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PubMed2004

Why people 'freeze' in an emergency: temporal and cognitive constraints on survival responses.

BACKGROUND: Many witnesses attest that victims of a disaster often perish despite reasonable possibilities for escaping because their behavior during the initial moments of the accident was inappropriate to the situation. Frequently witnesses report victims 'freezing' in the face of danger. OBJECTIVE: The aim of this paper was to identify the possible factors underpinning 'freezing' behavior in disaster victims. METHODS: Witness testimonies, survivor debriefings, and official inquiry reports from shipwreck and aircraft emergencies were analyzed for their behavioral content. RESULTS: It was found that 'freezing' behavior was a frequently cited response by witnesses to a disaster. 'Freezing' causes evacuation delays which increase the danger, establishing a closed loop process and further extending evacuation delays. This behavior can be accounted for by considering the temporal constraints on cognitive information processing in a rapidly unfolding, real-time environment. CONCLUSION: Cognitive limitations help to explain why survival training works and why there is a need for a survival culture to be developed. They also highlight the need to understand the behavior of children under threat as being different from that of adults due to the different stages of their neurological and cognitive development. There are implications for the development of proactive, rather than passive, life support equipment.

Accidents, Aviation↗
PubMed1984

Stress levels and health status of victims of a natural disaster.

Bereaved, property loss, and control groups (N = 155) were compared 11 months after the volcanic eruption of Mt. St. Helens using standardized instruments and structured interviews. It was hypothesized that the greater the loss the greater the stress and the poorer the health. Bereaved subjects reported significantly higher levels of stress and lower levels of mental health, but not physical health. Persons who lost their permanent homes reported high rates of stress, but did not report significantly higher levels of depression, somatization, or poorer physical health. Conceptual and methodological implications are discussed.

Adolescent↗
PubMed2003

Perception of risk and subjective health among victims of the Chernobyl disaster.

Several studies have demonstrated that the nuclear power plant accident at Chernobyl in 1986 had a strong impact on the subjective health of the inhabitants in the surrounding regions and that the majority of these health complaints appear to be stress-related. An epidemiological survey among the adult population of the Gomel region in Belarus near Chernobyl showed higher rates of self-reported health problems, psychological distress and medical service use in this region than in a comparable unexposed region. This paper presents an analysis of data on cognitive factors that were collected in this study. The findings support the hypothesis that cognitive variables such as risk perception and sense of control play an important role as mediating factors in the explanation of the observed health differences between the exposed and non-exposed regions. A tentative model is presented to further clarify the role of risk perception in the occurrence of non-specific health complaints after such ecological disasters.

Adult↗
PubMed1992

Multiple diagnoses in posttraumatic stress disorder in the victims of a natural disaster.

A population of the fire fighters who had been exposed to a natural disaster were screened using the General Health Questionnaire 4, 11, and 29 months after a natural disaster. On the basis of these data, a high-risk group of subjects who had scored as cases and probable cases and a symptom-free comparison group were interviewed using the Diagnostic Interview Schedule 42 months after the disaster. The prevalence of posttraumatic stress disorder (PTSD), affective disorders, and anxiety disorders was examined. Only 23% of the 70 subjects who had developed a PTSD did not attract a further diagnosis, with major depression being the most common concurrent disorder. Comorbidity appeared to be an important predictor of chronic PTSD, especially with panic disorder and phobic disorders. The subjects who had only a PTSD appeared to have had the highest exposure to the disaster. Adversity experienced both before and after the disaster influenced the onset of both anxiety and affective disorders.

Adult↗
PubMed1982

A computer-based analysis of injuries sustained by victims of a major air disaster.

A computer-based analysis of the injury patterns sustained by victims in the DC-10 aircraft that crashed into Mt. Erebus, Antarctica, On November 28, 1979, is presented. The distribution of these injury patterns supports the hypothesis that at impact the plane was in a nose-high attitude with respect to the slope and the impact point was the underside of the rear section of the fuselage.

Accidents, Aviation↗
PubMed2003

School reactivation programs after disaster: could teachers serve as clinical mediators?

Mental health interventions are known to prevent the progressive worsening of symptoms in young victims of disaster and, subsequently, to prevent a decline in their academic performance and self-esteem [8,46]. The tremendous needs that emerge after a disaster and the reluctance shown by most victims to seek professional help require mental health leaders to adopt a proactive stance and implement relief programs in the child's most natural setting. The school as institution and the teachers as empowered mediators offer the appropriate conditions for implementing an effective large-scale intervention program. Well-intentioned child professionals who deal with school administrators and teachers must take into account that, as stated by Pfefferbaum et al [25], "avoidance is at the core of the posttraumatic response, and it sometimes involves avoidance of treatment." For child mental health professionals, routine collaboration across systemic boundaries may prove critical for the rapid mobilization of resources during mass traumatic emergencies. Further studies are needed to identify the protective and risk factors that predict resilience and pathology, respectively, and factors that facilitate or aggravate factors that predict improvement, resistance, and deterioration in response to treatment.

Analysis of Variance↗
PubMed1994

Neurological sequelae of the operation "baby lift" airplane disaster.

The aircraft disaster of the first flight of Operation "Baby Lift", which departed from Saigon, Vietnam, April 4, 1975, was survived by 149 orphaned children on their way to adoptive homes in the West. It had 157 passenger fatalities. The aircraft disaster exposed the surviving children to a complex disaster environment in which subatmospheric decompression, hypoxia, and deceleration were experienced, many children suffered a transient unconsciousness. We examined 135 surviving children between 1978 and 1985. The U.S. resident children were examined in the years 1979 to 1982 at an average age of 8 years and 6 months. They displayed the following symptomatology: attention deficit (> 75%), hyperactivity (> 65%), impulse disorder (> 55%), learning disabilities (> 35%), speech and language pathology (> 70%), and soft neurological signs (> 75%). The European children were examined in the years 1983 to 1985. On arrival at the adoptive home, 2 weeks after the accident they displayed the following symptomatology: muscle hypotonia (26%), seizures (2.5%), and regressed developmental milestones (33%). At the time of the diagnostic evaluations (1983 to 1985) the average age was 11 years and 8 months. They displayed the following symptomatology: attention deficit (59%), hyperactivity (52%), impulse disorder (48%), learning disabilities (43%), soft neurological signs (43%), epilepsy (16%), and speech and language pathology (34%). We conclude that a complex disaster environment can cause brain damage in children without prolonged unconsciousness, and that victims of disasters require a thorough evaluation from a multidisciplinary team.

Accidents, Aviation↗
PubMed2004

Decision-making capacity and disaster research.

The extent to which victims of a disaster are able to make capacitated and voluntary decisions to enroll in research is an important and virtually unexplored question. Although there are no compelling data to suggest that experiencing a severe trauma, in and of itself, renders all or even most individuals incapable of making autonomous decisions, the assessment of decision-making capacity (DMC) for research participation warrants serious consideration. This paper provides a framework for and procedural approach to the assessment of DMC in research with individuals exposed to disaster. Particular attention is paid to the implementation of additional safeguards to protect subjects who are vulnerable by virtue of impaired DMC. Recommendations are offered to clinical investigators, ethical review boards, and policymakers with regard to the design, review, and conduct of research in the aftermath of disaster.

Decision Making↗