Early traumatic stress reactions among Swedish survivors of the m/s Estonia disaster

Background. This study is a three-month follow-up study in order to assess the short-term impact of traumatic stress among 53 Swedish survivors of the Estonia disaster. Method. A questionnaire consisting of general questions about conditions during and after the disaster and self-assessment by Post Traumatic Symptom Scale (PTSS-10) Impact of Event Scale (IES), Sense of Coherence-short version (SoC-12) and the DSM-IV list of dissociative symptoms of Acute Stress Disorder formulated as questions regarding individual reactions was distributed. Results. The response tate was 79.2% (n=42). The participants scored an average of 3.9 on PTSS-10, 28.5 on IES ('intrusion' and 'avoidance' subscales) and 62.8 on SoC-12, which shows elevated levels of post-traumatic stress reactions but a normal level of sense of coherence. The reported occurrence of dissociative symptoms during the disaster was as follows: emotional numbing in 43% of the survivors, reduction of awareness in 55%, derealisation in 67%, depersonalisation in 33%, and dissociative amnesia in 29%. Survivors scoring low in SoC scored significantly higher in both PTSS-10 and IES than those with high scores in SoC. All dissociative symptoms were predictive of post-traumatic reactions. Conclusions. This study substantiates the importance of assessing dissociative symptoms during a life-threatening event as a possible predictor for later post-traumatic reactions and possible PTSD. The Sense of Coherence Scale may be useful as an instrument to sort out survivors at risk.