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Variables affecting duty-related stress after an air crash disaster

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Title:
Variables affecting duty-related stress after an air crash disaster
Series Title:
Quick response research report ;
Physical Description:
18 p. : ; 28 cm.
Language:
English
Creator:
Hartsough, Don M
University of Colorado, Boulder -- Natural Hazards Research and Applications Information Center
University of Colorado, Boulder -- Institute of Behavioral Science
Publisher:
Natural Hazards Research and Applications Information Center, University of Colorado
Place of Publication:
Boulder, Colo
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Subjects / Keywords:
Aircraft accidents -- Psychological aspects   ( lcsh )
Post-traumatic stress disorder   ( lcsh )
Disaster relief -- Psychological aspects   ( lcsh )
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government publication (state, provincial, terriorial, dependent)   ( marcgt )
bibliography   ( marcgt )
non-fiction   ( marcgt )

Notes

Bibliography:
Includes bibliographical references (p. 17-18).
Additional Physical Form:
Also issued online as part of a joint project with the Louis de la Parte Florida Mental Health Institute (FMHI) Research Library’s disaster mental health initiative.
Statement of Responsibility:
Don M. Hartsough.
General Note:
Cover title.
General Note:
"Institute of Behavioral Science #6."

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University of South Florida
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Resource Identifier:
aleph - 001985185
oclc - 39119287
usfldc doi - F57-00036
usfldc handle - f57.36
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SFS0001117:00001


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Variables affecting duty-related stress after an air crash disaster /
Don M. Hartsough.
260
Boulder, Colo. :
b Natural Hazards Research and Applications Information Center, University of Colorado,
1988.
300
18 p. ;
28 cm.
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Quick response research report ;
v #26
500
Cover title.
"Institute of Behavioral Science #6."
504
Includes bibliographical references (p. 17-18).
530
Also issued online as part of a joint project with the Louis de la Parte Florida Mental Health Institute (FMHI) Research Librarys disaster mental health initiative.
650
Aircraft accidents
x Psychological aspects.
Post-traumatic stress disorder.
Disaster relief
Psychological aspects.
710
University of Colorado, Boulder.
Natural Hazards Research and Applications Information Center.
University of Colorado, Boulder.
Institute of Behavioral Science.
4 856
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HAZARDHOUCpy V o.'C'\..'o\c.sQ,..AlA

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NaturalHazardsResearchandApplicationsInformationCenterCampusBox482UniversityofColoradoBoulder,Colorado80309-0482VARIABLESAFFECTINGDUTY-RELATEDSTRESSAFTERANAIRCRASHDISASTERDonM.Hartsough1988QuickResponseResearch Report#26ThisPUblication is partofth &Applications HazardsQUIckResponse Research R matlon ongoing httpp....... eport Senes .IVVVVVV.colorado.edu/hazardsInstituteofBehavioralScience#6 (303)492-6818

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VARIABLESAFFECTINGDUTY-RELATEDSTRESSAFTERANAIR GllASH DISASTERDonM.Hartsough, Ph.D. Purdue University* Finalreporttothe NaturalHazardResearchandApplications Information Center, UniversityofColorado, Boulder,CO.This studywasperformed as aQuickResponse Research Study, 1985-86.*Nowaffiliatedwith PersonnelDevelopmentGroup,222E.OhioStreet,Suite800,Indianapolis,IN46204

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AbstractThisexploratorystudyexaminedvariablesthatmaycontributetothestressofemergency workers following adisaster.Data were obtainedfromfieldinterviewswithdisasterworkers,standardpaper-and-penciltestsofstress,andanexperimentalquestionnairedesignedtoevaluatesubjectsforsymptomsofpost-traumaticstressdisorder.Thestudyfound a wide rangeofstressresponsesforthe13bodyrecovery workers who wereevaluatedfollowing a midaircollisionofaircraftovertheGrand Canyon.Thetragedykilledandbadly burnedall25persons aboardthe two aircraft.Oneworker was extremelystressed,3experienced moderatestress,and9showedlittleornostress.Unique hazardsofexposuretothisdisaster,pluspersonal knowledgeofVictims, wereidentifiedas causesofworkerstress.Variablesthatmitigatestresslevelsinworkers werehabituationtothebodyrecovery work, apositiveattitudeabout body recovery,andapersonalphilosophy aboutdeath.Itappearsinevitablethatdisasterworkerswillbeexposedtotheconditionsthatcausestress.Inthisparticularincident,however,theconditionsthatcausedthemoststresscould have been avoidedbygreatersensitivityonthepartofsupervisorstothepsychologicalaspectsofdisasterwork.

