How Does Negative Life Change Following Disaster Response Impact Distress Among Red Cross Responders? Shannon E. McCaslin, Gerard A. Jacobs, David L. Meyer, and Erika Johnson-Jimenez University of South Dakota Thomas J. Metzler and Charles R. Marmar University of California, San Francisco The American Red Cross is the largest nongovernmental organization responding to disasters in the United States. This study investigated the impact of negative life change occurring in the year following the September 11, 2001, terrorist attacks on levels of distress among 757 Red Cross Disaster Services Human Resources (national disaster team) employees and volunteers who responded to this disaster. Negative life change in the year following disaster response fully mediated the relationship between disaster response and symptoms of depression and partially mediated the responses between disaster response and posttraumatic stress and anxiety symptoms. Results highlight the importance of life experiences in the year following disaster response and, therefore, the education and follow-up services provided to disaster workers prior to and following disaster assignment. Suggestions for monitoring disaster-related stress during and following assignment are provided. Keywords: Red Cross, stressful life events, disasters, mental health, terrorism/psychology More than 55,000 American Red Cross employees and volun- teers provided disaster relief services to those affected by the terrorist attacks that took place in the New York City and Wash- ington, DC, areas on September 11, 2001 (B. Malfara, personal communication, February 24, 2003). The largest volunteer disaster relief organization in the United States, the Red Cross has provided SHANNON E. MCCASLIN received her PhD in clinical psychology from the University of South Dakota. She is currently a postdoctoral fellow at the Department of Psychiatry, University of California, San Francisco, and the Posttraumatic Stress Disorder (PTSD) Research Program at the San Francisco Department of Veterans Affairs Medical Center. At the time of the study, she was also affiliated with the Department of Psychology and the Disaster Mental Health Institute at the University of South Dakota. Her research interests focus on risk and resilience factors of traumatic stress among military veterans and emergency and disaster responders. GERARD A. JACOBS received his PhD in clinical/community psychology from the University of South Florida. He is a professor in the Department of Psychology and director of the Disaster Mental Health Institute at the University of South Dakota. His research and professional interests focus on disaster psychology. He is a disaster mental health manager for the American Red Cross National Disaster Team and the Red Cross Critical Response Team, instructor in disaster mental health for the Red Cross, and was a member of the American Psychological Association’s Advisory Committee for the Disaster Response Network from its inception in 1991 until 2000. He also serves as a consultant to the International Federation of Red Cross and Red Crescent Societies’ Psychological Support Program. DAVID L. MEYER received his MA in clinical psychology from the Uni- versity of South Dakota. He is currently a doctoral candidate in the Department of Psychology and fellow of the Disaster Mental Health Institute at the University of South Dakota. His research interests focus on disaster psychology and first-responder stress. ERIKA JOHNSON-JIMENEZ received her PhD in clinical psychology from the University of South Dakota. At the time of the study, she was affiliated with the Department of Psychology and the Disaster Mental Health Insti- tute at the University of South Dakota. She is currently affiliated with the Forensic Health Services, New Mexico’s Women’s Correctional Facility. Her research interests focus on disaster psychology, PTSD, and multicul- tural issues in psychology. THOMAS J. METZLER received his MA in cognitive psychology from the University of California, Berkeley. He is a research statistician at the Department of Psychiatry, University of California, San Francisco, and the PTSD Research Program at the San Francisco Department of Veterans Affairs Medical Center. His research interests focus on risk and resilience factors for PTSD among emergency responders. CHARLES R. MARMAR received his MD from the University of Mani- toba, Winnipeg, Manitoba, Canada, and completed his residency in psychiatry at the University of Toronto, Ontario, Canada. He is profes- sor and vice chair of the Department of Psychiatry, University of California, San Francisco, and associate chief of staff, psychiatry, and director of the PTSD Research Program at the San Francisco Depart- ment of Veterans Affairs Medical Center. He also serves on the exec- utive board of the Northern California Institute for Research and Education, San Francisco. An active researcher in the study of trauma and PTSD for the past 25 years, he has received funding from both federal and private institutions to conduct studies in psychopharmacol- ogy, psychopathology, psychobiology, quality of care, psychotherapy treatment and phenomenology of PTSD. THIS ARTICLE IS BASED ON Shannon E. McCaslin’s doctoral dissertation. Portions of the article were presented at the 111th Annual Convention of the American Psychological Association, Toronto, Ontario, Canada, Au- gust 2003.This research was supported in part by the American Red Cross and was conducted at the Disaster Mental Health Institute. WE THANK Susan Hamilton, the American Red Cross, and Randal Quevil- lon, S. Jean Caraway, Mark Daniels, and Dona Davis at the University of South Dakota for their helpful comments on drafts of this article. CORRESPONDENCE CONCERNING THIS ARTICLE should be addressed to Shan- non E. McCaslin, PTSD Research Program, Psychiatry Service 116P, Veterans Affairs Medical Center, 4150 Clement Street, San Francisco, CA 94121. E-mail: smccasli@itsa.ucsf.edu Professional Psychology: Research and Practice Copyright 2005 by the American Psychological Association 2005, Vol. 36, No. 3, 246 –253 0735-7028/05/$12.00 DOI: 10.1037/0735-7028.36.3.246 246 This document is copyrighted by the American Psychological Association or one of its allied publishers. This article is intended solely for the personal use of the individual user and is not to be disseminated broadly.