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Survivors in their third decade after the North Sea oil rig disaster of 1980
Norwegian University of Science and Technology, Faculty of Medicine, Department of Neuroscience.
2011 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Background and objective: In March 2010, a 30 years’ memorial assembly related to one of Norway’s worst disasters ever was held. The oil rig named after the Norwegian author, Alexander L. Kielland, capsized in the North Sea on the 27th March, 1980. Of the 212 men onboard, 89 survived. This doctoral thesis is a part of a larger longitudinal project which has been following-up the Norwegian survivors across four waves of data collections, in 1980, 1981, 1985 and 2007. A matched reference group of oil-rig workers from the same field, Ekofisk, was included in 1985. The objective of the present thesis was to study mental health outcomes after almost three decades of this civilian disaster.

Methods: Of the 75 Norwegian survivors in 1980, data sets from 70 were stored for the longitudinal analyses. In 2007, 57 survivors were still alive and traceable. Of these, 51 participated. Of the 92 men in the comparison group included in 1985, 62 took part in 2007. The study draws on self-reports collected at all four waves. Longitudinal measures covered posttraumatic stress (Impact of Event Scale; IES-15), general manifestations of stress (Posttraumatic Stress Scale; PTSS-10) as well as the detection of general mental health problems (General Health Questionnaire; GHQ-20). Included in the data collection of 2007 were a version of the General Health Questionnaire (GHQ-28), a personality inventory (NEO Five Factor Inventory; NEO-FFI), and a measure of positive psychological changes (Posttraumatic Growth Inventory; PTGI). Demographic information was also included.

Results: Five years after the North Sea oil rig disaster, the survivors clearly reported more suffering than the comparison group. In 2007, however, the difference had faded. A tendency to report more stress symptoms was still found for the survivors. Moreover, high stress scores in the very first days post disaster and a slow recovery during the initial weeks were both associated with long-term suffering.

When combining the initial recovery and the long-term course of mental health, four latent trajectories were identified: the resilient (61%), recovering (14%), chronic (11%), and relapsing (13%). The two thirds classified as resilient, showed a moderate starting point of stress. Subsequently, they had a rapid decline across the first eight weeks. Their long-term scores on mental health problems remained low. The trajectories of those in the recovery, chronic or relapse groups had initially high, stable stress scores, while their long-term course of mental health problems differed. A personality style with high scores on neuroticism was associated with the chronic and the relapsing trajectories.

Strong positive associations were found between reported posttraumatic growth and concurrent levels of posttraumatic stress 27 years post disaster. Weaker or no associations between growth and posttraumatic stress of the past were found. Decades after the disaster, general mental health problems coexisted with the higher levels of reported posttraumatic growth, but the associations were mediated by the concurrent posttraumatic symptoms.

Conclusions: Roughly two thirds of the survivors after the North-Sea oil rig disaster bounced back into adequate good mental health within the first two months. Another 14 % reported initial suffering, but recovered more slowly. Hence, in a long-term perspective three out of four remained mentally healthy. A minor part (24%) demonstrated chronic or relapsing courses of mental health problems. A high load of initial stress manifestations which did not decline during the first weeks, was associated with various patterns of suffering in the following three decades. Self-reports about posttraumatic growth after almost three decades did not indicate less mental suffering. Early screening may identify those who are at risk of long-term post-traumatic suffering.  

Abstract [no]

Etter Alexander L. Kielland ulykken på Ekofisk feltet 27.mars 1980, der 123 mennesker mistet livet, ble det erklært landesorg. Hendelsen er fortsatt blant de største katastrofer som har rammet Norge i fredstid. Nasjonale markeringer er siden blitt avholdt jevnlig i Stavanger, senest 30 års markeringen i mars 2010. Av de 212 oljearbeiderne ombord da plattformen gikk rundt, berget 89 livet. Denne avhandlinga er del av et større forskningsprosjekt som har fulgt de 75 norske overlevende i nesten 30 år. Det er benyttet intervjuer og/eller spørreskjema i 1980, 1981, 1985 og sist i 2007. En sammenligningsgruppe med 92 nordsjøansatte ble inkludert fra 1985; de var ikke med i ulykken.

Hensikten med denne avhandlinga er å belyse utviklinga av stress plager og den psykisk helse over et tidsrom på nesten tre tiår. Sammenhengen mellom tidlige reaksjoner og senere utfall er særlig vektlagt. Videre er angivelse av positive livsendringer undersøkt.

Kielland-undersøkelsene har fått høy oppslutning på grunn av stor velvilje fra de overlevende og fra sammenligningsgruppa. Av de 57 oppsporbare og gjenlevende norske overlevende i 2007 deltok 51 i en eller flere deler av undersøkelsen. Data fra 70 ble benyttet i analysene av forløpet over tid. I 2007 deltok 62 av 78 mulige fra sammenligningsgruppa.

Arbeidet som her presenteres omfatter tre vitenskaplige artikler. De bygger særlig på standardiserte spørreskjema om ulike typer stressplager, psykisk helse, personlighet og posttraumatisk vekst. I tillegg ble informasjon om alder, sivilstatus, arbeidsforhold og eventuelle senere katastrofer eller ulykker tatt med.

I 1985 viste de overlevende betydelig mer tegn på stress og psykiske plager enn sammenligningsgruppa. I 2007 var forskjellene mindre, men samlet sett var det fortsatt noe mer stressplager hos de overlevende. Høyt og vedvarende nivå av stress de første ukene rett etter ulykka viste seg å gi mer stress plager etter fem og 27 år.