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Emergency workersandpublicsafetypersonnel have beenidentifiedasanat-riskpopulationforpsychologicalstressanditsconsequences followingdisasters(Hartsough & Myers, 1985).Disasterpersonnelwhomaybe overlookedinmentalhealthrecoveryeffortsincludepolice,fire-fighters,emergency medicalpersonnel,morgue workers,rescuepersonnel,militarypersonnel usedasbody recovery workers, andthelike.Taylor andFrazer(1982) surveyed180membersofa body recovery mission following aDC-10crashonMountErebusinAntarctica.Theyfound 81% reportedsleepdisturbances, 76% reportedchangesinappetite,and 49% noted changesintheirownfeelings.Inspiteoftheseadmitted changesintheiremotional andpsychologicalstatus,onlyabout 1in10oftheseworkersreportedatfollow-upthatthey had soughthelpinresponsetotheincident.Inbrief,itisnot unusualforemergency workerstoresisttheacknowledgementofpsychologicalsymptomsfollowingdisasters(Jones,1985).Thereluctancetoperceivepsychologicalproblemsiscommonlyattributedtoa"mocho"worker image,butthemoreparsomoniousexplanationisthatmost workersdonot developseverestressaftermostdisasters,evenincludingeventswithsignificantlevelsofdeathanddistruction.Theresearchquestionofthisstudyishowmanyworkersdobecomestressed,and whatvariablesbringthisabout?Theproblemofworkerstresshas been recognizedbymentalhealthprofessionalsandsocialscientists,and procedures have been developedforitsmitigation(Mitchell,1985) andprevention(Dunning, 1985). For example,Mitchell(1983) has proposed atechniqueforprovidingstressdebriefingsfollowing acriticalincident.Thereare,however,noempiricallybasedguidelinesforidentifyingwhichofthemanyhundredsofincidentsthatinvolveemergency workersandpublicsafetypersonnelarecriticalincidentsintermsofcausingseverepsychologicalstress.Atpresent,supervisorsandincidentcommandersindisasterreliefandrescueorganizationsmustresorttotheirown2

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experienceandjudgmentinordertodetermine whetheranincident is criticalandwhetherstressdebriefingmaybenecessary.This study examined worker responsestoa body recoveryincidentinanefforttoidentifytwotypesofvariables:(a) onesthatcause workerstress;(b) onesthatpreventormitigateworkerstress.TheframeworkforthisinvestigationwasHartsough's (1985)observationof3major sourcesofstressfordisasterworkers: emergencyoccupations,theeventsandhazardsthatconfrontworkersindisasters,andtheorganizationalandsocialcontextoftheworkthey do. Also guidingthisworkwastheobservationofKling, (1988)thatcivilianandworkersurvivorsofadisasterareaffectedsomewhatdifferently.Workersmayexperiencegreaterorlonger exposuretohazardsandattimesfacemoredanger thancivilians,butarealsobetterprepared becauseoftheirskillsandexperience.MethodsTheintentofthestudywastoprovidedifferingperspectivesonthesourcesofdisasterworkerstress.For purposesofthisstudy,aneventwasidentifiedthatwaslikely(inthejudgmentoftheinvestigator)tobestressfulforsome,butnotall,oftheworkers involved.Participantswere interviewedindividuallyandalsocompletedpaper-and-pencilmeasuresofpsychologicalstress.Theevent.Themidaircollisionofa DeHavilandTwinOtterairplaneand aBellJetRangerhelicopteroccurred overtheGrandCanyononJune 18, 1986. Bothaircraftcarriedsightseers-all22passengers and3pilotswerekilledinstantly.ItwastheworstaircraftdisasterintheGrandCanyonin30years.There werenowitnessestothedisaster,whichwasreportedbyafiretower lookoutandalocalairtouroperator.BythetimetheNational ParkServicearrivedatthescene, bothaircraftwerefullyinvolvedinflames.Thetragedy3

