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The Danish Center of Psychotraumatology

Research Area

Catastrophes and Terror

Welcome to our research page on ´Disasters and Terror´. At the bottom of the page you can get an overview of all our current and completed projects. For many years The  Danish Center of Psychotraumatology has been researching the aftermath of Danish and foreign disasters and accidents. We have studied the psychological reactions and PTSD among victims of natural disasters such as earthquakes, avalanches and tsunamis. As well as examining the victims of explosion fire at Lindø, the firework disaster in Seest, the Scandinavian Star fire and the train accident of the Great Belt Bridge

Catastrophes and Terror

Both man-made and natural disasters and accidents can be traumatic for those who experience the event first-hand, through their profession or learn that a loved one has been affected by a disaster. 

Disasters often occur suddenly and traumatize many people at once. The impact can be widespread - people are shocked, they may have lost family members or friends, and their homes or neighborhoods may be have been destroyed. 

Our research focuses in particular on how to prepare coordinated responses in the first days after a disaster, and how in situations of crisis particular care and considerations can be taken for children, people with disabilities and minorities. We have expertise in helping children through the aftermath of a disaster, and study the impact of these treatments.

We are part of an international collaboration on psychosocial emergency management after natural disasters, NORDRESS, and in an international collaboration on the development of European guidelines for crisis- and disaster management adapted for deaf and disabled people, EUNAD and EUNAD-IP.

You will find a list of  ongoing and completed projects of the research area children below. You can view a more detailed description of the project, by clicking on the project title. 


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Project related to the research area: 

Ongoing projects

An interdisciplinary and international collaboration between The National Centre of Psychotraumatology and NORDRESS (The Nordic Centre of Excellence on Resilience and Societal Security) is working to increase  safety in the face of natural disasters such as massive  floods, avalanches and volcanic eruptions. NORDRESS aims to increase individual and societal resilience by increasing the understanding of the physical and psychological effects, that can occur in the aftermath of a natural disaster. This resilience is examined in individuals, communities, infrastructure and institutions. The project is lead by Dr. Guðrún Pétursdótti, Director of the Institute for Sustainability Studies and Dr. Guðrún Gísladóttir, Professor of Geography at the University of Iceland, in collaboration with, among others, Professor Ask Elklit from The National Centre of Psychotraumatology. The research project has investigated the long-term psychological impact that the experience of a disaster can have on children's health based on post-disaster PTSD symptoms. 
The shooting in the Danish shopping mall Field's,  on the 3rd of July 2022, has left a deep impression on all Danes and has been compared to similar shootings in other countries. It is not the first time that there are several dead and injured after a Danish shooting, but we lack a basic knowledge about the possible psychological impacts in the aftermath of such a disaster. The National Centre for Psychotraumatology at the University of Southern Denmark has therefore initiated a scientific study of the possible psychological and social consequences of the disaster. 

 

Completed projects

EUNAD–IP: European Network for Psychosocial Crisis Management – Assisting Disabled in Case of Disaster – Implementation: The cooperation with EUNAD was established for a two-year period during which The National Centre for Psychotraumatology worked on a project (EUNAD-IP) regarding the issues people with reduced mobility faces when involved in an accident. The Centre investigated the experiences of wheelchair users in coping with difficult and threatening situations and their thoughts on current support services. In addition, relevant information was presented to professional staff so that they can provide the best assistance in the event of disasters. 

EUNAD: European Network for Psychosocial Crisis Management – Assisting Disabled in Case of Disaster: In collaboration with EUNAD, The National Centre for Psychotraumatology also worked on mapping the experiences of a wide range of professionals in providing first aid and crisis care to deaf people involved in disasters, accidents or crisis. From this, new reflections on future recommendations for professionals working with this group emerged. The project was carried out with the aim of developing and implementing standardized guidelines on first aid and crisis care for disabled citizens who have been victims of a disaster or terrorism. 

The “European Network for Psychosocial Crisis Management – Assisting Disabled in Case of Disaster (EUNAD, 2013–2014)” project focused on people with sensory impairment. The follow-up project, entitled “European Network for Psychosocial Crisis Management – Assisting Disabled in Case of Disaster – Implementation (EUNAD IP, 2016–2017)”, also dealt with the psychosocial crisis management available to people with physical and mental disabilities and looked at the development of pedagogical self-help toolkits for people with disabilities.

