Nieuwe wetenschappelijke publicaties van Stichting Impact

24 januari 2019

2019 begint sterk met enkele nieuwe kernpublicaties vanuit Stichting Impact. Zo heeft het European Journal of Psychotraumatology twee artikelen gepubliceerd over nazorg bij rampen en crises. Juul Gouweloos schrijft over outreach en screening in de nafase van de poldercrash (A longitudinal evaluation of active outreach after an aeroplane crash). Jurriaan Jacobs publiceerde een overzichtsstudie van 25 jaar geleerde lessen over de organisatie van nazorg in Nederland (The organization of post-disaster psychosocial support in the Netherlands). De artikelen zijn open acces en dus voor iedereen toegankelijk!

The organization of post-disaster psychosocial support in the Netherlands: a meta-synthesis

Jurriaan Jacobs, Marjolaine Oosterbeek, Lars Tummers, Mirko Noordegraaf, Joris IJzermans & Michel Dückers

Background: Despite numerous calls for a more evidence-based provision of post-disaster psychosocial support, systematic analyses of post-disaster service delivery are scarce.

Objective: The aim of this review was evaluate the organization of post-disaster psychosocial support in different disaster settings and to identify determinants.

Methods: We conducted a meta-synthesis of scientific literature and evaluations of post-disaster psychosocial support after 12 Dutch disasters and major crises between 1992 and 2014. We applied systematic search and snowballing methods and included 80 evaluations, as well as grey and scientific documents.

Results: Many documents focus on the prevalence of mental health problems. Only a few documents primarily assess the organization of post-disaster psychosocial support and its determinants. The material illustrates how, over the course of two decades, the organizational context of post-disaster psychosocial support in the Netherlands has been influenced by changes in legislation, policy frameworks, evidence-based guidelines, and the instalment of formal expertise structures to support national and local governments and public services. Recurring organizational issues in response to events are linked to interrelated evaluation themes such as planning, training, registration, provision of information and social acknowledgement. For each evaluation theme, we identify factors helping or hindering the psychosocial support organization during the preparedness, acute and recovery phases.

Conclusions: The meta-synthesis illustrates that psychosocial service delivery has grown from a monodisciplinary to a multidisciplinary field over time. Suboptimal interprofessional collaboration poses a recurring threat to service quality. Despite the development of the knowledge base, post-disaster psychosocial support in the Netherlands lacks a systematic and critical appraisal of its functioning. Further professionalization is coupled with the strengthening of evaluation and learning routines.


A longitudinal evaluation of active outreach after an aeroplane crash: screening for post-traumatic stress disorder and depression and assessment of self-reported treatment needs

Juul Gouweloos-Trines, Hans te Brake, Marit Sijbrandij, Paul Boelen, Chris Brewin & Rolf Kleber

Background: In 2009, an aeroplane crashed near Amsterdam. To remedy unmet mental health needs, active outreach was used to identify victims at risk for post-traumatic stress disorder (PTSD) and depression.

Objective: The active outreach strategy was evaluated by examining the accuracy of screening methods in predicting PTSD and depression, self-reported treatment needs, and the extent to which perceived treatment needs predict trajectories of PTSD.

Method: In 112 adult survivors, semi-structured telephone interviews were held at 2 (T1, n = 76), 9 (T2, n = 77) and 44 months (T3, n = 55) after the crash. The Trauma Screening Questionnaire (TSQ) and the Patient Health Questionnaire-2 (PHQ-2) measured symptoms of PTSD and depression, respectively. At T3, a clinical interview assessed PTSD and depression diagnoses. Based on the TSQ scores at the three time-points, participants were grouped into five ‘trajectories’: resilient (n = 38), chronic (n = 30), recovery (n = 9), delayed onset (n = 9) and relapse (n = 3).

Results: The TSQ accurately predicted PTSD at T3 (sensitivity: .75–1.00; specificity: .79–.90). The PHQ-2 showed modest accuracy (sensitivity: .38–.89; specificity: .67–.90). Both measures provided low positive predictive values (TSQ: 0.57; PHQ-2: .50 at T3). A number of participants reported unmet treatment needs (T1: 32.9%; T2: 19.5%; T3: 10.9%). Reporting unmet needs at T2 was more often assigned to a chronic PTSD trajectory compared to reporting no needs (p < .01).

Conclusions: The prevalence of unmet needs at 44 months after the crash within a chronic PTSD trajectory indicated that active outreach may be warranted. Nevertheless, although the TSQ was accurate, many participants screening positive did not develop PTSD. This implies that, although active outreach may benefit those with unmet needs, it also has its costs in terms of possible unnecessary clinical assessments.