Rescue workers and trauma: Assessing interaction among risk factors after a firework factory explosio

Authors

  • Eugenia Romano, MS
  • Ask Elklit, MSc

DOI:

https://doi.org/10.5055/jem.2017.0339

Keywords:

post-traumatic stress disorder, trauma, explosion, predictors, risk factors, demographics, organizational variables, social support, personality, distress symptoms

Abstract

Introduction: This study investigates which factors had the biggest impact on developing distress in rescue workers who were involved in a firework factory explosion.

Method: Four hundred sixty-five rescuers were assessed using items investigating demographic factors, organizational variables, social support, personality variables, and distress symptoms. Correlation and regression analyses were performed.

Results: Our final model provided 70 percent of the predictive model for post-traumatic stress disorder (PTSD) severity. Waiting time, lack of rest, problems at work, and perceived level of danger seemed to have the highest impact on protective factors.

Discussion: In addition to perceived life danger and personality, small organizational factors seem to play an important role in the prediction of PTSD. The importance of such factors needs further investigation in future research, contributing to a better organization in the field of disaster management.

Author Biographies

Eugenia Romano, MS

Institute of Psychology, Health, and Society, University of Liverpool, Liverpool, UK

Ask Elklit, MSc

National Center of Psychotraumatology, Institute of Psychology, University of Southern Denmark, Odense, Denmark

References

Ersland S, Weisaeth L, Sund A: The stress upon rescuers involved in an oil rig disaster. Acta Psychiatr Scand. 1989; 80: 38-49.

Haraldsdottir HA, Gudmundsdottir D, Romano E, et al.: Volunteers and professional rescue workers: Traumatization and adaptation after an avalanche disaster. J Emerg Manag. 2013; 12(6): 457-466.

Marmar CR, Weiss DS, Metzler TJ, et al.: Longitudinal course and predictors of continuing distress following critical incident exposure in emergency services personnel. J Nerv Ment Dis. 1999; 187(1): 15-22.

Weiss D, Marmar C, Metzler T, et al.: Predicting symptomatic distress in emergency services personnel. J Consult Clin Psychol. 1995; 63: 361-368.

Alexander DA, Wells A: Reactions of police officers to body-handling after a major disaster—A before-and-after Comparison. Br J Psychiatry. 1991; 159: 547-555.

American Psychiatric Association: Diagnostic and Statistical Manual of Mental Disorders. 4th ed. Washington DC: American Psychiatric Association, 1994.

Dyregrov A, Kristoffersen JI, Gjestad R: Voluntary and professional disaster-workers: Similarities and differences in reactions. J Trauma Stress. 1996; 9: 541-555.

Wagner D, Heinrichs M, Ehlert U: Prevalence of symptoms of posttraumatic stress disorder in German professional firefighters. Am J Psychiatry. 1998; 155(12): 1727-1732.

Brown J, Mulhern G, Joseph S: Incident-related stressors, locus of control, coping, and psychological distress among firefighters in Northern Ireland. J Trauma Stress. 2002; 15(2): 161-168.

Yap MB, Devilly G J: The role of perceived social support in crime victimization. Clin Psychol Rev. 2004; 24: 1-14.

Tucker P, Pfefferbaum B, Nixon SJ, et al.: Predictors of posttraumatic stress symptoms in Oklahoma City: Exposure, social support, peri-traumatic responses. J Behav Health Serv Res. 2000; 27(4): 406-416.

Fedoroff IC, Taylor S, Asmundson GJ, et al.: Cognitive factors in traumatic stress reactions: Predicting PTSD symptoms from anxiety sensitivity and beliefs about harmful events. Behav Cogn Psychother. 2000; 28(01): 5-15.

Brewin CR, Andrews B, Valentine JD: Meta-analysis of risk factors for posttraumatic stress disorder in trauma-exposed adults. J Consult Clin Psychol. 2000; 68(5): 748-766.

Liao SC, Lee MB, Lee YJ, et al.: Association of psychological distress with psychological factors in rescue workers within two months after a major earthquake. J Formosan Med Assoc. 2002; 101(3): 169-176.

Wagner SL, Martin CA, McFee JA: Investigating the “Rescue Personality”. Traumatology. 2009; 15: 5-12.

Perrin M, DiGrande L, Wheeler K, et al.: Differences in PTSD prevalence and associated risk factors among World Trade Center disaster rescue and recovery workers. Am J Psychiatry. 2007; 164(9): 1385-1394.

