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Publications (11)5.44 Total impact

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    ABSTRACT: This 4-year prospective study (N=662) of victims of a fireworks disaster examines the independent predictive value of peritraumatic dissociation for self-reported intrusions, avoidance reactions, and posttraumatic stress disorder (PTSD) symptom severity at both 18-months (T2) and almost 4-years postdisaster (T3). Peritraumatic dissociation was measured 2-3 weeks after the disaster (T1). Hierarchical multiple regression analyses revealed that peritraumatic dissociation was not a strong independent predictor for intrusions and avoidance reactions and PTSD symptom severity at T2 or at T3 above initial intrusions, avoidance reactions, and psychological distress (T1). Results suggest that an early screening procedure for peritraumatic dissociation, which is aimed at identifying disaster victims who are at risk for long-term psychological disturbances can be omitted.
    Full-text · Article · Aug 2006 · Journal of Traumatic Stress
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    ABSTRACT: Firefighters are at risk to be confronted with critical incidents and disasters. This study focused on the predictive value of these variables and their interaction effect for intrusions, avoidance reactions, and health problems among firefighters 18 months post-disaster (N ¼ 639). Furthermore, the course of intrusions, avoidance reactions, and health problems in the period 2�3 weeks to 18 months post-disaster was assessed. Health problems were compared with those of non-affected firefighters (N ¼ 132). Results showed that only disaster exposure and critical incidents accounted for a significant but small proportion of the variance (R2 < .07) of intrusions, avoidance reactions and health problems among the affected firefighters. Health problems among affected firefighters did not decline in the period 2�3 weeks�18 months post-disaster, in contrast to intrusions and avoidance reactions. Health problems of both groups were comparable at T2. Results suggest that resilience in firefighters is rather high.
    No preview · Article · May 2006 · Stress Trauma and Crisis
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    ABSTRACT: Research about attentional functioning following trauma has almost exclusively been performed in patient populations with combat-related posttraumatic stress disorder (PTSD). In this study the relationship between sustained attention and PTSD symptoms was examined in a community sample of survivors of a major disaster using the Paced Auditory Serial Addition Task (PASAT) and the Self-Rating Scale for PTSD (SRS-PTSD) 2–3 years postdisaster. Analyses revealed low but significant partial correlations between PTSD symptoms and the least difficult subtests, ruling out the effects of age, education, depressive symptomatology, and sleep disturbances. These results demonstrate that PTSD symptoms link to attentional dysfunction 2–3 years postdisaster.
    Full-text · Article · Aug 2005 · Journal of Traumatic Stress
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    Full-text · Article · Jan 2005
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    ABSTRACT: BACKGROUND: So far very few studies have compared the use of the Mental Health Services (MHS) by inhabitants directly affected by the disaster and by those not directly affected and hardly any attention has been given to the link between the MHS and the psychological problems. AIM: To investigate whether those directly affected by the Enschede fireworks disaster (in May 2000) have more psychological problems and make more use of the MHS than a comparative group of persons not directly affected by the disaster; also to analyse the link between the use of the MHS and psychological problems 2 to 3 weeks after and/or 18 months after the disaster in inhabitants who were directly affected. METHOD: A longitudinal comparative health study was instituted directly after the fireworks disaster. For this article we analysed the data of the directly affected inhabitants who had completed a questionnaire 2 to 3 weeks and/or 18 months after the disaster (n=1116) and we analysed similar data obtained from the comparative group of inhabitants not directly affected (n = 609) RESULTS: Directly affected inhabitants had more psychological problems 18 months after the disaster and made more use of the MHS (31%) than did the comparative group (9%) 6 to 18 months after the disaster. Affected inhabitants with psychological problems according to the Symptom Checklist-90, Impact of Event scale and the Self-Rating Scale for Post-traumatic Stress Disorder on the occasion of the first and/or second measurement made more frequent use of the MHS, more often considered seeking help and still had more frequent contact with the MHS than did affected inhabitants without psychological problems. Of the affected inhabitants who, according to the Self-Rating Scale, satisfied the criteria for post-traumatic stress disorder (19.6%) 18 months after the disaster, 45.8% were still in contact with the MHS. CONCLUSION: In the 6 to 18 month period after the disaster those affected by the disaster used the MHS 3 times more often. The MHS succeeded in making contact with many affected inhabitants who had psychological problems. A minority of persons with psychological problems is still in contact with MHS. Ethnic minorities used the MHS just as often as affected inhabitants of Dutch origin.
