Predicting the mental health outcomes for Ebola first responders

  • Abstract
  • Keywords
  • References
  • PDF
  • Abstract

    Purpose: The 2014 Ebola epidemic resulted in 26,683 cases and 11,022 deaths by May 6th, 2015. With first responders deploying from the United States to assist with the many challenges being faced in the field, they encountered a new set of traumatic events and situations that undoubtedly put them at risk for developing a mental disorder. Organizations must be prepared to provide mental health services for their employees and volunteers once they return.

    Approach: The authors questioned the potential prevalence of PTSD, ASD, and depression among returning first responders and which therapy method would be the most effective in terms of an individual’s recovered or improved condition. This was done through the use of AnyLogic® 7.0. An agent-based method to model the stress levels a first responder may experience while dealing with Ebola was used, where all responders begin in the healthy state and can develop mental health disorders. The therapy options tested were Cognitive Processing Therapy, Prolonged Exposure, and Group Based Exposure Therapy.

    Results: GBET for PTSD patients provided the most positive results in terms of condition recovery and improvement.

    Conclusion: The results showed evidence that the type of therapy used can drastically affect the individual’s mental health outcome.

  • Keywords

    Ebola; First Responders; Mental Health; Anylogic; Modeling.

  • References

      [1] Center for Mental Health Services. (2005). A guide to managing stress in crisis response professionals. US Department of Health and Human Services, 1-40.

      [2] Fullerton, C. S., Ursano, R. J., & Wang, L. (2004). Acute stress disorder, posttraumatic stress disorder, and depression in disaster or rescue workers. American Journal of Psychiatry, 16, 1370-1376.

      [3] Kessler, R. C., Chin, W. T., Demler, O., Merikangas, K. R., & Walters, E. E. (2005). Prevalence, severity, and comorbidity of 12-month DSM-IV disorders in the National Comorbidity Survey Replication. Archives of General Psychiatry, 62, 617-627.

      [4] Eriksson, C. B., Vande Kemp, H., Gorsuch, R., Hoke, S., & Foy, D. W. (2001). Trauma exposure and PTSD symptoms in international relief and development personnel. Journal of Traumatic Stress, 14, 205–212.

      [5] Alexander, D. A., & Klein, S. (2001). Ambulance personnel and critical incidents: Impact of accident and emergency work on mental health and emotional well-being. British Journal of Psychiatry, 178, 76–81.

      [6] Pole, N. (2008). Predictors of PTSD in police officers: From childhood to retirement. In D. L. Delahanty (Ed.), the psychobiology of trauma and resilience across the lifespan (pp. 47–67). Landham, MD: Aronson

      [7] Bryant, R. A., & Harvey, A. G. (1996). Posttraumatic stress reactions in volunteer firefighters. Journal of Traumatic Stress, 9, 51–62.

      [8] Greiger, T.A, Kolkow, T.T., Spira, J.L., Morse, J.S., (2007) Posttraumatic Stress Disorder and Depression in Health Care Providers Returning from Deployment to Iraq and Afghanistan. Military Medicine. 172, 451

      [9] Perrin, M. A., Digrande, L., Wheeler, K., Thorpe, L., Farfel, M., & Brackbill, R. (2007). Differences in PTSD prevalence and associated risk factors among World Trade Centre disaster rescue and recovery workers. American Journal of Psychiatry, 164, 1385-1394.

      [10] Pietrzak, Schechter, Bromet, Katz, Reissman, Ozbay, Sharma, Crane, Harrison, Herbert, Levin, Luft, Moline, Stellman, Udasin, Landrigan, Southwick (2012) The burden of full and subsyndromal posttraumatic stress disorder among police involved in the World Trade Center rescue and recovery effort. Journal of Psychiatric Research. 46(7), 835-842

      [11] Laposa, J.M & Alden, L.E. (2003) Posttraumatic stress disorder in the emergency room: exploration of a cognitive model. Behaviour Research and Therapy. 41(1):49-65, ISSN 0005-7967

      [12] Ho, S., & Lo, R. (2012). Dispositional Hope as a Protective Factor among Medical Emergency Professionals: A Preliminary Investigation. Traumatology, (17), 3-9.

