Hostname: page-component-586b7cd67f-2brh9 Total loading time: 0 Render date: 2024-11-22T07:46:33.027Z Has data issue: false hasContentIssue false

Psychological Sequelae Following the Gulf War

Factors Associated with Subsequent Morbidity and the Effectiveness of Psychological Debriefing

Published online by Cambridge University Press:  02 January 2018

Martin P. Deahl*
Affiliation:
The Medical College of St Bartholomew's Hospital
Adrian B. Gillham
Affiliation:
Cambridge Military Hospital, Aldershot
Janice Thomas
Affiliation:
The Medical College of St Bartholomew's Hospital, West Smithfield, London
Margaret M. Searle
Affiliation:
Queen Elizabeth Military Hospital, Woolwich, London
Michael Srinivasan
Affiliation:
Queen Elizabeth Military Hospital, Woolwich, London
*
Dr M. P. Deahl, The Medical College of St Bartholomew's Hospital, West Smithfield, London EC1A 7BE

Extract

Background

The aim was to study the effect of brief counselling and psychological debriefing following a trauma on subsequent morbidity.

Method

We investigated psychological morbidity in 62 British soldiers whose duties included the handling and identification of dead bodies of allied and enemy soldiers during the Gulf War. Of these soldiers, 69% received a psychological debriefing on completion of their duties. The subjects completed by post a demographic questionnaire, the General Health Questionnaire (GHQ-28) and the Impact of Events Scale.

Results

After nine months 50% had evidence of some psychological disturbance suggestive of posttraumatic stress disorder (PTSD); 18% had sought professional help; 26% reported relationship difficulties. Neither prior training nor the psychological intervention appeared to make any difference to subsequent psychiatric morbidity. Morbidity at nine months was more likely in those with a history of psychological problems and those who believed their lives had been in danger in the Gulf.

Conclusions

These findings show that a psychological debriefing following a series of traumatic events or experiences does not appear to reduce subsequent psychiatric morbidity and highlights the need for further research in military and civilian settings.

