Trauma and Mental Health in the Wake of a Technological Disaster: The Ghislenghien Gas Explosion

Abstract

This thesis describes the mental health disturbances in the wake of the Ghislenghien gas explosion (July 30th 2004) which instantly killed five firefighters, one police officer and 18 other people. Moreover, 132 people were wounded among which many suffered severe burn injuries. The Ghislenghien studies aimed at clarifying the impact of a technological disaster, both phenomenologically and empirically. On the phenomenological side, the lived experiences of a disaster survivor are used to set the stage for a discussion on the conceptual differences between mainstream (Anglo-Saxon) trauma theories and the more classical (French) psychodynamic theories. On the empirical side, the study focused on the prevalence of posttraumatic stress symptoms in adult and child survivors of a massive gas explosion, in their family members as well in family members of deceased victims. Other research questions focused on the risk factors regarding the development of posttraumatic stress symptoms and other mental health disturbances. A secondary aim was also to better understand the challenges of the type and timing of psychological help in the wake of technological disaster. Therefore, this thesis consists of a phenomenological part and an empirical part. The phenomenological part consists of three chapters which provide contextual information on the trauma inflicted by a massive explosion. The empirical part consists of four chapters providing a quantitative approach of trauma-related mental health disturbances in adults and children after a technological disaster. The phenomenological part starts with the testimony of a survivor of the Ghislenghien disaster and the interpretation of this survival in terms of both empirical (Anglo-Saxon) trauma models and the psychodynamic (French) theories The phenomenological part also examines the conceptualization of psychological trauma in contemporary French theory and the disaster-related experiences in fire and emergency services personnel. The empirical part of this manuscript is based on a longitudinal study conducted in order to assess the impact of the disaster on physical, mental and social health. The study included adults (≥ 15 years) and children (8-14 years) at risk of developing adverse health effects related to the disaster at 5 months and 14 months after the disaster. Four chapters report on this study and discuss respectively: the strengths and weaknesses of the methodology employed, the difficulties and challenges encountered during the design of the study and the risk factors of developing trauma-related symptoms and mental health disturbances. The results clearly indicate the influence of the degree of exposure, peritraumatic dissociation and dissatisfaction with social support on the development of posttraumatic stress symptoms. The risk for the development of four types of mental health disturbances (somatization, depression, anxiety and sleeping disturbances) was much higher in direct witnesses who have seen human damage than in victims who have not seen human damage. In children, risk factors for the development of posttraumatic stress reactions were related to the type of exposure to the disaster, peritraumatic dissociation during or immediately after the disaster, and dissatisfaction with the received psychological help. This epilogue discusses possible future developments for early psychophysiological stabilization of disaster victims.