Hostname: page-component-586b7cd67f-t7fkt Total loading time: 0 Render date: 2024-11-23T17:28:01.978Z Has data issue: false hasContentIssue false

Pre-Traumatic Vaccination Intervention: Can Dissociative Symptoms be Reduced?

Published online by Cambridge University Press:  28 June 2012

Nir Essar*
Affiliation:
Psagot Institute, Ramat-Gan, Israel
Yuval Palgi
Affiliation:
Department of Psychology, Tel Aviv University, Tel Aviv, Israel
Ronen Saar
Affiliation:
Israel Defence Forces, Israel
Menachem Ben-Ezra
Affiliation:
School of Social Work, Ariel University Center of Samaria, Ariel, Israel
*
Psagot Institute, Aluf David 110, Ramat-Gan 52108, Israel E-mail: [email protected]

Abstract

The Pre-Traumatic Vaccination Intervention (PTV) has been developed in an attempt to help rescue personnel cope with anticipated and non-anticipated disasters, and to prevent trauma-related mental disorders during and after a traumatogenic exposure. Contrary to the generally accepted approach of treating trauma after it has occurred, the PTV has been designed to be administered prior to the potentially traumatic event. Based on empirical findings, the PTV training techniques were designed to prepare the participants for distressful situations. Trainees were gradually exposed to increasingly severe sights using cognitive-behavioral techniques along with foreseen situations relating to their profession. Various interventions were aimed at normalizing using personal resources and implementing relaxation techniques. The PTV was administrated as part of the Israeli Defense Forces rescue personnel's and military police training courses. The results of an uncontrolled, preliminary study suggest that the intervention reduced the level of dissociation leading to more awareness to the traumatic event's details, less suffering, lower probability of making mistakes, and increased likelihood of returning to normal functioning. Lower dissociation may suggest a lower probability to be diagnosed with post-traumatic stress disorder among rescue personnel.

Type
Brief Report
Copyright
Copyright © World Association for Disaster and Emergency Medicine 2010

