Posttraumatic stress and other health consequences of catastrophic avalanches: A 16-year follow-up of survivors

Þórðardóttir, Edda Björk; Valdimarsdóttir, Unnur; Hansdóttir, Ingunn; Resnick, Heidi S.; Shipherd, Jillian C.; Guðmundsdóttir, Berglind

doi:10.1016/j.janxdis.2015.03.005

Cited by 29 publications

(30 citation statements)

References 44 publications

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“…A previous study on the avalanche-affected populations found no difference between avalanche survivors and a non-exposed population with regard to SES (Thordardottir et al, 2015 ). When assessing childhood survivors specifically, we found no significant difference between the avalanche survivors and the non-exposed population with regard to current educational level ( χ 2 (2)=2.28, p =0.320), current personal finances ( χ 2 (2)=3.52, p =0.172), or current employment status ( χ 2 (2)=0.56, p =0.754).…”

Section: Methodsmentioning

confidence: 88%

“…Response rate was 66% (108/163; 48% females, 52% males). More information about the data collection process is available in Thordardottir et al ( 2015 ).…”

Section: Methodsmentioning

confidence: 99%

“…When assessing childhood survivors specifically, we found no significant difference between the avalanche survivors and the non-exposed population with regard to current educational level ( χ 2 (2)=2.28, p =0.320), current personal finances ( χ 2 (2)=3.52, p =0.172), or current employment status ( χ 2 (2)=0.56, p =0.754). The characteristics of the unexposed population are reported in Thordardottir et al ( 2015 ).…”

Section: Methodsmentioning

confidence: 99%

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Sixteen-year follow-up of childhood avalanche survivors

Þórðardóttir

Valdimarsdóttir

Hansdóttir

et al. 2016

European Journal of Psychotraumatology

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BackgroundEvery year a substantial number of children are affected by natural disasters worldwide. However, data are scarce on long-term psychological impact of natural disasters on children's health. Identifying risk factors and outcomes associated with the long-term sequelae of posttraumatic stress disorder (PTSD) can provide a gateway to recovery as well as enhancement of preventive measures.ObjectiveAmong childhood avalanche survivors, we aimed to investigate risk factors for PTSD symptoms and the relationship between socioeconomic status (SES) and PTSD symptoms in adulthood.MethodsChildhood survivors (aged 2–19 at the time of exposure) of two avalanches were identified through nationwide registers 16 years later. The Posttraumatic Diagnostic Scale was used to assess current PTSD symptoms. One-way ANOVA was used to explore PTSD symptoms by background and trauma-specific factors, as well as associations with current SES. Predictors of PTSD symptoms were examined by multivariable regression analysis.ResultsResponse rate was 66% (108/163). Results from univariate ANOVA analysis revealed that female sex was associated with PTSD symptoms (F=5.96, p<0.05). When adjusted for age and sex, PTSD symptoms were associated with lower education (F=7.62, p<0.001), poor financial status (F=12.21, p<0.001), and unemployment and/or disability (F=3.04, p<0.05). In a multivariable regression model, when adjusting for age and sex, lack of social support (t=4.22, p<0.001) and traumatic reactions of caregivers (t=2.49, p<0.05) in the aftermath of the disaster independently predicted PTSD 16 years post-trauma.ConclusionsLingering PTSD symptoms after childhood exposure to a disaster may negatively influence socioeconomic development in adulthood. Strengthening children's support systems post-disaster may prevent the long-term sequelae of symptoms.Highlights of the articlePTSD symptoms following avalanche exposure during childhood were associated with poorer socioeconomic status in adulthood.Lack of social support and traumatic reactions of caregivers in the aftermath of avalanches predicted PTSD symptoms among childhood survivors 16 years later.Findings underscore the importance of strengthening children's support systems in the aftermath of disasters.

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Section: Methodsmentioning

confidence: 88%

“…Response rate was 66% (108/163; 48% females, 52% males). More information about the data collection process is available in Thordardottir et al ( 2015 ).…”

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

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Sixteen-year follow-up of childhood avalanche survivors

