Learning From The Past and Planning For The Future
MENTAL HEALTH MOMENT June 27, 2003 "If you die in an elevator, be sure to push the Up button." - Sam Levenson
NOTE: There will be no Mental Health Moment on the 4th of July.
Short Subjects
LINKS Mental Health Moment Online
CONFERENCES AND WORKSHOPS:
The Australasian Critical Incident
Stress Association Conference
The Right Response in the
21st Century
Location: Carlton Crest Hotel
Melbourne Australia
Friday October 3, 2003 thru
Sunday October 5, 2003
For further information
please contact the conference organisers:
ammp@optushome.com.au
Conference Website:
http://www.acisa.org.au/ conference2003/6th Annual Conference
The University of South Dakota
Disaster Mental Health Institute
"Innovations in Disaster Psychology:
Time for a New Paradigm?
Reflecting on the Past:
Looking to the Future"
Radisson Hotel
Rapid City, SD
September 18-20, 2003
6th European Regional Congress
of the International Association
for Cross-Cultural Psychology (IACCP)
July 12-16, 2003
Budapest, HUNGARY
Contact: Dr. Marta Fulop
MTA Pszichologiai Kutatointezet
Victor Hugo utca 18-22
Budapest, Hungary-1132
E-mail: fmarta@mtapi.huMinnesota International Counseling Institute:
Global Mental Health in a Turbulent World
July 27-August 1, 2003
Minneapolis, Minnesota, USA
Contact:
Minnesota International Counseling Institute
CSPP/Department of Education Psychology
University of Minnesota
178 Pilsbury Drive, SE
Minneapolis, MN 55455, USA
E-mail: cspp-adm@tc.umn.edu
COOPERATION OF ELITES IS CRITICAL FOR SUCCESS OF NEW DEMOCRACIES
For democracy to work in countries with a heritage of autocracy or colonialism, the dominant elite members of those countries have to collectively hammer out their own versions of democracy, a process that to outsiders may seem noisy, messy and almost chaotic, a Penn State study notes. The official trappings of democracy, such as a constitution and a presidential or parliamentary government, will not by themselves guarantee long-term success of democracy in Iraq, Afghanistan or East Timor, says Gretchen Casper, associate professor of political science. Neither will a prospering economy alone, although that factor will certainly help. Once democratic institutions are in place, it is up to the dominant elites to learn the rules of negotiation and compromise, which form the essence of democracy. Read the full story at http://live.psu.edu/index.php?cmd=vs&story=3356
ASPEN FIRE RAGES ON
Firefighters fanned out above and below a raging wildfire on a mountaintop north of Tucson in an attempt to beat back flames that have destroyed more than 250 homes in a vacation community. For the full story, go to: http://www.fema.gov/press/ap/ap062403.shtm
WHAT IS A HURRICANE?
A hurricane is a tropical storm with winds that have reached a constant speed of 74 miles per hour or more. Hurricane winds blow in a large spiral around a relative calm center known as the "eye." The "eye" is generally 20 to 30 miles wide, and the storm may extend outward 400 miles. As a hurricane approaches, the skies will begin to darken and winds will grow in strength. As a hurricane nears land, it can bring torrential rains, high winds, and storm surges. A single hurricane can last for more than 2 weeks over open waters and can run a path across the entire length of the eastern seaboard. August and September are peak months during the hurricane season that lasts from June 1 through November 30. For More Information on Hurricanes, Go Here: http://www.fema.gov/hazards/hurricanes/survivingthestorm.shtm
REPRESENTATIVE IRAQI BODY VITAL FOR RECONSTRUCTION EFFORTS - UN AID OFFICIAL
The top United Nations aid official for Iraq made a strong plea today for the establishment of a representative Iraqi interim administration, without which he said the world body could not even begin to assess or address the reconstruction needs of the war shattered country. For full story, Go To: http://www.un.org/apps/news/story.asp?NewsID=7506&Cr=iraq&Cr1=reconstruct
UN REFUGEE AGENCY STEPS UP EFFORTS TO HELP PALESTINIANS, SYRIANS AND KURDS IN IRAQ
The United Nations refugee agency is stepping up its relief efforts in Iraq on several fronts, ranging from finding housing for hundreds of evicted Palestinians and registering undocumented Syrian refugees to providing aid for returning Iraqi Kurds forced from their homes by the previous regime. For full story, Go TO: http://www.un.org/apps/news/story.asp?NewsID=7514&Cr=iraq&Cr1=
POST-TRAUMATIC STRESS DISORDER: SYMPTOM PROFILES IN MEN AND WOMEN
Post-traumatic stress disorder may affect 2-3% of the general population at any time. This study investigates the symptom frequencies of PTSD sufferers, comparing male and female symptom profiles. Curr Med Res Opin 19(3) 2003 For the full article, Go To: http://www.medscape.com/viewarticle/456192
