Hostname: page-component-586b7cd67f-vdxz6 Total loading time: 0 Render date: 2024-11-24T02:56:11.207Z Has data issue: false hasContentIssue false

Acute Stress Symptoms, Dissociation, and Depression Among Rescue Personnel 24 Hours after the Bet-Yehoshua Train Crash: The Effects of Exposure to Dead Bodies

Published online by Cambridge University Press:  28 June 2012

Menachem Ben-Ezra*
Affiliation:
Department of Social Work, Ariel University Center of Samaria, Ariel, Israel
Yuval Palgi
Affiliation:
Department of Social Work, Ariel University Center of Samaria, Ariel, Israel Department of Psychology, Tel-Aviv University, Tel-Aviv, Israel
Nir Essar
Affiliation:
Psagot Institute, Ramat-Gan, Israel
Hilik Sofer
Affiliation:
Home Front Command, Israel Defense Forces, Israel
Yeela Haber
Affiliation:
Department of Psychology and Education, The Open University, Raanana, Israel
*
Department of Social WorkPO Box 3Ariel University Center of SamariaAriel 40700Israel E-mail: [email protected]

Abstract

Introduction:

The immediate impact of exposure to severe wounds, dead bodies, and immediate threat to life has been understudied. Most studies focus on the acute stress disorder and/or post-traumatic stress disorder phases in order to assess rescue personnel's symptomatology, and tend to neglect the immediate exposure to elements of the disaster.

Hypothesis:

Rescue personnel who had a history of previous exposure to dead bodies would exhibit higher levels of acute stress symptoms, dissociation, and depressive symptoms within the 24 hours following a traumatic event.

Methods:

Twenty-three rescue personnel participated in the search and excavation of dead and mutilated bodies following the Bet-Yehoshua train crash in Israel.The rescue personnel group was divided based on previous exposure to dead bodies. Each participant completed a demographic questionnaire, which included a question on perceived threat to life, the impact of event scale revised, the dissociative experience scale, and the center of epidemiologic studies depression questionnaire. Student's t-tests, along with multivariate analysis of covariance (MANCOVA) were conducted in order to learn which factors are related to psychiatric symptomatology following the immediate exposure to such stressors.

Results:

Among rescue personnel, those with previous exposure to dead bodies did not differ in their levels of acute stress symptoms, dissociation, and depressive symptoms from those who were not previously exposed to dead bodies.

Conclusions:

These results may suggest the possibility that the impact of exposure to dead bodies does not emerge in the acute stress reactions (ASR) phase (up to 24 hours after the event), but later when people have time to process the trauma. Another possibility is that the rescue coping mechanisms of detachment may serve as a buffer for the horrific sights encountered during the ASR period.

Type
Original Research
Copyright
Copyright © World Association for Disaster and Emergency Medicine 2008