Type
Research Article
Copyright
Copyright © Royal College of Psychiatrists, 1994 

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

Alexander, D. A. & Wells, A. (1991) Reactions of police officers to body handling after a major disaster. A before and after comparison. British Journal of Psychiatry, 159, 547555.CrossRefGoogle Scholar
Bloch, H. S. (1969) Army clinical psychiatry in the combat zone: 1967–1968. American Journal of Psychiatry, 126, 289298.Google Scholar
British Psychological Society (1990) Psychological Aspects of Disaster. Report, Sept. 1990. Leicester: British Psychological Society.Google Scholar
Cobb, S. & Lindemann, E. (1943) Neuropsychiatric observations after the coconut grove fire. Annals of Surgery, 117, 814824.Google Scholar
Curran, P. S. (1988) Psychiatric aspects of terrorist violence: Northern Ireland 1969–87. British Journal of Psychiatry, 153, 470475.CrossRefGoogle Scholar
Duckworth, D. H. (1986) Psychological problems arising from disaster work. Stress Medicine, 2, 315323.Google Scholar
Dunning, C. (1990) Mental health sequelae in disaster workers: Prevention and intervention. International Journal of Mental Health, 19, 91103.Google Scholar
Dyregrov, A. (1989) Caring for helpers in disaster situations: Psychological debriefing. Disaster Management, 2, 2530.Google Scholar
Foy, D. W., Rueger, D. B., Siprelle, R. C., et al (1984) Etiology of PTSD in Vietnam veterans: Analysis of premilitary, military, and combat experience influences. Journal of Consultation and Clinical Psychology, 52, 7987.Google Scholar
Goldberg, D. P. & Hilues, V. F. (1979) A scaled version of the GHQ. Psychological Medicine, 9, 139145.Google Scholar
Haywood, C. H. (1975) Emergency, crisis and stress services for rape victims. Crisis Intervention, 6, 4348.Google Scholar
Helzer, J. E., Robins, L. N. & McEvoy, L. (1987) Post-traumatic stress disorder in the general population. New England Journal of Medicine, 317, 16301634.Google Scholar
Horowitz, M., Wilner, N. & Alvarez, W. (1979) Impact of events scale: A measure of subjective stress. Psychosomatic Medicine, 41, 209218.Google Scholar
Hytten, K. & Hasle, A. (1989) Fire fighters: A study of stress and coping. Acta Psychiatrica Scandinavica, 80, suppl. 355.Google Scholar
Jones, D. J. (1985) Secondary disaster victims: the emotional effects of identifying and recovering human remains. American Journal of Psychiatry, 142, 303307.Google Scholar
Jones, F. D. & Johnson, A. W. (1975) Medical and psychiatric treatment policy and practice in Vietnam. Journal of Social Issues, 31, 4965.Google Scholar
Kulka, R. A., Schlenger, W. E., Fairbank, J. A., et al (1988) National Vietnam Veterans readjustment study (NVVRS): Description, current status, and initial PTSD prevalence estimates. Research Triangle Park, NC: Research Triangle Institute.Google Scholar
Lieberman, M. A. (1982) The effects of social support on responses to stress. In Handbook of Stress (eds Goldberger, L. & Brenitz, L.). New York: Free Press.Google Scholar
McFarlane, A. C. (1986) Long term psychiatric morbidity after a natural disaster: Implications for disaster planners and emergency services. Medical Journal of Australia, 145, 561563.Google Scholar
Rubin, E. H., (1988) The longitudinal course of posttraumatic morbidity. The range of outcomes and their predictors. Journal of Nervous and Mental Disease, 176, 3039.Google Scholar
Mezey, G. C. & Taylor, P. J. (1988) Psychological reactions of women who have been raped: a descriptive and comparative study. British Journal of Psychiatry, 152, 330339.CrossRefGoogle ScholarPubMed
Mitchell, J. T. (1983) “When disaster strikes. … The critical incident stress debriefing process”. Journal of Emergency Medical Services, 8, 3639.Google Scholar
O'Brien, L. S. & Hughes, S. J. (1991) Symptoms of post traumatic stress disorder in Falklands veterans five years after the conflict. British Journal of Psychiatry, 159, 135141.Google Scholar
Rachman, S. (1980) Emotional processing. Behaviour Research and Therapy, 18, 5160.Google Scholar
Ramsay, R. (1990) Invited review: Post-traumatic stress disorder; a new clinical entity? Journal of Psychosomatic Research, 34, 355365.CrossRefGoogle ScholarPubMed
Raphael, B., Lundin, T. & Weisaeth, L. (1989) A research method for the study of psychological and psychiatric aspects of disaster. Acta Psychiatrica Scandinavica, 80, suppl. 353.CrossRefGoogle Scholar
Searle, M. M. & Bisson, J. I. (1992) Psychological sequelae of friendly fire. In Proceedings of Military Psychiatry Conference “Stress Psychiatry and War”, Paris, 1992. Google Scholar
Solomon, Z. (1989) Untreated combat related PTSD – Why some Israeli veterans do not seek help. Israeli Journal of Psychiatry and Related Sciences, 26, 111123.Google Scholar
Solomon, Z. & Benbenishty, R. (1986) The role of proximity, immediacy, and expectancy in front line treatment of combat stress reactions among Israelis in the Lebanon war. American Journal of Psychiatry, 143, 613617.Google Scholar
Taylor, A. J. W. & Frazer, A. G. (1982) The stress of post disaster body handling and victim identification work. Journal of Human Stress, 8, 412.Google Scholar
Ursano, R. J. & McCarroll, J. E. (1990) The nature of a traumatic stressor: Handling dead bodies. Journal of Nervous and Mental Disease, 178, 396398.Google Scholar
Submit a response

eLetters

No eLetters have been published for this article.