The Mental Health Impact of Volunteering in a Disaster Setting: A Review

This article reviews the literature on mental health of volunteers after working in disasters. When mobilized they often are a community's major source for rescue and recovery. PsychINFO, PubMED, and Web of Science were searched for relevant articles published until October 2009. Of 448 articles screened, only 9 articles fulfilled our inclusion criteria. They examined the aftermath of earthquakes (4 articles), terrorist bombings (1), explosions (1), aviation disasters (1), tsunami (1), and a bus accident (1). Findings showed that, compared with professional workers, volunteers tend to have higher complaint levels. The following factors were found to contribute to mental health complaints of volunteers: Identification with victims as a friend, severity of exposure to gruesome events during disaster work, anxiety sensitivity, and lack of postdisaster social support. The review reveals the need for more research regarding predictors of stress in volunteers.

[1]  B. Dick,et al.  The International Federation of Red Cross and Red Crescent Societies , 1992, Tropical doctor.

[2]  Risk factors for psychological and physical health problems after a man-made disaster , 2006, British Journal of Psychiatry.

[3]  A. Hull,et al.  Survivors of the Piper Alpha oil platform disaster: long-term follow-up study. , 2002, The British journal of psychiatry : the journal of mental science.

[4]  J. Mackenbach,et al.  The effects of ill health on entering and maintaining paid employment: evidence in European countries , 2007, Journal of Epidemiology and Community Health.

[5]  M. Horowitz,et al.  Impact of Event Scale: A Measure of Subjective Stress , 1979, Psychosomatic medicine.

[6]  P. Muntner,et al.  Symptoms of Posttraumatic Stress Disorder in a New Orleans Workforce Following Hurricane Katrina , 2007, Journal of Urban Health.

[7]  C. Davos,et al.  Psychological consequences among adults following the 1999 earthquake in Athens, Greece. , 2008, Disasters.

[8]  C. Dolea,et al.  World Health Organization , 1949, International Organization.

[9]  J. McCarroll,et al.  The nature of a traumatic stressor: handling dead bodies. , 1990, The Journal of nervous and mental disease.

[10]  T. Paparrigopoulos,et al.  The Psychological Impact of a Catastrophic Earthquake: A Retrospective Study 50 Years After the Event , 2008, The Journal of nervous and mental disease.

[11]  B. Green,et al.  Outcomes of Single Versus Multiple Trauma Exposure in a Screening Sample , 2000, Journal of traumatic stress.

[12]  J. Twisk,et al.  Psychological Distress of Rescue Workers Eight and One-Half Years After Professional Involvement in the Amsterdam Air Disaster , 2007, The Journal of nervous and mental disease.

[13]  M. Chiu,et al.  Posttraumatic symptoms were worst among quake victims with injuries following the Chi-chi quake in Taiwan. , 2007, Journal of psychosomatic research.

[14]  M. Olff,et al.  The lifetime prevalence of traumatic events and posttraumatic stress disorder in the Netherlands. , 2009, Journal of traumatic stress.

[15]  Elizabeth M. Smith,et al.  Psychiatric disorders among survivors of the Oklahoma City bombing. , 1999, JAMA.

[16]  Elizabeth M. Smith,et al.  Psychiatric disorders in rescue workers after the Oklahoma City bombing. , 2002, The American journal of psychiatry.

[17]  Robert J Ursano,et al.  Acute stress disorder, posttraumatic stress disorder, and depression in disaster or rescue workers. , 2004, The American journal of psychiatry.

[18]  C. Fullerton,et al.  Posttraumatic stress disorder following an air disaster: a prospective study. , 1998, The American journal of psychiatry.

[19]  H. Resnick,et al.  Childhood physical assault as a risk factor for PTSD, depression, and substance abuse: findings from a national survey. , 1996, The American journal of orthopsychiatry.

