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 research, considering that such exposure is a risk factor for posttraumatic stress 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 responses of 352 military men and women who worked in the mortuary that received the dead from the Persian Gulf War (Operation Desert Storm) in 1990 to 1991. The respondents were volunteers and nonvolunteers for assignment to the mortuary; some had prior experience in handling the dead and some did not. Symptoms 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 statistically controlled. Post-exposure intrusion symptoms increased significantly for all groups exposed to the dead. Increased post-exposure avoidance symptoms were present in the two groups with the greatest exposure to remains. There were no significant increases in intrusion or avoidance in the unexposed group.