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 cours e 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 mor e than 60 injuries. Methods: The people who experienced the trauma were stratified into three g roups, 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 chronic ity. Another aim of the study was to detect different patterns of post-trau matic morbidity and to see how Post-Traumatic Stress Disorder (PTSD) fluctu ates in response to related stimuli such as the anniversary of the event an d 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 gr oups: 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 n umber of chronic cases and thus extent of trauma was one of the predictors of chronicity. Interestingly, up to ten patterns (subgroups) of PTSD agains t 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 st udy groups.