The prevention of trauma reactions

Exposure to traumatic or stressful events has been linked to the development of trauma symptomatology in a minority of individuals for some time now. Although there have been many studies which have examined the nature and aetiology of trauma reactions, few researchers have examined whether it is possible to prevent reactions to trauma. This is somewhat surprising, given the impact that an adverse trauma reaction can have to both an individual and an organisation (if the individual is also an employee). One exception is the body of work which has been created by researchers who investigated the psychological intervention known as psychological debriefing. This intervention has been designed to be administered immediately after an individual experiences a traumatic event, and is said to mitigate an individual's reaction to trauma. The scientific evidence for this intervention, however, has been equivocal. At the time that this thesis was being prepared, there were only two published randomised controlled trials of group debriefing. In addition, the impact of psychological debriefing upon an individual's memory for a traumatic event had never before been examined. This is important to note, because in many instances an individual who is a witness to a crime, will receive psychological debriefing before they give a statement to police officers. For Study 1, a randomised controlled trial of group debriefing was conducted. The aim was to assess the effect of this intervention upon eyewitness memory for a stressful event and eyewitness stress reactions, with a sample drawn from the general community (n = 61). Participants were randomly allocated to one of three groups: debriefing; debriefing with an experimenter confederate present (who supplied 3 pieces of misinformation to the group regarding the stressful event); and a no-treatment control. All groups were shown a very stressful video and were again reviewed one month later. Members of the debriefing group where a confederate provided misinformation were more likely to recall this misinformation as fact than members of the other two groups. The debriefing group was also more accurate in their recall of peripheral content than the confederate group. Across all groups, participants were found to be more accurate at central rather than peripheral recall yet more confident for incorrect memories of the video than correct memories. Although the video was rated as being distressing, it was found that there were no significant differences between the three groups on measures of affective distress. The results of Study 1 add to the growing body of literature which suggests that psychological debriefing is an ineffective intervention for mitigating the effects of trauma. As such, new intervention methods must be developed and explored. A new and promising area of research is targeted interventions which are applied to at-risk groups before they are exposed to traumatic incidents. This type of intervention is known as 'resilience training', i.e., preparing an individual before they are exposed to a potentially harmful situation. In order to explore whether resilience training has any promise as a burgeoning area of research, a randomised controlled trial of resilience training was conducted in Study 2. No such trial had ever been conducted before. One key purpose of Study 2 was also to investigate whether resilience training caused any adverse effects for individuals, given that no research previously existed on the types of reactions that such an intervention may cause. Furthermore, the impact of resilience training upon an individual's memory for a stressful event was also examined. For Study 2, a randomised controlled trial of resilience training was conducted. The aim was to assess the effect of this intervention upon eyewitness stress reactions and eyewitness memory for a stressful event, with a sample drawn from the general community (n = 80). Individuals were randomly assigned to either the resilience or the control condition. In small groups, participants received either resilience training, or the control training. All participants received training in session 1, were then shown a very stressful video in session 2, and were again reviewed after one month. Receiving the resilience training did not have a beneficial effect upon individuals' stress reactions for a stressful event. In addition, the resilience training did not affect the number of central or peripheral memories that participants were able to correctly recall. This has important implications in terms of eyewitness testimony, given that people who experience stressful or traumatic incidents are often required to make statements or give evidence about what they have witnessed. If an intervention were to impede an individual's ability to accurately recall the event, then this could have serious consequences. Once it was indicated that the resilience training did not have a negative impact upon individuals, the next step was to further develop the intervention, and trial it on an at-risk population who had the potential to receive significant benefits from this type of training. Such a group is police officers, who routinely face traumatic, sad and stressful incidents through-out the course of their career. For Study 3, a stratified randomised trial of resilience training was carried out with Victorian police officers (n = 89). The aim of the study was to assess the efficacy of resilience training in mitigating stress reactions, and decreasing reliance on drugs and alcohol. New recruit police officers were allocated to either the resilience or the control condition by virtue of the squad that they had been randomly allocated to when they entered the Police Academy. In groups, participants received either the resilience training or the control training, at a number of different intervals over the twenty weeks during which they were stationed at the Academy. Participants were reviewed again 6-months after they completed their training at the Academy. Resilience was conceptualised to consist of three domains: Health and Well-being, Reactivity to Trauma, and Workplace Functioning. Overall, there was no significant difference between the groups for resilience across all three domains. There was, however, a significant difference for Workplace Functioning, with those who received the resilience training more likely to show no deterioration or improvement in this domain at the 6-month follow-up. Immediately following the training there were no significant differences between the groups for participant satisfaction. Over time however, the satisfaction of those in the resilience group increased while satisfaction of those in the control group decreased. It may be that the efficacy of the resilience training was most evident to participants once they had a chance to consider the training in light of their working experiences. All recruits except one showed resilience for the Reactivity to Trauma domain, indicating that resilience in this domain is the norm. No significant differences were found between the groups for drug and alcohol usage. Resilience training was not found to have any beneficial effects and it may be possible that further effects of this resilience training will be most evident at a time point further down the line. Overall the results of this thesis provide support for the inclusion of resilience training as part of training for new recruit police officers.