improve treatment planning and prognosis. Future studies should evaluate the role of trauma‐informed programming and individual interventions to improve treatment response. Scientific Significance This study demonstrates the association between adverse childhood experiences and symptom severity among patients across participation in SUD treatment.