 

Further information on the EUNAD project can be found here under highlights


Related publications:

Elklit, A. (2018). Research results. Danish study. In federal office of civil protection and Disaster Assistance (Ed.) Assisting Disabled in Case of Disaster (pp69-74). Bonn:Author.

Elklit, A., Simonsen, L. D. & Todorovac, A. (2019). Medizinische und Psychosociale Versorgung von körperbehinderten Menschen in Notfallsituationen. Trauma – Zeitschrift für Psychotraumatogie und ihre Anwendungen, 17(2), 70-77.

Todorovac, A., Simonsen, L. D. & Elklit, A. (2018). Review of research. In Federal Office of Civil Protection and Disaster Assistance (Ed.) Assisting Disabled in Case of Disaster (pp 133-135). Bonn: Author.

Elklit, A., Simonsen, L. D. & Todorovac, A. (2018). No one left behind - The accessibility of medical and psychosocial services following disasters and other traumatic events: Experiences of physical disabled individuals in Denmark. In Federal Office of Civil Protection and Disaster Assistance (Ed.) Assisting Disabled in Case of Disas-ter (pp 136-152). Bonn: Author.

Todorovac, A., Simonsen, L. D. & Elklit, A. (2018). No one left behind. Journal of Emergency Management, 16, 1-13. Doi:10.5055/jem2018.0000

Skøt, L., Jeppesen, T., Mellentinc, A. S. & Elklit, A. (2017): Deaf and hard-of-hearing individuals in times of disaster and crisis. Disability and Rehabilitation, 39 (24), 2468-2476. Doi: 10.1080/09638288.2016.1236154

On November 3rd 2004, an explosion occurred at a fireworks factory in Seest, Kolding. The National Centre for Psychotraumatology in collaboration with Keld Molin, investigated the psychosocial consequences of the fireworks disaster for residents, rescue workers and the children of Seest. A part of this project examined the crisis intervention given to the children after the accident. 

The research project found a 9x higher prevalence of PTSD in the adult residents compared to the neighbouring district of Bramdrupdam. A follow-up screening of the children in 2008 showed that 15% of the children still suffered from PTSD after the disaster. After which a special 'empowerment' courses were implemented weekly for the pupils in the different age groups, who showed signs of PTSD or subclinical PTSD at the screening.  The courses were inspired from the Isreali Ofra Ayalon, who also trained the psychologists who conducted the courses.  The National Centre for Psychotraumatology's study of the psychological effects on the emergency personnel five months after the disaster, showed a relatively high level of resilience among the personnel. 

The research project was carried out in collaboration with Keld Molin, a specialist in psychotraumatology in Kolding, Denmark. 


Related publications:

Romano, E. & Elklit, A. (2017). Rescue workers and trauma: assessing interaction among risk factors after a firework factory explosion. Journal of Emergency Management, 15(5), 311-323. Doi: 10.5055/jem.2017.0339

Romano, E. & Elklit, A. (2017). Rescue workers and trauma: assessing interaction among risk factors after a firework factory explosion. Journal of Emergency Management, 15(5), 311-323. Doi: 10.5055/jem.2017.0339

Elmose, M., Elklit, A. & Duch, Christina. (2016) Children’s coping styles and trauma symptoms after an explosion disaster. Scandinavian Journal of Child and Adolescent Psychiatry and Psychology, 4(3), 132-140.

Elklit, A. & Gudmundsdóttir, D. (2014) A longitudinal study of post-traumatic stress symptoms and their predictors in rescue workers after a firework factory disaster. International Journal of Emergency Mental Health, 16(2), 99-103. Doi: 10.4172/1522-4821.1000118.

