title: Acute stress symptoms, dissociation, and depression among rescue personnel 24 hours after the Bet-Yehoshua train crash: the effects of exposure to dead bodies.
abstract: BACKGROUND
  The immediate impact of exposure to severe wounds, dead bodies, and immediate threat to life has been understudied. Most studies focus on the acute stress disorder and/or post-traumatic stress disorder phases in order to assess rescue personnel's symptomatology, and tend to neglect the immediate exposure to elements of the disaster.
  
  
  OBJECTIVE
  Rescue personnel who had a history of previous exposure to dead bodies would exhibit higher levels of acute stress symptoms, dissociation, and depressive symptoms within the 24 hours following a traumatic event.
  
  
  METHODS
  Twenty-three rescue personnel participated in the search and excavation of dead and mutilated bodies following the Bet-Yehoshua train crash in Israel. The rescue personnel group was divided based on previous exposure to dead bodies. Each participant completed a demographic questionnaire, which included a question on perceived threat to life, the impact of event scale revised, the dissociative experience scale, and the center of epidemiologic studies depression questionnaire. Student's t-tests, along with multivariate analysis of covariance (MANCOVA) were conducted in order to learn which factors are related to psychiatric symptomatology following the immediate exposure to such stressors.
  
  
  RESULTS
  Among rescue personnel, those with previous exposure to dead bodies did not differ in their levels of acute stress symptoms, dissociation, and depressive symptoms from those who were not previously exposed to dead bodies.
  
  
  CONCLUSIONS
  These results may suggest the possibility that the impact of exposure to dead bodies does not emerge in the acute stress reactions (ASR) phase (up to 24 hours after the event), but later when people have time to process the trauma. Another possibility is that the rescue coping mechanisms of detachment may serve as a buffer for the horrific sights encountered during the ASR period.
authors.affiliation: Department of Social Work, Ariel University Center of Samaria, Ariel, Israel. menbe@ariel.ac.il
authors.forename: Menachem
authors.initials: M
authors.lastname: Ben-Ezra
authors.forename: Yuval
authors.initials: Y
authors.lastname: Palgi
authors.forename: Nir
authors.initials: N
authors.lastname: Essar
authors.forename: Hilik
authors.initials: H
authors.lastname: Sofer
authors.forename: Yeela
authors.initials: Y
authors.lastname: Haber
mesh_terms: D000059:Accidents / Q000523:psychology; D000208:Acute Disease; D000223:Adaptation, Psychological; D000328:Adult; D000704:Analysis of Variance; D001293:Attitude to Death; D003863:Depression / Q000453:epidemiology / Q000209:etiology*; D004213:Dissociative Disorders / Q000453:epidemiology / Q000209:etiology*; D004634:Emergency Medical Technicians / Q000523:psychology*; D005260:Female; D006801:Humans; D007557:Israel / Q000453:epidemiology; D008297:Male; D015999:Multivariate Analysis; D010865:Pilot Projects; D011594:Psychometrics; D011890:Railroads / Q000706:statistics & numerical data; D018635:Rescue Work; D012307:Risk Factors; D013313:Stress Disorders, Post-Traumatic / Q000453:epidemiology / Q000209:etiology*; D013315:Stress, Psychological / Q000150:complications*; D011795:Surveys and Questionnaires; D013997:Time Factors