Hostname: page-component-cd9895bd7-fscjk Total loading time: 0 Render date: 2024-12-19T04:48:16.883Z Has data issue: false hasContentIssue false
  • English
  • Français

The Association Between Dissatisfaction with Debriefing and Post-Traumatic Stress Disorder (PTSD) in Rescue and Recovery Workers for the Oklahoma City Bombing

Published online by Cambridge University Press:  15 March 2018

Duy Vu Tran  and
Carol S. North
Duy Vu Tran*
Affiliation:
Department of Psychiatry, University of Michigan Health System, Ann Arbor, Michigan
Carol S. North
Affiliation:
The Altshuler Center for Education & Research, Metrocare Services, Dallas, Texas The Nancy and Ray L. Hunt Chair in Crisis Psychiatry and Professor of Psychiatry, The University of Texas Southwestern Medical Center, Dallas, Texas
*
Correspondence and reprint requests to Duy Vu Tran, MD, Department of Psychiatry, University of Michigan Health System, 1500 E Medical Center Dr, Ann Arbor, MI 48109-5295, USA (e-mail: [email protected]).
Get access Rights & Permissions [Opens in a new window]

Abstract

Objective

The purpose of this study was to investigate potential association between psychopathology and subjective evaluation of the experience of debriefing in disaster-exposed rescue and recovery workers.

Methods

Structured diagnostic interviews for DSM-III-R psychiatric disorders were conducted with 166 firefighters who served as rescue and recovery workers for the 1995 Oklahoma City bombing, who categorized their satisfaction with the debriefing on 4 levels. “Very dissatisfied” responses were examined for their association with post-traumatic stress disorder (PTSD) and with PTSD symptom groups.

Results

Being “very dissatisfied” with the debriefing was significantly associated with the DSM-III-R avoidance and numbing group and with PTSD.

Conclusions

These findings suggest that debriefing may be an unsatisfactory intervention for people with prominent avoidance and numbing symptoms, such as those with PTSD. These individuals might be better served by referral directly to psychiatric treatment (Disaster Med Public Health Preparedness. 2018;12:718-722).

Keywords

PTSDavoidance and numbingdebriefingcrisis interventiondisaster responders
Type
Original Research
Information
Disaster Medicine and Public Health Preparedness , Volume 12 , Issue 6 , December 2018 , pp. 718 - 722
Copyright
Copyright © Society for Disaster Medicine and Public Health, Inc. 2018 

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

1. Mitchell, JT. When disaster strikes...the critical incident stress debriefing process. J Emerg Med Serv. 1983;8(1):36-39.Google Scholar
2. Mitchell, JT, Everly, GS. Critical Incident Stress Management: a new era and standard of care in crisis intervention. Ellicott City, MD: Chevron Publishing; 1997.Google Scholar
3. Deahl, M. Psychological debriefing: controversy and challenge. Aust N Z J Psychiatry. 2000;34(6):929-939.Google Scholar
4. Mitchell, JT, Everly, GS Jr. Critical Incident Stress Debriefing: An Operations Manual for CISD, Defusing and Other Group Crisis Intervention Services, 3rd ed. Ellicott City, MD: Chevron Pub Corp; 2001; 330 pp.Google Scholar
5. Greenberg, N, Brooks, S, Dunn, R. Latest developments in post-traumatic stress disorder: diagnosis and treatment. Br Med Bull. 2015;114(1):147-155.Google Scholar
6. van Emmerik, AAP, Kamphuis, JH, Hulsbosch, AM, Emmelkamp, PMG. Single session debriefing after psychological trauma: a meta-analysis. Lancet. 2002;360(9335):766-771.Google Scholar
7. North, CS, Pfefferbaum, B. Mental health response to community disasters: a systematic review. J Am Med Assoc. 2013;310(5):507-518.Google Scholar
8. North, CS, Tivis, L, McMillen, JC, et al. Psychiatric disorders in rescue workers after the Oklahoma City bombing. Am J Psychiatry. 2002;159(5):857-859.Google Scholar
9. North, CS, Tivis, L, McMillen, JC, et al. Coping, functioning, and adjustment of rescue workers after the Oklahoma City bombing. J Trauma Stress. 2002;15(3):171-175.Google Scholar
10. Robbins, L, Cottler, L, Keating, S. NIMH Diagnostic Interview Schedule, Version III, Revised (DIS-III-R). St Louis, MO: Washington University; 1989.Google Scholar
11. Robins, LN, Smith, EM. The Diagnostic Interview Schedule/Disaster Supplement. St Louis, MO: Washington University School of Medicine; 1983.Google Scholar
12. North, CS, Suris, AM, Davis, M, Smith, RP. Toward validation of the diagnosis of posttraumatic stress disorder. Am J Psychiatry. 2009;166(1):34-41.Google Scholar
13. Foa, EB, Riggs, DS, Gershuny, BS. Arousal, numbing, and intrusion: symptom structure of PTSD following assault. Am J Psychiatry. 1995;152(1):116-120.Google Scholar
14. Shad, MU, Suris, AM, North, CS. Novel combination strategy to optimize treatment for PTSD. Hum Psychopharmacol. 2011;26(1):4-11.Google Scholar
15. Whitman, JB, North, CS, Downs, DL, Spitznagel, EL. A prospective study of the onset of PTSD symptoms in the first month after trauma exposure. Ann Clin Psychiatry. 2013;25(3):163-172.Google Scholar