The Association Between Dissatisfaction with Debriefing and Post-Traumatic Stress Disorder (PTSD) in Rescue and Recovery Workers for the Oklahoma City Bombing.

OBJECTIVE: The purpose of this study was to investigate potential association between psychopathology and subjective evaluation of the experience of debriefing in disaster-exposed rescue and recovery workers. METHODS: Structured diagnostic interviews for DSM-III-R psychiatric disorders were conducted with 166 firefighters who served as rescue and recovery workers for the 1995 Oklahoma City bombing, who categorized their satisfaction with the debriefing on 4 levels. "Very dissatisfied" responses were examined for their association with post-traumatic stress disorder (PTSD) and with PTSD symptom groups. RESULTS: Being "very dissatisfied" with the debriefing was significantly associated with the DSM-III-R avoidance and numbing group and with PTSD. CONCLUSIONS: These findings suggest that debriefing may be an unsatisfactory intervention for people with prominent avoidance and numbing symptoms, such as those with PTSD. These individuals might be better served by referral directly to psychiatric treatment (Disaster Med Public Health Preparedness. 2018;12:718-722).

The prevalence, characteristics, and correlates of anger among survivors of the 9/11 World Trade Center attacks.

BACKGROUND: Anger is a prominent and common emotion in postdisaster settings. However, there has been little systematic investigation of the association of anger with psychopathology or other individual characteristics in disaster survivors. This study examined anger responses reported by disaster survivors and correlates of that anger. METHODS: Structured interviews were conducted with a volunteer sample of 379 employees of 7 agencies that were highly affected by the September 11, 2001, terrorist attacks on the World Trade Center in New York City. Individuals were asked about their level of anger toward various entities and their coping methods after the disaster. Assessments were made for disaster-related posttraumatic stress disorder and other psychiatric disorders using the Diagnostic Interview Schedule for DSM-IV. Specifics of disaster trauma exposure were assessed using the Disaster Supplement. RESULTS: Anger was prevalent but was not associated with disaster trauma exposure. Anger was generally associated with lower level of education, younger age, and racial minority group membership, and was more prominent in survivors with indicators of post-disaster mental health problems. CONCLUSIONS: Anger may serve as an identifier of individuals at risk for psychopathology or who are at least highly distressed. There are potential implications for risk communication to address anger in the post-disaster setting.