Stress is underpinned by a biological reaction of the organism allowing the production ofenergy to respond to a change in the environment (or stressor). Stress reaction isexpressed in behavioural, cognitive, emotional and physiological terms. This biologicalresponse is non-specific because it is the same regardless of the stressor. Its evolutionover time has been conceptualised by Hans Selye (1956) in the General Adaptation Syndrome(GAS) which comprises three successive phases. (i) The first phase, known as the alarmphase, corresponds to the activation of all biological mechanisms according to a trendregulation, allowing a rapid response to the stressor. (ii) The second phase ofresistance which adjusts the stress response to the intensity of the perceived aggressionaccording to a constant regulation. (iii) When the aggression disappears, a recoveryphase dominated by the return of the parasympathetic brake allows a return to homeostasis(eustress).The "primum movens" of all pathologies is therefore the inability of the individual toadapt his stress response in duration and/or intensity to the course of the phases of theGAS (distress). The perception of not being in control of the situation contributes tothe perceived stress and constitutes a well-established risk of distress. It is a riskfactor for the emergence of burnout. It induces a biological cost called allostatic cost.Allostasis is a concept that characterizes the process of restoring homeostasis in thepresence of a physiological challenge. The term "allostasis" means "achieving stabilitythrough change", and refers in part to the process of increasing sympathetic activity andcorticotropic axis to promote adaptation and restore homeostasis. Allostasis works wellwhen allostasis systems are initiated when needed and turned off when they are no longerrequired. Restoring homeostasis involves effective functioning of the parasympatheticsystem. However, when the allostasis systems remain active, such as during chronicstress, they can cause tissue burnout and accelerate pathophysiological processes.The perception of uncontrollability depends on the stress situation, the psychologicaland physiological characteristics of the subject and his or her technical skills inresponding to the stressors of the situation. In particular, subjects with a high levelof mindfulness are more accepting of uncontrollability and less likely to activate thestress response.The COVID-19 pandemic situation is a situation characterized by many uncertainties aboutthe individual, family and work environment and the risk of COVID infection. Healthcareworkers, like the military, are high-risk occupations that are particularly exposed tothese uncertainties in the course of their work and continue to work in an uncertainsituation. These professionals are described as a population at risk ofoccupational/operational burnout that the level of burnout operationalises. Thisancillary study in a population of civilian and military non-healthcare workers willcomplement the study conducted among military health care workers. It will make itpossible to isolate the specificity of each profession (civilian or military, healthcarepersonnel or not) with regard to the risk of burnout in the COVID context.The objective of this project is to evaluate the impact of the perception of non-controlin the operational burnout of experts in their field of practice and to study thepsychological and physiological mechanisms mediating the relationship between thesubject's characteristics, perceived non-control and burnout.
Behavioral: Assessment of work-related stress
Assessment of burnout, mindfulness, interoceptive awareness, anxiety, post-traumatic
stress disorder, coping flexibility and sleep through questionnaires.
Biological: Saliva sample collection
Saliva sample is collected before and after emotional stimulation in order to measure
resting-state allostatic load biomarkers: Dehydroepiandrosterone (DHEA), cortisol and
chromogranin A levels
Device: Cardiac and electrodermal recordings
Electrocardiogram and electrodermal activity (tonic and phasic) is collected at rest and
after emotional stimulation.
Behavioral: Assessment of behavioral response to emotional stimulation
Emotional stimulation involves asking the participants to remember a recent event related
to the COVID-19 crisis that has been emotionally difficult for them.
Perceived stress, situational awareness and emotions is assessed after emotional
stimulation through questionnaires.
Inclusion Criteria:
- Volunteer personnel i) working at the "Groupement Hospitalier de la Région de
Mulhouse Sud Alsace" (GHRMSA) during the COVID-19 crisis OR ii) of the "Groupement
Commando Montagne" (GCM) deployed in Mali in June 2020.
Exclusion Criteria:
- Pregnant or breastfeeding woman,
- Person deprived of liberty by a judicial or administrative decision,
- Person subject to a legal protection measure or unable of giving consent
- Intercurrent pathology with inability to work
- History of psychiatric disorder or cardiac pathology
Groupement Hospitalier Régional de Mulhouse Sud Alsace
Mulhouse, France