Coping, functioning, and adjustment of rescue workers after the Oklahoma City bombing

Abstract

Studies have not previously considered postdisaster adjustment in the context of psychiatric disorders. After the Oklahoma City bombing, a volunteer sample of 181 firefighters who served as rescue and recovery workers was assessed with a structured diagnostic interview. The firefighters had relatively low rates of posttraumatic stress disorder (PTSD) and described little functional impairment, positive social adjustment, and high job satisfaction. PTSD was associated with reduced job satisfaction and functional impairment, providing diagnostic validity. Turning to social supports, seeking mental health treatment, and taking medication were not widely prevalent coping responses. Postdisaster alcohol use disorders and drinking to cope were significantly associated with indicators of poorer functioning. Surveillance for problem drinking after disaster exposure may identify useful directions for intervention.

Alcohol Use, Mental Health Status and Psychological Well-being 2 Years After the World Trade Center Attacks in New York City

“…For example, alcohol use may dampen the physiological responses related to PTSD such as hyperarousal or re-experiencing. Such self medication behavior, however, is typically seen as an avoidance coping strategy, which is usually not associated with positive outcomes (23,24,54,56). Thus, it is entirely possible that attempts at alcohol withdrawal may actually intensify symptoms for individuals with PTSD or depression (15,18,55).…”

“…These reactions may interfere with the resolution of the traumatic experience, prolonging symptoms following the disaster. Finally, studies assessing the link between PTSD and substance use within the context of the WTCD have shown that even when individuals no longer meet criteria for the disorder, their substance use remained elevated in the post disaster period, pointing to the addictive properties of alcohol, cigarettes, and illicit drugs (17,18,56).…”

Dissociative symptoms mediate the relation between PTSD symptoms and functional impairment in a sample of military members, veterans, and first responders with PTSD

“…physical assault), with the exception of sexual assault or molestation (Prigerson et al, 2001). Similarly, first responders involved in rescue and recovery following disasters or terrorist attacks also experience significant functional impairment (North et al, 2002; Ruggero et al, 2013). To illustrate, firefighters who were diagnosed with PTSD following a shared traumatic experience (the Oklahoma City Bombing) reported greater interference in their daily activities, relationships, and decreased job satisfaction in comparison to firefighters who were exposed to the same traumatic event but did not have PTSD (North et al, 2002).…”

The Impact of the 1995 Oklahoma City Bombing on the Partners of Firefighters

“…[1][2][3][4][5][6][7][8][9][10][11][12][13] For direct victims, exposure may be sudden, unanticipated, and life threatening. For professional rescuers, on the other hand, exposure to traumatic events is an anticipated part of their job.…”

“…9,10 Therefore, the exposure and emotional status of these significant others were of interest. The Oklahoma City Fire Department recognized the importance of significant others in the general wellbeing of the force and joined our efforts to explore the impact of the bombing in a volunteer sample of spouses and intimate partners of Oklahoma City firefighters who participated in the rescue.…”