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tookplace12mileswestofGrandCanyonVillageina rugged, remoteareaofthepark.Thewreckagewasscatteredover a 1/2 mileareaontheTontoPlateauatanelevationofapproximately4200feet,about2000feetabovetheColorado River and4000feetbelowtherim.Itappearedtoobserversthatbothaircrafthadburstintoflamesuponimpactwiththeground, andthattherewerenosurvivors.BoththeNational ParkServiceandtheSheriff'sOfficeofCoconino Countysuppliedworkersfortheinvestigationandbody recoveryoperationconductedinthedays followingthemidaircollision.BecausetheGrandCanyonisinCoconino County,thetwoagencies had workedtogetherfrequentlyinincidentsinvolvingemergencies. Accordingtojurisdictionalagreements,theNational ParkServicewasincommandofrescueefforts,andtheCoconino CountySheriff'sOfficewasincommandwhenever adeathhadoccurred.AlthoughtheSheriff'sOfficeprovidedincidentcommandforthismission,theNational ParkServicesuppliedahelicopterpadandcommandpost,supportsupplies,facilitiesforthehundredsofpresspersonnelwhoflockedtotheGrandCanyon, communications equipment, and personneltoassistinbodyrecovery.The18passengersontheairplaneincluded 4 Americans,11Dutch, 2 Swiss,and1 SouthAfrican.Thefour passengersonthehelicopterwere Americans.The3pilotsinbothaircraftwerelocaltotheGrandCanyonarea.Subjects.There were13subjectswhocompleted boththefieldinterviewandthewrittenquestionnaires;6 were RangersoftheNational ParkService,and7wereofficerstotheCoconino CountySheriff'sOfficelocatedinFlagstaff.Thesubjectsfrom law enforcement wereprimarilyfromtheDetectiveDivision,includingboththeSupervisorandCaptainofdetectives.TheNational ParkServiceemployeesalsoincluded bothfrontlineandsupervisorypersonnel.Allsubjectswere male andrepresentedanage range fromthelate20'stothemiddle40's.4

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Therewasa rangeofexposuretothewreckageandbodiesamongtheparticipants.Ofthetotal,only5actuallywentintothecanyontoinvestigatethecrashandtoremove bodiestoa nearbyhelicopter.Onerangerwentintothecanyonafterthebodies had beenrecovered.Theotherparticipantsdidnotgointothecanyon, althoughseveraltransferredbodiesattheincidentcommandpostontherimfromthehelicoptertoatruckfortransportationtothemorgueinFlagstaff.Severalparticipatedfurtherinbodyidentificationworkafterthebody recovery phase had ended.TwoSheriff'sOfficersspentalloftheirtimeinFlagstaffestablishingcontactwithfamiliesandusinginternationalresourcestonotifynextofkinofforeignvisitors.Subjectsforthisstudyalsoincluded23judgeswhoactedasratersoftheinterviewmaterial.Raters wereclinicalpsychologygraduatestudents,orundergraduatestudentstakingacourseinpsychologicalaspectsofdisasters.Researchprocedures.Eachnon-studentsubjectagreedtoparticipateinafieldinterviewthatfocusedonhisactionsandexperiencesduringtheincident,previousexperiencesinsimilarincidents,attitudesabout working with dead people,andhispersonalphilosophy towarddeath.Theinterviewwassemistructured,followinggeneraltopicsandallowingtheintervieweetocontributehisownobservations,attitudesandbeliefsabout emergency workers andcriticalincidents.(Asampleinterviewreportisappended.)Thestudyused 3 measures, eachcontributingadifferentperspectiveonstress.TheBriefSymptomInventory(BSI)isashortenedversionoftheSymptomChecklist,go(SCL-90), a measure widely usedforoutpatientandinpatientpopulationsas a measureofcurrentsymptoms.TheBSIconsistof53items(e.g.,"troublefallingasleep")thatareratedbysubjectsona5-pointscaletoindicatethedegreetowhich they have beenstressedbythatsymptominaspecifiedperiodoftime(commonlythelast7 days,includingthedayof5

