Skip to main content Accessibility help

We use cookies to distinguish you from other users and to provide you with a better experience on our websites. Close this message to accept cookies or find out how to manage your cookie settings.

Close cookie message
×
Hostname: page-component-586b7cd67f-g8jcs Total loading time: 0 Render date: 2024-11-28T13:44:53.338Z Has data issue: false hasContentIssue false

11 - Traumatic death in terrorism and disasters

from Part IV - Special topics

Published online by Cambridge University Press:  09 August 2009

By
Robert J. Ursano ,
James E. McCarroll  and
Carol S. Fullerton
Edited by
Robert J. Ursano ,
Carol S. Fullerton ,
Lars Weisaeth  and
Beverley Raphael
Robert J. Ursano
Affiliation:
Professor and Chairman Department of Psychiatry
James E. McCarroll
Affiliation:
Research Professor Department of Psychiatry
Carol S. Fullerton
Affiliation:
Research Professor Department of Psychiatry
Robert J. Ursano
Affiliation:
Uniformed Services University of the Health Sciences, Maryland
Carol S. Fullerton
Affiliation:
Uniformed Services University of the Health Sciences, Maryland
Lars Weisaeth
Affiliation:
Universitetet i Oslo
Beverley Raphael
Affiliation:
University of Western Sydney
Get access

Summary

Terrorism and disasters are not infrequent occurrences in the present-day world. Common to these events is the likelihood of violent death and the presence of human remains – burned, dismembered, mutilated, or relatively intact. Exposure to mass death as well as individual dead bodies is a disturbing and sometimes frightening event. The handling of the remains of the dead following combat, natural disasters, disasters of human origin, and terrorism, accidents, and other forms of traumatic death is known to cause distress. The nature of the stress of exposure to traumatic death and the dead and its relationship to post-traumatic stress disorder (PTSD) and other post-traumatic psychiatric illnesses is not well understood (Breslau & Davis, 1987; Lindy et al., 1987; Rundell et al., 1989; Ursano, 1987; Ursano & McCarroll, 1990).

The tasks of body recovery, identification, transport, and burial may require prolonged as well as acute contact with mass death. Recent research has shown that victims, onlookers, and rescue workers are traumatized by the experience or expectation of confronting death in disaster situations (Dyregrov et al., 1996; Jones, 1985; Miles et al., 1984; Schwartz, 1984; Taylor & Frazer, 1982). Exposure to abusive violence (Laufer et al., 1984) and to the grotesque (Green et al., 1989) significantly contributes to the development of psychiatric symptoms in war veterans, particularly intrusive imagery (Clohessy & Ehlers, 1999; Laufer et al., 1985; Lifton, 1973).

Keywords

close supervisionemotional involvementexposure to deathidiosyncratic reactionspsychological stresssensory stimulationman-made disastersnatural disastersterrorismtraumatic death
Type
Chapter
Information
Textbook of Disaster Psychiatry , pp. 227 - 246
Publisher: Cambridge University Press
Print publication year: 2007

