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Biomedical subjects

C S Fullerton

Publications and source records attributed to C S Fullerton.

At least 37 records · Page 2Linked to original sources
PubMed1999

Life events in health care providers before and during Persian Gulf War deployment: the USNS Comfort.

Just before the onset of Operation Desert Storm, health care personnel (N = 250) onboard the USNS Comfort reported the occurrence of life events for the preceding year, including before deployment and during the Persian Gulf War. Study participants noted both total and negative life events. The mean number of negative life events during the preceding year was 1.44; a sizable proportion of participants (38%) reported no negative life events during this time. There were no differences in the mean number of total or negative life events by gender, although women checked significantly more life event items related to interpersonal factors and men noted more life events concerning financial issues. Women, nurses, the childless, and lower ranking officers noted significantly greater negative life events during predeployment than deployment. Negative life events were moderately related to anxiety, depression, and post-traumatic stress disorder symptoms. Both research and policy implications are discussed.

Adolescent↗
PubMed1998

Posttraumatic stress disorder following an air disaster: a prospective study.

OBJECTIVE: The purpose of this study was to determine predictors of posttraumatic stress disorder (PTSD) in health care workers exposed to a disaster, in order to facilitate early case identification and prevention of subsequent morbidity. METHOD: Following an air disaster, 355 military medical health care workers were studied over an 18-month follow-up period. Measures included assessment of peritraumatic reactions associated with the disaster, the frequency of other stressful events after the disaster, and standard PTSD rating scales at 6, 12, and 18 months. RESULTS: Multivariate logistic regression of data on health care workers who cared for victims of the air disaster showed that PTSD was more likely to develop in those who had not completed college, those who had worked with burn victims, those who had experienced more stressful life events in a period of approximately 6 months following the disaster, and those who experienced emotional numbness immediately after the disaster. CONCLUSIONS: Results suggest that lower levels of education, exposure to grotesque burn injuries, stressful life events following exposure, and feelings of numbness following exposure are useful predictors of subsequent development of PTSD.

Accidents, Aviation↗
PubMed1997

The threat of biological weapons. Prophylaxis and mitigation of psychological and social consequences.

The microbial world is mysterious, threatening, and frightening to most people. The stressors associated with a biological terrorist attack could create high numbers of acute and potentially chronic psychiatric casualties who must be recognized, diagnosed, and treated to facilitate triage and medical care. Media communications, planning for quarantine and decontamination, and the role of community leaders are important to the mitigation of psychological consequences. Physicians will need to accurately diagnose anxiety, depression, bereavement, and organic brain syndromes to provide treatment, reassurance, and the relief of pain.

Biological Warfare↗
PubMed1997

Acute and chronic distress and posttraumatic stress disorder as a function of responsibility for serious motor vehicle accidents.

In this study on the effects of attributions of responsibility for traumatic events, stress, coping, and symptoms of posttraumatic stress disorder (PTSD) were measured, including intrusive thoughts among 130 victims of serious motor vehicle accidents (MVAs) 14-21 days and 3, 6, and 12 months after their accident. MVA victims and 43 control participants were categorized by accident and attribution of responsibility for their accidents (self-responsible, other-responsible, and control). Although initially all MVA victims reported higher levels of intrusive thoughts and were more likely to meet criteria for PTSD diagnoses, only other-responsible participants continued to demonstrate increased distress 6 and 12 months postaccident. Self-responsible participants used more self-blame coping than other-responsible participants, although within the self-responsible group, use of self-blame was associated with more distress.

Accidents, Traffic↗
PubMed1997

Psychiatric morbidity in medical and surgical patients evacuated from the Persian Gulf War.

Acute treatment records of all medical and surgical patients evacuated to Walter Reed Army Medical Center in Washington, D.C., from the Persian Gulf theater (N = 161) were examined to better understand the relationship of injury to psychiatric symptoms. A total of 110 (68 percent) sustained a traumatic injury. They were significantly more likely to have an axis I disorder or psychiatric symptoms of concern than participants in the Persian Gulf War who did not sustain traumatic injuries but who were evacuated for medical conditions. The results indicate that traumatically injured veterans are at greater risk of psychiatric symptoms than veterans who are not injured and that they should be referred for psychiatric evaluation.

Adolescent↗
PubMed1996

Acute stress disorder, subsequent posttraumatic stress disorder and depression after a series of typhoons.

