ORIGINAL ARTICLE Psychological sequelae: Post-traumatic stress reactions and personality factors among community residents as secondary victims Man Cheung Chung 1 PhD, Yvette Easthope 2 BSc, Steven Farmer 3 BSc, Julie Werrett 4 BSc and Catherine Chung 1 BA 1 University of Plymouth, Plymouth, England, UK 2 Univeristy of Manchester, Manchester, England, UK 3 University of Wolverhampton, Wolverhampton, England, UK and 4 University of Birmingham, Birmingham, England, UK Scand J Caring Sci; 2003; 17: 265–270 Psychological sequelae: Post-traumatic stress reactions and personality factors among community residents as secondary victims The aims of the present study were twofold: first, to ascertain the severity of post-traumatic stress among community residents as secondary victims exposed to a train disaster. Secondly, we aimed to identify the associ- ation between post-traumatic stress and personality vari- ables. Seven months after the train disaster in Stafford, United Kingdom, in 1996, 66 community residents were recruited and interviewed for the study. In the inter- views, residents were assessed using the Impact of Event Scale (IES), the General Health Questionnaire (GHQ) and the Eysenck Personality Questionnaire-R Short Scale (EPQ-R). Control group data were also collected, com- posed of 90 community residents who lived in another city and had not been exposed to the train disaster. They were assessed using the GHQ. The results showed that 51% of the residents scored at the high IES symptom level. No significant differences were found between the community residents who lived near and further away from the crash site in terms of the IES scores. Further analyses showed that the IES scores for the present two groups of community residents were significantly lower than those of Horowitz’s standardized stress clinic sam- ples, but higher than those of Danish rescue workers involved in a train rescue operation. The GHQ results showed that 35% could be considered to be psychiatric cases. The comparisons between the GHQ scores of the present community residents with those of the control group showed that there were significant differences in somatic problems, anxiety, depression and GHQ total. With regard to personality, the community residents who lived near to the crash site were significantly more introverted but less neurotic than Eysenck’s standardized samples. The community residents who lived further away were significantly more introverted but less neur- otic than the standardized samples. Regression analyses revealed that neuroticism predicted intrusion, avoidance and GHQ total. The conclusion was that there can be long-term, severe post-traumatic stress effects upon community residents, as secondary victims, after exposure to a train disaster. Residents with a neurotic personality tend to be associated with post-traumatic stress reactions and general health problems. Keywords: post-traumatic stress, personality, secondary victims. Submitted 26 November 2001, Accepted 24 January 2002 Introduction The notion of secondary victims has been defined in var- ious ways. For example, Figley and Kleber (1) referred to it as the significant others (e.g. families or spouses or chil- dren) of primary victims (i.e. those with maximal exposure to a traumatic event, such as war veterans). They also included, in their definition, crisis and rescue workers and psychotherapists. Agreeing with Figley and Kleber, Taylor and Frazer (2) included grieving relatives and friends of the primary victims as secondary victims; however, they clas- sified the crisis and rescue workers as tertiary victims. For the purposes of this study, the term secondary victims designated people who have experienced exposure to a train crash but not maximal exposure. They were not on the ‘front line’, in that they were not the passengers or the crew on the train. Neither had they witnessed the crash, although most of them had heard its impact. They did not Correspondence to: Dr Man Cheung Chung, Department of Psychology, University of Plymouth, Drake Circus, Plymouth, PL4 8AA, UK. E-mail: m.chung@plymouth.ac.uk Ó 2003 Nordic College of Caring Sciences, Scand J Caring Sci; 2003; 17: 265–270 265