Elklit, A., Nielsen, L. H., Lasgaard, M. and Duch, C. (2013) A Cartoon-Based Measure of PTSD Symptomatology in Children Exposed to a Disaster. Journal of Loss and Trauma, 18, 54–63. Doi: 10.1080/15325024.2012.679125

Rønholt, S., Karsberg, S. & Elklit, A. (2013). Preliminary Evidence for a Classroom Based Psychosocial Intervention for Disaster Exposed Children with Posttraumatic Stress Symptomatology. Child and Youth Care Forum, 42(6), 617-631. Doi: 10.1007/s10566-013-9220-3

Spindler, H., Elklit, A. & Christiansen, D.: (2010). Risk factors for post-traumatic stress disorder following a technological disaster in a residential area: A note on the origin of gender differences in post-traumatic stress disorder. Gender Medicine, 7(2), 156-165, 2010.

Elklit, A., Nielsen, L. H., Dinesen, C. S. & Jacobsen, M.(2009): Traumekursus for børnene på Bakkeskolen efter fyrværkerikatastrofen i Seest ved Kolding. Århus: Psykotraumatologisk Forskningsenhed, Psykologisk Institut, Aarhus Universitet (1-63).

Molin, K., Elklit, A. & Petersen, T. (2009) Seest: Tiden læger ikke alle sår. PsykologNyt, 63, 3-11.

Duch, C. & Elklit, A. (2008) Børneperspektiv på en katastrofe. Psykolog Nyt, 62, (4), 8-12.

Elklit, A., Petersen, T. & Molin, K. (2008) De psykosociale konsekvenser af fyrværkerikata-strofen i Seest. Del 3 – Beboerne 15 måneder efter. Psykologisk Skriftserie, 29(1), 1-100.

Duch, C. (2007) Børns reaktioner & tilpasning efter en katastrofe. København: Dansk Krise- og Katastrofepsykologisk Selskab.

Elklit, A. & Molin, K. (2007) De psykosociale følger af fyrværkerikatastrofen i Seest. Del 2 – Indsatspersonellet 5 måneder efter. Psykologisk Skriftserie, 28 (1), 1-104.

Molin, K. & Elklit, A. (2007) Indsatsen i Seest II. Psykolog Nyt, 61 (14), 8-14.

Molin, K. & Elklit, A. (2007) Indsatsen i Seest. Psykolog Nyt, 61 (13), 8-13.

Elklit, A. (2007) Psychological consequences of a firework factory disaster in a local community. Social Psychiatry and Psychiatric Epidemiology, 42 (8),  664-668.

Elklit, A. & Molin, K. (2006) De psykosociale konsekvenser af fyrværkerikatastrofen i Seest. Del 1 – Beboerne 3 måneder efter. Psykologisk Skriftserie, 27 (2), 1-142.

Molin, K. & Elklit, A. (2006) Tre måneder efter Seest. Psykolog Nyt, 60 (8), 6-11.

Molin, K. & Elklit, A. (2006) Læren af Seest-katastrofen. Psykolog Nyt, 60(10), 16-19.

Molin, K. & Elklit, A.: (2006) Oplevelsen af en katastrofe. Psykolog Nyt, 60, (9), 20-25.

In April 1990, the ferry Scandinavian Star were on it's way from Oslo to Frederikshavn, but on the night of the 7th April, a fire broke out in several places on the ferry. There were 482 crew and passengers on board, 159 of whom lost their lives. Investigations have since indicated that the fires were probably arson. The National Centre for Psychotraumatology has published a number of different studies on the survivors and the relatives of the deceased on Scandinavian Star, including a collaboration with Tine Arctander, who were the first to study the victims' reactions and symptoms. We are particularly proud of the publication, which examined the reactions and symptoms of the survivors and relatives of the deceased 3½ years after the disaster, because it was the first Danish long-term follow-up study of a highly traumatized group. The study did not support the idea that "time heals all wounds", but rather showed that the survivors and relatives of the deceased were still very much affected 3½ years after the disaster.

Related publications:
Levinsen, L. K. & Elklit, A. (2013). Kognitive senreaktioner og mestringsstrategier hos overlevende og efterladte til branden om bord på Scandinavian Star. Matrix, 30 (4), 250-267.

Elklit, A. (1997) Katastrofen på Scandinavian Star. Førstehjælp og Sundhedsfremme, 88, 3-6.

Elklit, A. (1996) Scandinavian Star-ofrene tre og et halvt år efter katastrofen. Tidsskrift for Norsk Psykologforening, 33,653-654.