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1.American Psychiatric Association: Diagnostic and Statistical Manual of Mental Disorders, 4th ed. Text Revision (DSM-IV-TR). Washington: APA, 2000.Google Scholar
2.Shore, JH, Vollmer, WN, Tatum, EL: Community patterns of post-traumatic stress disorders. J Nerv Ment Dis 1989;177:681685.CrossRefGoogle Scholar
3.Kluznick, JC, Speed, N, Van Valkenhurg, C, Magraw, R: Forty-year follow-up of United States prisoners of war. Am J Psychiatry 1986;143:1,443-1,446.Google Scholar
4.Harvey, AG, Bryant, RA: The relationship between acute stress disorder and posttraumatic stress disorder: A prospective evaluation of motor vehicle accident survivors. J Consult Clin Psychol 1998;66:507512.CrossRefGoogle ScholarPubMed
5.Elklit, A: Acute stress disorder in victims of robbery and victims of assault. J Interpers Violence 2002;17:872887.CrossRefGoogle Scholar
6.Cardeña, E, Spiegel, : Dissociative reactions to the San Francisco Bay Area earthquake of 1989. Am J Psychiatry 1993;150:474478.Google Scholar
7.Bryant, RA: Does dissociation further our understanding of PTSD? J Anxiety Disord 2007;21:183191.CrossRefGoogle ScholarPubMed
8.Putnam, FW: Pierre Janet and modern views of dissociation. J Trauma Stress 1989;2:413429.CrossRefGoogle Scholar
9.Spiegel, D: Dissociation and Trauma. In: Tasman, A, Goldfinger, SM, (eds): American Psychiatric Press Review of Psychiatry, Vol. 10. Washington, DC: American Psychiatric Press, 1991, pp 261275.Google Scholar
10.Van der Kolk, BA, Van der Hart, O: Pierre Janet and the breakdown of adaptation in psychological data. Am J Psychiatry 1989;146:1,530-1,540.Google Scholar
11.Marmar, CR, Weiss, DS, Schlenger, WE, Fairbank, JA, Jordan, K, Kulka, RA, Hough, RL: Peritraumatic dissociation and post-traumatic stress in male Vietnam theatre veterans, Am J Psychiatry 1994;151:902907.Google ScholarPubMed
12.Bernstein, EM, Putnam, FW: Development, reliability, and validity of a dissociation scale. J Nerv Ment Dis 1986;174:727735.CrossRefGoogle ScholarPubMed
13.Ozer, EJ, Best, SR, Lipsey, TL, Weiss, DS: Predictors of posttraumatic stress disorder and symptoms in adults: A meta-analysis. Psychol Bull 2003;129:5273.CrossRefGoogle ScholarPubMed
14.Wagner, D, Heinrichs, M, Eklert, U: Prevalence of symptoms of post-traumatic stress disorder in German professional firefighters. Am J Psychiatry 1998;155:17271732.CrossRefGoogle ScholarPubMed
15.Creamer, M, O'Donnell, M: Post-traumatic stress disorder. Curr Opin Psychiatry 2002;15:163168.CrossRefGoogle Scholar
16.Foa, EB, Kean, TM, Friedman, MJ: Effective Treatments for PTSD. New York: The Guilford Press, 1998.Google Scholar
17.Hembree, EA, Foa, BB: Post-traumatic stress disorder: Psychological factors and psychosocial interventions. J Clin Psychiatry 2001;61(Sup.7):3339.Google Scholar
18.Mitchell, JT, Bray, G: Emergency Services Stress: Guidelines for Preserving the Health and Careers of Emergency Services Personnel. Englewood Cliffs, NJ: Prentice Hall, 1990.Google Scholar
19.Arendt, M, Elklit, A: Effectiveness of psychological debriefing. Acta Psychiatr Scand 2001;104:423437.CrossRefGoogle ScholarPubMed
20.Mayou, RA, Ehlers, A, Hobbs, M: Psychological debriefing for road traffic accident victims. Three-year follow-up of a randomized controlled trial. Br J Psychiatry 2000;176:589593.CrossRefGoogle Scholar
21.Mitchell, JT, Everly, GS: The debriefing controversy and crisis intervention: A review of lexical and substantive issues. Int J Emerg Ment Health 2000;2:211225.Google Scholar
22.Solomon, RM: Utilization of EMDR in crisis intervention. Crisis Intervention 1998;4:239246.Google Scholar
23.Van Emmerick, AAP, Kamphuis, JH, Hulsbosch, AM, Em-melkamp, PMG: Single session debriefing after psychological trauma: A meta-analysis. Lancet 2002;360:766771.CrossRefGoogle Scholar
24.Ruzek, J, Watson, P: Early intervention to prevent PTSD and other trauma-related problems. PTSD Research Quarterly 2001;12:18.Google Scholar
25.Whealin, JM, Ruzek, JI, Southwick, S: Cognitive-behavioral theory and preparation for professionals at risk for trauma exposure. Trauma Violence Abuse 2008;9:100113.CrossRefGoogle ScholarPubMed
26.Chemtob, CM, Roitblat, HL, Hamada, RS, Muraoka, MY, Carlson, JG, Bauer, GB: Compelled attention: The effects of viewing trauma-related stimuli on concurrent task performance in posttraumatic stress disorder. J Trauma Stress 1999;12:309326.CrossRefGoogle ScholarPubMed
27.Ehlers, A, Hackmann, A, Steil, R, Clohessy, S, Wenninger, K, Winter, H: The nature of intrusive memories after trauma: The warning signal hypothesis. Behav Res Ther 2002;40:9951002.CrossRefGoogle ScholarPubMed