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Alexander, D. A. (1993). Stress among police body handlers. British Journal of Psychiatry, 163, 806–808.Google Scholar
Alexander, D. A. & Wells, A. (1991). Reactions of police officers to body-handling after a major disaster: a before and after comparison. British Journal of Psychiatry, 159, 547–555.Google Scholar
Arthur, A. Z. (1987). Stress as a state of anticipatory vigilance. Perceptual and Motor Skills, 64, 75–85.Google Scholar
Bartone, P. T., Ursano, R. J., Wright, K. M. & Ingraham, L. H. (1989). The impact of a military air disaster on the health of assistance workers: a prospective study. Journal of Nervous and Mental Disease, 177, 317–328.Google Scholar
Breslau, N. & Davis, G. C. (1987). Posttraumatic stress disorder – the stressor criterion. Journal of Nervous and Mental Disease, 175, 255–264.Google Scholar
Bryant, R. A. & Harvey, A. G. (1996). Posttraumatic stress reactions in volunteer firefighters. Journal of Traumatic Stress, 9, 51–62.Google Scholar
Cassem, N. (1977). Treating the person confronting death. In Harvard Guide to Modern Psychiatry, ed. Nicholi, A. M. Jr., pp. 599. Cambridge, Mass.: Belknap Press of Harvard University Press.
Cervantes, R. (1988). Psychological stress of body handling. Part II and Part III: debriefing of Dover AFB personnel following the Gander tragedy and the body handling experience at Dover AFB. In Exposure to Death, Disasters and Bodies, eds. Ursano, R. J. & Fullerton, C., pp. 125–162 (DTIC: A 203163). Bethesda, Md.: F. Edward Hebert School of Medicine, Uniformed Services University of the Health Sciences.
Clohessy, S. & Ehlers, A. (1999). PTSD symptoms, response to intrusive memories and coping in ambulance service workers. British Journal of Clinical Psychology, 38, 251–265.Google Scholar
Deahl, M. P. (2000). Debriefing and body recovery: war grave soldiers. In Psychological Debriefing, eds. Raphael, B. & Wilson, J. P., pp. 108–130. New York: Cambridge University Press.
Drinkwater, B. L., Cleland, T. & Flint, M. M. (1968). Pilot performance during periods of anticipatory physical threat stress. Aerospace Medicine, 39, 944–999.Google Scholar
Dyregrov, A., Kristoffersen, J. I. & Gjestad, R. (1996). Voluntary and professional disaster-workers: similarities and differences in reactions. Journal of Traumatic Stress, 9, 541–555.Google Scholar
Engen, T. (1987). Remembering odors and their names. American Scientist, 75, 497–503.Google Scholar
Engen, T., Kuisma, J. E. & Eimas, P. D. (1973). Short-term memory of odors. Journal of Experimental Psychology, 99, 222–225.Google Scholar
Ersland, S., Weisaeth, L. & Sund, A. (1989). The stress upon rescuers involved in an oil rig disaster, “Alexander L. Kielland” 1980. Acta Psychiatrica Scandinavica Supplementum, 80(355), 38–49.Google Scholar
Fenz, W. D. & Epstein, S. (1967). Gradients of physiological arousal in parachutists as a function of an approaching jump. Psychosomatic Medicine, 29, 33–51.Google Scholar
Fullerton, C. S., McCarroll, J. E., Ursano, R. J. & Wright, K. M. (1992). Psychological responses of rescue workers: fire fighters and trauma. American Journal of Orthopsychiatry, 62, 371–378.Google Scholar
Gist, R., Lohr, J., Kenardy, J.et al. (1997). Researchers speak out on CISM. Journal of Emergency Medicine, 22, 27–28.Google Scholar
Green, B. L., Lindy, J. D., Grace, M. C. & Gleser, G. C. (1989). Multiple diagnosis in posttraumatic stress disorder. The role of war stressors. Journal of Nervous and Mental Disease, 177, 329–335.Google Scholar
Hersheiser, M. R. & Quarantelli, E. L. (1976). The handling of the dead in a disaster. Omega, 7, 195–208.Google Scholar
Hytten, K. & Hasle, A. (1989). Fire fighters: a study of stress and coping. Acta Psychiatrica Scandinavica Supplementum, 355, 50–55.Google Scholar
Jones, D. J. (1985). Secondary disaster victims: the emotional effects of recovering and identifying human remains. American Journal of Psychiatry, 142, 303–307.Google Scholar
Keller, R. T. & Bobo, W. V. (2002). Handling human remains following the terrorist attack on the Pentagon: experiences of 10 uniformed health care workers. Military Medicine, 167, 8–11.Google Scholar
Kenardy, J. (2000). The current status of psychological debriefing. British Medical Journal, 321, 1032–1033.Google Scholar
Laufer, R. S., Gallops, M. S. & Frey-Wouters, E. (1984). War stress and trauma. Journal of Health and Social Behavior, 25, 65–85.Google Scholar
Laufer, R. S., Brett, E. & Gallops, M. S. (1985). Dimensions of posttraumatic stress disorder among Vietnam veterans. Journal of Nervous and Mental Disease, 173, 538–545.Google Scholar