[20]  Mong-Liang Lu,et al.  Posttraumatic stress disorder among professional and non-professional rescuers involved in an earthquake in Taiwan , 2004, Psychiatry Research.

[21]  Psychological distress among American Red Cross disaster workers responding to the terrorist attacks of September 11, 2001 , 2007, Psychiatry Research.

[22]  S. Klimidis,et al.  Prevalence of psychiatric disorder following the 1988 Yun Nan (China) earthquake , 2003, Social Psychiatry and Psychiatric Epidemiology.

[23]  A. O. Devay,et al.  Frequency of Post-Traumatic Stress Disorder among Relief Force Workers after the Tsunami in Asia: Do Rescuers Become Victims? , 2006, Prehospital and Disaster Medicine.

[24]  Michael Maes,et al.  Pre- and post-disaster negative life events in relation to the incidence and severity of post-traumatic stress disorder , 2001, Psychiatry Research.

[25]  K. Akazawa,et al.  Impaired psychological recovery in the elderly after the Niigata-Chuetsu Earthquake in Japan:a population-based study , 2006, BMC public health.

[26]  D. Weiss,et al.  Characteristics of emergency services personnel related to peritraumatic dissociation during critical incident exposure. , 1996, The American journal of psychiatry.

[27]  I. Carlier,et al.  DISASTER-RELATED POST-TRAUMATIC STRESS IN POLICE OFFICERS: A FIELD STUDY OF THE IMPACT OF DEBRIEFING , 1998 .

[28]  Melissa A. Polusny,et al.  Long-term correlates of child sexual abuse: Theory and review of the empirical literature , 1995 .

[29]  P. Santonastaso,et al.  Surviving the Vajont Disaster: Psychiatric Consequences 36 Years Later , 2004, The Journal of nervous and mental disease.

[30]  E. Spitznagel,et al.  Comparison of post-disaster psychiatric disorders after terrorist bombings in Nairobi and Oklahoma City. , 2005, The British journal of psychiatry : the journal of mental science.

[31]  D. Paton Posttraumatic growth in protective services professionals: Individual, cognitive and organizational influences: , 2005 .

[32]  Mustafa Yildiz,et al.  Psychological consequences of the 1999 earthquake in Turkey. , 2004, Journal of traumatic stress.

[33]  F. Norris,et al.  60,000 Disaster Victims Speak: Part II. Summary and Implications of the Disaster Mental Health Research , 2002, Psychiatry.

[34]  F. Norris,et al.  60,000 Disaster Victims Speak: Part I. An Empirical Review of the Empirical Literature, 1981—2001 , 2002, Psychiatry.

[35]  R. Kessler,et al.  Posttraumatic stress disorder in the National Comorbidity Survey. , 1995, Archives of general psychiatry.

[36]  Ask Elklit,et al.  Psychological reactions in Icelandic earthquake survivors. , 2004, Scandinavian journal of psychology.

[37]  Miranda Olff,et al.  Gender differences in posttraumatic stress disorder. , 2007, Psychological bulletin.

[38]  H. Armenian,et al.  Long Term Mortality and Morbidity Related to Degree of Damage Following the 1988 Earthquake in Armenia , 1998 .

[39]  J. Davidson,et al.  Full and partial PTSD among earthquake survivors in rural Taiwan. , 2004, Journal of psychiatric research.

[40]  C. Fullerton,et al.  Longitudinal Assessment of Posttraumatic Stress Disorder and Depression after Exposure to Traumatic Death , 1995, The Journal of nervous and mental disease.

[41]  C. Carver,et al.  Assessing coping strategies: a theoretically based approach. , 1989, Journal of personality and social psychology.

[42]  V. Carr,et al.  Recovery from Post-Earthquake Psychological Morbidity: Who Suffers and who Recovers? , 1998, The Australian and New Zealand journal of psychiatry.

[43]  C. Engel,et al.  Psychiatric Syndromes in Persian Gulf War Veterans: An Association of Handling Dead Bodies with Somatoform Disorders , 1998, Psychotherapy and Psychosomatics.

