E-ISSN : 2733-4538
Posttraumatic stress disorder is characterized by not only significant psychological distress but also long-term difficulties in social and occupational functioning and adjustment. Psychological response to exposure to trauma can vary depending on the type of traumatic incident or factors related to the individual exposed to trauma. As such, it is important to investigate the potential protective factors that consider individual characteristics and the particular nature of the trauma. The present study thus examined the effect of exposure to human error-related aircraft accident in air force pilots on posttraumatic stress symptoms. Secondly, the moderation effect of cognitive flexibility was tested. A total of 64 male air force pilots participated in the study. The results indicated that air force pilots exposed to human error-related aircraft accident evidenced more posttraumatic stress symptoms than pilots with no prior exposure to human error-related aircraft accident. Furthermore, cognitive flexibility moderated the relationship between flight-related trauma secondary to human error and posttraumatic stress symptoms. The findings indicate that exposure to traumatic events during flight missions may be significantly associated with posttraumatic stress symptoms and that high degree of cognitive flexibility may serve as a protective factor. The implications and suggestions for future research are discussed.
Aiken, L. S., & West, S. G. (1991). Multiple regression: Testing and interpreting interactions. London: Sage.
Alden, L. E., Regambal, M. J., & Laposa, J. M. (2008). The effects of direct versus witnessed threat on emergency department healthcare workers:Implications for PTSD criterion A. Journal of Anxiety Disorders, 22, 1337-1346.
American Psychiatric Association. (2013). Diagnostic and Statistical Manual of Mental Disorders-5th edition (DSM-5). Washington, DC: Author.
Bisson, J. I., Ehlers, A., Matthews, R., Pilling, S., Richards, D., & Turner, S.(2007). Psychological treatments for chronic post-traumatic stress disorder. British Journal of Psychiatry, 190, 97-104.
Bradley, R., Greene, J., Russ, E., Dutra, L., & Westen, D. (2005). A multidimensional meta-analysis of psychotherapy for PTSD. American Journal of Psychiatry, 162, 214–217.
Brewin, C. R., Andrews, B., & Valentine, J. D. (2000). Meta-analysis of risk factors for posttraumatic stress disorder in trauma-exposed adults. Journal of Consulting and Clinical Psychology, 68, 748-766.
Brewin, C. R., & Holmes E. A. (2003). Psychological theories of posttraumatic stress disorder. Clinical Psychology Review, 23, 339-376.
Byeon, S. C. (2009). Study of human factors accident investigation tool through CFIT aircraft accident cases. Korean Journal of Aerospace and Environmental Medicine, 19, 44-50.
Chard, K. M., Schumm, J. A., Owens, G. P., & Cottingham, S. M. (2010). A comparison of OEF and OIF veterans and Vietnam veterans receiving cognitive processing therapy. Journal of Traumatic Stress, 23, 25-32.
Chun, E. R. (2014). Development of an occupational stress inventory for fighter-pilots in Republic of Korea air force. (Unpublished doctoral dissertation). Seoul Venture University, Seoul, Korea.
Chung, Y. J., Kim, Y. S., & Cho, K. H. (2012). Air force reinforcement across Northeast Asia and the future direction of ROKAF against wartime OPCON transition. New Asia, 19, 252-282.
Cohen, J., Cohen, P., West, S. G., & Aiken, L. S. (2013). Applied multiple regression/correlation analysis for the behavioral sciences. London: Routledge.
Collins, R. L., Taylor, S. E., & Skokan, L. A. (1990). A better world or a shattered vision? Changes in life perspectives following victimization. Social Cognition, 8, 263-285.
Dekel, S., Solomon, Z., Horesh, D., & Ein-Dor, T. (2014). Posttraumatic stress disorder and depressive symptoms: Joined or independent sequelae of trauma? Journal of Psychiatry Research, 54, 64-69.
Dennis, J. P., & Vander Wal, J. S. (2010). The cognitive flexibility inventory:Instrument development and estimates of reliability and validity. Cognitive Therapy and Research, 34, 241-253.