Þórðardóttir

Valdimarsdóttir

Hansdóttir

et al. 2016

European Journal of Psychotraumatology

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“…A majority (60–90%) of individuals will experience a traumatic event in their lifetime (Kessler et al, 2017; Kilpatrick et al, 2013; Thordardottir et al, 2015). While most individuals adjust to the trauma and recover from the emotional strain that follows, it remains unexplained why some suffer more than others and experience mental health decline, even to the point of suicidal risk .…”

mentioning

confidence: 99%

The association between different traumatic life events and suicidality

Ásgeirsdóttir

Valdimarsdóttir

Thorsteinsdottir

et al. 2018

European Journal of Psychotraumatology

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Background: Traumatic life events have been associated with increased risk of various psychiatric disorders, even suicidality. Our aim was to investigate the association between different traumatic life events and suicidality, by type of event and gender. Methods: Women attending a cancer screening programme in Iceland (n = 689) and a random sample of men from the general population (n = 709) were invited to participate. In a web-based questionnaire, life events were assessed with the Life Stressor Checklist – Revised, and the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) criterion was used to identify traumatic life events. Reports of lifetime suicidal thoughts, self-harm with suicidal intent and suicide attempt were considered as lifetime suicidality. We used Poisson regression, adjusted for demographic factors, to express relative risks (RRs) as a measure of the associations between traumatic events and suicidality. Results: Response rate was 66% (922/1398). The prevalence of lifetime traumatic events was 76% among women and 77% among men. Lifetime suicidality was 11% among women and 16% among men. An overall association of having experienced traumatic life events with suicidality was observed [RR 2.05, 95% confidence interval (CI) 1.21–3.75], with a stronger association for men (RR 3.14, 95% CI 1.25–7.89) than for women (RR 1.45, 95% CI 0.70–2.99). Increased likelihood for suicidality was observed among those who had experienced interpersonal trauma (RR 2.97, 95% CI 1.67–5.67), childhood trauma (RR 4.09, 95% CI 2.27–7.36) and sexual trauma (RR 3.44, 95% CI 1.85–6.37), with a higher likelihood for men. In addition, an association between non-interpersonal trauma and suicidality was noted among men (RR 3.27, 95% CI 1.30–8.25) but not women (RR 1.27, 95% CI 0.59–2.70). Conclusion: Findings indicate that traumatic life events are associated with suicidality, especially among men, with the strongest association for interpersonal trauma.

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“…All casualties, injured or uninjured, may suffer from a prolonged posttraumatic stress syndrome (Peck et al, 1996 ; Thordardottir et al, 2015 ). The use of crisis intervention services (CIS) should be considered as soon as possible (Peleg, 2013 ; Carter and Amlot, 2016 ).…”

Section: Discussionmentioning

confidence: 99%

Management of Multi-Casualty Incidents in Mountain Rescue: Evidence-Based Guidelines of the International Commission for Mountain Emergency Medicine (ICAR MEDCOM)

Blancher

Albasini²,

Elsensohn³

et al. 2018

High Altitude Medicine & Biology

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Blancher, Marc, François Albasini, Fidel Elsensohn, Ken Zafren, Natalie Hölzl, Kyle McLaughlin, Albert R. Wheeler III, Steven Roy, Hermann Brugger, Mike Greene, and Peter Paal. Management of multi-casualty incidents in mountain rescue: Evidence-based guidelines of the International Commission for Mountain Emergency Medicine (ICAR MEDCOM). High Alt Med Biol. 19:131–140, 2018.Introduction: Multi-Casualty Incidents (MCI) occur in mountain areas. Little is known about the incidence and character of such events, and the kind of rescue response. Therefore, the International Commission for Mountain Emergency Medicine (ICAR MEDCOM) set out to provide recommendations for the management of MCI in mountain areas.Materials and Methods: Details of MCI occurring in mountain areas related to mountaineering activities and involving organized mountain rescue were collected. A literature search using (1) PubMed, (2) national mountain rescue registries, and (3) lay press articles on the internet was performed. The results were analyzed with respect to specific aspects of mountain rescue.Results: We identified 198 MCIs that have occurred in mountain areas since 1956: 137 avalanches, 38 ski lift accidents, and 23 other events, including lightning injuries, landslides, volcanic eruptions, lost groups of people, and water-related accidents.Discussion: General knowledge on MCI management is required. Due to specific aspects of triage and management, the approach to MCIs may differ between those in mountain areas and those in urban settings.Conclusions: Mountain rescue teams should be prepared to manage MCIs. Knowledge should be reviewed and training performed regularly. Cooperation between terrestrial rescue services, avalanche safety authorities, and helicopter crews is critical to successful management of MCIs in mountain areas.

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Posttraumatic stress and other health consequences of catastrophic avalanches: A 16-year follow-up of survivors

Cited by 29 publications

References 44 publications

Sixteen-year follow-up of childhood avalanche survivors

Sixteen-year follow-up of childhood avalanche survivors

The association between different traumatic life events and suicidality

Management of Multi-Casualty Incidents in Mountain Rescue: Evidence-Based Guidelines of the International Commission for Mountain Emergency Medicine (ICAR MEDCOM)

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