28.Dunmore, E, Clark, DM, Ehlers, A: Cognitive factors involved in the onset and maintenance of PTSD after physical or sexual assault. Behav Res Ther 1999;37:809829.CrossRefGoogle ScholarPubMed
29.Ehlers, A, Clark, DM: A cognitive model of PTSD. Behav Res Ther 2000;38:319345.CrossRefGoogle Scholar
30.Foa, EB, Davidson, JRT, Frances, A: Expert Consensus Guideline Series treatment of post-traumatic stress disorder. J Clin Psychiatry 1999;60:6976.Google Scholar
31.Jacobson, E: Progressive Relaxation. Am J Psychol 1925;36:7387.CrossRefGoogle Scholar
32.Solomon, SD, Bravo, M, Rubio-Stipec, M, Canino, GJ: The effect of family role on response to disaster. J Trauma Stress 1993;6:5569.CrossRefGoogle Scholar
33.Boscario, JA: PTS and associated disorders among Vietnam veterans: The significance of combat exposure and social support. J Trauma Stress 1995;8:317336.Google Scholar
34.Brewin, CR, Andrews, B, Valentine, JD: Meta-analysis of risk factors for post-traumatic stress disorder in trauma-exposed adults. J Consult Clin Psychol 2000;68:748766.CrossRefGoogle ScholarPubMed
35.Tarrier, N, Sommerfield, C, Reynolds, M, Pilgrim, H: Symptom self-monitoring in the treatment of post-traumatic stress disorder. Behav Ther 1999;30:597605.CrossRefGoogle Scholar
36.Lazarus, RS, Folkman, S: Stress, Appraisal, and Coping. New York: Springer, 1984.Google Scholar
37.Belleau, FP, Hagan, L, Masse, B: Effects of an educational intervention on the anxiety of women awaiting mastectomies. Can Oncol Nurs J 2001;11:172180.Google ScholarPubMed
38.Boeschen, LE, Koss, MP, Figueredo, AJ, Coan, JA: Experiential avoidance and post-traumatic stress disorder: A cognitive mediational model of rape recovery. J Aggress Maltreat Trauma 2001;4:211245.CrossRefGoogle Scholar
39.Allen, K, Golden, LH, Izzo, JL Jr, Ching, MI, Forrest, A, Niles, CR, Niswander, PR, Barlow, JC: Normalization of hypertensive responses during ambulatory surgical stress by perioperative music. Psychosom Med 2001;63:487492.CrossRefGoogle ScholarPubMed
40.Marhold, C, Litton, SJ, Melon, L: A cognitive-behavioral return-to-work program: Effects on pain patients with a history of long-term versus short-term sick leave. Pain 2001;91:155163.CrossRefGoogle ScholarPubMed
41.McNally, RJ: Psychological mechanisms in acute response to trauma. Biol Psychiatry 2003;53:779788.CrossRefGoogle ScholarPubMed
42.Roesch Scott, C, Bernard, Weiner, Vaughn Allison, A: Cognitive approaches to stress and coping. Curr Opin Psychiatry 2002;15:627632.CrossRefGoogle Scholar
43.Lahad, S, Shacham, Y, Niv, S: Coping and community resources in children facing disaster. In Shalev, AY, Yehuda, R, Mcfarlane, AC (eds): International Handbook of Human Response to Trauma. New York: Kulwer Academic/Plenum, 2000, pp 389395.CrossRefGoogle Scholar
44.Omer, H, Alon, N: Constructing Therapeutic Narratives. Lanham, MD: Jason Aronson, 1997.Google Scholar
45.Nice, DS, Garland, CF, Hilton, SM, Baggett, JC, Mitchell, RE: Long-term health outcomes and medical effects of torture among US Navy prisoners of war in Vietnam. JAMA 1996;276:375381.CrossRefGoogle ScholarPubMed
46.Sledge, WH, Boydstun, JA, Rabe, AJ: Self-concept changes related to war captivity. Arch Gen Psychiatry 1980;37:430443.CrossRefGoogle ScholarPubMed
47.Basoglu, M, Mineka, S, Paker, M, Aker, T, Livanou, M, Gok, S: Psychological preparedness for trauma as a protective factor in survivors of torture. Psychol Med 1997;27:14211433.CrossRefGoogle ScholarPubMed
48.Ben-Ezra, M, Essar, N, Saar, R: Gender differences and acute stress reactions among rescue personnel 36 to 48 hours after exposure to traumatic event. Traumatology 2006;12:139142.CrossRefGoogle Scholar
49.Ben-Ezra, M, Essar, N, Saar, R: The association between peritraumatic dissociation and acute stress reactions among rescue personnel 36-48 h after a gas pipe explosion in Tel-Aviv: A preliminary report. Stress and Health 2006;22:197201.CrossRefGoogle Scholar
50.Ben-Ezra, M, Essar, N, Saar, R: Post-traumatic reactions among rescue personnel before and after exposure to trauma: A brief report. Stress and Health 2006;22:337340.CrossRefGoogle Scholar
51.Bernstein, EM, Putnam, FW: Development, reliability, and validity of a dissociation scale. J Nerv Ment Dis 1986;174:727735.CrossRefGoogle ScholarPubMed
52.Weiss, DS, Marmar, CR: The impact of event scale-revised. In: Wilson, JP, Keane, TM (eds): Assessing Psychological Trauma and PTSD. New York: Guilford Press, 1997, pp 399411.Google Scholar
53.Cohen, J: Statistical Power Analysis for the Behavioral Sciences 2e. Hillsdale, NJ: Lawrence Erlbaum Associates, 1998.Google Scholar
54.Briere, J, Scott, C, Weathers, F: Peritraumatic and persistent dissociation in the presumed etiology of PTSD. Am J Psychiatry 2005;162:22952301.CrossRefGoogle ScholarPubMed