Stre ssors – stress-inducing factors – strain assessment

1. Stressors – stress-inducing factors – strain assessment • Qdeath of a spouse 100 • Q divorce 73 • separation 65 • imprisonment 63 • death of a relative or close friend 63 • disease or injury 53 • marriage 50 • loss of job 47 • reconciliation with a spouse 45 • retirement 45 • pregnancy 40 • new job, significant decrease in income 38 • death of a friend 37 • changes in the amount of professional tasks 29 • change in work hour schedule 20 • holidays 13

2. Acute Stress Traumatic Stress

3. TraumaticStress • qis induced by the impact of particularly strong stressors • 1These stressors are life and health threatening incidents: • Fire • Flood • Hurricane • Mining disasters • Construction disasters • Communication accidents • Earthquakes • Tsunami • Terrorist incidents • Kidnapping • Wars • Violence e.g. sexual, disappointed love

4. Traumatic Stress – Stressors • QLife threat • Q Serious injuries • Extreme exhaustion • Q Participation in traumatic incident • Q Witnessing devastating incident • Sense of self-responsibility for the tragic incident • Q

5. PTSD Post-Traumatic Syndrome • A person was exposed directly to a traumatic incident or witnessed such an incident which: • Caused or could cause death or serious body injury • q such an incident caused severe anxiety, sense of hopelessness or terror in an individual MCMP Lubin

6. PTSD Post-Traumatic Syndrome B.This traumatic incident constantly returns in the individual’s consciousness, taking form of: qintrusive memories, thoughts and images q returning nightmares, behaviours, feelings as if the incident has occurred again q psychological distress when detecting internal and external signals symbolising (recalling) the incident qincreased physiological reactivity to stimuli symbolising various aspects of the incident

7. PTSD Post-Traumatic Syndrome C.     Continuing persistent tendency to avoid any stimuli associated with the incident and emotional numbing demonstrated in: qAvoiding thoughts, feelings, conversations about the trauma q    Avoiding activities, places or people recalling the trauma qDisability to recall important aspects of incidents qSignificantly less interest and willingness to participate in the spheres of life important for the individual q    Sense of dissociating and strangeness towards others q    Narrowing the range of the experienced emotions q    Shortening the life perspective MCMP Lubin

8. PTSD Post-Traumatic Syndrome D.Symptoms of increased arousal, not appearing before the incident: qDifficulties in falling asleep and sleep interruptions qIrritation and outbursts of rage q       Difficulties in concentrating q       Hypervigilance q       Heightened startle response MCMP Lubin

9. PTSD Post-Traumatic Syndrome E.      Disorders mentioned in points B, C, D last longer than one month F.      Disorders have caused clinically significant distress or deterioration of the individual’s functioning in his or her family, work, and other areas important for the individual   MCMP Lubin

10. PTSD Research Tools Weiss’s and Marmar’sImpact of Event Scale has 3 dimensions: • Intrusion, • Hyperarousal • Avoidance Mini-COPE C.S. questionnaire by Carver assess the strategies to manage stress: activity, planning, positive reappraisal, acceptance, sense of humour, turning to religion, searching for instrumental support, taking up a different activity, denial, venting of emotions, stimulants, withdrawal, blaming oneself, Every scale includes 2 statements; the subject takes position towards each statement on the scale from 0 (I hardly ever act this way) to 3 (I always act this way)

11. The research involving the Canadian and American firemen revealed that almost 90% of them encountered at least one traumatic incident last year. • The PTSD symptoms were found in 17%-22% of the examined subjects. • The percentage of the Dutch policemen suffering from traumatic stress was 7%, whereas the study among rescueservices in Poland (the study was performed by IMP Occupational Health Institute in Łódź)showed the percentage between 3.4% and 4.8%(firemen, emergency medical aid). In the Institute’s research 79% of firemen experienced a traumatic incident.

12. The level of PTSD in firemen increases along with the years worked Strategies Used by the Examined Firemen The strategies consisting in the following were mostly preferred: 1. Focusing on the problem 2. Acceptance 3. Planning 4. Positive reappraisal 5. Active stress management Strategies Used by the Examined Firemen The least preferred strategiesconsist in: 1. Stopping the action 2. Denial 3. Stimulants 4. Social inhibition 5. Turning to religion 6. Diverting attention 7. Venting of emotions