title: Participation in a trauma-focused epidemiological investigation may result in sensitization for current health problems.
abstract: OBJECTIVE
  Participation in health survey research may result in a worsening of self-assessed health status and enhanced service-use by increasing self-awareness of current health status. The present study investigated whether participation in a trauma-focused epidemiological study sensitized participants for health problems irrespective of trauma exposure.
  
  
  METHODS
  A total of 1,019 rescue workers and 453 residents involved in varying degrees in a large scale aviation disaster participated. Data collection took place between December 2000 and April 2003. There were two measurements: one during the epidemiological investigation at a general hospital and one 12 weeks after the first measurement. Follow-up data were gathered in 80% of a randomly selected group of rescue workers and in 62% of the residents. Main outcome measures were: health anxiety, somatic sensitivity, the tendency to be reassured by a physician, psychopathology, post-traumatic stress symptoms, fatigue and quality of life.
  
  
  RESULTS
  Both rescue workers and residents reported less reassurance, and increased health anxiety and somatic sensitivity 12 weeks after the investigation compared to the first measurement. Exposure to the aviation disaster was not predictive of these changes in health perception, but higher levels of psychological and physical symptoms at baseline were. Only 0.2-1.6% of the residents and rescue workers indicated at baseline that the investigation had had a very negative impact on their mental and/or physical well-being. No evidence for systematic trends or changes in baseline scores for anxiety about health or subjective complaints during the 15 months inclusion period were found.
  
  
  CONCLUSIONS
  Participation in an epidemiological study of the long-term sequelae of disaster exposure does not lead to very strong negative reactions in most of the participants, but can result in an increased awareness of somatic sensations, enhancement of health worries and lowered reassurability by physicians, especially in participants with higher levels of psychological and physical symptoms at baseline. Future studies are needed to investigate the temporal stability of these inadvertent and unobtrusive negative consequences.
authors.affiliation: Dept. of Psychology, Division of Clinical Health and Neuropsychology, Leiden University, Leiden, RB, The Netherlands. verschuu@fsw.leidenuniv.nl
authors.forename: Margot J
authors.initials: MJ
authors.lastname: Verschuur
authors.forename: Philip
authors.initials: P
authors.lastname: Spinhoven
authors.forename: Arnold A P
authors.initials: AA
authors.lastname: van Emmerik
authors.forename: Frits R
authors.initials: FR
authors.lastname: Rosendaal
mesh_terms: D000328:Adult; D001007:Anxiety / Q000453:epidemiology / Q000209:etiology*; D004190:Disasters; D005260:Female; D006306:Health Surveys; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D009426:Netherlands / Q000453:epidemiology; D011602:Psychophysiologic Disorders / Q000453:epidemiology / Q000209:etiology*; D018635:Rescue Work; D035842:Research Subjects / Q000523:psychology*; D012306:Risk