Studying Persons Recently Exposed To Mass Disaster Does Not Cause Adverse Psychological Reactions, New Academy Study Finds

NEW YORK CITY, July 30 ??? Conducting research among people who have recently exposed to a massive disaster does not appear to cause them further psychological distress, according to a new study in the August issue of The Journal of Nervous and Mental Disease by scientists at The New York Academy of Medicine. The study was based on research involving New York City residents exposed to the Sept. 11, 2001 terrorist attacks.

???These findings put to rest the myth in the field of Disaster Psychiatry that studying persons after a major psychological trauma makes them worse off,??? said Principal Investigator Joseph A. Boscarino, Ph.D., M.P.H., a Senior Scientist in the Academy Division of Health and Science Policy and a Vietnam Veteran. ???Over-cautious policies that restrict research among trauma victims may prevent scientists from discovering effective mental health interventions.???

Random-digit-dial telephone surveys of 2,368 New York City adults were conducted in English and Spanish one year after Sept. 11. Two groups of people were interviewed: city residents in general, and city residents who received mental health treatment within a year of the attacks. Seventy-four percent of participants in the combined groups said that taking part in the survey was a positive experience. Only 15 percent reported that they considered some of the survey questions to be stressful.

Among New Yorkers who had sought mental health treatment after the World Trade Center attacks, 28 percent considered some survey questions to be stressful, but few people (less than two percent) were still upset upon the survey???s completion. Detailed analyses showed that participants who suffered from posttraumatic stress disorder (PTSD), depression or anxiety were more likely to find questions stressful, as were women. Those with PTSD or depression were the most likely to still be upset at the survey???s completion and to consent to psychiatric consultation.

For years, some emergency mental health service providers have been reluctant to permit research among recent victims of psychological trauma for fear of triggering further distress. A consequence is that common post-disaster mental health interventions, such as group debriefings in which victims are gathered and encouraged to talk about their experience, have not been proven effective at helping trauma victims to recover. Group debriefings are a key element of the ???Critical Incident Stress Management??? strategy that is recommended for mostly everyone exposed to a mass disaster. ???This strategy has never really been proven and validated,??? Boscarino said. ???Is it effective? Does it make people worse or better? Who should get it? This has never been well-defined.???

The Academy study was conducted to learn whether people exposed to a severe trauma will suffer psychological consequences by participating in a mental health study. That so few participants reported distress during the 45-minute survey, surprised even investigators, Boscarino said.

???Our study suggests that this research can be conducted safely and effectively with proper safeguards, such as using experienced mental health interviewers, having mental health clinicians involved with the research, and having proper institutional oversight,??? he said.

Co-authors of the study include Academy scientists Richard E. Adams, Ph.D., Sandro Galea, M.D., Dr.P.H., and Alan R. Fleischman, M.D. This study was supported by a grant from the National Institute of Mental Health. The New York Academy of Medicine is a non-profit institution founded in 1847 that is dedicated to enhancing the health of the public through research, education and advocacy, with a particular focus on disadvantaged urban populations.

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Posted on July 30, 2004

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