Critical Incidents: Background

Critical Incidents: Background

1. Cheshire City Council (1995) definition of critical incidents

   • Charged with profound emotion which may involve serious injury/death
   • Generate a high level of immediate or delayed emotional reaction
   • Involve serious threat or extremely unusual circumstances
   • Attract unusual attention from the community or media
   • Surpass an individual, group, or organisation's normal coping mechanisms

2. 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)

   • Examples from Parkinson (1993): flashbacks/intrusive memories, headaches, difficulty concentrating, feeling guilty/worthy of blame, feeling detached from others
   • Reactions to incidents vary depending on age, experience, personality, nature of the incident, and degree of involvement (McNally, 2003)
   • PTS is "a normal reaction of normal people to events which, for them, are unusual or abnormal" (Parkinson, 1993). Is it?
   • 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
     • 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)
     • For younger children, symptoms differ and may include reenacting, repetitive play, and emotional/behavioural difficulties
     • "The vast majority of people exposed to serious traumatic events do not develop PTSD" (McNally, 2003)
   • More than 90% had begun to re-experience some level of anxiety within 5 hours of rescue (Wiesaeth, 1983)