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Being Prepared for Disaster and Traumatic Stress Research:

Being Prepared for Disaster and Traumatic Stress Research:. Trust and Cooperation between the Researcher and the IRB Roxane Cohen Silver, Ph.D. Professor Department of Psychology and Social Behavior Department of Medicine University of California, Irvine

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Being Prepared for Disaster and Traumatic Stress Research:

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  1. Being Prepared for Disaster and Traumatic Stress Research: Trust and Cooperation between the Researcher and the IRB Roxane Cohen Silver, Ph.D. Professor Department of Psychology and Social Behavior Department of Medicine University of California, Irvine Presented at the Association for Psychological Science Annual Convention, Chicago, Illinois May 23, 2008

  2. Characteristics of Traumatic Life Events • Random • Unpredictable • Uncontrollable • When a community-based event (e.g., natural disaster): shared experience among many victims

  3. Spinal Cord Injury 1 week post accident (followed for 3 mos.) Death of an Infant 1-2 weeks post loss (followed for 18 mos.) 1993 Southern CA Firestorms 36 hours post evacuation (followed for 2 years) Columbine High School Shootings 5 days post attack Terrorist Attacks of Sept. 11, 2001 9-14 days (followed for 3 years) Program of Research on Acute Responses to Stressful Life Events

  4. The Myths of Coping with Traumatic Life Events • Psychological responses are predictable; that is, there are universal reactions to traumatic events • Individuals will respond to traumatic events with early and intense emotional distress • Distress is necessary, and failure to confront the experience will lead to subsequent pathology • Emotional responses to traumatic events will follow a pattern, or orderly sequence of stages

  5. Why Do We Need Early Research? • Distortion in recall of specific features of an event has been demonstrated by cognitive psychologists (“phantom” flashbulb memories) • Recall of emotional state is systematically distorted (even when pushed for accuracy)

  6. What is the Value of Early Research? • Immediate data are necessary to identify early predictors of long-term difficulties • Early identification of at-risk individuals enables mental health professionals to target interventions to those most vulnerable • Educational and intervention efforts can be better informed, more sensitive and more cost-effective • Causal paths and patterns of adjustment over time can only be investigated with longitudinal research

  7. “Delay in initiating data collectionlimits opportunities to obtain early information needed to understandmental health effects of disasters. If researchers cannot act quickly,important data may be lost forever.” (North & Pfefferbaum, JAMA, 2002, p. 634)

  8. Challenging Ethical Issues in Trauma/Disaster Research • Is it ethical to conduct research immediately after a tragedy – can/should we intrude on individuals during a very vulnerable period? • Is it ethical to randomly assign individuals to different treatment options if we believe strongly that one treatment should work? • Can individuals provide informed consent during the throes of a life crisis?

  9. Challenging Ethical Issues in Trauma/Disaster Research • Should we seek to replicate research when we may be depriving individuals of potentially helpful treatments? • Should we seek to replicate research results that demonstrate unhelpful or potentially harmful effects of interventions?

  10. Requirements for Solving Ethical Issues in Trauma/Disaster Research • The willingness of Institutional Research Boards to trust that such research should be done and can be done well • Confidence in the researcher to treat respondents fairly, sensitively, and with appropriate attention to ethical concerns

  11. Requirements for Ensuring Ethical Sensitivity in Research • Non-coercive subject recruitment • Provide multiple opportunities for refusal (of initial contact, of consenting, of specific questions, of ongoing data collection) • Development of data collection instrument and methods in collaboration with trauma victims • Well-trained interviewers

  12. The Result • >75% participation rate typical • Usually maintain approximately 80% of sample at each wave of data collection • “Boy, you really did your homework – your questions captured my feelings and experiences perfectly” • “Thanks for listening – most of my friends can’t handle it”

  13. “Generic” Disaster/Trauma Protocol • Background and rationale • Proposed methods • Proposed Risks/Benefits • Research Team • Sample questionnaire/interview questions

  14. UC Irvine’s IRB “contract” IRB will review and approve the specific project within 24-48 hrs of submission, once provided with: • Specific purpose / event to be studied • Specific research methodology • Specific sample and sample size • Any changes to research team, methods, compensation, etc.

  15. We must create mechanisms and a culture of collaboration to facilitate creativity for ethical research to be conducted on challenging topics.

  16. For further information: Roxane Cohen Silver, Ph.D. Department of Psychology and Social Behavior 3340 Social Ecology II University of California, Irvine Irvine, CA 92697-7085 Telephone: (949) 824-2192 rsilver@uci.edu http://www.seweb.uci.edu/faculty/silver

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