      [13] Clohessy, S., & Ehlers, A. (1999). PTSD symptoms, response to intrusive memories and coping in ambulance service workers. British Journal of Clinical Psychology, (38), 251-265.

      [14] Del Ben, K., Scotti, J., Chen, Y., Fortson, B., (2007) Prevalence of posttraumatic stress disorder symptoms in firefighters. Work & Stress: An International Journal of Work, Health & Organizations. 20.

      [15] American Psychiatric Association. (2013) Diagnostic and statistical manual of mental disorders, (5th ed.). Washington, DC: Author.

      [16] Kleim, B., Westphal, M. (2011) Mental Health in First Responders: A Review and Recommendation for Prevention and Intervention Strategies. Traumatology. 17(4) 17-24

      [17] CDC (2014). Ebola Virus Disease. Retrieved from, Dec. 2 Atlanta: Centers for Disease Control and Prevention.

      [18] DeAngelis, T. (2008). PTSD treatments grow in evidence, effectiveness. Monitor on Psychology, 39, 40.

      [19] Monson, C., Schnurr, P., Resick, P., Friedman, M., Young-Xu, Y., & Stevens, S. (2006). Cognitive Processing Therapy For Veterans With Military-related Posttraumatic Stress Disorder. Journal of Consulting and Clinical Psychology, 74, 898-907.

      [20] Rauch, S., Defever, E., Favorite, T., Duroe, A., Garrity, C., Martis, B., & Liberzon, I. (2009). Prolonged Exposure For PTSD In A Veterans Health Administration PTSD Clinic. Journal of Traumatic Stress, 22, 60-64.

      [21] Sutherland, R., Mott, J., Lanier, S., Williams, W., Ready, D., & Teng, E. (2012). A pilot study of a 12-week model of group-based exposure therapy for veterans with PTSD. Journal of Traumatic Stress, 25, 150-156.

      [22] Alvarez, J., Mclean, C., Harris, A., Rosen, C., Ruzek, J., & Kimerling, R. (2011). The comparative effectiveness of cognitive processing therapy for male veterans treated in a VHA posttraumatic stress disorder residential rehabilitation program. Journal of Consulting and Clinical Psychology, 79, 590-599.

      [23] Ready, D., Vega, E., Worley, V., & Bradley, B. (2012). Combining Group-Based Exposure Therapy With Prolonged Exposure to Treat U.S. Vietnam Veterans With PTSD: A Case Study. Journal of Traumatic Stress, 25, 574-577.

      [24] Ready, D., Thomas, K., Worley, V., Backscheider, A., Harvey, L., Baltzell, D., & Rothbaum, B. (2008). A field test of group based exposure therapy with 102 veterans with war-related posttraumatic stress disorder. Journal of Traumatic Stress, 21, 150-157.

      [25] Bonabeau, E. (2002). Agent-based modeling: Methods and techniques for simulating human systems. Proceedings of the National Academy of Sciences of the United States of America. Retrieved from, 4/24/2013.

      [26] Borshchev, A., Karpov, Y., & Kharitonov, V. (2001). From system dynamics and discrete event to practical agent based modeling: Reasons, techniques, tools. 6th International Conference on Parallel Computing Technologies. Retrieved from, 4/24/2013

      [27] Shendarkar, A., & Vasudevan, K. (2006). Crowd simulation for emergency response using BDI agent based on virtual reality. In L. F. Perrone, F. P. Wieland, J. Liu, B. G. Lawson, D. M. Nicol, and R. M. Fujimoto (Eds.), 2006 Winter Simulation Conference, (pp. 545-553). Retrieved from 4/24/2013.

      [28] Muhdi, R. A. (2006). Evacuation modeling: Development, characteristics, and limitations. Proceedings of the IEEE CEC, Vancouver, BC, Canada, (pp. 87-92). Retrieved from,%20Rani.pdf., 4/24/2013.

      [29] Banerjee, D., Dasgupta, G., & Desai, N. (2011). Simulation-based evaluation of dispatching. In S. Jain, R. Creasey, J. Himmelspach, K. White, and M. Fu (Eds.), 2011 Winter simulation conference, (pp. 779-791).




Article ID: 5275
DOI: 10.14419/ijsw.v5i1.5275

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