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Acute Psychological Impact of Disaster and Large-Scale Trauma: Limitations of Traditional Interventions and Future Practice Recommendations

Published online by Cambridge University Press:  28 June 2012

Matt J. Gray ,
Shira Maguen  and
Brett T. Litz
Matt J. Gray*
Affiliation:
Department of Psychology, University of Wyoming, Laramie, Wyoming, USA
Shira Maguen
Affiliation:
Boston Veterans Affairs Health Care SystemBoston University School of Medicine Boston, Massachusetts, USA
Brett T. Litz
Affiliation:
Boston Veterans Affairs Health Care SystemBoston University School of Medicine Boston, Massachusetts, USA
*
University of Wyoming, Department of Psychology, PO Box 3415, Laramie, WY 82071-3415USA E-mail: gray@uwyo.edu
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Abstract

Nearly everyone will experience emotional and psychological distress in the immediate aftermath of a disaster or other large-scale traumatic event. Although extremely upsetting and disruptive, the reaction is understood best as a human response to inordinate adversity, which in the majority of cases remits over time without formal intervention. Nevertheless, some people experience sustained difficulties. To prevent chronic post-traumatic difficulties, mental health professionals provide early interventions soon after traumatic exposure. These interventions typically take the form of single-session debriefings, which have been applied routinely following disasters. The research bearing on these traditional forms of early crisis interventions has shown that, although well-received by victims, there is no empirical support for their continued use. However, promising evidence-based, early interventions have been developed, which are highlighted. Finally, traumatic bereavement and complicated grief in survivors of disasters, an area largely neglected in the field, is discussed.

Keywords

cognitive-behavioral interventionscritical incident stress debriefingpost-disaster treatmentpsycho-educationtraumatic bereavementtraumatic grief
Type
Special Reports
Information
Prehospital and Disaster Medicine , Volume 19 , Special Issue 1: Psychosocial Themes , March 2004 , pp. 64 - 72
Copyright
Copyright © World Association for Disaster and Emergency Medicine 2004