Dohrenwend, B. P., Turner, J. B., Turse, N. A., Adams, B. G., Koenen, K. C., & Marshall, R. (2007). Continuing controversy over the psychological risks of Vietnam for U.S. veterans. Journal of Traumatic Stress, 20, 449-465.
Ehlers, A., & Clark, D. M. (2000). A cognitive model of posttraumatic stress disorder. Behaviour Research and Therapy, 38, 319-345.
Ehlers, A., Clark, D. M., Hackmann, A., McManus, F., & Fennell, M. (2005). Cognitive therapy for PTSD: Development and evaluation. Behaviour Research and Therapy, 43, 413–431.
Elhai, J. D., Contractor, A. A., Tamburrino, M., Fine, T. H., Cohen, G., Shirley, E., . . . Galea, S. (2015). Structural relations between DSM-5 PTSD and major depression symptoms in military soldiers. Journal of Affective Disorder, 175, 373-378.
Foa, E. B. (1995). The posttraumatic diagnostic scale(PDS) manual. Minneapolis, MN: National Computer Systems.
Foa, E. B., Hembree, E. A., Cahill, S. P., Raunch, S. A. M., Riggs, D. S., Feeny, N. C., & Yadin, E. (2005). Randomized trial of prolonged exposure for post-traumatic stress disorder with and without cognitive restructuring:Outcome at academic and community clinics. Journal of Consulting and Clinical Psychology, 73, 953–964.
Foa, E. B., & Rauch, S. A. M. (2004). Cognitive changes during prolonged exposure versus prolonged exposure plus cognitive restructuring in female assault survivors with posttraumatic stress disorder. Journal of Consulting and Clinical Psychology, 72, 879-884.
Forbes, D., Lewis, V., Varker, T., Phelps, A., O’Donnell, M., Wade, D. J., … Creamer, M. (2011). Psychological first aid following trauma: Implementation and evaluation framework for high-risk organizations. Psychiatry:Interpersonal and Biological Processes, 74, 224-239.
Garnefski, N., & Kraaij, V. (2007). The cognitive emotion regulation questionnaire. European Journal of Psychological Assessment, 23, 141-149.
Hembree, E. A., Street, G. P., Riggs, D. S., & Foa, E. B. (2004). Do assault-related variables predict response to cognitive behavioral treatment for PTSD? Journal of Consulting and Clinical Psychology, 72, 531-534.
Heo, S. Y. (2011). Role of cognitive flexibility in the relationship between perfectionism and psychological maladjustment. (Unpublished master’s thesis). Seoul National University, Seoul, Korea.
Hoge, C. W., Castro, C. A., Messer, S. C., McGurk, D., Cotting, D. I., & Koffman, R. L. (2004). Combat duty in Iraq and Afghanistan, mental health problems and barriers to care. The New England Journal of Medicine, 351, 13-22.
Hoge, C. W., Lesikar, S. E., Guevara, R., Lange, J., Brundage, J. F., Engel, C. C., … Orman, D. T. (2002). Mental disorders among U.S. military personnel in the 1990s: Association with high levels of health care utilization and early military attrition. American Journal of Psychiatry 159, 1576-1583.
Jang, J. H., & Lee, K. H. (2013). Concept mapping for post-traumatic psychological difficulties and resiliency factors for survivors of ROK ship Cheonan attack. Korean Journal of Counseling, 14, 1145-1164.
Janoff-Bulman, R. (1989). Assumptive worlds and the stress of traumatic events: Applications of the schema construct. Social Cognition, 7, 113-136.
Janoff-Bulman, R. (1992). Shattered assumptions: Toward a new psychology of trauma. New York: The Free Press.
John, O. P., & Gross, J. J. (2004). Healthy and unhealthy emotion regulation:Personality processes, individual differences, and life span development. Journal of Personality, 72, 1301-1334.
Jones, D. G., & Endsley, M. R. (1996). Sources of situation awareness errors in aviation. Aviation Space and Environmental Medicine, 67, 507-512.
