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Cited by 515Posttraumatic Stress Disorder ResearchDisaster Response and ManagementCOVID-19 and Mental Health

Acute stress disorder, posttraumatic stress disorder, and depression in disaster or rescue workers

Fullerton, Carol S., Ursano, Robert J., Wang, Leming·2004·American Journal of Psychiatry
DOI 10.1176/appi.ajp.161.8.1370
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Abstract

OBJECTIVE: The events of Sept. 11, 2001, highlighted the importance of understanding the effects of trauma on disaster workers. To better plan for the health care of disaster workers, this study examined acute stress disorder, posttraumatic stress disorder (PTSD), early dissociative symptoms, depression, and health care utilization in disaster workers. METHOD: Exposed disaster workers (N=207) and unexposed comparison subjects (N=421) were examined at 2, 7, and 13 months after an airplane crash. RESULTS: Exposed disaster workers had significantly higher rates of acute stress disorder, PTSD at 13 months, depression at 7 months, and depression at 13 months than comparison subjects. Those who were younger and single were more likely to develop acute stress disorder. Exposed disaster workers with acute stress disorder were 3.93 times more likely to be depressed at 7 months. Those with high exposure and previous disaster experience or who had acute stress disorder were more likely to develop PTSD. Similarly, those who were depressed at 7 months were 9.5 times more likely to have PTSD. Those who were depressed at 13 months were 7.96 times more likely to also meet PTSD criteria. More exposed disaster workers than comparison subjects obtained medical care for emotional problems at 2, 7, and 13 months. Overall, 40.5% of exposed disaster workers versus 20.4% of comparison subjects had acute stress disorder, depression at 13 months, or PTSD. CONCLUSIONS: Exposed disaster workers are at increased risk of acute stress disorder, depression, or PTSD and seek care for emotional problems at an increased rate.

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Crossref · 10.1176/appi.ajp.161.8.1370

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  • Following exposure to a significant airplane crash, rates of acute stress disorder, PTSD, and depression at 13 months post-exposure were more significant than comparison participants; acute stress disorder rates were 25.6% (n=53) versus 2.4% (n=10), and PTSD rates at 13 months were 16.7% (n=19) versus 1.9% (n=4).

    “It was highlighted that there were more significant rates of acute stress disorder, PTSD, and depression at 13 months post-exposure than comparison participants. Acute stress disorder rates were 25.6% (n = 53), whereas comparison participant rates were 2.4% (n=10). Similarly, PTSD rates at 13 months were reported at 16.7% (n = 19) compared to 1.9% (n = 4)”

    From Understanding the Occupational Factors that Influence Paramedic Health and Wellbeing (2024) · cites this paper as Fullerton et al., 2004

  • Exposed disaster workers are at an increased risk of acute stress disorder, depression or PTSD.

    “Exposed workers are at an increased risk of acute stress disorder, depression or PTSD”

    From Understanding the Occupational Factors that Influence Paramedic Health and Wellbeing (2024) · cites this paper as Fullerton, C., Ursano, R. & Wang, L. 2004

  • Exposed disaster workers seek care for emotional distress at an increased rate.

    “and seek care for emotion- al distress at an increased rate.”

    From Understanding the Occupational Factors that Influence Paramedic Health and Wellbeing (2024) · cites this paper as Fullerton, C., Ursano, R. & Wang, L. 2004

  • Rescue and disaster workers exposed to a disaster were significantly more likely to experience depression at 7 and 13 months following the event relative to rescue and disaster workers who were not exposed to a similar event.

    “Rescue and disaster workers who were exposed to a disaster were significantly more likely to experience depression at 7 and 13 months following the event relative to rescue and disaster workers who were not exposed to a similar event [58].”

    From The Cyclical Battle of Insomnia and Mental Health Impairment in Firefighters: A Narrative Review (2024) · cites this paper as [58]

  • Specifically, 21.7% of exposed rescue and disaster workers experienced depression, while 12.6% of non-exposed workers experienced similar feelings of depression 13 months after the event.

    “Specifically, 21.7% of the exposed workers experienced depression, while 12.6% of non-exposed workers experienced similar feelings of depression 13 months after the event [58].”

    From The Cyclical Battle of Insomnia and Mental Health Impairment in Firefighters: A Narrative Review (2024) · cites this paper as [58]

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Authors
Fullerton, C. S., Ursano, R. J., & Wang, L.
Affiliations
Uniformed Services University of the Health Sciences (US)
ORCID
Venue
American Journal of Psychiatry
Publisher
American Psychiatric Association Publishing
Published
2004-08-01
Volume
161
Issue
8
Pages
1370-1376
ISSN
  • 0002-953X (ISSN-L)
  • 1535-7228
DOI
10.1176/appi.ajp.161.8.1370
OpenAlex
W2140846624
Cited by
515
References
34
Citations by year
2026: 10 · 2025: 22 · 2024: 24 · 2023: 20 · 2022: 19 · 2021: 37 · 2020: 38 · 2019: 36 · 2018: 25 · 2017: 30 · 2016: 27 · 2015: 34 · 2014: 26 · 2013: 19 · 2012: 28
FWCI
20.77
Type
journal article
Language
en
Open access
closed
Locations
  • American Journal of Psychiatry (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Social Sciences › Psychology › Clinical Psychology › Posttraumatic Stress Disorder Research
  • Health Sciences › Health Professions › Emergency Medical Services › Disaster Response and Management
  • Social Sciences › Psychology › Clinical Psychology › COVID-19 and Mental Health
Keywords
acute stress disorder, post-traumatic stress disorder, depression, disaster workers, rescue workers, trauma exposure, dissociative symptoms, health care utilization, September 11 attacks, airplane crash
MeSH terms
Accidents, Aviation, Adult, Age Factors, Community Mental Health Services, Depressive Disorder, Disaster Planning, Disasters, Dissociative Disorders, Female, Follow-Up Studies, Humans, Longitudinal Studies, Male, Patient Acceptance of Health Care, Prospective Studies, Risk Factors, Stress Disorders, Post-Traumatic, United States, Marital Status, Rescue Work, Stress Disorders, Traumatic, Acute

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