Elklit, A. (1996) De psykologiske reaktioner og eftervirkninger hos ofre for transportkata-strofer til søs. Nordisk Psykologi, 48 (1), 1-20.

Elklit, A., Andersen, L. B., Arctander, T. (1995 )Scandinavian Star. Anden del. De fysiske, psykologiske og sociale eftervirkninger 3½ år efter katastrofen. Psykologisk Skriftserie, 20, (2), 1-90.

Elklit, A. (1995) Hvordan klarede ofrene sig fra “Scandinavian Star” sig?
Forskningsnyt fra Psykologien 4(1), 3-5.

Elklit, A.: The Psychological Aftermath of Transportation Catastrophes at Sea. Psykologisk Institut, Aarhus Universitet, 1995.

Elklit, A., Andersen, L. B., Arctander, T. (1995 )Scandinavian Star. Anden del. De fysiske, psykologiske og sociale eftervirkninger 3½ år efter katastrofen. Psykologisk Skriftserie, 20, (2), 1-90.

Elklit, A. & Andersen, L. B. (1994) Scandinavian Star - en undersøgelse af de fysiske, psykologiske og sociale eftervirkninger af en katastrofe. Psykologisk Skriftserie, 19 (5). (2. udgave 1995).

The aim of this study was to explore the psychological consequences of two earthquakes in Iceland in two probability samples of subjects – residents in the exposed area and a control group from an unexposed area. The sample was composed of 52 adults exposed to the earthquakes and 29 adults in a control group. Three months after the earthquakes, both groups were approached with questions from a survey consisting of the Harvard Trauma Questionnaire (HTQ), the Trauma Symptom Checklist (TSC), the Coping Styles Questionnaire (CSQ), the World Assumption Scale (WAS), and the Crisis Support Scale (CSS). The results revealed that 24% in the exposed group had Posttraumatic Stress Disorder (PTSD), and none in the control group had PTSD. Earthquake‐related anxiety, inability to express one's thoughts and feelings, and emotional coping predicted 81% of the HTQ variance for both groups. Previous life events, low self‐worth, and luck attributions, together with numbing and the feeling of being let down, predicted 56% of the symptom variance for both groups. When degree of traumatization and emotional coping were added to the model, another 30% of the variance could be explained.


Related publications:
Bödvarsdóttir, I. & Elklit, A. (2004) Psychological reactions in Icelandic earthquake survivors. Scandinavian Journal of Psychology, 45(1), 3-13.

Bödvarsdóttir, I., Elklit, A. & Guðmundsdóttir, D. (2006) Posttraumatic stress reactions in children after two large earthquakes in Iceland. Nordic Psychology, 58(2), 91-107.

Six months after the 1994 explosion at the shipyard at Lindø, 270 workers took part in a study carried out by The National Centre of Psychotraumatology. The study examined the relationship between objective stressors, the workers' own feelings and family menbers' reactions to the explosion. In addition, the study examined workers' attitudes towards the workplace and received crisis counselling. 

The study showed that the workers and their families were strongly emotionally affected by the explosion and that the degree of traumatization was higher in the group that had felt the explosion, but was located further away, than the group who worked in the room where the atomized diesel fuel burned. 


Related publications:
Elklit, A. (1997) The Aftermath of an Industrial Disaster. Acta Psychiatrica Scandinavica, 96, 1-25.

Disasters of any nature whether man made or due to nature's fury are well known to cause a variety of psychological sequelae. One such natural disaster took place in August 2010 in Leh, when cloudburst triggering torrential rains, flash floods and mud slides struck Leh town of Ladakh causing massive destruction to flora and fauna. The present study aims to gauge the effect of number of trauma events previously faced by an individual, positive affect, negative affect and social support on Post Trauma Stress Disorder (PTSD) among 98 (48 female & 50 male) residents of Leh who were exposed to the fury of the cloudburst in one way or the other. Participants were in the age range of 19-76 years with mean age being 33.6 years. Nearly 9 % of the participants reported to be in the diagnosable range of PTSD. Multiple regression analysis further revealed that number of previous trauma events faced by an individual, positive affect, negative affect, and social support together predicted 12.5% variance in PTSD. Relief and rehabilitation programmes to be effective should consider the factors that affect the trauma scores for the well being of individuals.


