Chemical and Biological Terrorism Research and Development to Improve Civilian Medical Response (1999) / Chapter Skim
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9 Prevention, Assessment, and Treatment of Psychological Effects
9 Prevention, Assessment, and Treatment of Psychological Effects
Pages 165-173
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From page 165... ...
LONG-TERM EFFECTS OF TERRORISM (POST TRAUMATIC STRESS DISORDER) The literature on civilian terrorist attacks reveals a number of reports of very high rates of Post Traumatic Stress Disorder (PTSD)
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From page 166... ...
These reports suggest that chemical and biological terrorist attacks might cause high rates of PTSD and risks for physical illnesses and suicide, not only among rescue workers but especially among unprepared witnesses to grotesque sights and untrained "good Samaritans" voluntarily joining rescue and first aid efforts. The early identification of persons at risk for long-term psychological effects is complicated by the fact that PTSD symptoms within a few days of a traumatic event have been shown to have low predictive validity by themselves for later psychiatric outcome (Shalev,1992~.
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From page 167... ...
These services are designed to help disaster survivors recognize typical reactions and emotions that occur following a disaster and to regain control over themselves and their environment. Although the focus is on short-term interventions, helping people with normal reactions to abnormal experiences rather than longterm therapy for pathological conditions, the program provides for up to 12 months of services, and local mental health workers and other disaster workers are eligible for training (training is also offered annually to state mental health authorities by FEMA's Emergency Management Institute)
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From page 168... ...
For example, Critical Incident Stress Debriefing (CISD) , a technique aimed at helping field rescue personnel cope with the stress of extraordinary traumatic events, has gained widespread popularity (Mitchell and Everly, 1996~.
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From page 169... ...
Because many of the neurological effects of chemical agents may be confused with the emotional and psychological effects, the authors caution against assuming that the symptoms of chemical trauma victims are psychological in nature and recommend treating victims in a site other than the department of psychiatry. In nerve gas attacks where the enzyme acetylcholinesterase is inhibited, signs of central and peripheral nervous system poisoning include apathy, mood liability, thought disorders, sleep disorders, and delusions and hallucinations, in addition to psychological stress sequelae.
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From page 170... ...
and of unintentional chemical or biological disasters, little is known about the psychological effects that are specific to chemical or biological terrorism. This lack of knowledge further emphasizes the need for updating protocols and providing additional training of health providers to assure adequate mental health support in existing disaster networks.
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From page 171... ...
Large cities, such as New York, Chicago, Denver, Boston, and smaller municipalities in Kentucky, Rhode Island, and Massachusetts have developed training programs for their existing emergency response personnel. However, these programs, essential in the immediate remediation of the physical hazards of a terrorist attack, are not currently designed to integrate, plan, provide, or coordinate their efforts with specialty mental health response teams.
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From page 172... ...
This will be especially important in the case of chemical or biological terrorism, one goal of which is often to produce fear, panic, demoralization, and loss of confidence in government. Little is known about the fears and feelings engendered by the threat of infection, but considerable research on risk perception and risk communication has been conducted in connection with hazardous waste sites, nuclear power plants, and other real and perceived environmental threats, and general guidelines for government officials have been produced (Hence et al., 1988; National Research Council, 1989; Stern and Fineberg, 1996~.
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From page 173... ...
9-4 Evaluative research is needed on interventionsfor preventing or ameliorating adverse psychological effects in emergency workers, victims, and near-victims. Specific crisis intervention methods may be necessary for chemical or biological terrorist incidents, but in the absence of such incidents researchers might draw on studies of chemical spills, epidemics of infectious disease, and more conventional terrorist incidents.
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