Posttraumatic reactions of hostages after an aircraft hijacking

Child Debriefing: A Review of the Evidence Base

Introduction

Debriefing, a controversial crisis intervention delivered in the early aftermath of a disaster, has not been well evaluated for use with children and adolescents. This report constitutes a review of the child debriefing evidence base.

Methods

A systematic search of selected bibliographic databases (EBM Reviews, EMBASE, ERIC, Medline, Ovid, PILOTS, PubMed, and PsycINFO) was conducted in the spring of 2014 using search terms related to psychological debriefing. The search was limited to English language sources and studies of youth, aged 0 to 18 years. No time limit was placed on date of publication. The search yielded 713 references. Titles and abstracts were reviewed to select publications describing scientific studies and clinical reports. Reference sections of these publications, and of other literature known to the authors that was not generated by the search, were used to locate additional materials. Review of these materials generated 187 publications for more thorough examination; this assessment yielded a total of 91 references on debriefing in children and adolescents. Only 15 publications on debriefing in children and adolescents described empirical studies. Due to a lack of statistical analysis of effectiveness data with youth, and some articles describing the same study, only seven empirical studies described in nine papers were identified for analysis for this review. These studies were evaluated using criteria for assessment of methodological rigor in debriefing studies.

Results

Children and adolescents included in the seven empirical debriefing studies were survivors of motor-vehicle accidents, a maritime disaster, hostage taking, war, or peer suicides. The nine papers describing the seven studies were characterized by inconsistency in describing the interventions and populations and by a lack of information on intervention fidelity. Few of the studies used randomized design or blinded assessment. The results described in the reviewed studies were mixed in regard to debriefing’s effect on posttraumatic stress, depression, anxiety, and other outcomes. Even in studies in which debriefing appeared promising, the research was compromised by potentially confounding interventions.

Conclusion

The results highlight the small empirical evidence base for drawing conclusions about the use of debriefing with children and adolescents, and they call for further dialogue regarding challenges in evaluating debriefing and other crisis interventions in children.

PfefferbaumB, JacobsAK, NitiémaP, EverlyGSJr.Child debriefing: a review of the evidence base. Prehosp Disaster Med. 2015;30(3):110.

A Qualitative Investigation of Averted School Shooting Rampages

The recent rash of school violence has again brought to the fore a need to investigate ways to enhance the safety of America’s children. With its emphases on prevention and collaboration with schools, a counseling psychology perspective can add much to the growing body of research on lethal school violence. This article aims to understand school violence prevention from the perspectives of school personnel who intervened to avert deadly shootings. As such, this study used consensual qualitative research methodology. Six primary domains emerged from the data, including school conditions, intervention, crisis planning, relationship, prevention efforts, and problematic issues. A seventh other domain captured important data that did not fit with the aforementioned six domains. From all domains, data were collapsed into 42 core ideas.

Ready! Fire! Aim! The Status of Psychological Debriefing and Therapeutic Interventions: In the Work Place and after Disasters

Psychological debriefing (PD) is a brief, short-term intervention aimed at mitigating long-term distress and preventing the emergence of posttraumatic stress. In recent years, it has become a ubiquitous intervention, one which has evolved as almost prescriptive following harrowing events and grew through a practical need to offer assistance to those who are exposed to severe trauma. Despite disturbing data from the recent refereed literature of psychology, it is still referred to as the “standard of care” for disaster and crisis response and its use in many quarters continues. This article critically reviews the evidence for and against its use and outlines the weaknesses in the research. The emphasis of this review is on the appropriateness of debriefing in organizations. This article also proposes a set of hypothesized constructs that may, in part, be responsible for the paradoxical effects found in some outcome studies on debriefing. Guidelines are also proposed to help organizations and professionals react appropriately using evidence-based interventions.

Traumatic events and physical health in a New Zealand community sample

Traumatic event exposure and physical health were examined in a community-residing sample of 1,500 New Zealand adults. Half (51%) reported past traumatic event exposure, 9% reported recent (past 12 months) trauma exposure, and 40% reported no exposure. After adjusting for gender, ethnic, and age differences, those experiencing crime and accident trauma exhibited significantly deteriorated physical health, as measured by current physical symptoms, chronic medical conditions, and chronic limitations in daily functioning. Further research is required to assess the influence of traumatic events on the physical health among adults from other countries, and to evaluate the factors that may mediate or moderate this relationship for different subgroups of the New Zealand population. Limitations of this study are outlined.

Effectiveness of psychological debriefing

OBJECTIVE

To identify literature concerning the effectiveness of psychological debriefing (PD) and analyse results according to different criteria of success and different uses of the intervention format.

METHOD

Literature search was made in databases PubMed, PsycInfo and Psychlit. Twenty-five studies were selected for a thorough description. Forty-two studies provided additional information.

RESULTS

Results indicate that, in general, debriefing does not prevent psychiatric disorders or mitigate the effects of traumatic stress, even though people generally find the intervention helpful in the process of recovering from traumatic stress. The intervention holds potential as a screening procedure, and there may be economic arguments for continued use. When used with adherence to traditional descriptions of treatment group, events, group format, leadership and time spent, a preventive effect emerges. No tendency according to timing was found.

CONCLUSION

Current uses of PD are problematic. The concept needs to be redefined, and the scope of application must be revised. The objectives for use need to be clarified.