[44]  M. Olff,et al.  Effects of appraisal and coping on the neuroendocrine response to extreme stress , 2005, Neuroscience & Biobehavioral Reviews.

[45]  J. Davidson,et al.  Posttraumatic Distress and Coping Strategies among Rescue Workers after an Earthquake , 2003, The Journal of nervous and mental disease.

[46]  Abdurrahman Altindag,et al.  One-year follow-up study of posttraumatic stress disorder among earthquake survivors in Turkey. , 2005, Comprehensive psychiatry.

[47]  M. Morren,et al.  The Health of Volunteer Firefighters Three Years after a Technological Disaster , 2005, Journal of occupational health.

[48]  G. Canino,et al.  Somatic symptoms after a natural disaster: a prospective study. , 1992, The American journal of psychiatry.

[49]  R. Thurston,et al.  Emotional vitality and incident coronary heart disease: benefits of healthy psychological functioning. , 2007, Archives of general psychiatry.

[50]  Jeani Chang,et al.  Electrocardiogram abnormalities among men with stress-related psychiatric disorders: Implications for coronary heart disease and clinical research , 1999, Annals of behavioral medicine : a publication of the Society of Behavioral Medicine.

[51]  C. Fullerton,et al.  Posttraumatic stress disorder and identification in disaster workers. , 1999, The American journal of psychiatry.

[52]  Crystal L. Park,et al.  Assessment and prediction of stress-related growth. , 1996, Journal of personality.

[53]  P. Spinhoven,et al.  Predictors of Fatigue in Rescue Workers and Residents in the Aftermath of an Aviation Disaster: A Longitudinal Study , 2006, Psychosomatic medicine.

[54]  H. Akiskal,et al.  Risk factors for depression in the survivors of the 1988 Earthquake in Armenia , 2002, Journal of Urban Health.

[55]  P. Schnurr,et al.  Physical health and post-traumatic stress disorder: review and synthesis. , 1999, Seminars in clinical neuropsychiatry.

[56]  C. Kuo,et al.  Prevalence of psychiatric disorders among bereaved survivors of a disastrous earthquake in taiwan. , 2003, Psychiatric services.

[57]  P. Näätänen,et al.  Trauma-related Emotional Patterns and their Association with Post-Traumatic and Somatic Symptoms , 2002 .

[58]  S. Stewart,et al.  ‘We Will Never Ever Forget...’: The Swissair Flight 111 Disaster and its Impact on Volunteers and Communities , 2004, Journal of health psychology.

[59]  R. Ursano,et al.  Posttraumatic stress disorder: somatic comorbidity and effort tolerance. , 1990, Psychosomatics.

[60]  D. Goldberg,et al.  A scaled version of the General Health Questionnaire , 1979, Psychological Medicine.

[61]  Dan J Stein,et al.  Posttraumatic Stress Disorder and Occupational Disability in South African Security Force Members , 2003, The Journal of nervous and mental disease.

[62]  L. Gao,et al.  Post‐earthquake quality of life and psychological well‐being: Longitudinal evaluation in a rural community sample in northern China , 2000, Psychiatry and clinical neurosciences.

[63]  D. Williamson,et al.  Relationship of childhood abuse and household dysfunction to many of the leading causes of death in adults. The Adverse Childhood Experiences (ACE) Study. , 1998, American journal of preventive medicine.

[64]  Social support and psychological trauma: A methodological review , 1990 .

[65]  I. Carlier,et al.  Stress Reactions in Disaster Victims Following the Bijlmermeer Plane Crash , 1997, Journal of traumatic stress.

[66]  A. C. McFarlane,et al.  Psychiatric morbidity following a natural disaster: An Australian bushfire , 1997, Social Psychiatry and Psychiatric Epidemiology.

