Post-traumatic Stress and Preventive Interventions in

Journalists

Lars Weisæth, MD, Ph DProfessor, Senior Research Supervisor

Norwegian Centre for Violence and Traumatic Stress Studies

University of Oslo

Journalism. The Global Investigative ConferenceLillehammer, 14. September 2008

Various approaches to prevention:

• Selection of personnel

• Training / preparing

• Organizing

• Early interventions and appropriate and sufficient follow up.

0

1

2

3

4

5

6

7

8

9

10

Jump sequence

Sel

f-ra

tin

g of

fea

r

Inexperienced(N=63)

Critical decision for inexperiencedparachutist

Critical decision for both groups

Experienced(N=32)

Critical decision for experiencedparachutist

The role of experience

The COPE study: Coping and stressors in Norwegian disaster response personnel mobilized for the 2004

tsunami disaster

Siri Thoresen, Arnfinn Tønnessen, Camilla Vibe Lindgaard, Anne Lie Andreassen & Lars Weisæth

The Sumatra-Andaman earthquake 26. December 2004 triggered a series of tsunamies - affecting most of the landmasses bordering the Indian Ocean.

The Tsunami disaster caused the death of more than 230,000 people (CRED, 2006). Many of them were children.

The disaster caused the death of 2,448 tourists from 37 different countries (WHO, 2008). 84 Norwegians died in the disaster

• Authorities from several countries mobilized personnel for a support and rescue operation

• 3 large personnel groups mobilized for the Tsunami disaster:Non-governmental organisations Police Journalists Others, including air force, health personnel, chaplains, Foreign Ministry personnel, travel agencies, and more.

Aim of the COPE study

• To investigate risk factors and protective factors for stress reactions in Norwegian personnel mobilized for the tsunami disaster.

Methods

• Cross-sectional • Questionnaire study• 9-10 months post Tsunami• Web and postal

Subjects

Total Journalists

• Disaster area personnel 63% 63%Response Rate (N = 335) (N = 56)

• Home base personnel 48% 32%Response Rate (N = 246) (N= 33)

Results(Disaster area only)

Demographics NGO’s (N=111)

Police(N=89)

Journalists(N=56)

Age (mean) 48 år 46 år 41 år

Male gender 60% 73% 80%

Married / cohabitating 66% 81% 66%

Experience and training NGO’s (N=111)

Police(N=89)

Journalists(N=56)

Relevant work experience 95% 84% 77%

Relevant training 81% 67% 48%

Mass casualty exercises 67% 48% 43%

Specific preparation 59% 52% 32%

Demographics NGO’s (N=111)

Police(N=89)

Journalists(N=56)

Age (mean) 48 år 46 år 41 år

Male gender 60% 73% 80%

Married / cohabitating 66% 81% 66%

Stressful experiences, examples NGO’s (N=111)

Police(N=89)

Journalists(N=56)

Strong smells/other sensory perceptions of the disaster scene

74% 95% 98%

Witnessing disaster victims searching for next of kin

61% 46% 93%

Seeing children separated from next of kin

68% 3% 34%

Witnessing disaster victims with major physical injuries

61% 10% 62%

Seeing dead bodies 48% 70% 83%Seeing body parts 21% 69% 40%Witnessing disaster victims in despair 94% 44% 94%Having to reject victims in need 69% 10% 50%

Exposure to stressful stimuli, sum scores

NGO’s (N=111)

Police(N=89)

Journalists(N=56)

Witnessing experiences (mean)

5.0(SD 2.2)

4.5(SD 1.6)

6.0 1,2

(SD 1.6)

Personal contact with disaster victims (mean)

3.0(SD 0.9)

1.7(SD 1.5)

3.21

(SD 1.2)

1 Jour > pol, p<0.05, 2 Jour > hum, p<0.05

NGO’s (N=111)

Police(N=89)

Journalists(N=56)

Stress reactions (IES-22, mean score) 10.3 7.1 12.91

Exposure to stressful stimuli, sum scores

NGO’s (N=111)

Police(N=89)

Journalists(N=56)

Witnessing experiences (mean)

5.0(SD 2.2)

4.5(SD 1.6)

6.0 1,2

(SD 1.6)

Personal contact with disaster victims (mean)

3.0(SD 0.9)

1.7(SD 1.5)

3.21

(SD 1.2)

1 Jour > pol, p<0.05, 2 Jour > hum, p<0.05

1 Jour > pol, p<0.05

Note: None of the groups were highly traumatized – the vast majority do well

Politiet(n=89)

Hum.org(n=111)

Journ.(n=56)

Experience/training Middle Most Least

Being well prepared Middle Best Least

Witnessing exp. Lowest Middle Highest

Rejecting victims Lowest Higher Higher

Clear work tasks Most clear

Lessclear

Lessclear

Possibility for rest Best Middle Lowest

Support from peers Best Lower Lowest

Stress reactions Lowest Middle Highest

Summing up – differences between groups

For All Disaster Area Personnel (N = 335):

A low level of stress reactions was associated with:

Low level of -

Witnessing Being well preparedexperiences Possibilities to rest and ”time-out”

Personal contact with Not ”over achieving”disaster victims Low level of avoidant coping

Having to reject disaster Low level of restlessness or victims sadness following mission

High social support after mission

Predictors for stress reactions in the three groups:

• PoliceSecondary stressorsAvoidanct copingRecognition for mission

Social support after mission• NGOs

Being well prepared for missionRejecting victims in need of help and witnessing experiencesPossiblities for necessary rest during missionRecognition for missionAvoidant coping

• Journalists Being well prepared for mission Support from superior during missionSocial support after missionAvoidant coping

”Take home”: Possible implications

Journalists were less trained, more exposed, and had higher stress reactions than the other groups

Possible interventions: • Specific preparation for the mission• Preparations for exposure, and having to reject victims

in need• Organizing rests and time-outs• Strengthen work structure and peer support/ support

from superior during mission• First weeks after mission: Important period (identify

needs for follow-up)

Limitations

• Cross-sectional• Retrospective• Self-report• Lower response rate in home base

personnel compared to disaster area personnel

Principles of intervention:

• A sense of safety• Calming• A sense of self- and community

efficacy• Connectedness• Hope

Textbook of Disaster PsychiatryCambridge University Press 2007

Edited by:

• Robert J. Ursano• Carol S. Fullerton• Lars Weisaeth • Beverley Raphael

Thank you for listening