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References

1.Green, B: Disasters and post-traumatic stress disorder. In: Davidson, J, Foa, E (eds), Post-traumatic Stress Disorder: DSM-IV and Beyond. Washington, DC: American Psychiatric Press, 1993, pp 75–98.Google Scholar
2.Resnick, H, Acierno, R, Holmes, M, et al. : Emergency evaluation and intervention with female victims of rape and other violence. J Clin Psychol 2000;56:1317–1333.3.0.CO;2-H>CrossRefGoogle ScholarPubMed
3.American Psychiatric Association: Diagnostic and Statistical Manual of Mental Disorders (4th ed) Washington, DC, American Psychiatric Association: 1994.Google Scholar
4.Kessler, RC, Sonnega, A, Bromet, E, et al. :Post-traumatic stress disorder in the National Comorbidity Survey. Arch Gen Psychiat 1995;52:1048–1060.CrossRefGoogle ScholarPubMed
5.Breslau, N, Kessler, R, Chilcoat, H, et al. : Trauma and post-traumatic stress disorder in the community: The 1996 Detroit area survey of trauma. Arch Gen Psychiat 1998;55:626–632.CrossRefGoogle ScholarPubMed
6.Shalev, A,: Stress management and debriefing: Historical concepts and present patterns. In: Raphael, BWilson, J (eds), Psychological Debriefing. Cambridge: Cambridge University Press, 2000.Google Scholar
7.Bisson, J, McFarlane, A, Rose, C: Psychological debriefing. In: Foa, E, Keane, T, Friedman, M (eds), EffectiveTtreatments for post-traumatic stress disorder.New York:Guilford, 2000, pp 39–59.Google Scholar
8.Mitchell, JT, Everly, GS (eds): Critical Incident Stress Debriefing: An Operations Manual for the Prevention of Traumatic Stress among Emergency Services and Disaster Workers (2nd ed). Ellicott City, MD: Chevron Publishing Corporation, 1993.Google Scholar
9.Mitchell, JT, Everly, GS: The critical incident stress debriefing (critical incident stress debriefing) and the prevention of work related traumatic stress among high-risk occupational groups. In: Everly, G, Lating, J (eds), Psychotraumatology: Key Papers and Core Concepts in Post-Traumatic Stress. New York, NY: Plenum Press, 1995, pp 159–169.Google Scholar
10.Deahl, M, Srinivasan, M, Jones, N, et al. : Preventing psychological trauma in soldiers: The role of operational stress training and psychological debriefing. Brit J Med Psychol 2000;73:77–85.Google Scholar
11.Litz, B, Gray, M, Bryant, R, Adler, A: Early intervention for trauma: Current status and future directions. Clinical Psychology: Science and Practice 2002;9:112–134.Google Scholar
12.Van Emmerik, A, Kamphuis, J, Hulsbosch, A, Emmelkamp, P: Single-session debriefing after psychological trauma: A meta-analysis. Lancet 2002;360:766–770.Google Scholar
13.Everly, GS, Flannery, RB, Mitchell, JT: Critical incident stress management(critical incident stress management): A review of the literature. Aggression and Violent Behavior 2000;5:23–40.CrossRefGoogle Scholar
14.Hokanson, M, Wirth, B: The critical incident stress debriefing process for the Los Angeles County Fire Department: Automatic and effective. Inter J Emer Mental Health 2000;2:249–257.Google ScholarPubMed
15.Young, BH, Gerrity, E: Critical incident stress debriefing (critical incident stress debriefing): Value and limitations in disaster response. National Center for Post-Traumatic Stress Disorder Clinical Quarterly 1994;4:17–19.Google Scholar
16.Gist, R, Woodall, S: There are no simple solutions to complex problems. In: Violanti, JM, Douglas, P (eds.). Post-traumatic Stress Intervention: Challenges, Issues, and Perspectives. Springfield, IL: Charles C. Thomas, 2000, pp 81–95.Google Scholar
17.Rose, S, Bisson, J, Wessely, S: Psychological Debriefing for Preventing Post Traumatic Stress Disorder (post-traumatic stress disorder) (Cochrane Review). In: The Cochrane Library; 3,Oxford: Update Software. 2001.Google Scholar
18.Bisson, JI, Jenkins, PL, Alexander, J, Bannister C: Randomized controlled trial of psychological debriefing for victims of acute burn trauma. Brit J Psychiat 1997;171:78–81.CrossRefGoogle ScholarPubMed
19.Conlon, L, Fahy, TJ, Conroy, R: post-traumatic stress disorder in ambulant RTA victims: A randomized controlled trial of debriefing. J Psychosom Res 1999;46:37–44.CrossRefGoogle ScholarPubMed
20.Hobbs, M, Mayou, R, Harrison, B, Warlock, P: A randomized trial of psychological debriefing for victims of road traffic accidents. Brit Med J 1996;313:1438–1439.Google Scholar
21.Mayou, R, Ehlers, A, Hobbs, M: Psychological debriefing for road traffic accident victims: Three-year follow-up of a randomised controlled trial. Brit J Psychiat 2000;176:589–593.Google Scholar
22.Rose, S, Brewin, CR, Andrews, B, Kirk, M: A randomized controlled trial of individual psychological debriefing for victims of violent crime. Psychol Med 1999;29:793–799.CrossRefGoogle ScholarPubMed
23.Everly, GS, Mitchell, JT: The debriefing “controversy” and crisis intervention: A review of the lexical and substantive issues. Inter J Emer Mental Health 2000;2:211–225.Google Scholar
24.Lundin, T: Long-term outcome of bereavement. Brit J Psychiat 1984;145:424–428.Google Scholar
25.Prigerson, HG, Shear, MK, Jacobs, SC, et al. : Consensus criteria for traumatic grief: A preliminary empirical test. Brit J Psychiat 1999;174:67–73.Google Scholar
26.Pfefferbaum, B, Call, JA, Lensgraf, SJ, et al. :Traumatic grief in a convenience sample of victims seeking support services after a terrorist accident. Ann Clin Psychiat 2001;13:19–24.CrossRefGoogle Scholar
27.Rynearson, EK, McCreery, JM: Bereavement after homicide: A synergism of trauma and loss. Amer J Psychiat 1993;150:258–261.Google Scholar