Dolce A, Ricciardi M: Impact of psychological risk factors on disaster rescue operations: The case of Italian volunteers. Disasters. 2007; 31(1): 91-103.

Holmgren H, Sondergaard H, Elklit A: Stress and coping in traumatised interpreters: A pilot study of refugee interpreters working for a humanitarian organisation. Intervention Int J Ment Health Psychosoc Work Counsel Areas Armed Conflict. 2003; 1(3): 22-28.

Opie T, Dollard M, Lenthall S, et al.: Occupational stress in remote area nursing: Development of the remote area nursing stress scale (RANSS). J Nurs Measurement. 2010; 21(2): 246-263.

Wright KM, Britt TW, Bliese PD, et al.: Insomnia as predictor versus outcome of PTSD and depression among Iraq combat veterans. J Clin Psychol. 2011; 67(12), 1240-1258.

Luxton DD, Greenburg D, Ryan J, et al.: Prevalence and impact of short sleep duration in redeployed OIF soldiers. Sleep. 2011; 34(9): 1189-1195.

Elklit A, Gudmundsdottir D: A longitudinal study of posttraumatic stress symptoms and their predictors in rescue workers after a firework factory disaster. Int J Emerg Ment Health Human Resilience. 2014; 16: 99-103.

Fullerton CS, Ursano RJ, Wang L: Acute stress disorder, posttraumatic stress disorder, and depression in disaster or rescue workers. Am J Psychiatry. 2004; 161: 1370-1376.

Carlier IV, Lamberts RD, Gersons BP: Risk factors for posttraumatic stress symptomatology in police officers: A prospective analysis. J Nerv Ment Dis. 1997; 185(8): 498-506.

Smith LM, Paton D: A structural re-assessment of the impact of event scale: The influence of occupational and cultural contexts. In Looking Back, Moving Forward: Fifty Years of New Zealand Psychology. Wellington: New Zealand Psychological Society, 1997: 240-251.

Renck B, Weisath L, Skarbo S: Stress reactions in police officers after a disaster rescue operation. Nordic J Psychiatry. 2002; 56(1): 7-14.

Bennett P, Williams Y, Page N, et al.: Associations between organizational and incident factors and emotional distress in emergency ambulance personnel. Brit J Clin Psychol. 2005; 44(2): 215-226.

Eriksson CB, Kemp HV, Gorsuch R, et al.: Trauma exposure and PTSD symptoms in international relief and development personnel. J Trauma Stress. 2001; 14(1): 205-212.

Murphy SA, Beaton RD, Pike KC, et al.: Occupational stressors, stress responses, and alcohol consumption among professional firefighters: A prospective, longitudinal analysis. Int J Stress Manag. 1999; 6(3): 179-196.

Marmar CR, Weiss DS, Metzler TJ, et al.: Stress responses of emergency services personnel to the Loma Prieta earthquake Interstate 880 freeway collapse and control traumatic incidents. J Trauma Stress. 1996; 9(1): 63-85.

Pearlman LA, MacIan PS: Vicarious traumatization: An empirical study of the effects of trauma work on trauma therapists. Prof Psychol Res Pract. 1995; 26: 558-565.

Taylor SE: Adjustment to threatening events: A theory of cognitive adaptation. Am Psychologist. 1983; 38(11): 1161.

Bogaerts S, Daalder AL, Van Der Knaap LM, et al.: Critical incident, adult attachment style, and posttraumatic stress disorder: A comparison of three groups of security workers. Soc Behav Personality. 2008; 36(8): 1063-1072.

Ursano RJ, Fullerton CS, Norwood AE: Psychiatric dimensions of disaster: Patient care, community consultation, and preventive medicine. Harv Rev Psychiatry. 1995; 3(4): 196-209.

Labbate LA, Cardena E, Dimitreva J, et al.: Psychiatric syndromes in Persian Gulf War veterans: An association of handling dead bodies with somatoform disorders. Psychother Psychosom. 1998; 67(4-5): 275-279.

McCarroll JE, Ursano RJ, Fullerton CS, et al.: Somatic symptoms in Gulf War mortuary workers. Psychosom Med. 2002; 64(1): 29-33.

Skogstad L, Fjetland AM, Ekeberg O: Exposure and posttraumatic stress symptoms among first responders working in proximity to the terror sites in Norway on July 22, 2011–a cross-sectional study. Scand J Trauma Resusc Emerg Med. 2015; 23(1): 1-9.

