Annelieke N. Drogendijk

The Effects of Disaster Exposure and Post-Disaster Critical Incidents on Intrusions, Avoidance Reactions and Health Problems Among Firefighters: A Comparative Study

Firefighters are at risk to be confronted with critical incidents and disasters. This study focused on the predictive value of these variables and their interaction effect for intrusions, avoidance reactions, and health problems among firefighters 18 months post-disaster (N = 639). Furthermore, the course of intrusions, avoidance reactions, and health problems in the period 2–3 weeks to 18 months post-disaster was assessed. Health problems were compared with those of non-affected firefighters (N = 132). Results showed that only disaster exposure and critical incidents accounted for a significant but small proportion of the variance (R 2 < .07) of intrusions, avoidance reactions and health problems among the affected firefighters. Health problems among affected firefighters did not decline in the period 2–3 weeks–18 months post-disaster, in contrast to intrusions and avoidance reactions. Health problems of both groups were comparable at T2. Results suggest that resilience in firefighters is rather high.

Psychosocial care to affected citizens and communities in case of CBRN incidents: A systematic review

Disasters are associated with a substantial psychosocial burden for affected individuals (including first responders) and communities. Knowledge about how to address these risks and problems is valuable for societies worldwide. Decades of research into post-disaster psychosocial care has resulted in various recommendations and general guidelines. However, as CBRN (chemical, biological, radiological, nuclear) events form a distinctive theme in emergency planning and disaster preparedness, it is important to systematically explore their implications for psychosocial care. The aim of this study is to answer two questions: 1). To what extent does psychosocial care in the case of CBRN events differ from other types of events? 2). How strong is the scientific evidence for the effectiveness of psychosocial care interventions in the context of a CBRN event? A systematic literature review was conducted. Searches were performed in Medline, PsychINFO, Embase and PILOTS. Studies since January 2000 were included and evaluated by independent reviewers. The 39 included studies contain recommendations, primarily based on unsystematic literature reviews, qualitative research and expert opinions. Recommendations address: 1) public risk- and crisis communication, 2) training, education and exercise of responders, 3) support, and 4) psychosocial counselling and care to citizens and responders. Although none of the studies meet the design criteria for effectiveness research, a substantial amount of consensus exists on aspects relevant to CBRN related psychosocial care. Recommendations are similar or complementary to general post-disaster psychosocial care guidelines. Notable differences are the emphasis on risk communication and specific preparation needs. Relevant recurring topics are uncertainty about contamination and health effects, how people will overwhelm health care systems, and the possibility that professionals are less likely to respond. However, the lack of evidence on effectiveness makes it necessary to be careful with recommendations. More evaluation research is absolutely needed.

Lack of perceived social support among immigrants after a disaster: comparative study

BACKGROUND Disaster research suggests that immigrant groups who are affected by a disaster receive less emotional support than their native counterparts. However, it is unclear to what extent these differences can be attributed to post-disaster mental health problems or whether they were present before the event. AIMS To examine the association between lack of social support, immigration status and victim status, as well as differences in support between immigrants and Dutch natives with disaster-related post-traumatic stress disorder (PTSD). METHOD Social support and psychological distress were assessed among immigrants and Dutch natives, among affected and non-affected individuals 4 years post disaster. Post-traumatic stress disorder was examined in the affected groups. RESULTS Affected immigrants more often lacked various kinds of perceived social support compared with affected Dutch natives. Remarkably, we found no differences in support between affected immigrants and non-affected immigrants. Immigrants with PTSD differ on only two out of six aspects of support from the Dutch natives with PTSD. CONCLUSIONS Results clearly indicate that differences in support between immigrants and Dutch natives are not so much a consequence of the disaster but were largely present before the disaster.

