Hostname: page-component-7c8c6479df-fqc5m Total loading time: 0 Render date: 2024-03-29T06:15:55.367Z Has data issue: false hasContentIssue false

Medium-Term Course of Disaster Victims

A Naturalistic Follow-Up

Published online by Cambridge University Press:  02 January 2018

C. Duggan*
Affiliation:
University of Nottingham Department of Psychiatry
J. Gunn
Affiliation:
Institute of Psychiatry, London
*
Professor Gunn, Institute of Psychiatry, De Crespigny Park, Denmark Hill, London SE5 8AF. Fax: (0171) 277 0283

Abstract

Background

Our aim was to describe the medium-term course (2–3 years) in a series of victims who had experienced severe trauma.

Method

We selected a consecutive series of 31 trauma victims and applied a structured clinical schedule (CAPS-2) to their psychiatric evaluations prepared for the court on two separate occasions approximately one year apart.

Results

Post-traumatic stress disorder and depression were the commonest diagnoses, occurring in 39% and 16% of the victims respectively when they were first assessed. Most had improved between the assessments and this was especially the case for the re-experiencing of the trauma and over-arousal, but less so for avoidance; 20% of subjects showed no improvement, often being handicapped by secondary psychiatric illness.

Conclusion

Traumatised victims generally showed recovery in the 2–3 years after the trauma, but this was slow and was not universal.

Type
Papers
Copyright
Copyright © 1995 The Royal College of Psychiatrists 

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

Agras, W. S., Chapin, N. & Oliveau, D. C. (1972) The natural history of phobia: course and prognosis. Archives of General Psychiatry, 26, 315317.Google Scholar
American Psychiatric Association (1987) Diagnostic and Statistical Manual of Mental Disorders (3rd edn, revised) (DSM–III–R). Washington, DC: APA.Google Scholar
American Psychiatric Association (1994) Diagnostic and Statistical Manual of Mental Disorders (4th edn) (DSM-IV). Washington, DC: American Psychiatric Association.Google Scholar
Angst, J. (1988) Clinical Course of Affective Disorders. In Depressive Illness: Prediction of Course and Outcome (1st edn) (eds Helgason, T. & Daly, R. J.), pp. 145. Berlin: Springer.Google Scholar
Beck, A. T., Ward, C. H., Mendelson, M., et al (1961) An inventory for measuring depression. Archives of General Psychiatry, 4, 461571.Google Scholar
Blake, D., Weathers, L. N., Kalcupek, D., et al (1990) Clinician-Administered PTSD Scale (CAPS). Boston: National Center for Post-traumatic Stress Disorder.Google Scholar
Blank, A. S. (1993) The longitudinal course of post-traumatic stress disorder. In Post-traumatic Stress Disorder: DSM–IV and beyond (1st edn) (eds Davidson, J. R. T. & Foa, E. B.), pp. 322. Washington, DC: American Psychiatric Press.Google Scholar
Bremner, J. D., Southwick, S. M., Johnson, D. R., et al (1993) Childhood physical abuse and combat-related post-traumatic stress disorder in Vietnam veterans. American Journal of Psychiatry, 150, 235239.Google Scholar
Davidson, J., Swartz, M. & Storck, M. (1985) A diagnostic and family study of post-traumatic stress disorder. American Journal of Psychiatry, 142, 9093.Google Scholar
Dooley, E. & Gunn, J. (1995) The psychological effects of disaster at sea. British Journal of Psychiatry, 167, 233237.Google Scholar
Duggan, C., Marks, I. & Richards, D. (1993) Clinical audit of behaviour therapy training of nurses. Health Trends, 25, 2530.Google Scholar
Gleser, G. C., Green, B. L. & Winget, C. N. (1981) Prolonged Psychosocial Effects of Disaster: A Study of Buffalo Creek. New York: Academic Press.Google Scholar
Horowitz, M. J., Wilner, N. & Acvarez, W. (1979) Impact of events scale: a measure of subjective stress. Psychosomatic Medicine, 41, 209218.Google Scholar
Jones, J. C. & Barlow, D. H. (1990) Etiology of posttraumatic stress disorder. Clinical Psychology Review, 10, 299328.Google Scholar
Joseph, S., Yule, W. & Williams, R. (1994) The Herald Free Enterprise disaster: the relationship of intrusion and avoidance to subsequent depression and anxiety. Behaviour Research and Therapy, 32, 115117.Google Scholar
McFarlane, A. C. (1988) The phenomenology of posttraumatic stress disorders following a natural disaster. Journal of Nervous and Mental Diseases, 170, 2229.Google Scholar
Mullen, P. E., Martin, J. L., Anderson, J. C., et al (1994) The effect of child sexual abuse on social, interpersonal and sexual function in adult life. British Journal of Psychiatry, 165, 3547.Google Scholar
Ooden, M., Wright, M. & Crowther, W. (1989) Report of an arbitrarian concerning claims of ten passengers who survived the capsize of the “Herald of Free Enterprise”. Personal and Medical Injuries Law Letter, 5, 3739.Google Scholar
Pitman, R. K., Altman, B., Greenwald, E., et al (1991) Psychiatric complications during flooding therapy for posttraumatic stress disorder. Journal of Clinical Psychiatry, 51, 1720.Google Scholar
Rosser, R., Dewar, S. & Thompson, J. (1991) Psychological aftermath of the King's Cross fire. Journal of the Royal Society of Medicine, 84, 48.Google Scholar
Schwarz, E. D. & Kowalski, J. M. (1992) Malignant memories – reluctance to utilize mental health services after a disaster. Journal of Nervous and Mental Diseases, 180, 767772.Google Scholar
Submit a response

eLetters

No eLetters have been published for this article.