Long-term effects of the Entre-os-Rios tragedy on grief and traumatic stress symptoms

Abstract

In 2001, in Entre-os-Rios, Portugal, a bridge fell on Douro River; all 59 passengers from 1 bus and 3 cars died and 36 bodies have never been recovered. The objective is to reveal the cumulative risk from multiple losses and unrecovered bodies, 10 years after, compared with grievers from road accidents. There are 2 groups of relatives of victims: from this tragedy (n = 20), with at least 1 unrecovered body; and from road traffic accidents (n = 20), with the same time after loss. The prevalence of prolonged grief was 95% and for traumatic stress was 70%. The associated factors of multiple losses and unrecovered bodies increase the long-term risk (relative risk = 1.6 to 2.8; R = .20 to .28) for prolonged and traumatic grief, providing evidence that the absence of body is an important long-term factor.

Factors Associated with Complicated Grief Following a Railway Tragedy

“…These results are consistent with the notion that bereavement in the context of disaster accentuates the stress reactions and defense mechanisms of grief, such as blaming oneself or others ( Johannesson et al, 2011 ; Kuo et al, 2003 ; Shultz et al, 2012 ). Injuries, witnessing people dying and the accumulation of losses (e.g., house, furniture, sources of income) have all been associated with the development of CG ( Cardoso et al, 2017 ; Ghaffari-Nejad et al, 2007 ; Johannesson et al, 2009 ; Hagl et al, 2015 ; Shultz et al, 2012 ).…”

“…Compared to natural disasters, those of a technological nature have long-lasting consequences on psychological health ( Bromet et al, 2011 ; Chung & Kim, 2010 ; Morgan & Bhugra, 2010 ). The prevalence of CG in a post-disaster context varies, ranging from 10% to 20% ( Rynearson et al, 2002 ) and up to 95% of bereaved people ( Cardoso et al, 2017 ; Djelantik et al, 2020 ). Complicated grief in the context of train accidents has received little attention: in the 39 studies focused on grief in the wake of a disaster ( Maltais et al, 2020 ), only one concerned a train derailment ( Sigh & Raphael, 1981 ).…”

Toward an integrated understanding of traumatic grief: Connecting prolonged grief, posttraumatic stress, and depression symptoms in traumatically and non-traumatically bereaved individuals

“…In such cases, the studies with the highest number of bereaved individuals or studies providing the most relevant data were included. The characteristics of all 25 included studies can be found in Table 2 (Bartik, Maple, Edwards, & Kiernan, 2013;Cardoso et al, 2017;Dyregrov, Dyregrov, & Kristensen, 2015;Dyregrov et al, 2003;Harms et al, 2015;Hu et al, 2015;Kristensen, Heir, Herlofsen, Langsrud, & Weisaeth, 2012;Kristensen, Weisaeth, Hussain, & Heir, 2015;J. Li, Chow, Shi, & Chan, 2015;McDevitt-Murphy, Neimeyer, Burke, Williams, & Lawson, 2012;Mitchell, Kim, Prigerson, & Mortimer-Stephens, 2004;Morina & Emmelkamp, 2012;Morina, Rudari, Bleichhardt, & Prigerson, 2010;Morina, Von Lersner, & Prigerson, 2011;Neria et al, 2007;Prigerson, Bridge, et al, 1999;Schaal, Elbert, & Neuner, 2009;Shear, Jackson, Essock, Donahue, & Felton, 2006;Spooren, Henderick, & Jannes, 2001;Stammel et al, 2013;Tsutsui, Hasegawa, Hiraga, Ishiki, & Asukai, 2014;van Denderen, de Keijser, Huisman, & Boelen, 2016;Williams & Rheingold, 2015;Xu, Herrman, Bentley, Tsutsumi, & Fisher, 2014;Yun, Huh, Han, Huh, & Chae, 2018).…”

“…Most studies assessing psychopathology following unnatural losses have been carried out after specific events such as a large accident, e.g., Cardoso, Ferreira, Rocha, Leite, and Almeida (2017), a natural disaster, e.g., Hu, Li, Dou, and Li (2015), or a specific terrorism incident, e.g., Neria et al (2007). If we were able to investigate the differences and similarities of prevalence rates and loss-related characteristics between studies assessing PGD following unnatural losses in a metaanalysis, we might be able to identify vulnerable groups of bereaved individuals.…”

“…Investigating the heterogeneity of the studies in a meta-analysis, such as the degree to which the prevalence is influenced by the precise cause of death, can help to identify the most vulnerable group of bereaved individuals. Studies investigating PGD prevalence after unnatural losses have mostly been conducted in homogeneous samples, such as individuals who lost loved ones in a large accident, e.g., Cardoso et al (2017), a natural disaster, e.g., Hu et al (2015), or a specific terrorism incident, e.g., Neria et al (2007). However, substantial heterogeneity in PGD prevalence rates can be expected across studies due to differences in study methodology, sample demographic features, and loss-related characteristics.…”