Effects of Vicarious Trauma on Mental Health in Firefighters

소방 공무원에서 간접 외상이 정신 건강에 미치는 영향

  • Baik, Jun-Hyuck (Department of Psychiatry, College of Medicine, The Catholic University of Korea) ;
  • Jung, Young-Eun (Department of Psychiatry, College of Medicine, The Catholic University of Korea) ;
  • Chae, Jung-Mi (Department of Preventive Medicine, The Catholic University of Korea) ;
  • Myong, Jun-Pyo (Korea Catholic Industrial Medical Center, The Catholic University of Korea) ;
  • Yim, Hyeon-Woo (Department of Preventive Medicine, The Catholic University of Korea) ;
  • Cha, Jeong-Ho (Department of Psychiatry, College of Medicine, The Catholic University of Korea)
  • 백준혁 (가톨릭대학교 의과대학 정신과학교실) ;
  • 정영은 (가톨릭대학교 의과대학 정신과학교실) ;
  • 채정미 (가톨릭대학교 예방의학교실) ;
  • 명준표 (가톨릭대학교 산업의학센터) ;
  • 임현우 (가톨릭대학교 예방의학교실) ;
  • 채정호 (가톨릭대학교 의과대학 정신과학교실)
  • Received : 2010.04.12
  • Accepted : 2010.04.17
  • Published : 2010.04.30

Abstract

Objectives : Indirect contact with trauma may occur when a person empathically listens to detailed descriptions, exposing the person to intense emotional pain from trauma victims. Although less severe than direct trauma, indirectly traumatized persons may experience the same fear, rage, and despair as direct trauma victims. This phenomenon has been variously termed vicarious trauma, traumatic countertransference, burnout, compassion fatigue, and secondary traumatic stress. Using a psychiatric symptoms questionnaires, this study investigated the effects of indirect exposure to co-worker's trauma on the mental health of firefighters who had not directly experienced traumatic events in the previous year. Methods : We administered self-report questionnaires, such as the Impact of Event Scale-Revised (IESR) and Alcohol Use Disorder Identification Test (AUDIT), to firefighters working at two fire stations in a metropolitan city. We analyzed 188 of 232 collected surveys, after excluding falsely entered data (28 cases) and questionnaires by directly-traumatized victims (16 cases). Results : Alcohol consumption and posttraumatic stress disorder (PTSD) symptoms, as determined by the AUDIT and IES-R, were significantly higher in the indirectly-traumatized group. The ratio of high-risk members scoring higher than 23 in IES-R was larger in the indirectly traumatized group, although this was not statistically significant. Conclusion : Alcohol consumption was significantly higher in the indirectly traumatized group. This group also included more members at high risk for PTSD. Further research, with a larger group of indirectly traumatized firefighters and ongoing investigation of PTSD development and other psychiatric symptoms, is needed.

