title: Modification effects of coping on post-traumatic morbidity among earthquake rescuers.
abstract: This study aims to investigate the modification effects of coping strategies on the relationships between rescue effort and psychiatric morbidity (i.e. general psychiatric morbidity and post-traumatic morbidity) in earthquake rescue workers. Firefighters (n=193) who were involved in the rescue effort after the Taiwan Chi-Chi earthquake were invited to complete a questionnaire which contained questions on demographics, exposure to rescue work, general psychiatric morbidity, post-traumatic morbidity, and coping strategies. Multivariate regression models with interaction terms were carried out to investigate the modification effect of coping strategies on the relationships between rescue effort and psychiatric morbidities. Older age and longer job experiences (>3 years) were associated with both general psychiatric and post-traumatic morbidities. Coping strategies such as confrontive coping, distancing, seeking social support, accepting responsibility, escape-avoidance, planful problem solving, and positive appraisal significantly modified the effect of exposure to dead bodies on general psychiatric morbidity. Furthermore, confrontive coping, distancing, and planned problem solving significantly modified the effect of exposure to direct rescue involvement on general psychiatric morbidity. However, coping strategies were not observed to buffer the effect of rescue involvement or contact with dead bodies on post-traumatic morbidity. More frequent use of coping strategies could reduce the effect that exposure to rescue efforts has on the incidence of general psychiatric morbidity in rescue workers. However, coping strategies do not seem to reduce the influence of such exposure on trauma-related morbidities. This suggests that coping strategies can be used to prevent general psychiatric morbidity but not trauma-related morbidities.
authors.affiliation: Department of Psychiatry and Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan.
authors.forename: Chia-Ming
authors.initials: CM
authors.lastname: Chang
authors.forename: Li-Ching
authors.initials: LC
authors.lastname: Lee
authors.forename: Kathryn M
authors.initials: KM
authors.lastname: Connor
authors.forename: Jonathan R T
authors.initials: JR
authors.lastname: Davidson
authors.forename: Te-Jen
authors.initials: TJ
authors.lastname: Lai
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D002391:Catchment Area, Health; D003710:Demography; D004190:Disasters; D005260:Female; D006304:Health Status; D006801:Humans; D008297:Male; D008875:Middle Aged; D018635:Rescue Work / Q000706:statistics & numerical data*; D013313:Stress Disorders, Post-Traumatic / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology*; D011795:Surveys and Questionnaires; D013624:Taiwan / Q000453:epidemiology; D013997:Time Factors