[67]  R. Ursano,et al.  The Impact of a Military Air Disaster on The Health of Assistance Workers: A Prospective Study , 1989, The Journal of nervous and mental disease.

[68]  L. Weisæth,et al.  Stress reactions in police officers after a disaster rescue operation , 2002, Nordic journal of psychiatry.

[69]  P. Vokonas,et al.  Prospective study of posttraumatic stress disorder symptoms and coronary heart disease in the Normative Aging Study. , 2007, Archives of general psychiatry.

[70]  Robert Kohn,et al.  Psychological and psychopathological reactions in Honduras following Hurricane Mitch: implications for service planning. , 2005, Revista panamericana de salud publica = Pan American journal of public health.

[71]  Helena Motlagh,et al.  Impact of Event Scale-revised. , 2010, Journal of physiotherapy.

[72]  Gholamreza Garmaroudi,et al.  Psychological distress among Bam earthquake survivors in Iran: a population-based study , 2005, BMC public health.

[73]  Miranda Olff,et al.  TENTS guidelines: development of post-disaster psychosocial care guidelines through a Delphi process , 2010, British Journal of Psychiatry.

[74]  Miranda Olff,et al.  The psychobiology of PTSD: coping with trauma , 2005, Psychoneuroendocrinology.

[75]  A. Rüstemli,et al.  Psychological consequences of the 1992 Erzincan (Turkey) earthquake. , 1995, Disasters.

[76]  C. Acarturk,et al.  Post-Traumatic Growth among Marmara Earthquake Survivors Involved in Disaster Preparedness as Volunteers: , 2005 .

[77]  C. Kılıç,et al.  Prevalence of Posttraumatic Stress Disorder and Comorbid Depression in Earthquake Survivors in Turkey: An Epidemiological Study , 2004, Journal of traumatic stress.

[78]  P. Schnurr,et al.  Physical symptom trajectories following trauma exposure: longitudinal findings from the normative aging study. , 1998, The Journal of nervous and mental disease.

[79]  S. Reiss,et al.  Anxiety sensitivity, anxiety frequency and the prediction of fearfulness. , 1986, Behaviour research and therapy.

[80]  Gonzalo López-Abente,et al.  Association between health information, use of protective devices and occurrence of acute health problems in the Prestige oil spill clean-up in Asturias and Cantabria (Spain): a cross-sectional study , 2006, BMC public health.

[81]  L. Bickman,et al.  Social support and psychological symptomatology following a natural disaster , 1990 .

[82]  Tina Dorn,et al.  A cohort study of the long-term impact of a fire disaster on the physical and mental health of adolescents. , 2008, Journal of traumatic stress.

[83]  F. Shih,et al.  The impact of the 9-21 earthquake experiences of Taiwanese nurses as rescuers. , 2002, Social science & medicine.

[84]  Bruce P. Bernard,et al.  Depressive Symptoms among Firefighters and Related Factors after the Response to Hurricane Katrina , 2007, Journal of Urban Health.

[85]  B. L. Cardozo,et al.  The mental health of expatriate and Kosovar Albanian humanitarian aid workers. , 2005, Disasters.

[86]  J. Kenardy,et al.  Psychosocial sequelae of the 1989 Newcastle earthquake: III. Role of vulnerability factors in post-disaster morbidity , 1997, Psychological Medicine.

[87]  J. Boscarino Posttraumatic stress disorder and mortality among U.S. Army veterans 30 years after military service. , 2006, Annals of epidemiology.

[88]  P. A. van den Brandt,et al.  BMC Public Health BioMed Central Study protocol , 2004 .

[89]  H. Resnick,et al.  The Modified PTSD Symptom Scale: A brief self-report measure of posttraumatic stress disorder. , 1993 .

[90]  M. Olff,et al.  Post-Disaster Mental Health Problems and the Utilization of Mental Health Services: A Four-year Longitudinal Comparative Study , 2006, Administration and Policy in Mental Health and Mental Health Services Research.

