Abstract
Objectives
Participation in health survey research may result in a worsening of self-assessed health status and enhanced service-use by increasing self-awareness of current health status. The present study investigated whether participation in a trauma-focused epidemiological study sensitized participants for health problems irrespective of trauma exposure.
Methods
A total of 1,019 rescue workers and 453 residents involved in varying degrees in a large scale aviation disaster participated. Data collection took place between December 2000 and April 2003. There were two measurements: one during the epidemiological investigation at a general hospital and one 12 weeks after the first measurement. Follow-up data were gathered in 80% of a randomly selected group of rescue workers and in 62% of the residents. Main outcome measures were: health anxiety, somatic sensitivity, the tendency to be reassured by a physician, psychopathology, post-traumatic stress symptoms, fatigue and quality of life.
Results
Both rescue workers and residents reported less reassurance, and increased health anxiety and somatic sensitivity 12 weeks after the investigation compared to the first measurement. Exposure to the aviation disaster was not predictive of these changes in health perception, but higher levels of psychological and physical symptoms at baseline were. Only 0.2–1.6% of the residents and rescue workers indicated at baseline that the investigation had had a very negative impact on their mental and/or physical well-being. No evidence for systematic trends or changes in baseline scores for anxiety about health or subjective complaints during the 15 months inclusion period were found.
Conclusions
Participation in an epidemiological study of the long-term sequelae of disaster exposure does not lead to very strong negative reactions in most of the participants, but can result in an increased awareness of somatic sensations, enhancement of health worries and lowered reassurability by physicians, especially in participants with higher levels of psychological and physical symptoms at baseline. Future studies are needed to investigate the temporal stability of these inadvertent and unobtrusive negative consequences.
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References
American Psychiatric Association (APA) (2000) Diagnostic and statistical manual of mental disorders-IV-TR. APA, Washington, DC
Barsky AJ, Wyshak G, Klerman GL (1990) The Somatosensory Amplification Scale and its relationship to hypochondriasis. J Psychiatr Res 24:323–334
Boin A, van Duin M, Heyse L (2001) Toxic fear: the management of uncertainty in the wake of the Amsterdam air crash. J Hazard Mater 88:213–234
Brom D, Kleber RJ (1985) De Schok Verwerkings Lijst. [Impact of event scale]. Ned Tijdschr Psychol 40:164–168
Elklit A (2007) Psychological consequences of a firework factory disaster in a local community. Soc Psychiatry Psychiatr Epidemiol 42:664–668
EuroQol Group (2001) EQ-5D: A measure of health-related quality of life developed by the EuroQol Group. User guide, 9th ed. EuroQol Group, Rotterdam
Ford JD, Adams ML, Dailey WF (2006) Factors associated with receiving help and risk factors for disaster-related distress among Connecticut adults 5–15 months after the September 11th terrorist incidents. Soc Psychiatry Psychiatr Epidemiol 41:261–270
Galea S, Nandi A, Stuber J, Gold J, Acierno R, Best CL, et al. (2005) Participant reactions to survey research in the general population after terrorist attacks. J Trauma Stress 18:461–465
Goldberg DP (1972) The detection of psychiatric illness by questionnaire. Oxford University Press, London
Havenaar JM, van den Brink W (1997) Psychological factors affecting health after toxicological disasters. Clin Psychol Rev 17:359–374
Havenaar JM, de Wilde EJ, van den Bout J, Drottz-Sjöberg BM, van den Brink W (2003) Perception of risk and subjective health among victims of the Chernobyl disaster. Soc Sci Med 56:569–572
Henderson AS, Jorm AF (1990) Do mental health surveys disturb? Psychol Med 20:721–724
Horowitz M, Wilner N, Alvarez W (1979) Impact of event scale: a measure of subjective stress. Psychosom Med 41:209–218
Jacomb PA, Jorm AF, Rodgers B, Korten AE, Henderson AS, Christensen H (1999) Emotional response of participants to a mental health survey. Soc Psychiatry Psychiatr Epidemiol 34:80–84
Jorm AF, Henderson AS, Scott R, Mackinnon AJ, Korten AE, Christensen H (1994) Do mental health surveys disturb? Further evidence. Psychol Med 24:233–237
