Critical Incidents: Background

Cheshire City Council (1995) definition of critical incidents
1. Charged with profound emotion which may involve serious injury/death
2. Generate a high level of immediate or delayed emotional reaction
3. Involve serious threat or extremely unusual circumstances
4. Attract unusual attention from the community or media
5. Surpass an individual, group, or organisation's normal coping mechanisms
Post-traumatic Stress (PTS) = "the development of certain characteristic symptoms following a psychologically distressing event which is outside the range of normal human experience" DSM (1987)
1. Examples from Parkinson (1993): flashbacks/intrusive memories, headaches, difficulty concentrating, feeling guilty/worthy of blame, feeling detached from others
2. Reactions to incidents vary depending on age, experience, personality, nature of the incident, and degree of involvement (McNally, 2003)
3. PTS is "a normal reaction of normal people to events which, for them, are unusual or abnormal" (Parkinson, 1993). Is it?
4. Post-traumatic stress disorder (PTSD) occurs when symptoms of PTS emerge later, persist or intensify long after the event (i.e. more than 6 weeks), and/or disrupt normal living
  1. DSM crtieria for adults and children over 6 years involves 3 aspects: re-experiencing; avoidance; arousal (DSM IV) or negative cognition and mood (DSM V)
  2. For younger children, symptoms differ and may include reenacting, repetitive play, and emotional/behavioural difficulties
  3. "The vast majority of people exposed to serious traumatic events do not develop PTSD" (McNally, 2003)
5. More than 90% had begun to re-experience some level of anxiety within 5 hours of rescue (Wiesaeth, 1983)

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Critical Incidents: Background

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