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testing).Ninesymptomsdimensionsarescored:somatization,obsessivecompulsive,interpersonalsensitivity,depression,anxiety,hostility,phobicanxiety,paranoidideation,andpsychoticism. A GeneralSeverityIndexreflectingboththenumberandintensityofsymptomsistheprimary outcome oftheBSI, whichcorrelatesplus.89 withtheSCL-90(Derogaits,1977).(AcopyoftheBSIisappended.)TheWaysofCoping(WOC)isa measure developedbyFolkmanandLazarus (1985)tomeasurehowa person copes with aspecificevent.Itiscomposedofa 24-item problem-focused copingscaleanda 40-item emotion-focused copingscale.Theprimary useoftheWOCforthisstudywasas anotherindicatorofstress,basedontherepeatedfindingthatthegreaterthestressthathas been experienced,themorecopingstrategiesareemployedbydisastervictims.(Acopyisappended.)ThethirdmeasurewasthePurduePTSDscale(PPTSD).ThePPTSDisanexperimental instrumentthatreflectsarespondent'stendencytohavesymptomsofpost-traumaticstress.Items were designedtoassesscompliance withthecriteriaforpost-traumaticstressdisorder,asdescribedintheDiagnosticandStatisticalManual,VolumeIII(APA,1980).Symptomsofposttraumaticstressdisorderincludere-experiencingofthetrauma, psychologicalnumbingorwithdrawalofemotions, autonomicarousal,feelingsofanxiety,andtheincreaseofsymptomswith remindersoftheevent.A5-pointscaleisusedtorecordreactionstoeach item.(Acopyisappended.) Procedures.TwotripsweremadetotheGrandCanyonandFlagstafftogatherdata.Trip#1wasarrangedforearlyJulysothatI couldattendanoperationaldebriefingmeeting scheduledforJuly3.Unfortunately,this.meetingwaspostponed duetoafireinthepark, sothatresearchmaterialswereactuallydistributedby a ranger duringthefollowing week,whenthemeetingwasheld.Interviews were conducted during Trip #1,andIalsobecameorientedtorescueprocedures usedbytheNational ParkService,andtobody recoveryand6

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identificationprocedures usedbytheCoconino CountySheriff'sOffice.Trip #2 tookplaceinAugust, andthefocuswastointerviewresponderstotheincident.Oneinterviewwasconductedbytelephone following Trip #2.' Interviewreportswereconstructedforeachparticipantwhowasinterviewed.Theindividualwasidentifiedonlybya ranqom number, agencyaffiliation,rankandfunctionwithintheorganization.Thereportofeachinterviewincluded adetaileddescriptionoftherespondent's P?rticipation intheevent,effectsoftheparticipation,attitudesabout recovery work, andinterviewerobservations.NoattemptwasmadetoassessparticipantsforevidenceofPTSDsymptoms.Anyproblems orsymptomsincludedintheinterviewreportwere those volunteeredbythesubjectinresponsetogeneral,openquestions.Aninterviewratingformwith a5-pointagree-disagreescalewasdeveloped so thatjudges couldrateeachinterviewreport.Theinterviewratingformincluded 5questionsaboutpost-traumaticstressdisorderanditssymptoms, one itemonpositivecopingstyleandafinalitemonbeliefsaboutdeath.CAcopyoftheinterviewratingscale is appended.) Data management.The3paperandpencilinstrumentsCBSI,woeandPPTSD)were scored accordingtostandardprocedures. Asummaryscoreforeach measurewasderivedforeachsubject.Inaddition,eachsubject'sinterviewreportwasratedbythe23judgesforevidenceofpost-traumaticstresssymptoms,positivecopingstyle,andbeliefsaboutdeath.Ofspecialinterestwerethetwoindependentestimatesofpost-traumaticstresssymptoms, onefromthePPTSDandtheotherfromtheinterviewmaterial.Correlationswere obtained betweenthe3paper andpencilmeasures andthe7itemsontheinterviewratingscale.7

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ResultsTheresultsareexamined from 3perspectives,group performance,individualperformance,andrelationshipsbetweenthemeasures.Groupanalysis.A wide rangeofstressscoresisshownbytheresults.TheBSIscoresrangedfrom0 (nosymptomsatall)to2.80(aclinicallystressedindividual).TheaverageBSIscorewas.47,oratthehighendoftheaverage rangefornormalpopulations,accordingtothemanual(Derogatis,1977).Thewoescoresranged 36-100 withanaverageof54.77. TherearecurrentlynonormsfortheWOC,butithas beencorrelatedinanumberofstudieswithotherstressscores.InthisstudythecorrelationbetweentheWOCandtheBSIwas+.89,anindicationthatcopingandstresssymptomswerehighlycorrelatedinthisstudy.ForthePPTSD,scoresrangedfrom19-54 withanaverageof29.08.NonormsareavailablecurrentlyforthePPTSD.Anotherestimateofthestressofworkersinthisstudywasprovidedbytheratingsoftheirinterviews.Judges (n=23) usedaninterviewratingformwith7questionsaboutvariousaspectsofpost-traumaticstress.Theaveragesdescribedbelowrepresentthemeanratingsofall23ratersonall13subjectsforeach itemontheinterviewratingform.Theratingformitems wereasfollows: 1. This workerwasexposedtostressorsthatwould evokesignificantsymptomsofdistressinalmost everyone.Themeanwas1.87,anindicationthatraterstendedtoagreewiththeideathatworkers had been exposedtostressors.2.Aftertheincident,thisworkershowedsignsofre-experiencingthetraumainsomeway(example:recurrentdreams,intrusiverecollectionsoftheevent).Themeanwas3.11,indicatingthatjudges wouldneitheragreenordisagreewiththestatement,butinsteadtook aneutralposition.8