Ozer EJ, Best SR, Lipsey TL, et al.: Predictors of posttraumatic stress disorder and symptoms in adults: A meta-analysis. Psychol Bull. 2003; 129: 52-73.

Kessler RC, Sonnega A, Bromet E, et al.: Posttraumatic stress disorder in the National Comorbidity Survey. Arch Gen Psychiatry. 1995; 52(12): 1048-1060.

Litt MD, Kadden RM, Cooney NL, et al.: Coping skills and treatment outcomes in cognitive-behavioral and interactional group therapy for alcoholism. J Consult Clin Psychol. 2003; 71(1): 118-128.

Rosenberg M: Conceiving the Self. Malabar, FA: Robert E. Krieger Publishing Company, 1986.

Collins NL: Working models of attachment: Implications for explanation, emotion, and behavior. J Pers Soc Psychol. 1996; 71(4): 810-832.

Briere J, Runtz M: The trauma symptom checklist (TSC-33) early data on a new scale. J Interpers Violence. 1989; 4(2): 151-163.

Huppert FA, Garcia AW: Qualitative differences in psychiatric symptoms between high risk groups assessed on a screening test (GHQ-30). Soc Psychiatry Psychiatr Epidemiol. 1991; 26(6): 252-258.

Mollica RF, Caspi-Yavin Y, Bollini P, et al.: The Harvard Trauma Questionnaire: Validating a cross-cultural instrument for measuring torture, trauma, and posttraumatic stress disorder in Indochinese refugees. J Nerv Ment Dis. 1992; 180(2): 111-116.

Bach ME: En empirisk belysning og analyse af ‘‘Emotional Numbing’’ som eventual selvstandig faktor i PTSD. Psykologisk Studie Skriftserie. 2003; 6: 1-199.

Elklit A: Psykologisk traumebehandling—En effektundersogelse [Psychological treatment of trauma—A study of effect]. Copenhagen: Dansk Krise- og Katastrofepsykologisk Selskab, 2000.

Booth-Kewley S, Schmied EA, Highfill-McRoy RM, et al.: Predictors of psychiatric disorders in combat veterans. BMC Psychiatry. 2013; 13: 130.

Prati G, Pietrantoni L, Cicognani E: Self-efficacy moderates the relationship between stress appraisal and quality of life among rescue workers. Anxiety Stress Coping. 2010; 23(4): 463-470.

Marmar CR, McCaslin SE, Metzler TJ, et al.: Predictors of posttraumatic stress in police and other first responders. Ann N Y Acad Sci. 2006; 1071(1): 1-18.

Regehr C, Hill J, Knott T, et al.: Social support, self-efficacy and trauma in new recruits and experienced firefighters. Stress Health. 2003; 19(4): 189-193.

American Psychiatric Association: Diagnostic and Statistical Manual of Mental Disorders. 4th text revision. Washington, DC: 51. American Psychiatric Association, 2000.

Fullerton CS, McCarroll JE, Ursano RJ, et al.: Psychological responses of rescue workers: Fire fighters and trauma. Am J Orthopsychiatry, 1992; 62(3): 371-378.

Kashdan TB, Uswatte G, Steger MF, et al.: Fragile self-esteem and affective instability in posttraumatic stress disorder. Behav Res Ther. 2006; 44(11): 1609-1619.

Jonsson A, Segesten K: Guilt, shame and need for a container: A study of post-traumatic stress among ambulance personnel. Acc Emerg Nurs. 2004; 12(4): 215-223.

Brown J, Campbell EA: Stress and Policing. New York: John Wiley, 1994.

Violanti JM, Aron F: Ranking police stressors. Psychol Rep. 1994; 75: 824-826.

Flannery RB, Everly GS: Crisis intervention: A review. Int J Emerg Ment Health. 2000; 2(2): 119-126.

Headquarters, Department of the Army: Field Manual 8-51: Combat and Operational Stress Control: Tactics, Techniques, and Procedures. Washington, DC: US Government Printing Office, 2003.

Published

09/01/2017

How to Cite

Romano, MS, E., and A. Elklit, MSc. “Rescue Workers and Trauma: Assessing Interaction Among Risk Factors After a Firework Factory Explosio”. Journal of Emergency Management, vol. 15, no. 5, Sept. 2017, pp. 311-23, doi:10.5055/jem.2017.0339.