From August to November 1992, five typhoons struck the U.S. Pacific island territory of Guam. Three hundred and twenty subjects exposed to all five typhoons participated in a population survey measuring their acute stress symptoms and subsequent diagnoses of posttraumatic stress disorder (PTSD) and depression. A 23-item scale approximating the new DSM-IV diagnosis of acute stress disorder (ASD) was used to classify subjects into three groups based on their symptoms one week after the first typhoon: (1) probable ASD, (2) an early traumatic stress response (ETSR) of fear, intrusion, avoidance, and arousal, without dissociation, and (3) no acute diagnosis. A multi-dimensional measure of PTSD and the Zung Self-Rating Depression Scale were used to assess PTSD and depression 8 months after the first storm. The point prevalence of ASD at one week was 7.2%. An additional 15% of subjects had ETSR. Subjects with probable ASD at one week had significantly increased rates of PTSD and somewhat higher rates of depression at 8 months than those without ASD. In contrast, subjects with ETSR at one week did not have a poorer outcome than those with no acute diagnosis. These findings suggest that ASD is prognostically important, but also indicate that all acute stress symptoms do not have the same discriminative value. In this study, the acute dissociative symptoms of emotional numbing and derealization differentiated highly symptomatic subjects at risk for subsequent psychopathology (ASD) from others who were highly symptomatic at one week, but then had a more benign, posttraumatic course (ETSR).

Adult↗
PubMed1996

Posttraumatic stress symptoms following forensic dental identification: Mt. Carmel, Waco, Texas.

OBJECTIVE: This study was conducted to determine risk factors for posttraumatic stress in medical care professionals who perform postmortem identifications. METHOD: Thirty-one dentists (29 men and two women) who had identified the dead from the fire at the Branch Davidian compound in April 1993 were compared to 47 dentists (45 men and two women) who lived in the area but had not identified any of these remains. Posttraumatic symptoms in both groups were measured by using the Impact of Event Scale and the Brief Symptom Inventory. For the remains handlers only, the subjective distress of handling remains and the social support received during the procedure were reported. RESULTS: Higher scores on the Impact of Event Scale intrusion subscale, the overall Impact of Event Scale, and the obsessive-compulsive subscale of the Brief Symptom Inventory were found for the remains handlers than for the comparison group. Within the remains handler group, distress was significantly related to the hours of exposure to the remains, prior experience handling remains, age, and the support received from spouses and co-workers during the identifications. CONCLUSIONS: Posttraumatic stress symptoms can be expected in some health professionals who perform postmortem identifications. Prior experience and social support may mitigate some of these responses.

Adult↗
PubMed1995

Gruesomeness, emotional attachment, and personal threat: dimensions of the anticipated stress of body recovery.

Previous research has shown that exposure to grotesque death has been associated with posttraumatic stress disorder and higher levels of stress have been associated with mortuary workers who anticipated handling remains than those who did not. Additional research is presented here to further clarify the nature of the anticipated stress of handling the dead. Anticipated stress of handling human remains was rated for 13 different situations by 479 persons (384 men and 95 women) without such experience, but whose job was likely to require it. Factor analysis of their ratings revealed three psychological dimensions: the gruesomeness of the remains, an emotional link between the viewer and the remains, and personal threats to the remains handler. Suggestions for preventive measures, training, and interventions for those who may handle remains are made.

Adolescent↗
PubMed1995

Longitudinal assessment of posttraumatic stress disorder and depression after exposure to traumatic death.

Little is known of the specific effects of exposure to traumatic death, an important dimension of many disasters. This study examined acute and long-term intrusive and avoidant symptoms, depression, and posttraumatic stress disorder (PTSD) in disaster workers exposed to traumatic death after the USS Iowa gun turret explosion. Fifty-four volunteer body handlers were assessed at 1, 4, and 13 months. They were compared with 11 non-body handler disaster worker volunteers. The Impact of Events Scale, Zung Depression Scale, Symptom Checklist-90-Revised, and a multi-method assessment of PTSD were used. Intrusive and avoidant symptoms were elevated at 1, 4, and 13 months, and decreased over time. Probable PTSD was present in 11% at 1 month, 10% at 4 months, and 2% at 13 months. The frequency of depression was not increased. Single body handler disaster workers reported more avoidance (times 1 and 2) and somatization (time 1) than did married workers. Body handlers reported more intrusion, avoidance, hostility, and somatization at 1 month than did non-body handler volunteers. These results indicate that exposure to traumatic death increases intrusive and avoidant symptoms, hostility, somatization, and the risk of PTSD and that symptoms can persist for months.

Adolescent↗
PubMed1995

Anticipatory stress of handling human remains from the Persian Gulf War. Predictors of intrusion and avoidance.

High levels of distress were found in military mortuary workers prior to the arrival of the human remains from the Persian Gulf War of 1991. To better understand the stress of anticipating the handling of remains, we performed stepwise multiple regression analyses to identify the best predictors of intrusive thoughts and avoidant thoughts and behavior, two of the primary symptoms of posttraumatic stress disorder. After volunteer status and sex were controlled, fear and discomfort with mutilation and the grotesque, as measured by the Mutilation Questionnaire, and defensiveness or denial, as measured by the Marlowe-Crowne Scale, were significant predictors of intrusion and avoidance in the inexperienced group. In the experienced group, only the Mutilation Questionnaire predicted intrusion and avoidance. Results have implications for selection, training, and interventions for mortuary workers and other disaster workers whose job includes exposure to human remains.