PTSD COMMON AMONG PARENTS OF TRANSPLANT RECIPIENTS
Many parents of pediatric transplant patients have posttraumatic stress disorder (PTSD), according to a report published in the June issue of Pediatrics. For the full article, Go To: http://www.medscape.com/viewarticle/456868?mpid=14762
DISASTER AND TRAUMA RESOURCE CENTER
Medscape's editors have put together this collection of news, notices, articles, and related links to provide healthcare professionals with the latest information and resources related to caring for those affected by volatile world events such as terrorist attacks, war and natural disasters. This information is updated regularly. GO HERE: http://www.medscape.com/pages/editorial/resourcecenters/public/disastertrauma/rc-disastertrauma.ov
DISASTER WORK AND STRESS
Stress is a natural phenomenon. It is not necessarily negative. The body needs certain levels of stimulation and stress in order to be able to function. Stress is the body's normal, adaptive response to the environment. A stressor is the actual event which produces a demand or stress on an individual. The resulting wear and tear on an individual is called strain (Mitchell & Resnik, 1981).
Stress and distress are two different things. When an individual is distressed it is due to a disorder in their adaptation to stressors. Stressors fall into a number of categories. Charlesworth and Nathan (1984) have identified the following, some of which are positive stressors:
Cognitive
Social
Family
Work
Transitional
Environmental
Chemical
PhysicalThe following, generally considered to be positive events, are also considered stressors:
Change
Progress
Creativity, Invention
Growth
Survival
Increased energy and enduranceThe stress reaction prepares the body for change. It puts the body on alert to respond and adapt. This reaction goes back to a much earlier time in the evolution of the human species. The need to adapt to the environment still exists, but the physical dangers no longer exist as they once did. However, the stress reaction provokes the same biochemical reactions.
The part of the brain known as the hypothalamus alerts the nervous system to release energy when faced with physical danger or threat. The nervous system alerts the endocrine system to send large amounts of hormones into the blood stream, mobilizing the body for action. Muscles tighten up, blood sugar rises, adrenalin and noradrenalin provide emergency energy. This all prepares the body for what Cannon (1929) termed the "fight or flight response".
Hans Selye (1956, 1978) labeled three phases of this normal defense reaction of the body "The General Adaptation Syndrome". General because the consequences of the stressors have effects on several areas of the body. Adaptation refers to its stimulation of defenses designed to help the body adjust or deal with the stressors. Syndrome indicates that the individual pieces of the reaction occur more or less together and are at least partially interdependent. These reactions are similar for all forms of animal life. The physiological responses are the same whether the stressor produces fear, anger, or anxiety (Mitchell & Resnik, 1981).
While the physiological effects occur whether the stress is positive or negative, the psychological effects depend on the type of stress. Excitement, joy and high self-esteem are associated with positive stress. This extra charge of energy, for a short time, produces a controlled form of intense concentration called "eustress". Some examples of eustress include athletes striving to win, surgeons operating for long hours, and marathons. Such examples of eustress contribute to individual excellence. The benefits of optimal stress, if handled properly, include: opportunity for increased growth and maturity, independence, and control.
ONGOING OR LONG-TERM STRESS EFFECTS
Following long continued exposure to the same stressor(s), to which the body has become adjusted, adaptation energy is finally exhausted. This results in what Selye called "diseases of adaptation". These include asthma, chest and back pains, migraines, neuroses, psychoses, skin rash, and others (Selye, 1956; Cox, 1978). Selye pointed out that if stressors did not diminish over a certain period of time, the organism would move from a state of alarm into a state of exhaustion. With continued exhaustion, severe illness may occur. Finally, if signs of the alarm reaction reappear, resistance is gone. The situation becomes irreversible, and the individual dies.
The following are some of the health effects that continued strain, wear and tear can have on individuals (Mitchell & Resnik, 1981; Davis et al, 1982; Charlesworth & Nathan, 1984):
Decrease in the effectiveness of the body's immune system, with an increase in colds, flu, and other communicable diseases.