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3.Atsometimeafterthetrauma,thisworker experienced diminishedresponsivelytotheexternalworld. (Example:feelingdetachedfromothers,lossofinterestinsignificantactivities).Themeanwas3.76,anindicationthatjudges tendedtodisagreewiththestatementthatworkersshoweddimishedresponsiveness.4. This worker experiencedsymptomsofexcess autonomicarousalthatwerenotpresentbeforethetrauma (Example:hyperalertness,difficultysleeping,troubleconcentrating).Themeanwas3.31,anindicationthatjudgeswouldneitheragree nordisagreewiththestatement,butinsteadtook aneutralposition.5.This workershowedthesymptomsnecessaryforadiagnosisofPosttraumaticstressDisorder.Themeanwas3.90,whichshowsgeneraldisagreement withthestatement.6.This worker demonstrated apositivestyleofcopingthatwould allow himtomanagesignificantamountsofstress.Themeanwas2.41,anindicationofgeneralagreement withthisstatement.7.This worker holdsdefinite,wellthought-outbeliefsaboutdeath.Theaveragewas2.71,anindicationofaneutralpositiononthepartofjudges.Insummary,thissampleofdisasterworkers as a group demonstrated a rangeofstressresponsestovariousmeasuresofpsychologicalstress.Thegroupwasjudgedtohave been exposedtostressorsthatweresignificant,butitwasalsoseenasresistanttothedevelopmentofPTSDsymptoms, andtohave copedpositivelyinthesituation.Individualanalysis.Three groups could beidentifiedbyexaminingtheindividualscoresonthePPTSDscale,andtheinterviewratingscalequestionaboutthecriteriaforpost-traumaticstressdisorder.These groupsmaybe9

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characterizedas showing extremestress(n=1), moderatestress(n=3),andlowstress(n=9). For example,theindividualwhoshowedextremestressscored 1.22onquestion5oftheinterviewratingscale,whilethemoderatestressindividualsrangedfrom2.30to3.30andthelowstressgroup ranged from 4.00to4.87(alowscoreindicatesagreementthattheindividualshowsthesymptomsofPTSDfromtheinterviewmaterial).ThePPTSDscorefortheextremestressindividualwas54, whilethoseforthelowstressgroup rangedfrom19to32.Theconditionsthatprecipitatedextremestressinthesingleparticipantwith extremescoresaredescribedinthediscussion.Relationsbetween measures.Oneofthegoalsofthisstudywastotestthevalidityofanexperimentalscale(PPTSD)thatcouldbeused withdisasterworkerpopulations.Ofspecialinterest,therefore,wasthecorrelationwhichthePPTSDhad withothermeasuresofpsychologicalstress.ThePPTSDwashighlycorrelatedwithother,independent, measuresofpsychologicalstress,primarilythoseontheinterviewratingform. These were:symptomsnecessaryforadiagnosisofPTSD(+.89);diminished responsiveness(+.86);re-experiencingthetrauma(+.74);autonomicarousal(+.70);andexposuretostressors(+.65).Ofspecialinterestisthehighcorrelation(+.89) betweenthesummaryscoreofthePPTSDandthesummaryjudgmentoftheevidenceofposttraumaticstressfromtheinterview,asjudgedbyraters.ThePPTSDalsocorrelatedhighlywiththeothertwomeasuresofpsychologicalstress,theBSI(+.81)andthewac(+.77).Finally,therewasa+.90correlationbetween items 6and7ontheinterviewratingform. Thisfindingrelatesfirmlyheldbeliefsaboutdeathtopositivecopingstyle.DiscussionTheframeworkforthisstudywastheobservationthatdisasterworkerstressiscausedbyhazardsofthedisasterevent,andbycharacteristicsoftheworker'soccupation andhisorherownorganization.(Hartsough, 1985).The10

