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Psychology of a Crisis Module 2

Psychology of a Crisis Module 2. What Constitutes Crisis? Naturally occurring Earthquake Tornado Flood Wildfire Pandemic Disease Manmade Hazardous Material

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Psychology of a Crisis

Module 2

What Constitutes Crisis?

Naturally occurring Earthquake Tornado Flood Wildfire Pandemic Disease

Manmade Hazardous Material Release Terrorism Other Criminal Activity

Traumatic Events

Sudden and unexpected Children more vulnerable – less experience in

coping with life Adults may be overwhelmed by events that

occur suddenly and are beyond their control – may produce psychological reactions including Post Traumatic Stress Disorder (PTSD)

Public Perspectives

61% fear terrorism more than natural disaster 77% believe information to cope with fear and

distress are needed 57% do not think the health system is

meeting the mental health needs resulting from the threat of terrorism

Information received after a crisis significantly shapes reactions over the weeks and years following

Immediate Reactions to a Crisis

Disbelief Disorientation Dislocation Fear Feeling time is slowed down Feeling numb or disconnected Feeling helpless Feeling responsible (should be doing more)

HOW DO YOU FEEL?

Response to 9/11 Attacks

First week 44% of adults & 35% of children – 1 or more

substantial stress symptoms Intrusive thoughts Very upset when reminded Nightmares, sleep disturbance Poor concentration Anger outbursts

Response to 9/11 Attacks

20% of Americans know someone who was missing, hurt or killed

64% had a shaken sense of safety & security 43% less willing to travel by airplane

Within 2 months in Manhattan 7.5% increase in PTSD (67,000 new cases) 9.7% increase in Depression (87,000 new cases)

Secondary trauma via TV and other media correlate to PTSD symptoms – 60% witnessed via live TV

General Psychological Effects

Emotional Effects Grief, anger, despair, sadness, hopelessness,

numbness, denial, flashbacks, generalized Anxiety Disorder, Panic Disorder, Post Traumatic Stress Disorder (PTSD)

Cognitive Effects Impaired concentration & decision-making,

impaired memory, disbelief, worry, tunnel vision

General Psychological Effects

Physical Effects Fatigue, insomnia, cardiovascular strain, hyper-

arousal, health problems/concerns headaches, decreased appetite, nonspecific distress, MUPS – Medically Unexplained Physical Symptoms (worried well)

Interpersonal Effects Increased relational conflict, social withdrawal,

impaired performance, over-protectiveness, feeling abandoned and rejected

Who’s At Risk?

Those with severe exposure, injury, threat to life, extreme loss, disrupted community, and high secondary stress

Females age 40 -60 with no experience in coping techniques

Young & middle aged adults (vs. older adults) Prior exposure to violence and trauma Ethnic minorities Persons with prior psychiatric history Adults with children School children First responders

Protecting the Public’s Psychological Health Provide basic resources – food, shelter,

communication, transportation, and medical services

Programs to promote individual and community resilience

Surveillance for psychological consequences Treatment for acute and long-term effects of

the trauma

Protecting the Public’s Psychological Health Human Services – reuniting families, child

care, housing, job assistance Risk Communication – dissemination of

information Training service providers to respond,

protected against psychological trauma Surge capacity Identifying the underserved, marginalized

persons needing psychological services

Traumatic Stress

Traumatic stress may affect: Cognitive functioning. Physical health. Interpersonal relations.

Mediating Factors

Prior experience with a similar event The intensity of the disruption in the survivors’

lives The emotional strength of the individual The length of time that has elapsed between

the event occurrence and the present

Physiologic Response

Stress Increases Heart rate increases Motor skill ability decreases Perceptual narrowing occurs – tunnel-vision Response programming is delayed until threat

identified

Actions to Perform Under Stress

Take a deep breath Look around during size up, view the BIG

picture Think before acting – develop a plan

Remember: IT’S NOT MY EMERGENCY!

Phases of a Crisis

Impact: stunned, shock

Inventory: confusion, then assessment

Rescue: inclined to act, compliant

Recovery: relief, anger

Reconstruction: grief, long term resolution

Possible Psychological Symptoms

Acting differently than normal for this person Performing activities that do not make sense for the time Irritability, anger Self-blame, blaming others Isolation, withdrawal Fear of recurrence Feeling stunned, numb, or overwhelmed Feeling helpless Mood swings Sadness, depression, grief Denial Concentration, memory problems Relationship conflicts/marital discord

Possible Physiological Symptoms

Loss of appetite Headaches, chest pain Diarrhea, stomach pain, nausea Hyperactivity Increase in alcohol or drug consumption Nightmares Inability to sleep Fatigue, low energy

Team Well-Being

Team leaders should: Provide pre-disaster stress management training. Brief personnel before response. Emphasize teamwork. Encourage breaks. Provide for proper nutrition. Rotate personnel. Phase out workers gradually. Conduct a debrief discussion. Arrange for a post-event debriefing later.

Critical Incident Stress Debriefing

Six phases: Introduction and a description Review of the factual material Sharing of initial thoughts/feelings Sharing of emotional reactions to the incident Instruction about normal stress reactions Review of the symptoms Closing and further needs assessment

Risk Communications - EPA

Accept & involve the public as a legitimate partner

Listen to the audience Be honest, frank and open Coordinate and collaborate with other

credible sources Meet the needs of the media Speak clearly and with compassion Plan carefully and evaluate performance

Avoid Saying . . .

“I understand” “Don’t feel bad” “You’re strong/You’ll get through this” “Don’t cry” “It’s God’s will” “It could be worse” or “At least you still

have…” “I’m sorry for what’s happened to you”