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

Am J Psychiatry. 2004 Aug;161(8):1370-6. doi: 10.1176/appi.ajp.161.8.1370.


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.

Publication types

  • Comparative Study

MeSH terms

  • Accidents, Aviation / psychology*
  • Adult
  • Age Factors
  • Community Mental Health Services / statistics & numerical data
  • Depressive Disorder / diagnosis
  • Depressive Disorder / epidemiology*
  • Disaster Planning / methods
  • Disasters / statistics & numerical data*
  • Dissociative Disorders / diagnosis
  • Dissociative Disorders / epidemiology
  • Female
  • Follow-Up Studies
  • Humans
  • Longitudinal Studies
  • Male
  • Marital Status
  • Patient Acceptance of Health Care / statistics & numerical data
  • Prospective Studies
  • Rescue Work / statistics & numerical data*
  • Risk Factors
  • Stress Disorders, Post-Traumatic / diagnosis
  • Stress Disorders, Post-Traumatic / epidemiology*
  • Stress Disorders, Traumatic, Acute / diagnosis
  • Stress Disorders, Traumatic, Acute / epidemiology*
  • United States / epidemiology