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study examined13workers exposedtoa gruesome body recovery missionona remote,flatplateauintheGrand Canyon.Asa group,theworker sample didnotshowhighlevelsofstressonstandardizedmeasures, norwasitjudged,onthebasisofinterviews,tobesufferingfrompost-traumaticstresssymptoms. Yet,threemembersofthesampledifferedsignificantlyfromtheirpeers.Twoshowedmoderatestress,andone hadbecomeextremelydistressedduring andaftertheincident.Thisportionofthereportwillexaminethevariablesthatwere mostlikelyresponsibleforthewellnessofthemajorityandthedistressofthefew.Inkeeping withtheconceptual frameworkofthestudy,theyarediscussedasevent,professionalrole(occupation),andorganizationvariables.Characteristicsoftheevent.Stressfactorswererelatedto(a)nosurvivors,(b)terrainandweather, (c)thepress,and(d)thebodies.Conditionsthatrepresenthazardsfordisaster vary withthenatureofthedisasteranditslocation.IntheGrandCanyonpotentialhazards occurwhenvictimsmustberescuedfromdangerousterrain,such assteepcanyonwalls.Theobservationthattherewerenosurvivorsofthemidaircollisionremovedthenecessityforsuchanurgentrescue.ThetwoaircraftcrashedontheTontoPlateau,aboutone-halfmileapart.Therelativelyflatterrainofthecrashsiteprovided asafeareainwhichtowork,thus,nulifyingapotentialstressor.(OtherrescuesintheGrandCanyonhave exposedrangerstosteepcanyonsandhazardousclimbs.)Onthedownside,thehot,dry weatherandtheparched landscape were uncomfortable,especiallywhencrews ranoutofwater.Themedia responsetothecrashwasso overpoweringthatcommunicationtoandfromthecanyonwasperiodicallycutoff,a sourceoffrustrationfororganizers.Therangerwho11

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wasfirstonthesceneinthecanyon 'for aninitialoverviewofthecrashwasswampedbymediarepresentativesonhisreturntotherim. Becauseofhisinexperiencewithpressconferences,he foundtheencounter verydistressing.Themajor sourcesofpsychologicalstressfortheworkers werethenumberofdead,andthebadly burnedconditionofthebodies.Thecharredremains proved hardtoidentify.Theage and sexofthebody were sometimes impossibletodetermine, sothatthelocationofthebodyinthewreckage andpersonaleffectsfoundonornearthecorpse hadtobecarefullydocumented. Also,thebodies were odorous,andsometimes sohotthatthey meltedtheplasticbody bags.Thetasksofidentification,baggingthebodies,andtransportingthemtowaitinghelicopterstook approximately6hours.SomeoftheworkerslaterreturnedtothescenetoseekmoreeVidence, andothersassistedwithworkinthemorgue. Insummary,themajor eventcharacteristicsofthisdisasterthatcaused workerdistresswerethenumberofdead,theconditionofthebodies,anddiscomfort.Forsomeworkers,themediaalsobecamea sourceoftensionassociatedwiththecrashsite.Mitigatingfactorsweretherelativesafetyoftheoperationandnot needingtoconductanemergencyrescue.Exposuretothetrauma.Themostdirect,predictivemeasureofworkerdistressisexposuretothepsychologicalhazardsoftheevent.Commonsensedictatesthatthelonger a workerisexposedtothetraumaofanincident,thegreaterthechancethatstresswilloccur.CharacteristicsoftheGrandCanyoncrashsiteprovided a uniqueopportunityfor adirecttestofthishypothesis.BecauseoflogisticalproblemsintransportationdownintotheCanyon, mostofthepersonnelassociatedwiththisincident(forexample,allofthemedia)didnotactuallyjourneytotheimmediatedisasterscene,butinsteadstayedatthecommandheadquartersontheSouthRimoftheGrandCanyonseveralmilesaway. Indeed,inthesample understudy,onlysixworkers wereactuallyon-scene.Theotherseven workers wereeitherstationedatthecommandheadquarters,oninthe12

