Fear, information and control during a pandemic. / Frykt, informasjon og kontroll under en pandemi.

When a threat is perceived as understandable and manageable, it is easier for people to adapt to the situation. That is why it is so important for the authorities to keep the public well-informed during the COVID-19 pandemic.

The trajectory of symptom burden in exposed and unexposed survivors of a major avalanche disaster: a 30 year long-term follow-up study.

BACKGROUND: Limited research exists concerning the long-term effects of avalanches on survivors' mental health beyond the first years after the accident. The aims of this study were to describe and evaluate possible differences in long-term mental health symptoms after a major avalanche disaster between exposed and unexposed soldiers using a longitudinal design. METHOD: Present mental health symptoms were examined among avalanche exposed (n = 12) and unexposed (n = 9) soldiers by PTSS-10, IES-15 and STAI-12 in four waves (1986-1987 and 2016). RESULTS: Binary logistic regression revealed that the odds to score above the cut-off were significantly lower for both groups after one year compared to baseline for PTSS-10 (p = 0.018) and significantly lower after 30 days compared to baseline for IES-15 (p = 0.005). Data did not reveal significant differences between the exposed and unexposed groups regarding adjusted PTSS-10, IES-15 or STAI-12 mean scores compared. Linear mixed model-analyses revealed significant effects of time. The adjusted mean scores declined over time for both groups: PTSS-10 (p = 0.001), IES-15 (p = 0.026) and STAI-12 (p = 0.001), and the time trajectories for PTSS-10 were significantly different between the groups (p = 0.013). Although not significant (all p > 0.05), results indicated that a larger proportion of soldiers in the exposed group experienced posttraumatic stress symptoms (5/12) (PTSS-10 score ≥ 4) and distress symptoms (6/12) (IES-15 score ≥ 26) above cut-off points, 30 years post-disaster. CONCLUSIONS: The course of mental health symptoms may persist, and even increase, in selected and trained military personnel 30 years after exposure to a natural disaster. These findings may be of great importance for health authorities planning appropriate follow-up.

Visiting the site of death: experiences of the bereaved after the 2004 Southeast Asian Tsunami.

The authors examined how many bereaved relatives of Norwegian tourists who perished in the 2004 Southeast Asian Tsunami had visited the site of death and the most important outcome from the visit. We conducted in-depth interviews (n = 110) and used self-report questionnaires (Impact of Event Scale-Revised, Inventory of Complicated Grief and General Health Questionnaire) in a total of 130 first-degree family members 2 years post-disaster. Results showed that the majority of participants (n = 113; 87%) had visited the site of death. The most important outcome was gaining an increased understanding of what occurred (61%) and a feeling of closeness to the deceased (27%). Those who had visited the site of death reported lower avoidance behavior and higher degree of acceptance of the loss than non-visitors. Although this could be a cause as well as a consequence of the visit, visiting the site of death may be an important part of the support offered to bereaved families after experiencing a disaster loss.

Stressful but rewarding: Norwegian personnel mobilised for the 2004 tsunami disaster.

Adequate responses to disasters and emergency situations rely, among other factors, on coping abilities in disaster workers and emergency personnel. In this study, different aspects of disaster-related stressors and training/experience were investigated in Norwegian personnel (n = 581) mobilised for the 2004 tsunami disaster. The level of stress reactions, measured nine to ten months after the tsunami, was relatively low in this sample, indicating that the personnel coped well with the challenges of the disaster. The level of intrusive memories was higher in disaster-area personnel (n = 335) than in home-base personnel (n = 246). Stress reactions were significantly associated with witnessing experiences (disaster-area group) and with having to reject victims in need of help (both groups). Specific preparation for the mission was associated with a lower level of stress reactions in disaster-area personnel. Such factors may be considered in training and preparation programmes for disaster workers.

Risk factors for completed suicide in veterans of peacekeeping: repatriation, negative life events, and marital status.

This psychological autopsy study focused on suicide risk factors in veterans of peacekeeping, specifically, a representative sample of Norwegian peacekeepers. A multivariate analysis yielded three dimensions with a unique impact on suicide risk: Involuntary repatriation from peacekeeping service, negative life-events before peacekeeping and marital status. In accordance with previous research into suicidal processes, repatriation probably reflects an event causing severe damage to peacekeepers' self-esteem, which combined with vulnerability and lack of protection could increase suicide risk. Preventive measures should focus on careful personnel selection and follow-up of repatriated individuals.

The caregiver reaction assessment: psychometrics, and temporal stability in primary caregivers of Norwegian cancer patients in late palliative phase.

BACKGROUND: Limited research has been done on the situation of primary caregivers (PCs) to patients staying at home with cancer in the palliative phase. This study uses the Caregiver Reaction Assessment (CRA) to examine PCs caregiver burden and well-being. PATIENTS AND METHODS: The sample consisted of 85 PCs examined at baseline, among them 42 were re-examined four months later. We explored the psychometric properties of the CRA at baseline, and introduced a CRA sum score. The CRA sum score was correlated with the Short Form 36 (SF-36) and The Hospital Anxiety and Depression Scale (HADS) scores. RESULTS: The internal consistency of the CRA dimensions varied between alpha 0.57 and 0.85, and the factor structure was in line with earlier studies. The CRA sum score correlated significantly with all mental dimensions on the SF-36 and the HADS. At baseline the PCs showed significantly worse scores except for family support when compared to newly diagnosed cancer patients. The mean scores on the CRA dimensions as well as the total score did not change significantly from baseline to follow-up. CONCLUSION: We have confirmed the psychometric properties of the CRA, which seems to be an appropriate instrument for assessment the PCs caregiver situation.

Silent disaster: a European perspective on threat perception from Chernobyl far field fallout.

Surveys investigated the perceived threat of radioactive fallout and public coping following a "silent disaster" (Chernobyl) across Europe. Survey data from national representative samples in 12 European countries are compiled, 6 months and 2 years after the accident, across 12 countries. Exposure to information about the accident, and perception of the consequences of Chernobyl as a health threat, were significantly related to the level of fallout in each country. Another significant relationship was found between the level of fallout in these 12 countries and the proportion of respondents who reported having taken countermeasures. Information challenges for the authorities are highlighted.

Technological disasters, crisis management and leadership stress.

This paper discusses how psychological stress disturbs decision making during technological crisis and disaster, and how to prevent this from happening. This is exemplified by scientific studies of a Norwegian large scale accident involving hazardous material, and of handling the far-off effects of the nuclear disaster at Chernobyl. The former constitutes an operative level of crisis management, whereas the latter involves crisis management at the strategic and political level. We conclude that stress had a negative effect on decision making in both cases.