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A follow-up study of 120 adult survivors of the Buffalo Creek dam collapse of 1972 showed group changes 14 years after the event. Decreased symptoms were noted in all areas, although significant psychopathology remained in about one-quarter of the survivors. A small group with delayed onset of symptoms was identified.

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The present study used a model of individual response to catastrophic events to guide the analysis of data collected from survivors of the Beverly Hills Supper Club fire of 1977. One hundred seventeen subjects were seen 1-year postfire, and 67 subjects were reinterviewed a year later. Hierarchical regression analyses for multiple outcome measures showed that the most predictable symptoms at 1 year were those associated with stress disorders. The independent variables contributing most to that prediction were aspects of the individual's fire experience (e.g., bereavement and injury). Predictability shifted somewhat in the second year for the outcome measures: Secondary measures (those with a Hostility component) became more predictable. Overall, up to 45% of outcome variance 1-year postfire could be explained by the individual's experiences surrounding the fire. The role of mediating variables was also addressed.

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Following a devastating fire at the Beverly Hills Supper Club, mental health professionals developed an outreach program to identify survivors at risk for long-term impairment and to offer preventive services. Differences among four outreach modes, in terms of impairment and efficiency of effort, are discussed in the context of a general survivors' reluctance to utilize mental health resources.