title: Psychological sequelae of the station nightclub fire: Comparing survivors with and without physical injuries using a mixed-methods analysis.
abstract: BACKGROUND
  Surveying survivors from a large fire provides an opportunity to explore the impact of emotional trauma on psychological outcomes.
  
  
  METHODS
  This is a cross-sectional survey of survivors of The Station Fire. Primary outcomes were post-traumatic stress (Impact of Event Scale - Revised) and depressive (Beck Depression Inventory) symptoms. Linear regression was used to examine differences in symptom profiles between those with and without physical injuries. The free-response section of the survey was analyzed qualitatively to compare psychological sequelae of survivors with and without physical injuries.
  
  
  RESULTS
  104 participants completed the study survey; 47% experienced a burn injury. There was a 42% to 72% response rate range. The mean age of respondents was 32 years, 62% were male, and 47% experienced a physical injury. No significant relationships were found between physical injury and depressive or post-traumatic stress symptom profiles. In the qualitative analysis, the emotional trauma that survivors experienced was a major, common theme regardless of physical injury. Survivors without physical injuries were more likely to experience survivor guilt, helplessness, self-blame, and bitterness. Despite the post-fire challenges described, most survivors wrote about themes of recovery and renewal.
  
  
  CONCLUSIONS
  All survivors of this large fire experienced significant psychological sequelae. These findings reinforce the importance of mental health care for all survivors and suggest a need to understand factors influencing positive outcomes.
authors.affiliation: Massachusetts General Hospital Depression Clinical and Research Program, Boston, Massachusetts, United States of America.
authors.forename: Nhi-Ha T
authors.initials: NH
authors.lastname: Trinh
authors.affiliation: Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital, Harvard Medical School, Boston, Massachusetts, United States of America; Spaulding Center of Neuromodulation, Department of Physical Medicine and Rehabilitation, Harvard Medical School, Boston, Massachusetts, United States of America.
authors.forename: Deborah L
authors.initials: DL
authors.lastname: Nadler
authors.affiliation: Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital, Harvard Medical School, Boston, Massachusetts, United States of America; Spaulding Center of Neuromodulation, Department of Physical Medicine and Rehabilitation, Harvard Medical School, Boston, Massachusetts, United States of America.
authors.forename: Vivian
authors.initials: V
authors.lastname: Shie
authors.affiliation: Spaulding Center of Neuromodulation, Department of Physical Medicine and Rehabilitation, Harvard Medical School, Boston, Massachusetts, United States of America.
authors.forename: Felipe
authors.initials: F
authors.lastname: Fregni
authors.affiliation: Department of Social and Behavioral Sciences, and Department of Epidemiology, Harvard School of Public Health, Boston, Massachusetts, United States of America, and Department of Psychiatry, Massachusetts General Hospital, Boston, Massachusetts, United States of America.
authors.forename: Stephen E
authors.initials: SE
authors.lastname: Gilman
authors.affiliation: Sumner Redstone Burn Center, Surgical Services Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, United States of America, and Shriners Hospitals for Children-Boston, Boston, Massachusetts, United States of America.
authors.forename: Colleen M
authors.initials: CM
authors.lastname: Ryan
authors.affiliation: Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital, Harvard Medical School, Boston, Massachusetts, United States of America.
authors.forename: Jeffrey C
authors.initials: JC
authors.lastname: Schneider
mesh_terms: D000328:Adult; D002056:Burns / Q000503:physiopathology / Q000523:psychology*; D003071:Cognition; D003863:Depression / Q000503:physiopathology / Q000523:psychology; D005260:Female; D005390:Fires; D006801:Humans; D008297:Male; D015999:Multivariate Analysis; D012237:Rhode Island; D017741:Survivors / Q000523:psychology*