CRM: Desarrollo de Aspectos Críticos Pendientes / CRM: Development of Pending Critical Aspects

La evolución de los programas de CRM ha supuesto para la aviación un enorme progreso en cuanto al estudio de los factores humanos y su relación con la reducción de los accidentes aéreos. Si bien es cierto que los programas de CRM han sufrido una exitosa evolución desde su aparición en 1979, no lo es menos, que los avances en la ciencia psicológica de las últimas décadas hacen necesario revisar y profundizar en aspectos ya abordados en etapas anteriores por dichos programas. Uno de estos aspectos es la importancia que presentan los Tripulantes de Cabina de Pasajeros (TCP) como integrantes del equipo de vuelo. Retrotrayéndose a los programas de CRM de tercera generación, el presente artículo analiza las actuaciones que han tenido los TCP en diferentes accidentes aéreos, poniendo de manifiesto la importancia que tiene su ejecución y la coordinación de la misma con la del resto de la tripulación de cara al éxito en la resolución de la emergencia aérea.(AU)

The evolution of CRM programs has meant enormous progress for aviation in terms of the study of human factors and their relationship with the reduction of air accidents. Although it is true that CRM programs have undergone a successful evolution since their appearance in 1979, it is no less true that the advances in psychological science in recent decades make it necessary to review and expand on aspects already addressed in previous stages by these programs. One of these aspects is the importance of the cabin crew members (CCM) as members of the flight team. Going back to the third generation programs, this paper analyzes the actions that the CCM have taken in different air accidents, highlighting the importance of their performance and their coordination with the rest of the crew in order to achieve success in resolving the air emergency.(AU)

Physician Mental Health: My Personal Journey and Professional Plea.

Longitudinal surveys of adults in the United States have shown that approximately 1 in 5 individuals experienced a mental illness in the prior year, with an increase in the observed prevalence over the last decade. Studies of physicians, including medical students, residents, and fellows, have shown that they also experience mental disorders, with some research (e.g., on depression) showing prevalence rates higher than those in the general population. Tragically, physicians also have higher suicide rates than the general population. In this commentary, the author discusses his own challenges with mental disorders beginning in early childhood. He shares how earlier trauma led to the emergence of symptoms that nearly caused him to withdraw from medical school during his first year, and he describes how support from a faculty member helped him receive psychiatric treatment that allowed him to successfully negotiate that serious crisis and experience a long, productive career. The author underscores how the idealized image of the physician as care giver rather than care receiver that many bring to their medical career, as well as the stigma associated with mental disorders, may prevent physicians from seeking care. He uses the narrative of his personal journey to make a plea to colleagues to share their own stories of mental illness and successful treatment, arguing that this is key to ultimately destigmatizing these issues for the profession of medicine.

The experience of sudden loss of a colleague or neighbor following the MH17 plane crash in the Ukraine: a qualitative interview study.

BACKGROUND: The literature on loss and traumatic grief after disasters provides findings on the impact of losing a partner, child or close friend on partners, parents and friends. However, little attention has been given to the broader everyday social environment of deceased persons. The present study constitutes a qualitative exploration of the impact on colleagues and neighbors following the MH17 airplane disaster in the Ukraine, July 2014. METHODS: Eighteen structured interviews were conducted with eleven colleagues and seven neighbors. The interviews focused on the relation(-ship) with the victim, on the disaster, the first days and weeks hereafter, and the status one and a half years after the crash. RESULTS: Especially for colleagues and neighbors with an intensive, long-lasting relation and ties based on friendship and trust, the impact of the sudden death was large. The MH17 disaster was considered a special event, different from, for instance, an "ordinary" accident. It was actively covered by the media and a recurrent conversation topic in meetings with other people. In the workplace, employers and less involved colleagues show empathy for a limited period of time, but grief has an expiration date - a moment where it gets more difficult to others or influences productivity. The appreciation for rituals in the workplace or in the neighborhood varies. CONCLUSIONS: The interviews indicate a "hierarchy of bereavement". People are not part of the typical inner circle, but feel "affected" and experience little social recognition and acknowledgment, particularly in the longer term. As such, colleagues and neighbors may experience loneliness and/or isolation. Generally, there is no need to consult a practitioner, despite the experience of health complaints such as intrusive dreaming and lack of sleep.

Trajectories of grief, depression, and posttraumatic stress in disaster-bereaved people.