Related publications:

Charak, R., Spalzes L. (2011) Exposure to Cloudburst in Leh: Post Traumatic Stress Disorder and Associated Factors. Researchgate, 2(2), 79-88.

While physical infrastructure is quickly rebuilt following a natural disaster, the psychological effects on victims are often neglected. This study investigated symptoms of posttraumatic stress disorder (PTSD) among adolescents exposed to the 2004 tsunami in Northern Peninsular Malaysia. The randomly selected participants were 216 adolescents living in small villages affected by the tsunami. The study used a cross-sectional design in which PTSD symptoms were assessed with the Child Posttraumatic Stress Reaction Index. Results showed that 8.3% of the participants had severe symptoms of PTSD, 39.8% had moderate symptoms, 42.1% had mild symptoms, and 9.7% had no significant symptoms. Females had significantly higher criterion B symptom scores than males. Multiple regression analysis results indicated that number of lifetime traumas and age were significant predictors of PTSD scores. The prevalence of PTSD symptoms was high even 4 years after the tsunami, a finding consistent with previous studies. The findings are discussed and several recommendations put forward.


Related publications:
Armour, C., Ghazali, S. R. & Elklit, A.(2013) PTSD’s latent structure in Malayan tsunami victims: Assessing the newly proposed Dysphoric Arousal model. Psychiatry Research, 206 (1) 26-32. Doi: 10.1016/j.psychres.2012.09.012

Ghazali, S. R., Elklit, A., Yaman, K., & Ahmad, M. (2013) Symptoms of PTSD Among Adolescents in Malaysia 4 Years Following the 2004 Tsunami. Journal of Loss and Trauma, 18, 260-274. Doi: 10.1080/15325024.2012.688703

On the 16th of January 1995, an avalanche hit the fishing town of Sudavik in western Iceland. 14 people died, eight of them children. Just 10 months later, an avalanche hit the north-western coastal town of Flateyri. This avalanche claimed the lives of 20 people. The National Centre for Psychotraumatology investigated the degree of traumatization of both survivors and responders in the two towns,  and has since conducted two follow-up studies 16 years after the disaster. 


Related publications:
Thordardottir, E. B., Valdimarsdottir, U. A., Hansdottir, I., Hauksdóttir, A., Dyregrov, A., Shipherd, J. C., Elklit, A., Resnick, H., Gudmundsdottir, B. (2017) Sixteen-year follow-up of childhood avalanche survivors. European Journal of Psychotraumatology, 7. Doi:10.3402/ejpt.v7.30995

Thordardottir, E. B., Hansdottir , I., Valdimarsdottir, U. A., Resnick, H., Elklit, A., & Gudmundsdottir , B. (2016). Risk Factors for Posttraumatic Stress Symptoms Among Avalanche Survivors: A 16 Year Follow-up. Journal of Nervous and Mental Disease. 204(4), 298-305. Doi: 10.1097/NMD.0000000000000475

Haraldsdóttir, H., Gudmundsdóttir, D., Romano, E., Pordardóttir, E., Gudmundsdót-tir, B. & Elklit, A. (2014). Volunteers and Professional Rescue Workers - Traumatization and Adaptation after an Avalanche Disaster in an Isolated Community. Journal of Emergency Management, 12(6), 457-66. Doi: 10.5055/jem.2014.0209.

Finnsdóttir, T. & Elklit, A.(2002) Posttraumatic Sequelae in a Community hit by an Avalanche. Journal of Traumatic Stress, 15 (6), 479-485.

In collaboration with The European Network for Traumatic Stress (TENTS), The National Centre for Psychotraumatology participated in the development of guidelines for providing psychosocial support to disaster victims. The aim of this project was to create evidence-based and effective support for those who have suffered a disaster. The guidelines were developed within six main categories: 1) Planning, 2) Preparation and management, 3) General components of response, 4) Specific components of initial response (within the first week), 5) Specific components of response provided one to three months after the disaster, and 6) Specific components of ongoing response (more than three months).

From these guidelines, a series of interventions were compiled, consisting of community interventions, trauma-focused psychological treatment and pharmacological treatment for adults with PTSD, as well as interventions for traumatized children and adults.