Most of the time the stress reactions elicited are so mild that they go unnoticed. Everyone has experienced events which were intensely stressful for a brief period of time. However, once the threat has passed, systems return to normal. Such an isolated stress event, in spite of the internal havoc it raised, probably resulted in absolutely no long-lasting physical damage to the body. On the other hand, a constant state of agitation can result in serious health dysfunctions (Ivancevich & Matteson, 1980). While mild stress and short-term infrequent intense stress produce no lasting harm, constant stress, or acute stress, results in a step-by- step exhaustion of the body's fuel reserves, with the end result - burnout.
BURNOUT
Burnout is an effect of long-term stress. It shows up most commonly in the level of an individual's work performance. Farberow & Gordon (NIMH, 1978) have defined burnout as a state of exhaustion, irritability, and fatigue which markedly decreases an individual's effectiveness and capability.
Burnout is an advanced stage of stress. It occurs when there is chronic stress over a long period of time. Burnout can be defined as "collapse of the human spirit". Emotional exhaustion is another way to define it. Some of the early signs of burnout are the same as those for advanced stages of stress: fatigue, sleep disturbances, negative attitude, disillusionment, lowered resistance to infection, hypertension, headache, and stomach disturbances.
IMPACT OF STRESS
The impact of stress depends on a number of factors. Three of these are one's general health, genetics, and prior exposure to stressors. These factors may strengthen and support a disaster worker, resulting in mitigation or softening of the emotional consequences of a disaster. On the other hand, they may place the worker at risk for stress reactions.
GENERAL HEALTH
The relationship of stress to physical and psychological health has been documented extensively in literature and research. Selye's (1956) research has demonstrated that stressors can cause changes in the immune system, thus wearing down resistance. A super-abundance of hormones secreted can considerably reduce immunity to infection.
GENETICS
Evidence suggests that individuals with certain physical or psychological characteristics are more at risk as potential victims of stress disorders. For example, Type A individuals constantly strive to attain achievements. They are competitive and hard driving. They strive to accomplish more and more in less time. They are chronically impatient with people and situations which they perceive as thwarting their attempts.
Type B individuals, on the other hand, are characterized by the absence of these behaviors. They are relatively relaxed and easygoing, even though they too may be goal-oriented. They appear to have a protective shield which allows them to experience less stress.
EXPOSURE TO PREVIOUS STRESSORS
It is a recognized fact that illness is due to external viruses and pathogenic agents entering the body. However, there is increasing evidence that illness is also due to the eventual broken-down state of the body. After long and continuous exposure to stress (or intermittent periods of intensive stress) hypertension, coronary heart disease, diabetes and ulcers occur (Cox, 1978; Beehr & Newman, 1978).
Research has demonstrated that stressful experiences can make animals more or less vulnerable to a number of cancer tumors, and researchers can speed up the time at which the tumors appear by controlling the number of times the animals are exposed to stress. The stressors applied in these studies resemble many human experiences of stress, such as forced restraint, crowding, handling, shock and noise (as opposed to a non-demanding more protected environment). Over time, the body parts break down.
On the other hand, research has demonstrated that less severe physiological damage to the body occurs when the following circumstances are present: fewer major life changes, socially supportive relationships, experience in handling stress, immunity as a result of many experiences with stress, and high self-esteem (Klein, 1971; House, 1980).
ADDITIONAL FACTORS AFFECTING STRESS AMONG DISASTER WORKERS
Four groups of factors can affect the stress levels experienced by disaster workers. These include:
A. Individual Factors
B. Interpersonal Factors
C. Community Factors
D. General Aspects of the Disaster or Type of Event
There are three major sources of stress which disaster workers face in their work. These are: Personal loss or injury; Traumatic stimuli; and Mission failure or human error. Each of these can contribute significantly to the stress reactions workers experience during or after a disaster event.
Occupational stressors also affect workers in disasters. Disaster work involves some pretty heavy professional responsibilities. The stakes are high and often involve life or death. Public as well as self-expectations for workers are high. Emergency responses are immediate, continuous and often without letup. There are significant physical, mental and emotional demands placed upon workers under extremely adverse chaotic and traumatic conditions. The physical properties of the work environment can cause additional stress. These include: work area, amount of contact with victims (injured, dead and dying), weather, hazards, work conditions, living conditions, human resources, frustrations and bystanders.
