A Systematic Review:What is the psychological impact of acute traumatic events on direct survivors, witnesses and first responders?

The past century has seen an influx of horrific incidents which have resulted in trauma for the people who experienced them, previous research into traumatic events has tended to focus solely on Post Traumatic Stress Disorder (PTSD). The current review aims to identify and understand the trauma responses and psychological impacts from acute traumatic events in recent years. Reviewers used the search terms: “trauma” OR “traumatic events” AND “terror” OR “terrorism” OR “terrorist attacks” AND “terrorism survivors” OR “terrorism victims” OR “survivors” OR “witnesses” OR “first responders” OR “police” OR “paramedics” AND “natural disaster” OR “mass shooting” OR “school shooting”. These search terms were inputted onto EBSCOhost using multiple databases. The search produced 266 results. After applying strict inclusion and exclusion criteria, title/abstract screening, and full text screening the final review included 19 studies. Narrative synthesis was chosen as the analytic method and the finalised list of studies naturally fell into synthesis groups (natural disasters, WTC attacks, Europe, Oslo, and Oklahoma City). Individual study results were reported as well as group synthesis themes, which included, exposure, mental health, positive outcomes, vulnerability, and policy improvements. Researchers found overlap amongst the themes for synthesis groups and further explored these in the discussion. Several limitations of the studies were noted including, generalisability, cultural differences, self-report bias, and recall bias. Future implications are discussed including, replicating studies for new events, investigating specific vulnerabilities and comorbidity, improving health care, treatment and policies, and the post traumatic growth.