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

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.

Social and occupational factors associated with psychological distress and disorder among disaster responders: a systematic review

“…Several studies demonstrated significant differences in stress reactions between professional and non-professional (volunteer) responders. In several studies professionals had lower levels of post-traumatic stress disorder (PTSD), preoccupation and unpleasant thoughts [ 14 – 18 ], and found it easier to talk about their experiences than non-professionals [ 19 ] although one study found that professional fire-fighters had greater levels of PTSD than volunteers [ 20 ]. A small number of studies showed differences between occupational groups.…”

“…Some studies found prior experience was associated with greater distress [ 45 , 46 ]. However several studies found no significant wellbeing differences between those who were involved in previous disasters and those who were not [ 14 , 32 , 33 , 47 – 49 ] and one study found that previous experience was a protective factor [ 50 ]. It may be that the impact of previous disaster experience is mitigated by other factors: for example, one study [ 49 ] suggested that body handlers are a resilient group and have protective factors such as a strong sense of community.…”

Depression after exposure to stressful events: lessons learned from the severe acute respiratory syndrome epidemic

“…The mental disorder that is most commonly linked, in the literature, to disaster-related experiences is posttraumatic stress disorder (PTSD), but studies have also found that, among those with PTSD after a disaster, comorbid depression is common [9,10]. A few studies [7,[11][12][13], including one of Hong Kong's SARS outbreak [7], have specifically examined levels of depressive symptoms among health care workers affected by disaster. Health care workers in Hong Kong who had worked closely with patients with SARS during the SARS outbreak were found to have relatively high levels of depressive symptoms 1 year later [7].…”

Impact of the <em>Body Worlds]</em> Exhibition on Mental Health Indices and Death-Related Fears

“…In addition, other groups are likely to be exposed to cadavers (for example, first responders or military personnel), 7,8 in which case the use of a controlled and sterile setting for exposure to cadavers may help reduce probable psychological distress.…”