Kang, S. R., Kim, S. H., & Lee, H. Y. (2014). Predictors of PTSD symptoms in Korean Vietnam war veterans. Korean Journal of Clinical Psychology, 33, 35-50.
Kessler, R. C., Chiu, W. T., Demler, O., & Walters, E. E. (2005). Prevalence, severity and comorbidity of 12-month DSM-Ⅳ disorders in the national comorbidity survey replication. Archives General Psychiatry, 62, 617-627.
Kessler, R. C., Gillis-Light, J., Magee, W. J., Kendler, K. S., & Eaves, L. J. (1997). Childhood adversity and adult psychopathology. In I. H. Gotlib &B. Wheaton (Eds.), Stress and adversity over the life course: Trajectories and turning points (pp. 29-49). New York: Cambridge University Press.
Kim, D. H., & Sohn, Y. W. (2006). The effect of personality traits on confidence level and response bias in flight situation awareness. Korean Journal of Industrial and Organizational Psychology, 19, 85-104.
Kim, M. K. (2011). A Study of survivors of the Yeoncheon guard post shootings:Psychiatric symptoms and difference according to coping style and locus of control. Korean Journal of Clinical Psychology, 30, 571-585.
Kim, S. K., Lee, D. H., Jang, B. R., & Cheon, S. M. (2015). The research trends on PTSD of workers in high risk public positions in Korea. Journal of Rehabilitation Psychology, 22, 393-416.
Kim, T. Y., & Chang, M. S. (2009). Psychopathological protocols of the Korean civil war veterans using Rorschach tests. The Journal of Humanities, 14, 199-217.
Kleim, B., Ehlers, A., & Glucksman, E. (2012). Investigating cognitive pathways to psychopathology: Predicting depression and posttraumatic stress disorder from early responses after assault. Psychological Trauma:Theory, Research, Practice, and Policy, 4, 527-537.
Koss, M. P., Figueredo, A. J., & Prince, R. J. (2002). Cognitive mediation of rape's mental, physical, and social health impact: Tests of four models in cross-sectional data. Journal of Consulting and Clinical Psychology, 70, 926-941.
Kulka, R. A., Schlenger, W. E., Fairbank, J. A., Hough, R. L., Jordan, B. K., Marmar, C. R., & Weiss, D. S. (1990). Trauma and the Vietnam war generation:Report of finding from the national Vietnam veterans readjustment study. New York: Brunner/Mazel.
Lee, E. J., & Park, S. H. (2015). The effects of rumination and thought suppression on depression: The moderating effect of neuroticism. Cognitive Behavior Therapy in Korea, 15, 501-517.
Lee, Y. J. (2014). Fatigue symptoms and their association with job stress and psychosocial factors in Korea air force pilots. Korean Journal of Aerospace and Environmental Medicine, 24, 51-63.
Lenné, M. G., Ashby, K., & Fitzharris, M. (2008). Analysis of general aviation crashes in Australia using the human factors analysis and classification system. International Journal of Aviation Psychology, 18, 340-352.
Luxenberg, T., Spinazzola, J., & van der Kolk, B. (2001). Complex trauma and disorders of extreme stress (DESNOS) diagnosis, part one: Assessment. Directions in Psychiatry, 21, 373-415.
Marshall, G. N., Schell, T. L., Glynn, S. M., & Shetty, V. (2006). The role of hyperarousal in the manifestation of posttraumatic psychological distress following injury. Journal of Abnormal Psychology, 115, 624-628.
Martin, M. M., & Rubin, R. B. (1995). A new measure of cognitive flexibility. Psychological Reports, 76, 623-626.
Masys, A. J. (2005). A systemic perspective of situation awareness: An analysis of the 2002 mid-air collision over Überlingen, Germany. Disaster Prevention and Management, 14, 548-557.
Monson, C. M., Schnurr, P. P., Resick, P. A., Friedman, M. J., Young-Xu, Y., & Stevens, S. P. (2006). Cognitive processing therapy for veterans with military-related posttraumatic stress disorder. Journal of Consulting and Clinical Psychology, 74, 898-907.