Acculturation and post-disaster mental health problems among affected and non-affected immigrants: A comparative study

BACKGROUND It is unknown to what extent acculturation among disaster-affected immigrants is associated with mental health problems (MHP) compared to non-affected immigrants. METHODS We examined the associations between acculturation and post-disaster MHP among affected and non-affected immigrants in The Netherlands. RESULTS Among the affected group, keeping norms and values of original culture and limited skills to cope with the demands of the new society were independently associated with PTSD-symptomatology, anxiety, depression, hostility, and somatic problems at 18 months post-event. In the non-affected comparison group no associations were found. Interestingly, levels of acculturation did not differ between both groups, in contrast to MHP. LIMITATIONS The acculturation levels could be influenced by the experience of a disaster. However, levels did not differ statistically between the study groups. Furthermore, the groups were reasonably small and the response rates were, although not uncommon in health studies among immigrants, relatively low. CONCLUSIONS The findings of this unique study clearly suggest that post-disaster mental health policies should target low levels of skills to survive in the new society. Furthermore, the acculturation domain of keeping traditional norms and values can be contrary to the Dutch care after a disaster where self-efficacy and individualistic, cognitive functioning are the central goals. Further research is warranted to explore and examine post-event interventions aimed at increasing the levels of acculturation that may facilitate recovery.

Loss of loved ones or home due to a disaster: Effects over time on distress in immigrant ethnic minorities

Exposure to mass trauma may bring about increased sensitivity to new or ongoing stressors. It is unclear whether sensitivity to stress associated with ethnic minority/immigrant status may be affected by severe exposure to mass trauma. We examined whether the loss of loved ones or home due to a disaster is associated with more persistent disaster-related distress in ethnic minorities compared with Dutch natives in the Netherlands. In residents affected by a fireworks disaster (N = 1029), we assessed disaster-related distress after 3 weeks, 18 months, and 4 years. The effects of loss of loved ones or home and ethnic minority/immigrant status on distress were analyzed using latent growth modeling. After controlling for age, gender, education, employment, and post-disaster stressful life events, the loss of loved ones was associated with more persistent disaster-related distress in ethnic minorities compared with natives at 18 months, and the loss of home was associated with more persistent disaster-related distress in ethnic minorities compared with natives between 18 months and 4 years. Our results suggest that the loss of loved ones may increase sensitivity to stress associated with ethnic minority/immigrant status during the early phase of adaptation to a disaster. Loss of home may lead to further resource loss and thereby increase sensitivity to stress associated with ethnic minority/immigrant status in the long term. Efforts to prevent stress-related psychopathology following mass trauma should specifically target ethnic minority groups, notably refugees and asylum seekers, who often experienced multiple losses of loved ones as well as their homes.

Evaluating the experiences with an Information and Referral Center (IRC) following a large air crash disaster.

Study/Objective: To evaluate the use of, and experiences with a ‘one-stop-shop’ website for information and referral for bereaved people following an air crash disaster. Background: On July 17, 2014 the disaster of Flight MH17 (Malaysia Airlines) took place above Eastern Ukraine. None of the 298 passengers and crew survived the flight, of which 196 were of Dutch nationality. Within 26 hours, an Information and Referral Center (IRC) was set up. Methods: A total of 128 bereaved persons filled out a questionnaire, and 22 bereaved persons joined in to 5 focus groups to discuss their experiences. In addition, data was gathered via a popup questionnaire on the IRC itself, as well as statistics of website use. Finally, in a series of 16 interviews, representatives from all the agencies involved with the IRC, were asked about their expectations and experiences in the development of the IRC. Results: Three main goals of the IRC were tested. (1)Dependable information: The IRC is seen as a dependable source of information. Specifically appreciated was the availability of news before it appeared in the media, and its function as a newsarchive. (2) Peer-to-peer contact: Results on this goal were more ambiguous. Some of the bereaved used the IRC for personal contact, most however, had difficulties sharing via an open forum, and preferred real-life contact. (3) Collection of meaningful data on specific needs: It proved difficult to generate data on specific needs for additional care. Conclusion: Systematic evaluations, including experiences from bereaved persons, as well as the organizations facilitating online communities as the IRC are scarce, and underlying assumptions are rarely made explicit or tested. Based on a more elaborate presentation of the results in the presentation, assumptions on what an IRC should constitute will be further discussed.