There are also organizational stressors that can occur due to the nature of the emergency organization. Among these are stresses due to: differences among professional vs volunteer organizations; day-to-day vs disaster responsibilities (Warheit, 1970), role clarity and role conflict (Garaventa, 1984); the size of the organization (Garaventa, 1984); rank of the individual in the organization (Kahn et al., 1964; Schein, 1965); chain of command; organizational conflict; and rewards.
REFERENCES Beehr,T.A. & Newman, J.E. Job stress, employee health, and organizational effectiveness: A facet analysis, model and literature review. Personnel Psychology, 1978, 31, 665-699.
Beehr, T.A., Walsh, J.T., & Taber, T.D. Relationship of stress to individually and organizationally valued states: Higher order needs as a moderator. Journal of Applied Psychology, 1976, 61, 41-47.
Cannon, W.B. (1929). Bodily changes in pain, hunger, fear, and rage. (2nd ed.) P. xvi+, 404 pp.
Charlesworth, E.A. & Nathan, R.G. Stress management: A comprehensive guide to wellness. New York: Atheneum, 1984.
Cox, T. Stress. Baltimore: University Park Press, 1978.
Davis, M.; Eshelman, E.R.; & McKay, M. The relaxation and stress reduction workbook. Oakland, CA: New Harbinger Publications, 1982.
Farberow, N.L. & Gordon, N.S. Training manual for human service workers in major disasters. National Institute of Mental Health, Rockville, MD, 1978.
Garaventa, D. "Role conflict and stress for emergency service workers". Paper presented at the American Psychological Association, National Institute of Mental Health, and Federal Emergency Management Agency Conference on Role Conflict and Support for Emergency Workers, Washington, DC, 1984.
House, J. S. Occupational stress and coronary heart disease: A review and theoretical integration. Journal of Health and Social Behavior, 1974, 15, 12-27.
Ivancevich, J.M. & Matteson, M.T. Stress and work: A managerial perspective. Glenview, Ill.: Scott, Foresman, 1980.
Kahn, R.L.; Wolfe, D.M.; Quinn, R.P.; Snoek, J.D.; & Rosenthal,R.A. Organizational stress: Studies in role conflict and ambiguity. New York: Wiley, 1964.
Kahn, R. Stress research and its implications: The United States. Proceedings of the Industrial Relations Research Association, 1981.
Mitchell, J.T. & Resnik, H.L.P. Emergency response to crisis. Bowie, MD: Robert J. Brady Co., 1981.
Schein, E.H. Organization psychology. Englewood Cliffs, NJ: Prentice-Hall, 1965.
Selye, H. Stress without distress. New York: New American Libraries, 1975.
Selye, H. Stress in health and disease. West Yarmouth, Mass.: Butterworths, 1976.
Selye, H. The stress of life (2nd ed.). New York: McGraw-Hill, 1978.
Selye, H. Guide to stress research: Volume I. New York: Van Nostrand Reinhold, 1980.
Warheit, G.J. Fire departments: Operations during major community emergencies. American Behavioral Scientist 13(3): 363-367, 1970.
To search for books on disasters and disaster mental
health topics, leaders, leadership, orgainizations,
crisis intervention, leaders and crises, and related
topics and purchase them online, go to the following url:
https://www.angelfire.com/biz/odochartaigh/searchbooks.html
RECOMMENDED READING
Coping With Catastrophe: A Handbook of Post-Disaster Psychosocial Aftercare
by Peter E. Hodgkinson, Michael Stewart
Book Description
Coping with Catastrophe is a practical handbook for people who provide psychosocial aftercare for victims of disasters. This completely revised and updated second edition includes the latest findings on the nature and effects of trauma, the psychological debriefing process and the effects of emergency work, and the latest treatment models for post-traumatic stress and abnormal grief. Eminently practical and easy to read, this volume provides readers with information and skills to respond effectively and confidently to the needs of disaster survivors. It will be of immense value to a wide variety of helping professionals and carers, including social workers, psychologists, doctors, voluntary counsellors, and all those whose work brings them into contact with disaster victims.
Additional Readings at: Disaster Work and Stress in the search engine. Also try looking here for Disaster Psychology.
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Contact your local Mental Health Center or
check the yellow pages for counselors, psychologists,
therapists, and other Mental health Professionals in
your area for further information.
**********************************************************************
George W. Doherty
Rocky Mountain Region
Disaster Mental Health Institute
Box 786
Laramie, WY 82073-0786
MENTAL HEALTH MOMENT Online: https://www.angelfire.com/biz3/news
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