Adult↗
PubMed1995

Symptoms of PTSD following recovery of war dead: 13-15-month follow-up.

OBJECTIVE: The authors explored whether individuals who participated in the recovery of war dead were more likely to experience later symptoms of posttraumatic stress disorder (PTSD) than were individuals who were not involved in the recovery of war dead. METHOD: PTSD symptoms were assessed by questionnaire in men and women who had or had not handled human remains during the Persian Gulf War: 116 men and women who had and 118 who had not handled human remains participated in the study 3-5 months after returning from the war; 55 of the subjects who had and 56 of those who had not handled human remains participated in a follow-up assessment 13-15 months after their return. RESULTS: Subjects who had been involved in the recovery of war dead had significantly higher symptom levels than comparison subjects at both time points. CONCLUSIONS: After more than 1 year, individuals who had handled human remains during wartime were at higher risk for PTSD symptoms than those who had not.

Adult↗
PubMed1994

Factor analysis of the General Health Questionnaire.

We present the factor structure of the General Health Questionnaire-60 as derived from a population of 2115 Army soldiers. An eight-factor principal components analysis provided the most clinically relevant solution and explained 58.0% of the variance. We distinguished two types of depressive symptomatology, suggesting the questionnaire may be useful in differentiating shame-ridden dysphoria from anergic disinterest.

Adolescent↗
PubMed1994

Health care delivery in the high-stress environment of chemical and biological warfare.

Understanding health care delivery in high-stress environments, such as the chemical and biological warfare (CBW) environment, is important to developing better procedures for providing health care to individuals and groups exposed to this and other traumas and disasters. Little is known about the behavioral and psychological responses affecting health and performance in the CBW environment. In this paper, we report preliminary observations of the behavioral and psychological responses of a health care delivery exercise occurring over 1 week in a simulated CBW environment. Results suggest that responses to the CBW environment will include: claustrophobia, difficulties with masks, overheating, feelings of having failed, increased risk associated with dedication to the group, dehydration secondary to alcohol use, failure to recognize danger, and anxiety.

Adolescent↗
PubMed1993

Handling bodies after violent death: strategies for coping.

Interviews with and observations of experienced and inexperienced personnel were conducted to determine their coping strategies before, during, and after their work with the bodies of people who had died violently. Avoidance, denial, and social support from the work group and spouse appeared to facilitate coping. The implications of these findings for therapeutic intervention are discussed.

Accidents, Aviation↗
PubMed1993

Traumatic stress of a wartime mortuary. Anticipation of exposure to mass death.

Exposure to traumatic death is a risk factor for posttraumatic stress disorder. For some groups, anticipation of such exposure may contribute to traumatic stress. We studied the anticipated stress of working in the Operation Desert Storm mortuary in two groups prior to the arrival of the dead. We examined those who would handle remains (mortuary workers, N = 386, 330 men and 56 women) and those who would not (support workers, N = 87, 67 men and 20 women). These two groups were a mixture of volunteers and nonvolunteers as well as persons with and without experience in handling the dead. The mortuary workers had higher levels of preexposure distress than support workers; nonvolunteer mortuary workers had higher levels of distress than volunteers. Female mortuary workers had higher levels of distress than males, although this effect was modest. Experienced mortuary workers reported fewer intrusive and avoidant symptoms than did inexperienced workers. Those persons at highest risk for generalized distress as well as intrusive and avoidant symptoms were inexperienced nonvolunteer mortuary workers.

Adult↗
PubMed1993

Anticipation of handling the dead: effects of gender and experience.

In addition to the direct psychological effects of disaster stressors, anticipation of stress can itself be debilitating. We examined the relationship between the anticipated stress of handling the dead and gender and experience. Experienced persons had lower anticipated stress than inexperienced persons. Inexperienced, females had higher anticipated stress than inexperienced males; experienced males and females did not differ. Results provide support for an 'inoculation' theory of stress buffering in disaster workers.

Adaptation, Psychological↗
PubMed1993

Symptoms of posttraumatic stress disorder following recovery of war dead.

Persons who handled human remains in Operation Desert Storm (N = 116) were compared with those who did not handle remains (N = 118) on symptoms of posttraumatic stress disorder. Subjects who handled remains reported more intrusive and avoidant symptoms than other subjects. Subjects who were inexperienced at handling remains had more symptoms than those who were experienced. Within the experienced group, there was a significant correlation between the number of remains handled and level of symptoms reported.

Adolescent↗