Kellner R, Abbott P, Winslow WW, Pathak D (1987) Fears, beliefs, and attitudes in DSM-III hypochondriasis. J Nerv Ment Dis 175:20–25
Koeter MWJ, Ormel J (1991) General health questionnaire. Nederlandse bewerking handleiding. [Dutch version of manual]. Swets and Zeitlinger, Lisse
McNally RJ (2003) Remembering trauma. Belknap Press of Harvard University Press, Cambridge
Medical Investigation Bijlmermeer Aviation Disaster Website (2002) URL: http://www.movb.nl/en/index.htm Accessed 23 January 2002
Newman E, Kaloupek DG (2004) The risks and benefits of participating in trauma-focused research studies. J Trauma Stress 17:383–394
Norris FH, Friedman MJ, Watson PJ, Byrne CM, Diaz E, Kaniasty K (2002) 60,000 Disaster victims speak: part I. An empirical review of the empirical literature, 1981–2001. Psychiatry 65:207–239
Parslow RA, Jorm AF, Christensen H, Rodgers B (2004) Use of medical services after participation in a community-based epidemiological health survey. Soc Psychiatry Psychiatr Epidemiol 39:311–317
Parslow RA, Jorm AF, O’Toole BI, Marshall RP, Grayson DA (2000) Distress experienced by participants during an epidemiological survey of posttraumatic stress disorder. J Trauma Stress 13:465–471
Salkovskis PM, Warwick HMC (1986) Morbid preoccupations, health anxiety and reassurance: a cognitive-behavioural approach to hypochondriasis. Behav Res Ther 24:597–602
Slottje P, Bijlsma JA, Smidt N, et al. (2005) Epidemiologic study of the autoimmune health effects of a cargo aircraft disaster. Arch Intern Med 165:2278–2285
Slottje P, Huizink AC, Twisk JWR, et al. (2005) Epidemiological study air disaster in Amsterdam (ESADA): study design. BMC Public Health 5:54
Slottje P, Huizink A, Witteveen A, et al. (2003) Long-term physical symptoms without laboratory abnormalities in workers occupationally involved in an air disaster. Epidemiological study air disaster Amsterdam. Epidemiology 14:S113
Speckens AEM, Spinhoven P, van Hemert AM, Bolk JH (2000) The reassurance questionnaire (RQ): psychometric properties of a self-report questionnaire to assess reassurability. Psychol Med 30:841–847
Speckens AEM, Spinhoven P, Sloekers PPA, Bolk JH, Van Hemert AM (1996) A validation study of the Whitely index, the illness attitude scales, and the somatosensory amplification scale in general medical and general practice patients. J Psychosom Res 40:95–104
Thalheimer W, Cook S (2002) How to calculate effect sizes from published research articles: A simplified methodology. URL: http://www.work-learning.com/effect_sizes.htm Accessed 16 April 2004
Turnbull JE, McLeod JD, Callahan JM, Kessler RC (1988) Who should ask? Ethical interviewing in psychiatric epidemiology studies. Am J Orthopsychiatry 58:228–239
Vasterman P, Yzermans CJ, Dirkzwager AJE (2005) The role of the media and media hypes in the aftermath of disasters. Epidemiol Rev 27:107–114
Vercoulen JHMM, Swanink CMA, Fennis JFM, Galama JMD, Van der Meer JWM, Bleijenberg G (1994) Dimensional assessment of chronic fatigue syndrome. J Psychosom Res 38:383–392
Walker EA, Newman E, Koss M, Bernstein D (1997) Does the study of victimization revictimize the victims? Gen Hosp Psychiatry 19:403–410
Witteveen AB, Bramsen I, Twisk JWR, et al. (2007) Psychological distress of rescue workers eight and one-half years after professional involvement in the Amsterdam air disaster. J Nerv Ment Dis 195:31–40
Yzermans CJ, Gersons BPR (2002) The chaotic aftermath of an airplane crash in Amsterdam: a second disaster. In: Havenaar JM, Cwikel JG, Bromet EJ (eds) Toxic turmoil; psychological and societal consequences of ecological disasters. Kluwer Academic/Plenum Publishers, New York
Acknowledgements
This study was supported by the Ministry of Public Health, Welfare and Sports, the Amsterdam-Amstelland Police, KLM Royal Dutch Airlines and the City of Amsterdam, The Netherlands. We are most grateful to the participants of our study and also to the staff of the EMGO Institute, KLM Health Services, the Executive Organization MOVB and the Counseling Committee MOVB.
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Verschuur, M.J., Spinhoven, P., van Emmerik, A.A. et al. Participation in a trauma-focused epidemiological investigation may result in sensitization for current health problems. Soc Psychiat Epidemiol 43, 132–139 (2008). https://doi.org/10.1007/s00127-007-0278-9
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DOI: https://doi.org/10.1007/s00127-007-0278-9