The Phenomenology of Post-Traumatic Stress Disorder

Abstract

This study analyses and categorises the subjective experiences and psychological symptoms of those involved in a major disaster but not themselves physically injured. It examines the concept of post-traumatic stress disorder (PTSD) and relates it to other psychiatric diagnoses and also to the particular nature of the disaster. 70 police officers are the subjects of this study, 59 men and 11 women, all of them involved in the Hillsborough Football Stadium Disaster. Assessment included detailed psychiatric history and examination with an account of the events experienced by the informants and their psychological reaction to this at the time and subsequently. Psychiatric diagnosis was made and quantified measurements were also recorded, including a rating scale for the criteria of PTSD, the General Health Questionnaire and rating scales for depression and anxiety. Severity of PTSD symptoms was associated with higher scores on rating scales for both depressive and anxiety symptomatology. Subjective depressive symptoms and depersonalisation were associated with severity of PTSD. Frustrated helplessness was a recurring theme in the psychopathology. Alcohol consumption of those who were already drinkers increased. Social functioning at work and in marriage deteriorated with increased severity of PTSD. Although PTSD has features that distinguish it from other conditions, the degree of distress and long-term disability is more related to depressive symptomatology than to the severity of PTSD itself.

Rescuers at risk: a systematic review and meta-regression analysis of the worldwide current prevalence and correlates of PTSD in rescue workers

“…After applying the inclusion/exclusion criteria, 29 studies were selected. However, one study [33] that used an unspecified diagnostic interview for PTSD and reported an unusually high current prevalence of 85.7% among a non-representative group of self-selected police officers was considered an outlier and excluded from the analyses. Our final pool of studies comprised 28 articles, with 40 samples and 20,424 rescue workers from 14 countries of all continents [6, 8–10, 12, 34–56] (these studies were included in the meta-analysis).…”

Differences in PTSD Prevalence and Associated Risk Factors Among World Trade Center Disaster Rescue and Recovery Workers

“…An assessment 7-13 weeks after Hurricane Katrina, however, documented no disparity in the prevalence of PTSD among police and firefighters (19% and 22%, respectively) (31). These findings may be explained by other experiences known to increase risk for psychological distress, such as civil disobedience, hostility, and aggression toward police (32), all widely depicted in post-Katrina media coverage. Lack of access to mental health services may also account for increased risk of PTSD among sanitation workers, construction/engineering workers, and unaffiliated volunteers.…”

Stressful life experiences, alcohol consumption, and alcohol use disorders: the epidemiologic evidence for four main types of stressors

“…These have included studies of natural disasters such as exposure to flood (North et al 2004), volcano (Adams and Adams 1984), earthquakes (Shimizu et al 2000), and hurricanes (Cerda et al 2011; Kohn et al 2005). Studies have also addressed man-made disasters such as exposure to mass shootings (North et al 1994; Smith et al 1999), fire/exposure to grotesque death (Green et al 1985; Reijneveld et al 2003; Sims and Sims 1998), ferry disaster (Joseph et al 1993), and nuclear accidents (Kasl et al 1981). In studies whose timeframe is a year or less, these studies consistently indicate post-disaster increases in alcohol consumption (Joseph et al 1993; Kasl et al 1981; Kohn et al 2005; Reijneveld et al 2003; Sims and Sims 1998; Smith et al 1999).…”

“…Studies have also addressed man-made disasters such as exposure to mass shootings (North et al 1994; Smith et al 1999), fire/exposure to grotesque death (Green et al 1985; Reijneveld et al 2003; Sims and Sims 1998), ferry disaster (Joseph et al 1993), and nuclear accidents (Kasl et al 1981). In studies whose timeframe is a year or less, these studies consistently indicate post-disaster increases in alcohol consumption (Joseph et al 1993; Kasl et al 1981; Kohn et al 2005; Reijneveld et al 2003; Sims and Sims 1998; Smith et al 1999). Studies with multiple and/or longer follow-ups generally find attenuation of this relationship over time (Joseph et al 1993).…”