28.Prigerson, HG, Jacobs, SC: Traumatic grief as a distinct disorder: A rationale, consensus criteria, and a preliminary empirical test. In: Stroebe, MS, Stroebe, W, Hansson, RO, Schut, H, (eds), New Handbook of Bereavement: Consequences, coping, and care. Washington, DC: American Psychological Association Books, 2001, pp 613–645.CrossRefGoogle Scholar
29.Prigerson, HG, Kupfer, DJ, Beery, LC, et al. :Traumatic grief as a risk factor for suicidal ideation among young adult men and women. Amer J Psychiat 1999;156:1994–1995.CrossRefGoogle Scholar
30.Raphael, B, Minkov, C, Dobson, M. Psychotherapeutic and Pharmacological Intervention for Bereaved Persons. In: Stroebe, MS, Stroebe, W, Hansson, RO, Schut, H (eds), New Handbook of Bereavement: Consequences, Coping, and Care. Washington, DC: American Psychological Association Books, 2001, pp 587–612.Google Scholar
31.Murphy, SA, Das Gupta, A, Cain, KC, et al. : Changes in parents' mental distress after the violent death of an adolescent of young adult child: A longitudinal prospective analysis. Death Studies 1999;23:129–159.Google Scholar
32.Ness, DE, Pfeffer, CR: Sequelae of bereavement resulting from suicide. Amer J Psychiat 1990;147:279–285.Google ScholarPubMed
33.Seguin, M, Lesage, A, Kiely, MC: Parental bereavement after suicide and accident: A comparative study. Suicide and Life Threatening Behavior 1995;25:489–498.Google Scholar
34.Lehman, DR, Ellard, JG, Wortman, CB, Williams, AF: Long-term effects of losing a spouse or child in a motor vehicle crash. J Person Soc Psychol 1987;52:218–231.CrossRefGoogle Scholar
35.Schwartzberg, SS, Halgin, RP: Treating grieving clients: The importance of cognitive change. Professional Psychology: Research & Practice 1991;22:240–246.Google Scholar
36.Janoff-Bulman, R: Assumptive worlds and the stress of traumatic events: Application of the schema construct. Social Cognition 1989;7:113–136.CrossRefGoogle Scholar
37.Spooren, DJ, Henderick, H, Jannes, C: Survey description of stress of parents bereaved from a child killed in a traffic accident. A retrospective study of a victim support group. Omega 2000;42:171–185.Google Scholar
38.Lehman, DR, Ellard, JG, Wortman, CB: Social support for the bereaved: Recipients and providers' perspectives on what is helpful. J Consult Clin Psychol 1986;54:438–446.Google Scholar
39.Armour, MP: Journey of family members of homicide victims: A qualitative study of their posthomicide experience. Amer J Orthopsychiat 2002;72:372–382.CrossRefGoogle ScholarPubMed
40.Murphy, SA, Johnson, C, Cain, K, et al. : Broad-spectrum group treatment for parents bereaved by the violent deaths of their 12 to 28 year-old children: A randomized controlled trial. Death Studies 1998;22:1–27.Google ScholarPubMed
41.Salloum, A, Avery, L, McClain, RP: Group psychotherapy for adolescent survivors of homicide victims: A pilot study. J Amer Acad Child Adol Psychiat 2001;40:1261–1267.Google Scholar
42.Rynearson, EK, Favell, JL, Gold, R, Prigerson, H: Bereavement intervention with incarcerated youth. J Amer Acad Child Adol Psychiat 2001;41:893–894.CrossRefGoogle Scholar
43.Shear, MK, Frank, E, Foa, E, et al. : Traumatic grief treatment: A pilot study. Amer J Psychiat 2001;158:1506–1508.Google Scholar
44.Mawson, D, Marks, I, Ramm, E, Stern, RS: Guided mourning for morbid grief: A controlled study. Brit J Psychiat 1981;138:185–193.Google Scholar
45.Sireling, L, Cohen, D, Marks, I: Guided mourning for morbid grief: A controlled replication. Behav Ther 1988;19:121–132.CrossRefGoogle Scholar
46.Schut, H, Stroebe, MS, van den Bout, JT: The Efficacy of Bereavement Interventions: Determining Who Benefits. In: Stroebe, MS, Hansson, RO, Stroebe, W, Schut, H (eds), Handbook of Bereavement Research. Washington, DC:American Psychological Association, 2001, pp 705–738.Google Scholar
47.Buckley, T, Blanchard, E, Hickling, E: A prospective examination of delayed onset post-traumatic stress disorder secondary to motor vehicle accidents. J Abnorm Psychol 1996;105:617–625.Google Scholar
48.Ehlers, A, Mayou, R, Bryant, B: Psychological predictors of chronic posttraumatic stress disorder after motor vehicle accidents. J Abnorm Psychol 1998;107:508–519.CrossRefGoogle ScholarPubMed
49.Bramsen, I, Dirkzwager, A, van der Ploeg, H: Predeployment personality traits and exposure to trauma as predictors of post-traumatic stress symptoms: A prospective study of former peacekeepers. Amer J Psychiat 2000;157:1115–1119.CrossRefGoogle ScholarPubMed
50.Harvey, AG, Bryant, RA: The relationship between acute stress disorder and posttraumatic stress disorder: A prospective evaluation of motor vehicle accident survivors. J Consult Clin Psychol 1998;66:507–512.Google Scholar
51.Harvey, AG, Bryant, RA: Two-year prospective evaluation of the relationship between acute stress disorder and posttraumatic stress disorder following mild traumatic brain injury. Amer J Psychiat 2000;157:626–628.CrossRefGoogle ScholarPubMed
52.Solomon, Z, Laor, N, Weiler, D, Muller, UF: The psychological impact of the Gulf War: A study of acute stress in Israeli evacuees. Arch Gen Psychiat 1993;50:320–321.Google Scholar
53.Foa, EB, Hearst-Ikeda, D, Perry, KJ: Evaluation of a brief cognitive-behavioral program for the prevention of chronic post-traumatic stress disorder in recent assault victims. J Consult Clin Psychol 1995;63:948–955.CrossRefGoogle ScholarPubMed
54.Bryant, RA, Harvey, AG, Dang, S, et al. :Treatment of acute stress disorder: A comparison of cognitive-behavioral therapy and supportive counseling. J Consult Clin Psychol 1998;66:862–866.Google Scholar