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Sheriff'sOfficeinFlagstaff,contactingrelativesofthedeceasedvictims.Thesample,therefore,breaksconvenientlyintoanin-canyongroup(n=6)andanot-in-canyongroup(n=7).Workerswhowentintothecanyonhadmuchgreaterexposuretoancontactwiththebodiesthanthosewhodidnot,althoughsomeinthelattergroupdidtransportbodies(inbodybags)aftertheyarrivedatcommandheadquarters.Intheory,thein-canyongroupshouldregistermuchhigherstresslevelsthanthosewhodidnotgointothecanyon.Meanscoresonthestressmeasuresforthetwogroupssupportthisconclusion.Ontheinterviewratingscaleitemreferringtopost-traumaticsymptomsnecessaryforadiagnosisofPTSD,thein-canyongroupscored3.07versustheothergroup's4.62(lowerscoremeansmoresymptoms).Resultsfortheothermeasuresalsosupportedthisconclusion.OnthePPTSD,thein-canyongroupscored36.33versus22.86forthenot-in-canyongroup.OntheBSI,thein-canyongrouphadanaverageof.77,whereastheothergroup's averagewas.21.Finally,onthewoethe intothecanyonscored63.00asopposedto47.71forthegroupthatstayedontherim.Professionalrole.Workersusedseveralmeanstocopewiththestressorstheyencountered,includinggloves,protectiveclothingandsurgicalmaskssmearedwithVicks(fortheodor).Some,whoexperiencednausea,tookbreaksoravoidedcontactwiththecorpsesforatime.Theworkerswhosufferedfewerstresssymptomsalsoseemedtoidentifystronglywiththeirprofessionalroleduringthedifferenttask.Theyemphasizedthatsuccessfullyrecoveringtheremainsandmakingsureoftheirproperidentification'wereveryimportantfor13

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therelativesofthedeceased, andforinsuranceclaims.TotheseworkersitoutwasamatterofprofessionalpridethatthesetaskswerecarriedAproperly sothatanaccuratedescriptioncould be givenastohowandwheretheindividualdied.Thiscognitiveframework allowedtheworkerstoappraisetheremainsintermsoftaskstobe completed,ratherthanasunsavorystimulithatwould causethemdistress.Thus,activelymaintaining astrongpersonalcommitmenttoones'professionalroleprovedaneffectivebuffertoworkerstress.Whentheprofessionalroleofthedisasterworker could not be maintainedadequately,psychologicalstresswasmuchmorelikelytodevelop.Theusualreasonforlossofprofessionalroleduringtheincidentwaspersonalacquaintance with oneofthevictims.Fourmembersofthestudysample werepilots,whoknewoneormoreofthemenpilotingtheaircraftwhich had crashedintothecanyon. Only oneofthefourwasinthelowstressgroup,twowereinthemoderatestressgroup andthefourthwastheindividualwhodemonstrated extremestressonthemeasures.Interviewswiththeseparticipaterevealedthatknowingthepilotsofthedownedandburningaircraftmadethisacriticalincidentforthem,especiallyifthey had beensentintothecanyon. Thesemensaidthat,incontrasttotheirusualequanimityatthesightofbadlymangledbodies,thisincidenthadbecomeverydistressingbecauseoftheirown,personalloss.OrganizationalErrors.Theworker'sownagency can be a sourceofprotection,comfortandsupportagainstthehazardouseffectsofdisasterwork.Ontheotherhand, agenciesmaycontributetothestressoftheirworkers throughdecisionsoroperationalproceduresthatmakeworkersmorevulnerabletostress.Itisimportanttostudytheorganizationalcontributionstostress,becausethesearetheonesthatcanbeavoidedindisasterwork.Onesuch examplewasprovidedbythisincident.Theorganizationalerrorwastostationa workerbyhimself,overnight,in 14

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thecanyonatthecrashsite-a workerwhowaspersonallyacquaintedwithoneofthemenkilledbecause they were bothpilots.Thedecisionwasamistake,butitwasbasedonfollowingstandardprocedure, and,therefore,anunintendedmistake.Thevictimoccupied aliasonpositionbetweenthetwoagencies,and hadinvestigatedcitizendeathsintheGrandCanyononpreviousoccasions.HewasorderedtosayatthecrashsiteinordertocomplywitharequestfromtheNationalTransportationSafetyBoardforovernightsecurity.Thisofficer'sexperiencewasdescribedwithgreatemotionduringhisinterview.Hetriedtowalktheone-halfmile fromthemainrecoveryareatothehelicopter,but,"Icouldn'tgonearthehelicopterbecause Iknewandlikedthepilot,aguynamedJohn. Also,thewreckagewasburning andsowerethebodies.Aftertheotherpeopleleft,I wentuptowardtheairplane,butthebodies werestillhot,theywerestillbubbling.AtthatpointIjustsatdownandcried,realhard.""Ijustwent andmadeacamp,and crawledinthissleepingbag andstayedthereallnight.But Ididn'tgotosleepuntilitwasalmostlightthenextmorning. I thought alotaboutdeathandghosts.Itwasreallyspooky-itremindedmeoftheItaliancrash(intheCanyon3or 4yearsbefore).Iknewthepilot,hewasteachingmetofly.Iinvestigatedthatone -itwasreallyhard work,wewerekickingbodiesoffofledgestogetthemout.Ittook 4 daystogetthebodies."1"The next day, Thursday, I worked doingtherecovery,butIwouldn'ttouch anyofthebodies.I backedoff,gotaway.Whenthey were bagged, I helped loadsomeofthemanddidhelpsomeonegettingphysicalevidence.OnceI got veryupsetduringthebodyloadingpartandgotawayfromit.I went backtothesite3dayslaterbecause they were havingdifficultyidentifyingoneofthebodies and I thought I couldhelpfindmoreevidence.I lookedformoreevidenceforoneofthepilots,and foundteethanda jawbone."15