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.Ursano, RJ, McCarroll, JE: The nature of the traumatic stressor: Handling dead bodies. J Nerv Ment Dis 1990;178:396398.CrossRefGoogle ScholarPubMed
2.Stephens, C., Miller, I: Traumatic experiences and post-traumatic stress disorder in the New Zealand police. Policing 1998;21:178191.CrossRefGoogle Scholar
3.Renck, B, Weisaeth, L, Skarbo, S: Stress reactions in police officers after a disaster rescue operation. Nord J Psychiatry 2002;56:714.CrossRefGoogle ScholarPubMed
4.North, CS, Tivis, L, McMillen, C., Pfefferbaum, B, Spitznagel, EL, Cox, J, Nixon, S, Bunch, KP, Smith, EM: Psychiatric disorders in rescue workers after the Oklahoma city bombing. Am J Psychiatry 2002;159:857859.CrossRefGoogle ScholarPubMed
5.Fullerton, CS, Ursano, RJ, Wang, L: Acute stress disorder, posttraumatic stress disorder, and depression in disaster or rescue workers. Am J Psychiatry 2004;161:13701376.CrossRefGoogle ScholarPubMed
6.Ben-Ezra, M, Essar, N, Saar, R: Post-traumatic reactions among rescue personnel 96 hours after the Hilton Hotel bombing in Sinai: The effect of previous exposure. Stress Health 2005;21:269272.CrossRefGoogle Scholar
7.Dougall, AL, Herberman, HB, Dalahanty, DL, Inslicht, SS: Similarity of prior trauma exposure as a determinant of chronic stress responding to an airline disaster. J Consult Clin Psychol 2000;68:290295.CrossRefGoogle Scholar
8.Weiss, D, Marmar, C: The Impact of Event Scale–Revised. In: J, Wilson, Keane, T (eds), Assessing Psychological Trauma and post-traumatic stress disorder. New York: Guilford, 1997, pp 168189.Google Scholar
9.Horowitz, M, Wilner, M, Alvarez, W: Impact of Event Scale: A measure of subjective stress. Psychosom Med 1979;41:209218.CrossRefGoogle Scholar
10.Creamer, M, Bell, R, Failla, S: Psychometric properties of Impact of Event Scale–Revised. Behav Res Ther 2003;41:14891496.CrossRefGoogle ScholarPubMed
11.Bernstein, EM, Putnam, FW: Development, reliability, and validity of a dissociation scale. J Nerv Ment Dis 1986;174;727735.CrossRefGoogle ScholarPubMed
12.Radloff, LS: The Center for Epidemiologic Studies-Depression Scale scale: A self-report depression scale for research in the general population. Appl Psych Meas 1977;1:385401.CrossRefGoogle Scholar
13.Resnick, HS, Yehuda, R, Pitman, RK, Foy, DW: Effects of previous trauma on acute plasma cortisol level following rape. Am J Psychiatry 1995;152:16751677.Google ScholarPubMed
14.Wagner, D, Heinrichs, M, Ehlert, U: Prevalence of symptoms of posttraumatic stress disorder in German professional firefighters. Am J Psychiatry 1998;155:17271732.CrossRefGoogle ScholarPubMed
15.Palgi, Y, Ben-Ezra, M, Essar, N: The effect of prolong exposure to war stress on the comorbidity of post-traumatic stress disorder and depression among hospital personnel. Psy Res; In press.Google Scholar
16.Ben-Ezra, M, Palgi, Y, Essar, N: Impact of war stress on post-traumatic stress disorder symptoms in hospital personnel. Gen Hosp Psychiatry 2007;29:264266.CrossRefGoogle ScholarPubMed
17.March, JS: What Constitutes a Stressor? The “Criterion A” Issue. In: JRT, Davidson, Foa, EB (eds), Posttraumatic Stress Disorder: DSM-IV and Beyond. Washington, DC: American Psychiatric Press, 1993, pp 3754.Google Scholar
18.Jones, E, Wessely, S: Psychiatric battle casualties: An intra- and interwar comparison. Br J Psychiatry 2001;178:242247.CrossRefGoogle ScholarPubMed
19.Harvey, PD, Yehuda, R: Strategies to Study Risk for the Development of post-traumatic stress disorder. In: R, Yehuda (ed), Risk Factors for Posttraumatic Stress Disorder. Washington, DC: American Psychiatric Press, 1999, pp 122.Google Scholar
20.Brewin, CR, Andrews, B, Valentine, JD: Meta-analysis of risk factors for post-traumatic stress disorder in trauma-exposed adults. J Consult Clin Psychol 2000;68:748766.CrossRefGoogle ScholarPubMed
21.Ozer, EJ, Best, SR, Lipsey, TL, Weiss, DS: Predictors of posttraumatic stress disorder and symptoms in adults: A Meta-analysis. Psychol Bull 2003;129:5273.CrossRefGoogle ScholarPubMed
22.Koren, D, Arnon, I, Klein, E: Acute stress response and posttraumatic stress disorder in traffic accident victims: A one-year prospective, follow-up study. Am J Psychiatry 1999;156:367373.CrossRefGoogle ScholarPubMed
23.Breslau, N, Chilcoat, HD, Kessler, RC, Davis, GC: Previous exposure to trauma and post-traumatic stress disorder effects of subsequent trauma: Results from the Detroit area survey of trauma. Am J Psychiatry 1999;156;902907.CrossRefGoogle ScholarPubMed