Den psykiske helsa varierte over tid. Etter sine ulike forløp kunne de overlevende deles i fire grupper. De fleste (61%) kan karakteriseres som motstandsdyktige eller resiliente. De hadde noe stress plager i starten, men de forsvant ganske raskt etter ulykka. Senere hadde de få psykiske plager. De tre andre gruppene hadde høye, vedvarende stress plager rett etter ulykka, men i de neste tre tiårene var forløpene deres nokså forskjellige. En gruppe fikk gradvis mindre psykiske vansker; de ble bedre og bedre med tiden (14%). En annen gruppe ble stadig verre med tilbakefall (13%). Den tredje gruppa hadde kroniske, varige plager (11%). Personligheten til den enkelte påvirket også utfallet.

De som i 2007 uttrykte at Kielland-ulykken hadde ført til positive livsendringer, altså posttraumatisk vekst, var samtidig også sterkt psykisk plaget.

Avhandlinga viser at selv om Alexander L. Kielland ulykken gjorde inntrykk på de fleste overlevende i tiden like etter, kom om lag to tredjedeler seg nokså raskt. For et mindretall, ca en fjerdedel, satte hendelsen dypere spor. Deres psykiske helse var enten preget av tilbakefall eller kroniske plager. For å forebygge negative følger etter sivile katastrofer eller ulykker kan tidlig kartlegging og vurdering av stress-plager i den første tiden gi en nyttig pekepinn om hvem som står i fare på lengre sikt.

Place, publisher, year, edition, pages
NTNU, 2011.
Series
Doctoral theses at NTNU, ISSN 1503-8181 ; 2011:26Dissertations at the Faculty of Medicine, ISSN 0805-7680 ; 467
Identifiers
URN: urn:nbn:no:ntnu:diva-12383ISBN: 978-82-471-2570-0 (printed ver.)ISBN: 978-82-471-2571-7 (electronic ver.)OAI: oai:DiVA.org:ntnu-12383DiVA: diva2:407672
Available from: 2011-04-05 Created: 2011-03-31 Last updated: 2011-04-05Bibliographically approved
List of papers
1. Initial stress responses in relation to outcome after three decades.
Open this publication in new window or tab >>Initial stress responses in relation to outcome after three decades.
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2010 (English)In: Journal of Nervous and Mental Disease, ISSN 0022-3018, E-ISSN 1539-736X, Vol. 198, no 3, 230-3 p.Article in journal (Refereed) Published
Abstract [en]

The present study aimed at predicting posttraumatic stress 5 and 27 years after the North Sea oil rig disaster. The predictions were based on the initial levels of stress responses and the early recovery as reported in 1980. The Posttraumatic Stress Scale (PTSS) was used at 3 measure points. From 1980, data from 69 survivors were used in latent growth modeling. Follow-up studies included 65 survivors and 85 matched unexposed oil-rig workers in 1985; and 47 and 62 in 2007. In 1985, the survivors had higher total PTSS scores and more frequent endorsements on most single PTSS-items than the comparison group. In 2007, a few single items remained different. The initial levels of stress responses and the early recovery rate predicted the long-term outcomes after 5 and 27 years. Initial screenings may be helpful in the early detection of posttraumatic stress in the very long-term perspective.

Identifiers
urn:nbn:no:ntnu:diva-12381 (URN)10.1097/NMD.0b013e3181d106a9 (DOI)20216002 (PubMedID)
Available from: 2011-03-31 Created: 2011-03-31 Last updated: 2011-04-05Bibliographically approved
2. Disaster survivors in their third decade: Trajectories of initial stress responses and longterm course of mental health
Open this publication in new window or tab >>Disaster survivors in their third decade: Trajectories of initial stress responses and longterm course of mental health
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2011 (English)In: Journal of Traumatic Stress, ISSN 0894-9867, E-ISSN 1573-6598, Vol. 24, no 3, 334-341 p.Article in journal (Refereed) Published
Identifiers
urn:nbn:no:ntnu:diva-12382 (URN)10.1002/jts.20636 (DOI)
Available from: 2011-03-31 Created: 2011-03-31 Last updated: 2012-05-21Bibliographically approved
3. Long-term perspectives on posttraumatic growth in disaster survivors.
Open this publication in new window or tab >>Long-term perspectives on posttraumatic growth in disaster survivors.
2010 (English)In: Journal of Traumatic Stress, ISSN 0894-9867, E-ISSN 1573-6598, Vol. 23, no 3, 413-6 p.Article in journal (Refereed) Published
Abstract [en]

Findings on posttraumatic growth (PTG) and distress have not been consistent. This study examines the relationship in a very long-term perspective. The Posttraumatic Growth Inventory was completed by 46 survivors from a single disaster 27 years posttrauma. Posttraumatic stress was measured by the Impact of Event Scale (IES) immediately after the event, and after 1, 5, and 27 years. In the final follow-up, general mental health was also assessed. Strong positive associations were found between PTG and concurrent posttraumatic stress. Although weaker associations were found for the past, concurrent problems in general mental health clearly coexisted with PTG decades after a disaster, yet mediated by IES.

Identifiers
urn:nbn:no:ntnu:diva-12380 (URN)10.1002/jts.20530 (DOI)20564376 (PubMedID)
Available from: 2011-03-31 Created: 2011-03-31 Last updated: 2011-04-05Bibliographically approved

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