Keywords

References

  1. American Psychiatric Association: Diagnostic and statistical manual of mental disorders, 4th edition; Washington, DC: American Psychiatric Press;1994.
  2. Falki P. Mirtazapine: other indication. J Clin Psychiatry 1999;60:36-40. https://doi.org/10.4088/JCP.v60n0108
  3. Eun HJ, Lee SM, Kim TH. The epidemiological study of posttraumatic stress disorder in an urban area. J Korea Neuropsychiatr Assoc 2001;40:581-591.
  4. Ajou university educational industrial consortium: Research on the actual condition of posttraumatic stress disorder of firefighters, Seoul: National Emergency Management Agency;2008.
  5. Alexander DA, Klein S. Ambulance personnel and critical incidents: impact of accident and emergency work on mental health and emotional well-being. Br J Psychiatry 2001;178:76-81. https://doi.org/10.1192/bjp.178.1.76
  6. Corneil W, Beaton R, Murphy S, Johnson C, Pike K. Exposure to traumatic incidents and prevalence of posttraumatic stress symptomatology in urban firefighters in two countries. J Occup Health Psychol 1999;4:131-141. https://doi.org/10.1037/1076-8998.4.2.131
  7. Heinrichs M, Wagner D, Schoch W, Soravia LM, Hellhammer DH, Ehlert U. Predicting posttraumatic stress symptoms from pretraumatic risk factors: a 2-year prospective follow-up study in firefighters. Am J Psychiatry 2005;162:2276-2286. https://doi.org/10.1176/appi.ajp.162.12.2276
  8. McCann IL, Pearlman LA. Vicarious traumatization: a framework for understanding the psychological effects of working with victims. J Trauma Stress 1990;3:131-150. https://doi.org/10.1002/jts.2490030110
  9. Sabin-Farrell R, Turpin G. Vicarious traumatization: implications for the mental health of health workers? Clin Psychol Rev 2003;23:449-480. https://doi.org/10.1016/S0272-7358(03)00030-8
  10. Lim HK, Woo JM, Kim TS, Choi KS, Chung SK, Chee IS, et al. Disaster psychiatry committee in Korean academy of anxiety disorders: reliability and validity of the Korean version of the impact of event scale-revised. Compr Psychiatry 2009;50:385-390. https://doi.org/10.1016/j.comppsych.2008.09.011
  11. Weiss DS, Marmar CR, Wilson JP, Keane TM. The Impact of Event Scale-Revised: assessing psychological trauma and PTSD. New York: Guilford Press;1997. p.399-411.
  12. Lee YS. Relations between attributional style, life events, event attribution, hopelessness and depression [dissertation]. Seoul National University;1993.
  13. Lee SM, Kim CH. Precipitating factors of posttraumatic stress disorder and psychological characteristics in bus accident victims. Korean J Clin Psychol 2002;21:547-563.
  14. Park BK. Comparison of screening tests for alcoholism in terms of reliability, sensitivity and specificity [dissertation]. Chungnam National University;2000.
  15. Lee BU, Lee CH, Lee PG, Choi JM, Nam KK. Development of Korean version alcohol use disorders identification test: research about reliability and validity, Report of Ministry for Health, Welfare and Family Affairs;2000.
  16. Smith AJ, Kleijn WC, Trijsburg RW, Hutschemaekers GJ. How therapists cope with clients' traumatic experiences. Torture 2007;17:203-215.
  17. Fischman Y. Interesting with trauma: clinician's responses to treating psychological after effect of political repression. Am J Orthopsychiatry 1991;61:179-185. https://doi.org/10.1037/h0079247
  18. Schauben LJ. Vicarious trauma: the effects on female counselors of working with sexual violence survivors. Psycol Women Q 1995;19: 49-64. https://doi.org/10.1111/j.1471-6402.1995.tb00278.x
  19. Benatar M. A qualitative study of the effect of a history of childhood sexual abuse on therapists who treat survivors of sexual abuse. J Trauma Dissoc 2000;1:9-28. https://doi.org/10.1300/J229v01n03_02
  20. Read JP, Brown PJ, Kahler CW. Substance use and posttraumatic stress disorders: symptom interplay and effects on outcome. Addict Behav 2004;29:1665-1672. https://doi.org/10.1016/j.addbeh.2004.02.061
  21. Brunello N, Davidson JR, Deahl M, Kessler RC, Mendlewicz J, Racagni G, et al. Posttraumatic stress disorder: diagnosis and epidemiology, comorbidity and social consequences, biology and treatment. Neuropsychobiology 2001;43:150-162. https://doi.org/10.1159/000054884
  22. Kessler RC, Sonnega A, Bromet E, Hughes M, Nelson CB. Posttraumatic stress disorder in the national comorbidity survey. Arch Gen Psychiatry 1995;52:1048-1060. https://doi.org/10.1001/archpsyc.1995.03950240066012
  23. Beckham JC, Lytle BL, Feldman ME. Caregiver burden in partners of Vietnam war veterans with posttraumatic stress disorder. J Consult Clin Psychol 1996;64:1068-1072. https://doi.org/10.1037/0022-006X.64.5.1068
  24. Sorscher N, Cohen LJ. Trauma in children of Holocaust survivors: transgenerational effects. Am J Orthopsychiatry 1997;67:493-500. https://doi.org/10.1037/h0080250
  25. Salston M, Figley CR. Secondary traumatic stress effects of working with survivors of criminal victimization. J Trauma Stress 2003;16: 167-174. https://doi.org/10.1023/A:1022899207206
  26. Regehr C, Hill J, Glancy GD. Individual predictors of traumatic reactions in firefighters. J Nerv Ment Dis 2000;188:333-339. https://doi.org/10.1097/00005053-200006000-00003
  27. Bae J. A study on the relationship between mobilization impacts, social supports, coping behaviors and PTSD symptoms & psychological wellbeing in emergency service firefighters [dissertation] urban science, Seoul National University;2008.
  28. Schnider KR, Elhai JH, Grey MJ. Coping style use predicts posttraumatic stress and complicated grief symptoms severity among college students reporting a traumatic loss. J Couns Psychol 2007;54:344-350. https://doi.org/10.1037/0022-0167.54.3.344