Nam, B. R., Kwon, H. I., & Kwon, J. H. (2010). Psychometric qualities of the Korean version of the posttraumatic diagnosis scale(PDS-K). Korea Journal of Clinical Psychology, 29, 147-167.
Oum, S. J., Choi, J. H., Kim, T. Y., Chung, H. G., Chung, M. Y., & So, H. S.(2011). The relationship between posttraumatic stress disorder and the quality of life among the Vietnam war veterans. Korean Journal of Psychosomatic Medicine, 19, 83-91.
Ozer, E. J., Best, S. R., Lipsey, T. L., & Weiss, D. S. (2003). Predictors of posttraumatic stress disorder and symptoms in adults: A meta-analysis. Psychological Bulletin, 129, 52-73.
Park, M. K. (2013). A study on mental health support program for ROK air force pilots. (Unpublished master’s thesis). Seoul National University, Seoul, Korea.
Rizvi, S. L., Vogt, D. S., & Resick, P. A. (2009). Cognitive and affective predictors of treatment outcome in cognitive processing therapy and prolonged exposure for posttraumatic stress disorder. Behaviour Research and Therapy, 47, 737-743.
Seol, J. H., & Park, S. H. (2015). The effect of stress and cognitive emotion regulation strategies on psychological health problems in Korean navy personnel: The moderated mediating effect of perceived social support. Korean Journal of Clinical Psychology, 34, 553-578.
Smith, D. W., & Frueh, B. C. (1996). Compensation seeking, comorbidity, and exaggeration of PTSD symptoms among Vietnam combat veterans. Psychological Assessment, 8, 3-6.
Sobel, A. A., Resick, P. A., & Rabalais, A. E. (2009). The effect of cognitive processing therapy on cognitions: Impact statement coding. Journal of Traumatic Stress, 22, 205-211.
Song, D. K. (2006). The systematic management for pilots to prevent accidents by human errors. (Unpublished master’s thesis). Gyeongsang National University, Jinju, Korea.
Susskind, O., Ruzek, J. I., & Friedman, M. J. (2012). The VA/DOD clinical practice guideline for management of post-traumatic stress (update 2010):Development and methodology. Journal of Rehabilitation Research and Development, 49, 17-27.
Tanielian, T. (2009). Assessing combat exposure and post-traumatic stress disorder in troops and estimating the costs to society: Implications from the RAND invisible wounds of war study (No. RAND-CT-321). RAND CORP SANTA MONICA CA.
Taylor, S., Fedoroff, I. C., Koch, W. J., Thordarson, D. S., Fecteau, G., & Nicki, R. M. (2001). Posttraumatic stress disorder arising after road traffic collisions: Patterns of response to cognitive-behavior therapy. Journal of Consulting and Clinical Psychology, 69, 541-551.
Thurston, B. J., & Runco, M. A. (1999). Flexibility. In M. A. Runco, & S. R. Pritzker, (Eds.), Encyclopedia of creativity (pp. 729-732), San Diego, CA:Academic Press.
Urcuyo, K. R., Boyers, A. E., Carver, C. S., & Antoni, M. H. (2005). Finding benefit in breast cancer: Relations with personality, coping, and concurrent well-being. Psychology & Health, 20, 175-192.
Wickens, C. D. (2002). Situation awareness and workload in aviation. Current Directions in Psychological Science, 11, 128-133.
Wickens, C. D. (2008). Situation awareness: Review of Mica Endsley's 1995articles on situation awareness theory and measurement. Human Factors:The Journal of the Human Factors and Ergonomics Society, 50, 397-403.
Wiegmann, D. A., & Shappell, S. A. (2003). A human error approach to aviation accident analysis. Burlington, VT: Ashgate.
Woo, C. H. (2012). A study on posttraumatic stress disorder of the overseasdispatched soldiers. Korean Terrorism Studies Review, 5, 72-103.
Xue, C., Ge, Y., Tang, B., Liu, Y., Kang, P., Wang, M., & Zhang, L. (2015). A meta-analysis of risk factors for combat-related PTSD among military personnel and veterans. Plos One, 10, e0120270.