    No preview · Article · Jan 2005 · Tijdschrift voor psychiatrie

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    ABSTRACT: As a result of the firework disaster in the city of Enschede, the Netherlands on 13 May 2000, a health study of the victims was performed 2-3 weeks after the disaster. At the end of 2001, approximately 18 months after the disaster, the questionnaire survey was repeated and over 75% (N=2851) of the victims in the first study participated in the second survey. New in the second survey is the introduction of comparison groups, that is, the health status of the victims was compared to people who were not involved in the disaster. Among all victims, the physical and mental health problems have decreased compared to 2-3 weeks after the disaster. Although many victims by the disaster have an improved health, the victims in Enschede still report more physical and mental health problems than the comparison groups. Victims who lost a loved one, who sustained heavy damage to their homes, or report dissociative reactions during the disaster report more health problems than those who did not. First- and second-generation immigrants who resided in the affected area report more health problems than immigrants in the comparison group. Twice as many victimized residents as comparison subjects with serious mental health problems have received mental health care. The results of the second health survey make it possible to better direct the care to those who most need it. The efforts thus far to provide follow-up care in Enschede appear successful. However, this study makes clear that a large number of victims with serious mental health problems still need attention and mental health care. Naar aanleiding van de vuurwerkramp in Enschede op 13 mei 2000 vond 2 tot 3 weken later een uitgebreid gezondheidsonderzoek onder de getroffenen plaats. Eind 2001, circa 18 maanden na de ramp, is het vragenlijstonderzoek herhaald en circa 75% (N=2851) van de getroffenen uit het eerste onderzoek heeft opnieuw deelgenomen. Nieuw in dit onderzoek zijn de vergelijkingsgroepen, d.w.z. dat de gezondheid van de getroffenen is vergeleken met personen die de ramp niet mee hebben gemaakt. Bij alle deelnemende getroffenen zijn veel lichamelijke en psychische klachten 18 maanden na de ramp afgenomen ten opzichte van het eerste onderzoek, 2-3 weken na de ramp. Hoewel veel getroffenen hersteld zijn van hun klachten, hebben de getroffenen woonachtig in Enschede meer lichamelijke en psychische klachten dan de vergelijkingsgroepen. Getroffenen die een dierbare hebben verloren, waarvan het huis zwaar is beschadigd door de ramp of die tijdens de ramp erg verward waren, hebben meer klachten dan degenen waarvoor dat niet geldt. Getroffen allochtone bewoners rapporteren meer klachten dan allochtone bewoners uit de vergelijkingsgroep. Van de getroffen bewoners met ernstige psychische klachten zijn tweemaal zoveel mensen terecht gekomen in de geestelijke gezondheidszorg ten opzichte van de bewoners met ernstige psychische klachten in de vergelijkingsgroep. De inspanningen in Enschede om nazorg te verlenen lijken dus succesvol. De uitkomsten van het tweede gezondheidsonderzoek maken het mogelijk de nazorg nog gerichter in te zetten. Dankzij het onderzoek is een scherp beeld ontstaan van groepen getroffenen die zorg en aandacht nodig hebben.
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    ABSTRACT: Health status of those affected by the firework disaster in Enschede, four years later.Among the group of affected residents with severe damage to their homes, recovery from health problems did not continue in the period from 18 months to four years after the disaster. The current health problems are of a chronic nature. Affected rescue workers four years after the disaster did not unambiguously report more health or work-related problems than unaffected rescue workers.The presence of chronic health problems in particular groups of affected residents is of importance to the health care providers in Enschede. They can direct their follow-up care toward these specific groups.Native Dutch residents with severe damage to their homes reported health problems 1.5 to 2 times more often than unaffected native Dutch residents of Tilburg. Native Dutch residents without severely damaged homes had scarcely more health problems than the native Dutch in Tilburg. Affected (first- and second-generation) immigrant residents, independent of whether their homes sustained serious damage, reported 1.5 to 3 times more health problems than the unaffected immigrants in Tilburg. Among 80-90% of all affected residents with health problems, the complaints appeared to be chronic: residents had reported the same health problems in earlier surveys.While some groups of affected residents still reported work-related problems four years after the disaster, residents of Enschede were not more likely to be receiving disability benefits than the unaffected residents of Tilburg.Among affected residents with psychological symptoms, 70-83% have had contact with mental health care professionals at some point in the past four years; a minority (25-40%) has ongoing contact. Gezondheid getroffenen vier jaar na de vuurwerkramp Enschede.Bij de groep getroffen bewoners met zware schade aan het huis zet het herstel van de gezondheidsklachten niet door in de periode van 18 maanden tot 4 jaar na de ramp. De aanwezige gezondheidsklachten zijn chronisch van aard. Getroffen reddingswerkers rapporteerden vier jaar na de ramp niet eenduidig meer gezondheidsklachten of problemen op het werk dan niet-getroffen reddingswerkers.De aanwezigheid van chronische klachten bij bepaalde groepen getroffen bewoners is van belang voor de zorgverleners in Enschede. Zij kunnen hun nazorgactiviteiten specifiek op deze groepen richten.Autochtone bewoners met zware schade aan het huis rapporteerden 1,5 tot 2 keer zo vaak gezondheidsklachten als de niet-getroffen autochtonen uit Tilburg. Autochtone getroffenen zonder zware schade aan het huis hadden nauwelijks meer klachten dan de autochtonen uit Tilburg. Allochtone getroffenen rapporteerden 1,5 tot 3 keer meer gezondheidsklachten dan de niet-getroffen allochtonen uit Tilburg, ongeacht of ze wel of geen zware schade aan het huis hadden.In 80-90% van alle getroffen bewoners met gezondheidsklachten vier jaar na de ramp bleken deze klachten chronisch te zijn; zij rapporteerden deze klachten ook al op eerdere onderzoeken. Alhoewel sommige getroffen groepen bewoners nog problemen op het werk hadden, zaten getroffen bewoners vier jaar na de ramp niet vaker in de WAO dan de niet-getroffenen uit Tilburg. Van de getroffen bewoners met psychische klachten heeft 70-83% contact gehad met de GGZ in de afgelopen vier jaar. Een minderheid van 25-40% heeft nu nog contact.
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