Leffler, C. T. & Dembert, M. L. (1998). Posttraumatic stress symptoms among U.S. Navy divers recovering TWA Flight 800. Journal of Nervous and Mental Disease, 186, 574–577.Google Scholar
Lifton, R. J. (1973). Home From the War. New York: Simon & Schuster, Inc.
Lindy, J. D., Green, B. L. & Grace, M. C. (1987). The stressor criterion and posttraumatic stress disorder. Journal of Nervous and Mental Disease, 175, 269–272.Google Scholar
Lundin, T. (1990). The rescue personnel and the disaster stress. In Proceedings of the Second International Conference on Wartime Medical Services, eds. Lundeberg, J. E., Otto, U. & Rybeck, B., pp. 208–216. Stockholm, 25–29 June. Sweden: Frsvarets forskningsanstalt-FOA.
Maloney, J. (1988a). The Gander disaster: body handling and identification process. In Exposure to Death, Disasters and Bodies, eds. Ursano, R. J. & Fullerton, C., pp. 41–66 (DTIC: A 203163). Bethesda, Md.: F. Edward Hebert School of Medicine, Uniformed Services University of the Health Sciences.
Maloney, J. (1988b). Body handling at Dover AFB: the Gander disaster. In Individual and Group Behavior in Toxic and Contained Environments, eds. Ursano, R. J. & Fullerton, C., pp. 97–102 (DTIC: A 203267). Bethesda, Md.: F. Edward Hebert School of Medicine, Uniformed Services University of the Health Sciences.
Marmar, C. R., Weiss, D. S., Metzler, T. J., Ronfeldt, H. & Foreman, C. (1996). Stress responses of emergency services personnel to the Loma Parieta earthquake Interstate 880 freeway collapse and control traumatic incidents. Journal of Traumatic Stress, 9, 63–85.Google Scholar
McCarroll, J. E., Ursano, R. J. & Fullerton, C. S. (1993a). Symptoms of posttraumatic stress disorder following recovery of war dead. American Journal of Psychiatry, 150, 1875–1877.Google Scholar
McCarroll, J. E., Ursano, R. J., Fullerton, C. S. & Lundy, A. (1993b). Traumatic stress of a wartime mortuary: anticipation of exposure to mass death. Journal of Nervous and Mental Disease, 181, 545–551.Google Scholar
McCarroll, J. E., Ursano, R. J., Wright, K. M. & Fullerton, C. S. (1993c). Handling of bodies after violent death: strategies for coping. American Journal of Orthopsychiatry, 63, 209–214.Google Scholar
McCarroll, J. E., Ursano, R. J., Ventis, W. L.et al. (1993d). Anticipation of handling the dead: effects of experience and gender. British Journal of Clinical Psychology, 32 (Pt 4), 466–468.Google Scholar
McCarroll, J. E., Blank, A. S. & Hill, K. (1995a). Working with traumatic material: effects on Holocaust Memorial Museum staff. American Journal of Orthopsychiatry, 65, 66–75.Google Scholar
McCarroll, J. E., Ursano, R. J. & Fullerton, C. S. (1995b). Symptoms of PTSD following recovery of war dead: 13–15 month follow-up. American Journal of Psychiatry, 152, 939–941.Google Scholar
McCarroll, J. E., Ursano, R. J., Fullerton, C. S. & Lundy, A. C. (1995c). Anticipatory stress of handling remains of the Persian Gulf War: predictors of intrusion and avoidance. Journal of Nervous and Mental Disease, 183, 698–703.Google Scholar
McCarroll, J. E., Ursano, R. J., Fullerton, C. S.et al. (1995d). Gruesomeness, emotional attachment, and personal threat: dimensions of anticipated stress of body recovery. Journal of Traumatic Stress, 8, 343–347.Google Scholar
McCarroll, J. E., Fullerton, C. S., Ursano, R. J. & Hermsen, J. M. (1996). Posttraumatic stress symptoms following forensic dental identification: Mt. Carmel, Waco, Texas. American Journal of Psychiatry, 153, 778–782.Google Scholar
McCarroll, J. E., Ursano, R. J., Fullerton, C. S., Liu, X. & Lundy, A. (2001). Effect of exposure to death in a war mortuary on posttraumatic stress symptoms. Journal of Nervous and Mental Disease, 189, 44–48.Google Scholar
McCarroll, J. E., Ursano, R. J., Fullerton, C. S., Liu, X. & Lundy, A. (2002). Somatic symptoms in Gulf War mortuary workers. Psychosomatic Medicine, 64, 29–33.Google Scholar
Mefferd, R. B., Hale, H. B., Shannon, I. L., Prigmore, J. R. & Ellis, J. P. (1971). Stress responses as criteria for personnel selection: baseline study. Aerospace Medicine, 42, 42–51.Google Scholar
Miles, M. S., Demi, A. S. & Mostyn-Aker, P. (1984). Rescue workers' reactions following the Hyatt Hotel disaster. Death Education, 8, 315–331.Google Scholar
Mitchell, J. H., Sproule, B. J. & Chapman, C. B. (1958). The physiological meaning of the maximal oxygen intake test. Journal of Clinical Investigation, 37, 538–547.Google Scholar
Myers, D. G. (1989). Mental health and disaster. In Psychosocial Aspects of Disaster, eds. Gist, R. & Lubin, B., pp. 198. New York: John Wiley & Sons.
