Effects of exposure to death in a war mortuary on posttraumatic stress disorder symptoms of intrusion and avoidance

Exposure to the dead has been an important subject for traumatic stress res earch, considering that such exposure is a risk factor for posttraumatic st ress disorder (PTSD). Individuals required to handle the dead from war are exposed to multiple stressors. No previous studies, however, have examined pre- and post-responses to traumatic death. We studied the pre-post respons es of 352 military men and women who worked in the mortuary that received t he dead from the Persian Gulf War (Operation Desert Storm) in 1990 to 1991. The respondents were volunteers and nonvolunteers for assignment to the mo rtuary; some had prior experience in handling die dead and some did not. Sy mptoms of intrusion and avoidance were measured before and after exposure. Four groups were examined based on the degree of exposure to remains. Age, sex, volunteer status, and prior experience handling remains were statistic ally controlled. Post-exposure intrusion symptoms increased significantly f or all groups exposed to the dead. Increased post-exposure avoidance sympto ms were present in the two groups with the greatest exposure to remains. Th ere were no significant increases in intrusion or avoidance in the unexpose d group.