A5 5..5

Avoiding the problems inherent in retrospective assessment of pre-disaster health, Dirkzwager et al (pp. 144–149) found that pre-existing psychological problems were predictive of both self-report and general practitioner-recorded health problems (both psychological and physical) among survivors of a major explosion at a fireworks depot in The Netherlands. They also found poor post-disaster outcomes for those with a greater degree of exposure to the disaster, for those forced to relocate and those with an immigrant background. In examining the constituent elements of post-trauma debriefing, Sijbrandij et al (pp. 150–155) found no benefit of either emotional ventilation or psychoeducation on symptoms of post-traumatic stress disorder, anxiety or depression. Emotional debriefing appeared to have an adverse effect among the subgroup of participants with baseline hyperarousal symptoms.