National Institute of Mental Health (2002). Mental health and mass violence: evidence based early psychological intervention for victims/survivors of mass violence. A workshop to reach consensus on best practices. NIH Publication No. 02–5138. Washington, D.C.: US Government Printing Office.
Norris, F. H. & Murrell, S. A. (1988). Prior experience as a moderator of disaster impact on anxiety symptoms in older adults. Journal of Community Psychology, 16, 665–683.Google Scholar
Raphael, B. & Wilson, J. P. (2000). Psychological Debriefing. New York: Cambridge University Press.
Raphael, B. & Wooding, S. (2004). Debriefing: its evolution and current status. Psychiatric Clinics of North America, 27, 407–423.Google Scholar
Regehr, C., Hill, J. & Glancy, G. D. (2000). Individual predictors of traumatic reactions in firefighters. Journal of Nervous and Mental Disease, 188, 333–339.Google Scholar
Robinson, M. (1988). Psychological support to the Dover AFB body handlers. In Exposure to Death, Disasters and Bodies, eds. Ursano, R. J. & Fullerton, C., pp. 68–74 (DTIC: A 203163). Bethesda, Md.: F. Edward Hebert School of Medicine, Uniformed Services University of the Health Sciences.
Rundell, J. R., Ursano, R. J., Holloway, H. C. & Silberman, E. K. (1989). Psychiatric responses to trauma. Hospital and Community Psychiatry, 40, 68–74.Google Scholar
Schwartz, H. J. (1984). Fear of the dead: the role of social ritual in neutralizing fantasies from combat. In Psychotherapy of the Combat Veteran, ed. Schwartz, H. J., pp. 253–267. New York: Spectrum Publications.
Sledge, M. (2005). Soldier Dead. New York: Columbia University Press.
Susnowski, T. (1988). Patterns of skin conductance and heart rate changes under anticipatory stress conditions. Journal of Psychophysiology, 2, 231–238.Google Scholar
Sutker, P. B., Uddo, M., Brailey, K., Vasterling, J. J. & Errera, P. (1994). Psychopathology in war-zone deployed and non-deployed Operation Desert Storm troops assigned graves registration duties. Journal of Abnormal Psychology, 103, 383–390.Google Scholar
Taylor, A. J. W. & Frazer, A. G. (1982). The stress of post-disaster body handling and victim identification work. Journal of Human Stress, 8, 4–12.Google Scholar
Thompson, J. & Solomon, M. (1991). Body recovery teams at disasters: trauma or challenge?Anxiety Research, 4, 235–244.Google Scholar
Tucker, P., Pfefferbaum, B., Doughty, D. E.et al. (2002). Body handlers after terrorism in Oklahoma City: predictors of posttraumatic stress and other symptoms. American Journal of Orthopsychiatry, 72, 469–475.Google Scholar
Ursano, R. J. (1987). Commentary. Posttraumatic stress disorder: the stressor criterion. Journal of Nervous and Mental Disease, 175, 273–275.Google Scholar
Ursano, R. J. & Fullerton, C. S. (1990). Cognitive and behavioral responses to trauma. Journal of Applied Social Psychology, 20, 1766–1775.Google Scholar
Ursano, R. J. & McCarroll, J. E. (1990). The nature of a traumatic stressor: handling dead bodies. Journal of Nervous and Mental Disease, 178, 396–398.Google Scholar
Ursano, R. J., Fullerton, C. S., Wright, K. M.et al. (eds.) (1992). Disaster Workers: Trauma and Social Support. Bethesda, Md.: Uniformed Services University of the Health Sciences.
Ursano, R. J., Fullerton, C. S., Kao, Tzu-Cheg & Bhartiya, V. R. (1995). Longitudinal assessment of posttraumatic stress disorder and depression after exposure to traumatic death. Journal of Nervous and Mental Disease, 183, 36–42.Google Scholar
Ursano, R. J., Fullerton, C. S., Vance, K. & Kao, T. C. (1999). Posttraumatic stress disorder and identification in disaster workers. American Journal of Psychiatry, 156, 353–359.Google Scholar
Weisaeth, L. (1989). A study of behavioral responses to an industrial disaster. Acta Psychiatrica Scandinavica Supplementum, 80, 13–24.Google Scholar
Weiss, D. S., Marmar, C. R., Metzler, T. J. & Ronfeldt, H. M. (1995). Predicting symptomatic distress in emergency services personnel. Journal of Consulting and Clinical Psychology, 63, 361–368.Google Scholar

Save book to Kindle

To save this book to your Kindle, first ensure [email protected] is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about saving to your Kindle.

Note you can select to save to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

Find out more about the Kindle Personal Document Service.

Available formats
×

Save book to Dropbox

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Dropbox.

Available formats
×

Save book to Google Drive

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Google Drive.

Available formats
×