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Theexperienceofthisdisasterworkervividlydemonstratestheconsequencesofdecisionsthatdisregardthepsychologicalaspectsofdisasterwork.Hewasthelone workerwhobecameextremelydistressedbecauseofhisparticipationinthisincident.Hewasexposedtoa unique combinationoftraumaticstressors,manyofwhich could have been avoidedbyadifferentdecisiononthepartofhisorganization.Thecaseofthisindividualisincluded becauseitshowshoweasilythepsychological consequencesofcommanddecisionscan belostinprocedural concerns,buthowimportant theyaretotheworker. Lessons Learned This studywasundertakentoprovide information abouttheextentofpsychologicalstressindisasterworkers. Inthisstudy,fourofthe13workers experiencedatleastmoderatestress,orabout 30%. Oneofthefour experienced extremestressduetoa unique combinationoffactorsthatmadeanalreadyvulnerableindividualhighlyat-risk.Thelessontobelearnedfromthisstudyisthatthemajorityofworkersareunlikelytobeunusuallydistressed,butthatsomeindividualsmaybecomeextremelyupset.Variablesassociatedwiththedevelopmentofworkerstressinthisstudywere exposuretothetrauma, a breakdownofprofessionalroleduetopersonalacquaintance withdisastervictims,andorganizationalorsupervisoryerrorsthatexposed workerstomoretrauma thanwasnecessary.16

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References AmericanPsychiatricAssociation(1980). Diagnosticandstatisticalmanualofmentaldisorders(3rded.).Washington, D.C.: Author.Derogatis,L.R.(1977).SCL-90:Administration,scoringand procedures manual-Ifortherevisedversionandotherinstrumentsofthepsychopathologyratingscaleseries.Baltimore: John HopkinsUniversitySchoolofMedicine. Dunning,C.M.(1985). Preventionofstress.Proceedingsfroma workshop: Rolestressorsandsupportsforemergency workers.Rockville,MD:NationalInstituteofMental Health, pp. 126-139. Folkman,S., & LazarusR.S. (1985).Ifitchangesitmust be aprocess:Studyofemotionandcoping duringthreestagesofacollegeexamination.JournalofPersonalityandSocialPsychology, 48, 150-170. Hartsough,D.M.(1985).stressandmentalhealthinterventionsinthreemajordisasters.InD.M.Hartsough & D.G.MyersDisasterworkandmentalhealth:Preventionandcontrolofstressamongworkers. Washington, D.C.: NationalInstituteofMental Health, CenterforMental HealthStudiesofEmergencies. Hartsough,D.M. & Myers,D.G.(1985).Disasterworkand mentalhealth:Preventionandcontrolofstressamongworkers. Washington,DC:NationalInstituteofMental Health, CenterforMental HealthStudiesofEmergencies. Jones,E.E.(1985). Limited responsebyapractitioner.Proceedings from a workshop: Rolestressorsandsupportsforemergency workers.Rockville,MD:NationalInstituteofMental Health,p.59. Kling,E.A.(1988).Factorsrelatedtotheappraisalofstressinfirefighters.Unpublisheddissertation.WestLafayette,IN:PurdueUniversity.17

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Mitchell,J.T.(1983).Whendisasterstrikes:Thecriticalincidentstressdebriefingprocess.JournalofEmergencyMedical Systems, 36-39.Mitchell,J.T.(1985). Helpingthehelper.Proceedingsfroma workshop: Rolestressorsand supportsforemergency workers. Rockville,MD:NationalInstituteofMental Health, pp. 105-118. Taylor,J.W.,&Frazer,A.G.(1982).Thestressof body handlingandvictimidentificationwork.JournalofHumanStress,4-12.Acopyofthesampleinterviewreportisavailablefromauthor:DonM.Hartsough,Ph.D.222EastOhioStreet,Suite800Indianapolis, Indiana4620418