Department of Psychiatry, Psychotherapy and Psychotraumatology, Bundeswehr Hospital, Berlin, Germany.
Fire Department Berlin, Volunteer Fire Brigade Wedding, Berlin, Germany.
Disaster Med Public Health Prep. 2020 Apr;14(2):168-172. doi: 10.1017/dmp.2019.60. Epub 2019 Jul 23.
The most common crisis intervention used with German rescue workers is Critical Incident Stress Management (CISM). Results regarding its effectiveness are inconsistent. A negative reinforcement of avoidance, due to premature termination of strong emotions during the Critical Incident Stress Debriefing (CISD), may explain this. The effectiveness of the CISD after terror attacks in Germany has not yet been investigated.
All emergency responders deployed at the terror attack on Breitscheidplatz in Berlin were invited to take part in the study; 37 of the N = 55 participants had voluntarily participated in CISD; 18 had not.
Participants with CISD showed lower quality of life in psychological health and higher depressive symptomatology. Of these, females had lower quality of life in social relationships, whereas males showed more posttraumatic stress symptoms. Emergency responders from non-governmental organizations had higher phobic anxiety. Emergency medical technicians showed more somatic and depressive symptoms.
There is no conclusive explanation for why rescue workers with CISD score worse on certain measures. It is possible that CISD has a harmful influence due to negative reinforcement, or that there was a selection effect. Further research differentiating occupational group, sex, and type of event is necessary.
德国救援人员最常采用的危机干预方法是重大事件应激晤谈（CISM）。关于其效果的结果不一致。在重大事件应激晤谈（CISD）期间，由于过早终止强烈情绪，可能会产生回避的负强化，从而导致这种情况。在德国发生恐怖袭击后，CISD 的有效性尚未得到调查。
邀请部署在柏林布赖特沙伊德广场恐怖袭击事件中的所有应急响应人员参加研究；N=55 名参与者中有 37 名自愿参加了 CISD；18 名没有。
接受 CISD 的参与者在心理健康和抑郁症状方面的生活质量较低。其中，女性在社会关系方面的生活质量较低，而男性则表现出更多的创伤后应激症状。非政府组织的应急响应人员表现出更高的恐惧症焦虑。急救人员表现出更多的躯体和抑郁症状。
没有明确的解释为什么接受 CISD 的救援人员在某些方面的得分较低。CISD 可能由于负强化而产生有害影响，或者存在选择效应。需要进一步研究区分职业群体、性别和事件类型。