BACKGROUND: Previous latent trajectory studies in adult bereaved people have identified individual differences in reactions postloss. However, prior findings may not reflect the complete picture of distress postloss, because they were focused on depression symptoms following nonviolent death. We examined trajectories of symptom-levels of persistent complex bereavement disorder (PCBD), depression, and posttraumatic stress disorder (PTSD) in a disaster-bereaved sample. We also investigated associations among these trajectories and background and loss-related factors, psychological support, and previous mental health complaints. METHODS: Latent class growth modeling was used to identify distinct trajectories of PCBD, depression, and PTSD symptoms in people who lost loved ones in a plane disaster in 2014. Participants (N = 172) completed questionnaires for PCBD, depression, and PTSD at 11, 22, 31, and 42 months postdisaster. Associations among class membership and background and loss-related variables, psychological support, and previous mental health complaints were examined using logistic regression analyses. RESULTS: Two PCBD classes emerged: mild (81.8%) and chronic (18.2%) PCBD. For both depression and PTSD, three classes emerged: mild (85.6% and 85.2%), recovered (8.2% and 4.4%), and chronic trajectory (6.2% and 10.3%). People assigned to the chronic PCBD, depression, or PTSD class were less highly educated than people assigned to the mild/recovered classes. CONCLUSIONS: This is the first latent trajectory study that offers insights in individual differences in longitudinal symptom profiles of PCBD, depression, and PTSD in bereaved people. We found support for differential trajectories and predictors across the outcomes.

Anticipated Negative Emotions Effect on Incident Involvement Among Civil Pilots.

INTRODUCTION: Human factors have contributed to a constant increase in the level and numbers of aviation incident involvement. The primary objective of this study is to investigate the relationships between anticipated negative emotions (ANEs) and incident involvement among Chinese civil pilots. Furthermore, this paper examines the role of risk perception and proactive coping within the relationships in order to understand the mechanisms underlying pilots' involvement in air transport incidents.METHODS: A cross-sectional regression design was used to measure ANEs (Anticipated Negative Emotions Scale), proactive coping (Proactive Coping Scale), risk perception (Pilot Risk Perception Scale), and incident involvement (Hazardous Events Scale) among 295 Chinese civil pilots from China Southern Airlines. Mediation and moderating effects were explored using regression analyses and were confirmed by the bootstrapping approach.RESULTS: The results show that ANEs are significantly correlated with risk perception (r = -0.55) and incident involvement (r = 0.28). ANEs have a direct effect on pilot involvement in incidents and have an indirect effect on pilot incident involvement through the influencing of risk perception. Proactive coping was also found to weaken the direct effect of anticipated negative emotions on incident involvement.DISCUSSION: The safety benefits of proactive coping are more pronounced among pilots with high levels of ANEs. The practical implications of the study include recommendations relating to injury prevention efforts in incident involvement. Future research directions are also discussed.Wang H, Xu Q, Yang C, You X, Ji M. Anticipated negative emotions effect on incident involvement among civil pilots. Aerosp Med Hum Perform. 2019; 90(9):774-781.

You're the Flight Surgeon.

Zhang JJ. You're the flight surgeon: airman with emotional trauma following deployments. Aerosp Med Hum Perform. 2019; 90(5):496-500.

Acute stress responses after indirect exposure to the MH17 airplane crash.

People can experience disasters vicariously (indirectly) via conversation, social media, radio, and television, even when not directly involved in a disaster. This study examined whether vicarious exposure to the MH17-airplane crash in Ukraine, with 196 Dutch victims, elicited affective and somatic responses in Dutch adults about 2,600 km away, who happened to participate in an ongoing diary study. Participants (n = 141) filled out a diary three times a day for 30 days on their smartphones. Within-person changes in positive affect (PA) and negative affect (NA) and somatic symptoms after the crash were studied. Additionally, we tested whether between-person differences in response could be explained by age, baseline personality (NEO-FFI-3), and media exposure. The MH17 crash elicited a small within-person decrease in PA and an increase in NA and somatic symptoms. This response waned after 3 days and returned to baseline at day four. The decrease in PA was larger in more extraverted participants but smaller in those higher on neuroticism or conscientiousness. The NA response was smaller in elderly. Personality did not seem to moderate the NA and somatic response, and neither did media exposure. Dutch participants showed small acute somatic and affective responses up till 3 days to a disaster that they had not directly witnessed. Vicariously experienced disasters can thus elicit affective-visceral responses indicative of acute stress reactions. Personality and age explained some of the individual differences in this reaction.

