Abstract
In the wake of the massive Canadian wildfire of May 2016 in the area of Fort McMurray Alberta, we observed increased rates of mental health problems, particularly post-traumatic stress disorder (PTSD), in school-aged adolescents (ages 11–19). Surprisingly, we did not see these rates decline over the 3.5-year follow-up period. Additionally, our research suggested that the impact of this mass incident resulted in other unanticipated effects, including the finding that children who were not present for and relatively unaffected by the wildfire showed a similar PTSD symptom profile to children more directly involved, suggesting some degree of spillover or stress contagion. A potential explanation for these high rates in individuals who were not present could be undiagnosed retraumatization in some of the students. To investigate this possibility, we compared two groups of students: those who reported the wildfire as their most significant trauma (n = 740) and those who had their most significant trauma prior to the wildfire (n = 295). Those with significant pre-existing trauma had significantly higher rates of both depression and PTSD symptoms, although, unexpectedly the groups exhibited no differences in anxiety level. Taken together, this evidence suggests retraumatization is both longer-lasting and more widespread than might be predicted on a case-by-case basis, suggesting the need to reconceptualize the role of past trauma history in present symptomatology. These findings point to the need to recognize that crises instigated by natural disasters are mass phenomena which expose those involved to numerous unanticipated risks. New trauma-informed treatment approaches are required that incorporate sensitivity to the collective impact of mass crises, and recognize the risk of poorer long-term mental health outcomes for those who experienced trauma in the past.
Highlights
Mass trauma events such as the Canadian wildfire of May 2016 in the area of Fort McMurray Alberta provide a unique opportunity to examine how an entire population reacts to a traumatic event, and different factors that might affect the risk profile of individuals in these circumstances
To examine effects of previous traumatization on reaction to the wildfire, students were selected if they indicated that the wildfire was the worst trauma they had experienced (“wildfire group”), or if they indicated that they had experienced a worse trauma prior to the wildfire (“prior trauma” group)
Nearly two-thirds (1789; 63.3%) of the total sample was excluded at this stage because they reported their most significant trauma had occurred in the time period following the wildfire
Summary
Mass trauma events such as the Canadian wildfire of May 2016 in the area of Fort McMurray Alberta provide a unique opportunity to examine how an entire population reacts to a traumatic event, and different factors that might affect the risk profile of individuals in these circumstances. Chronic maltreatment has been shown to hinder maturation, increasing risk for PTSD symptoms [1], as well as internalizing and externalizing behaviors [2] This is possibly due to structural and/or functional alterations in the brain [3] occurring as a product of prolonged hypothalamic pituitary adrenal (HPA) axis activation [4]; it has been posited that permanent sensitization of this pathway is a consequence of childhood abuse [5]. Structural changes in the amygdala have recently been confirmed in human subjects [6] Given these neural changes, retraumatization—a condition in which an individual with pre-existing trauma is triggered by a new stressor, presumably responding more quickly or intensely—is a potential outcome. What has been less recognized is the propensity for these kinds of underlying issues to inform how one responds in a mass trauma situation, in which it is unclear exactly which individuals are at increased risk for retraumatization
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