Unclassified

Psychological Effects of Chemical,

Biological, Radiological, Nuclear
Incidents
Emergency Manager Course
Skopje, Republic of North Macedonia
20-24 January 2020

Distribution Statement A
Approved for Public Release: Distribution is Unlimited
 Course Overview
• Historical Examples
• Common Psychological Effects
• Outbreak of Multiple Unexplained Symptoms
• Risk Communication and Risk Perception
• Higher Risk Groups for Psychological Effects
• Normal Disaster Behavior
• Mass Panic
• Diagnosis and Triage
• Psychological Factors
• Response to Incident or Attack
• Incident Trauma Mediators
• Prevention / Intervention of Biological Weapon Attack
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 Objective

Discuss treatment suggested to mitigate the

psychological effects of a chemical, biological,
radiological, nuclear event

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 Historical Examples

• Chemical: Aum
Shinrikyo sarin attack
• Biological: Severe
Acute Respiratory
Syndrome outbreak
• Radiological:
Fukushima Daiichi

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 Post-Event Immediate Psychological
Consequences

• Transition states
• Acute cognitive,
emotional, and
behavioral states
• Frightened, confused,
depersonalization,
suggestible,
discouraged, etc.

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 Common Psychological Effects
(1 of 2)

• Acute stress disorder

• Post-traumatic stress disorder
• Conversion disorder
• Dissociative identity disorder
• Dissociative disorder: Not Otherwise Specified
• Amnestic disorder
• Somatization

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 Common Psychological Effects
(2 of 2)

• Depression
• Adjustment disorder
• Substance and alcohol
abuse and dependency
• All endemic psychiatric
disease
• “Hallucinations”
• Insomnia

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 Outbreak of Multiple Unexplained
Symptoms

• Symptoms are real, but unexplained

• May or may not have been exposed
• Diagnosis and triage are important

Macy Hinds
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 Risk Communication and Risk
Perception

• Risk = Hazard + Outrage

• Risk Perception
• Not completely understood
• Important driver for “outrage”
• Media
• Influences risk perception and outrage

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 Risk Perception

Characteristics of biological weapon agent

contributing to risk perception
• Invisible, odorless
• Ubiquitous symptoms
• Uncertainty
• Novelty (unfamiliarity)
• Grotesqueness
• Magical thinking

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 Higher Risk Groups for Psychological
Effects (1 of 2)

• Previously
psychologically
traumatized
• Untrained and
inexperienced
• Very young and very old
• The injured

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 Higher Risk Groups for Psychological
Effects (2 of 2)

• Professional rescue teams

• Medical personnel
• Those most exposed to horror of trauma
• People suffering multiple losses
• Individuals who perceive self as failing others

Bryan can der Beek

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 Normal Disaster Behavior

• Cool and collected (12-25%)

• Stunned and bewildered (50-75%)
• Disorganized behaviors (10-25%)
• Confusion

Organisation for the Prohibition of Chemical

• Overly active
• Anxiety
• Panic (rare)

Weapons
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 Mass Panic Misconception

An acute fear reaction marked by loss of self-control

and followed by nonsocial and unreasoning flight
• Perceive imminent threat
• Especially limited escape routes

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 Diagnosis and Triage (1 of 2)

• Neuropsychiatric casualties included as category

• Chemical, biological, radiological, nuclear agent
psychological / medical effects

Tech. Sgt. Andrew Satran

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 Diagnosis and Triage (2 of 2)

• Outbreak of multiple unexplained symptoms

occurring independently or in conjunction with
incident
• Treatment for somatic illnesses key

vaXine
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 Medical Response to Symptoms

Control of symptoms secondary to hyper-arousal

• Realistic reassurance
• Diazepam-like drugs for acute relief, if indicated
• Provide respite as required

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 Psychological Factors (1 of 2)

• Scapegoating
• Blaming unproven source
• Paranoia
• Health and safety concerns
• Social isolation
• Those contaminated are ostracized

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 Psychological Factors (2 of 2)

• Demoralization
• Sense of doom
• Loss of faith in social institutions
• Hospitals and government

Staff Sgt. Christopher Sofia

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 Sociocultural Context

• Physical injury and disease

• Psycho-physiological changes
• Psychological changes

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 Response to Incident or Attack
(1 of 2)

• Effective risk communication

• Rapid, updated release of information to the public

Spc. Kahlil Dash

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 Response to Incident or Attack
(2 of 2)

• Rapid medical evaluation, treatment, and/or

infectious control procedures
• Training for emergency response includes
psychological trauma

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 Incident Trauma Mediators (1 of 2)

• Nature of trauma and injury

• Developmental history (previous trauma)
• Knowledge of nature of attack
• Faith in counter-measures

U.S. Defense Threat Reduction Agency

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 Incident Trauma Mediators (2 of 2)

• Successful training
• Experience managing near disasters or disasters
facilitates successful performance

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 Long-Term Psychological Treatment

• Restoration to a useful social role

• Allow reasonable review of experience
• Avoid early psychological labeling
• Psychiatric treatment on follow-up

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 Recovery Environment

• Restore order
• Return to social group / family
• Restore health and functioning
• Difficult in biological weapon environment

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 Medical Goals – Restore

• Value as a person
• Social supports
• Autonomy
• Sense of justice
• Health

Maria Pinel
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 Consequences of Terrorism or Incident

• Create new symbolic assumptions (stereotype of

authorities, ethnic groups, etc.)
• Decrease trust in public officials
• Over estimation of probability of personal injury
or loss

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 Prevention Goals for Responders

• Prevent group panic

• Manage rage / anger / fear
• Avoid emotion-based responses (e.g. “knee jerk”
quarantine, premature use of new drug)
• Manage misattribution of symptoms

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 Prevention / Intervention of Biological
Weapon Attack (1 of 2)

• Educate the public about microbes / viruses

• Coordinate responsible agencies prior to attack

Senior Airman Jamie Titus

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 Prevention / Intervention of Biological
Weapon Attack (2 of 2)

• Train emergency responders with biological

weapon scenarios
• Include political leaders in all planning

Airman 1st Class Daniel Hughes

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 Summary

• Demonstrated the historical, medical management, and

response implications of a chemical, biological,
radiological, nuclear incident
• Illustrated some of the psychological effects
• Discussed some of the psychological trauma mitigation and
treatment methods
• Identified medical management considerations
• Discussed possible steps towards prevention

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Questions?

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