[91]  Lr Derogatis,et al.  SCL-90-R, Administration, Scoring, and Procedures Manual-II for the R(evised) Version and Other Instruments of the Psychopathology Rating Scale Series , 1983 .

[92]  D. Weiss,et al.  Predictors of posttraumatic stress disorder and symptoms in adults: a meta-analysis. , 2003, Psychological bulletin.

[93]  C. Brewin,et al.  Meta-analysis of risk factors for posttraumatic stress disorder in trauma-exposed adults. , 2000, Journal of consulting and clinical psychology.

[94]  Klea Katsouyanni,et al.  PSYCHOLOGICAL STRESS AND FATAL HEART ATTACK: THE ATHENS (1981) EARTHQUAKE NATURAL EXPERIMENT , 1983, The Lancet.

[95]  Identification and posttraumatic stress disorder symptoms in rescue workers in the Marmara, Turkey, earthquake. , 2005, Journal of traumatic stress.

[96]  L. Thorpe,et al.  Differences in PTSD prevalence and associated risk factors among World Trade Center disaster rescue and recovery workers. , 2007, The American journal of psychiatry.

[97]  L. DeLisi,et al.  Research on psychiatric outcomes and interventions subsequent to disasters: a review of the literature , 2002, Psychiatry Research.

[98]  J. van der Zee,et al.  Disaster and Subsequent Healthcare Utilization: A Longitudinal Study Among Victims, Their Family Members, and Control Subjects , 2006, Medical care.

[99]  M. Morren,et al.  The influence of a disaster on the health of rescue workers: a longitudinal study , 2007, Canadian Medical Association Journal.

[100]  T. Keane,et al.  Mississippi Scale for Combat-Related Posttraumatic Stress Disorder: three studies in reliability and validity. , 1988, Journal of consulting and clinical psychology.

[101]  M. Morren,et al.  Use of mental health services among disaster survivors: predisposing factors , 2007, BMC public health.

[102]  P. Calhoun,et al.  PTSD symptom clusters associated with physical health and health care utilization in rural primary care patients exposed to natural disaster. , 2008, Journal of traumatic stress.

[103]  J. Bremner,et al.  Adverse childhood experiences and prescribed psychotropic medications in adults. , 2007, American journal of preventive medicine.

[104]  Peter Gates,et al.  Effects of backpacking holidays in Australia on alcohol, tobacco and drug use of UK residents , 2007, BMC public health.

[105]  I. Levav,et al.  Prevalence, risk factors and aging vulnerability for psychopathology following a natural disaster in a developing country , 2005, International journal of geriatric psychiatry.

[106]  C. Brewin,et al.  Delayed-onset posttraumatic stress disorder: a systematic review of the evidence. , 2007, The American journal of psychiatry.

[107]  Tzung Lieh Yeh,et al.  Psychiatric morbidity and posttraumatic symptoms among earthquake victims in primary care clinics. , 2003, General hospital psychiatry.

[108]  H. Tan,et al.  Social support and posttraumatic stress disorder among flood victims in Hunan, China. , 2007, Annals of epidemiology.

[109]  D. Alexander,et al.  Reactions of Police Officers to Body-Handling after a Major Disaster a Before-and-After Comparison , 1991, British Journal of Psychiatry.

[110]  Schnurr Pp,et al.  Physical health and post-traumatic stress disorder: review and synthesis. , 1999, Seminars in clinical neuropsychiatry.

[111]  A. Dyregrov,et al.  Voluntary and professional disaster-workers: similarities and differences in reactions. , 1996, Journal of traumatic stress.

[112]  Fabrizio Jossa,et al.  Long-Term Psychological Effects of Natural Disasters , 1996, Psychosomatic medicine.

[113]  M. Goodarzi,et al.  Psychological consequences of the Bam earthquake on professional and nonprofessional helpers. , 2005, Journal of traumatic stress.