Factores humanos en aviación: CRM (crew resource management-gestión de recursos de la tripulación) / Human factors in aviation: CRM (crew resource management)

Uno de los campos aplicados a los que más ha contribuido la ciencia psicológica es, sin lugar a dudas, el de la aviación. El análisis y estudio de los factores humanos constituye actualmente uno de los puntos fuertes en el sector aeronáutico de cara a la reducción de los accidentes aéreos. Desde su aparición en 1979, los programas de Gestión de Recursos de la Tripulación (CRM) han sido una de las herramientas que con mayor éxito han gestionado el denominado "error humano". El presente artículo realiza un breve recorrido por la historia de estos programas globales de entrenamiento que suponen uno de los grandes logros de la Psicología Aplicada

One of the applied fields to which psychological science has most contributed is, without doubt, aviation. The analysis and study of human factors is currently one of the strong points in the aeronautical sector in order to reduce accidents in aviation. Since its appearance in 1979, the Crew Resource Management (CRM) programs have been one of the most successful tools that have managed the so-called "human error". This paper makes a brief tour through the history of these global training programs that represent one of the great achievements of Applied Psychology

Aircraft-Assisted Pilot Suicides in the General Aviation Increased for One-Year Period after 11 September 2001 Attack in the United States.

Pilot aircraft-assisted suicides (AAS) are rare, and there is limited understanding of copycat phenomenon among aviators. The aim of this study was to evaluate the possible effect the 11 September 2001, terrorist attacks had on pilot AASs in the U.S. Fatal aviation accidents in the National Transportation Safety Board (NTSB) database were searched using the following search words: "suicide", "murder-suicide" and "homicide-suicide". The timeline between 11 September 1996, and 11 September 2004, was analyzed. Only those accidents in which NTSB judged that the cause of the accident was suicide were included in the final analysis. The relative risk (RR) of the pilot AASs in all fatal accidents in the U.S. was calculated in order to compare the one, two, and three-year periods after the September 11 terrorist attacks with five years preceding the event. The RR of a fatal general aviation aircraft accident being due to pilot suicide was 3.68-fold (95% confidence interval 1.04⁻12.98) during the first year after 11 September 2001, but there was not a statistically significant increase in the later years. This study showed an association, albeit not determinate causal effect, of a very specific series of simultaneous terrorist murder-suicides with subsequent pilot AASs.

Copycats in Pilot Aircraft-Assisted Suicides after the Germanwings Incident.

Aircraft-assisted pilot suicide is a rare but serious phenomenon. The aim of this study was to evaluate changes in pilot aircraft-assisted suicide risks, i.e., a copycat effect, in the U.S. and Germany after the Germanwings 2015 incident in the French Alps. Aircraft-assisted pilot suicides were searched in the U.S. National Transportation Safety Board (NTSB) accident investigation database and in the German Bundestelle für Flugunfalluntersuchung (BFU) Reports of Investigation database five years before and two years after the deliberate crash of the Germanwings flight into the French Alps in 2015. The relative risk (RR) of the aircraft-assisted pilot suicides was calculated. Two years after the incident, three out of 454 (0.66%) fatal incidents were aircraft-assisted suicides compared with six out of 1292 (0.46%) in the prior five years in the NTSB database. There were no aircraft-assisted pilot suicides in the German database during the two years after or five years prior to the Germanwings crash. The relative aircraft-assisted pilot suicide risk for the U.S. was 1.4 (95% CI 0.3-4.2) which was not statistically significant. Six of the pilots who died by suicide had told someone of their suicidal intentions. We consider changes in the rate to be within a normal variation. Responsible media coverage of aircraft incidents is important due to the large amount of publicity that these events attract.

Debiasing visual pilots' weather-related decision making.

Pilots who decide to continue a flight into deteriorating weather conditions, rather than turn back or divert, are a significant cause of fatal crashes in general aviation. Earlier research has suggested that cognitive biases such as the anchoring effect and confirmation bias are implicated in many decisions to continue into worsening weather. In this study, we explored whether a simple debiasing technique, 'considering the alternative', reduced the effect of these two potentially fatal biases. Despite the study being adequately powered, our attempts to reduce the effects of biases were both unsuccessful. Negative findings such as these are particularly useful in aviation, as they can provide information on what does not work in this high stakes industry, even though such strategies may work elsewhere.

