The onset and longitudinal course of a man-made post-traumatic morbidity: Survivors of the Sivas disaster

Introduction: This study examined the onset and 18-month longitudinal course of post-traumatic stress disorder morbidity in 79 people who were exposed to the man-made "Sivas disaster" in Turkey, which caused 37 deaths and more than 60 injuries. Methods: The people who experienced the trauma were stratified into three groups, according to the extent of exposure to the disaster, to find out if the extent (severity) of trauma was the main predictor of onset and chronicity. Another aim of the study was to detect different patterns of post-traumatic morbidity and to see how Post-Traumatic Stress Disorder (PTSD) fluctuates in response to related stimuli such as the anniversary of the event and the result of the court hearings related to the event. Results: Contrary to theoretical knowledge and expectations, there were no significant differences in the emergence of acute PTSD between the three groups: that is, PTSD emerged in all the groups, and higher extent of trauma did not predict higher onset of acute PTSD. Differences emerged throughout further stages of the study; higher extent of trauma resulted in a higher number of chronic cases and thus extent of trauma was one of the predictors of chronicity. Interestingly, up to ten patterns (subgroups) of PTSD against the expectation of only three (acute, chronic and delayed) emerged during the course of the study. Contrary to expectations, the delayed pattern of morbidity was more common than the chronic and acute forms in one of the study groups.