Find the TENTS-guidelines here.


Related publications:
Witteveen, A.B., Bisson, J. I., Bolding, H. B., Ajdukovic, D., Arnberg, F., Elklit, A., Jehel, L., Johannesson, K. B., Johansen, V. A., Lis-Turlejska, M., Nordanger, D. A., Orengo–García, F., Polak, A. R., Punamaki, R.-L., Schnyder, U., Wittmann, L., & Olff, M.(2012) Post-disaster Psychosocial Services across Europe: the TENTS project. Social Science and Medicine, 75, 1708-1714. Doi: 10.1016/j.socscimed.2012.06.017

Witteveen, A.B., Bisson, I. J., Ajdukovic, D., Bergh-Johannesen, K., Gurris, N., Johansen, V., Nordanger, D., Garcia, F. O., Punamäki, R.L., Sezgin, A. U., Elklit, A., Freeman, C., Jehel, L., Lis-Turlejska, M., Schnyder, U., Lueger-Schuster, B., Witt-mann, L., & Olff, M.(2010) The European Network for Traumatic Stress (TENTS). Traumatic Stress Points, 24(2), 7-8.


Related publications:

Anna Harpviken,  a former undergraduate student at The National Centre for Psychotraumatology, has published an article on radicalization.

Harpviken, A.N. (2019) Psychological Vulnerabilities and Extremism Among Western Youth: A Literature Review. Adolescent Research Review. Doi:  10.1007/s40894-019-00108-y


Elklit, A.(2016): Danske erfaringer med psykosociale indsatser efter katastrofer og terror. Videnscenter for Psykotraumatologi.


Elklit, A. (2005) Forberedt på terror? Psykolog Nyt, 59(14), 30-31.


Contractor, A. A., Mehta, P., Tiamiyu, M. F., Hovey, J. D., Geers, A., Charak, R., . . . Elhai, J. D. (2014). Relations between PTSD and Distress dimensions in an Indian child/adolescent sample following the 2008 Mumbai terrorist attacks. Journal of Abnormal Child Psychology, 42(6), 925-935. Doi: 10.1007/s10802-013-9846-5


We have conducted a review of transport disasters at sea.

Related publications:

Elklit, A. (1996). De psykologiske reaktioner og eftervirkninger hos ofre for transportkatastrofer til søs. Nordisk Psykologi, 48 (1),1-20.

Elklit, A.: The Psychological Aftermath of Transportation Catastrophes at Sea. Psykologisk Institut, Aarhus Universitet, 1995.

Experiences regarding the psychosocial response after disasters in Denmark are summarized in the publications below. The findings are derived from a number of studies conducted by The National Centre for Psychotraumatology after the disasters regarding trauma reactions in victims and the effect of psychosocial interventions. The challenges of the then - and to a large extent also the current - psychosocial post-disaster response  are highlighted in the publications. Proposals for strengthening and optimization of the Danish psychosocial interventions after disasters based on these and international experiences are presented.

Related publications:

Elklit, A.(2016): Danske erfaringer med psykosociale indsatser efter katastrofer og terror. Videnscenter for Psykotraumatologi.

Elklit, A. (2014). Danske erfaringer – efter katastrofen. Omsorg, 31(1), 15-20.

The project aims to map the psychological and social consequences of the survivors and their families after the train accident on the Great Belt, which took place on the 2nd of January 2019. Accidents and disasters affect many people and some of them develop psychological symptoms after the accidents. We know from the train accident in Sorø in 1989 that some of the rescue crew developed PTSD. British and Norwegian experiences after terrorism have shown that many affected people are reluctant to seek help, thinking that it will pass or that many others are worse off and need help more than they do.

Related publications: 

Elklit, A., & Jørgensen, L. K. (2022). The Great Belt Bridge Railway Accident: Post-traumatic stress reactions among passengers and bereaved family members. American Journal of Disaster Medicin, 17(2). Doi: 10.5055/ajdm.2022.0429

Jørgensen, L. K. & Elklit, A. (2020). Togulykken på Storebæltsbroen den 2. januar 2019. Odense: Videnscenter for Psykotraumatologi, SDU. (1-107).

 

Last Updated 27.07.2024