Shifting blame? Impact of reports of violence and mental illness in the context of terrorism on population attitudes towards persons with mental illness in Germany.

We examine whether reporting on violent and terrorist acts committed in July 2016 by persons who, among other characteristics, were suspected to have mental health issues did impact on mental illness stigma, and whether any changes added to changes observed after the Germanwings plane crash in 2015. Three identical online surveys (in 2014, 2015 and 2016) were conducted among persons >15 years old from an established market research panel in Germany (N=2195). Participants answered questions about a woman ("Anne") with either depression or schizophrenia as described in an unlabeled vignette. In the 2016 survey (<4 weeks after the attacks), we also elicited perceived causes of the violent incidents. Compared to 2014, the predicted probability to rate Anne as dangerous increased from 7% to 11%. Perceived unpredictability increased from 17% to 23%. Other stigma measures did not change significantly. No significant changes were visible between 2015 and 2016. Mental illness ranked third among the most important perceived causes for the attacks in 2016, after 'religious beliefs' and 'being manipulated by others'. Overall, the observed attitude changes were small. We discuss how the context of the attacks may have prevented further attitude change regarding persons with mental illness.

[Aeromedical Decision-Making in Psychiatry]. / Fliegerärztliche Entscheidungsfindung in der Psychiatrie.

This paper reviews aeromedical decision-making in psychiatry. It explains the "one-percent rule", the general medical criteria for fitness for flying and how they are applied to psychiatric disorders.

Human risk factors associated with pilots in runway excursions.

A breakdown analysis of civil aviation accidents worldwide indicates that the occurrence of runway excursions represents the largest portion among all aviation occurrence categories. This study examines the human risk factors associated with pilots in runway excursions, by applying a SHELLO model to categorize the human risk factors and to evaluate the importance based on the opinions of 145 airline pilots. This study integrates aviation management level expert opinions on relative weighting and improvement-achievability in order to develop four kinds of priority risk management strategies for airline pilots to reduce runway excursions. The empirical study based on experts' evaluation suggests that the most important dimension is the liveware/pilot's core ability. From the perspective of front-line pilots, the most important risk factors are the environment, wet/containment runways, and weather issues like rain/thunderstorms. Finally, this study develops practical strategies for helping management authorities to improve major operational and managerial weaknesses so as to reduce the human risks related to runway excursions.

Analysis of NTSB Aircraft-Assisted Pilot Suicides: 1982-2014.

On March 24, 2015, a Germanwings aircraft crashed in the Alps. The suicidal copilot killed himself and 150 others. Pilot suicide is rare, but does happen. This research analyzed the National Transportation Safety Board's accident database (eADMS) looking for pilots who died by suicide in flight. Fifty-one suicides were identified. Gender, age, and other characteristics were examined. Average age of suicidal pilots was 38, significantly different from the average age of 45 for all male pilots involved in aircraft accidents. A discriminant function accurately identified suicidal incidents at 96%. There was a high false-positive rate limiting the usefulness of the discriminant function.

[Medial Stigmatization of Mentally Ill Persons after the "Germanwings"-Crash]. / Mediale Stigmatisierung psychisch Kranker im Zuge der "Germanwings"-Katastrophe.

OBJECTIVE: The present study was designed to investigate the frequency of media stigmatization of mentally ill persons after the crash of the "Germanwings"-aircraft on March 2015. METHOD: Evaluation of 251 texts, which were published in 12 national German newspapers. Categorical distinction between risky coverage and explicit characteristics of stigmatization. RESULTS: In 64.1 % of the evaluated texts, a psychiatric disease of the co-pilot was discussed as the possible cause of the crash, making this the most widely-used explanation in the media that we view "risky coverage". Characteristics of explicit stigmatization were found in 31.5 % of the texts. Most prominent category of explicit stigmatization was the rubric "Metaphorical language/dramatizations". It was found in 23.5 % of the articles. CONCLUSION: Predominantly risky coverage of mentally ill persons has occured in the wake of a spectacular crime. By obtaining professional expertise of psychiatrists and consistent interpretation of journalistic guidelines, unintended effects of stigmatization could be avoided in the future.