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Objective: The present study evaluated the extent to which sleep assessed soon after a trauma predicted subsequent physical health and immune functioning in rescue workers., Methods: Participants included 159 men and women who performed rescue and clean-up operations at the site of a major airplane crash. One hundred twenty-eight participants were retained for a 1-year follow-up. Self-report measures of sleep quality and psychological distress were obtained within 2 months of the crash, and a physical health questionnaire was completed at 1-year follow-up. Natural killer cell number and cytotoxicity were assessed using blood samples collected from a subset of participants (n=51) at 1-year follow-up., Results: After adjustment for sex, age, body mass index, and initial distress, initial sleep quality complaints were associated with more physical symptoms (β=.32; p<.001), poorer perceived health (β=-.27; p=.009), and increased healthcare utilization (β=.31; p=.003) on follow-up. In contrast, initial sleep quality was not associated with natural killer cell number (r=0.10; p=.55) or activity (r=0.02; p=.90). Change in sleep quality during the year after the crash was not a significant predictor of health or immune outcomes., Conclusions: These data suggest that poor sleep quality in the aftermath of trauma signals an increased risk for future adverse physical health outcomes and underscore the importance of addressing sleep complaints soon after trauma to mitigate negative impact on physical health.

This study examined media exposure and adjustment to anthrax bioterrorism attacks and the terrorist attacks on 9/11 in a sample of 300 people who lived distant from the attacks. Measures of direct and indirect exposure to terrorism, perceived risk of anthrax exposure, psychological distress, and outlook were assessed at 2 to 3 months and at 8 months after the first reported anthrax attack. Initial anthrax media exposure was a powerful predictor of distress, whereas subsequent anthrax media exposure only predicted negative changes in outlook over time. Perceived risk of anthrax exposure predicted distress and outlook but did not appear to mediate the effects of media exposure. Determining the nature and consequences of media exposure to threatening and frightening events like terrorism will help predict and manage response to future bioterrorism.

To assess possible diurnal variations in natural killer reactivity to acute laboratory stressors, this study investigated changes in natural killer cell activity (NKCA) during and after three stressors (mental arithmetic, speech, and the Stroop) at 3 times of the day (08:00, 12:00, and 16:00) in 30 healthy men. NKCA activity increased during mental arithmetic and speech tasks at all 3 times of the day. Change in NKCA was greatest in the afternoon. Differences in the magnitude of mood changes were also observed at the 3 times of day, parallel to immune reactivity. These findings suggest that the dynamics of stress-related NKCA are more complex than previously believed and that time of day may affect the way they are generated or interpreted.

Objective: The present study examined the effects of working at the crash site of USAir Flight 427 on psychological, cardiovascular, and immunological sequelae of stress within 2 months of the recovery work and again 6 months after the crash., Method: A total of 159 workers at the crash site and 41 controls were examined within 2 months of the crash and again 6 months after the crash. Subjects were initially grouped according to whether they had contact with human remains. For a finer-grained analysis of exposure to bodies, subjects were also grouped by degree of exposure, determined by the area in which the workers were stationed. Dependent measures included intrusive thoughts, coping styles, and symptom reporting, as well as heart rate and blood pressure, and NK cell number and activity., Results: Workers exposed to body parts at the actual crash site, and those who were exposed to remains without expecting to be, exhibited more symptoms of stress than workers who saw bodies and body parts at the morgue and those who did not see human remains. Non-morgue workers who were exposed to bodies or body parts had the highest levels of intrusive thoughts at both time points, and the highest NK cell activity at Time 1. NK activity in this group decreased to levels comparable with other groups at Time 2., Conclusions: Increased NK activity is unusual in chronic stress situations, and may be because of acute stress experienced as a result of being asked to talk and think about the crash. The finding that the more one was exposed to human remains the less distress he or she reported is discussed in terms of adaptation, expectancy, and control.