The experiences of dealing with consequences of an avalanche – surviving soldiers’ perspectives

Figures & data

Table I. Subjective clinical variables of soldiers exposed to the avalanche at Vassdalen in 1986–30 years post-disaster.

	Exposed (N = 12)
Age
Mean age—30 years post-disaster	52.4
Mean age at time of avalanche	20.5
	n/N
Compared to the alcohol consumption pre-disaster, how is your alcohol consumption after the disaster?:
Six months post-disaster:* Lower than before Same as before Higher than before Much higher than before Six to twelve months post-disaster: Lower than before Same as before Higher than before Much higher than before Today—30 years post-disaster:* Lower than before Same as before Higher than before Much higher than before	1/12 6/12 3/12 1/12 0/12 6/12 3/12 3/12 5/12 6/12 0/12 0/12

* Missing value = one out of twelve

Table II. Broad open-ended interview guide.

Please describe how you have coped/managed to live with the avalanche disaster in daily life afterward?  ∘ Follow-up questions during the interview might be e.g., that interviewer asked the survivors to talk about/deepen/describe in more detail the challenges that came up in the interview: i.e.,

▪ Can you tell me more about how often you drank alcohol aftermath?

▪ Could you describe more the sleep problems you talked about?

▪ What do you think about other conditions at work or in your private life that were stressful during the period post-disaster?

▪ How did you cope with that in your daily life?

▪ Do you have the same resources or coping strategies available today, that you think are important today, 30 years’ post-disaster?

Table III. Examples of development from units of meaning to categories.

Units of meaning	Code	Category
“I felt I acted quite appropriately then. I was also a bit proud of the way I had responded to the avalanche.”	Proud of how I responded to the avalanche	Consequences of processing the disaster: A comfortable life
“I have a pragmatic approach to the psyche anyway. I do not dig into things.”	Pragmatic approach	Consequences of processing the disaster: A comfortable life
“The accident has helped me to reflect more on what’s good and what’s bad.”	Self-reflection	Consequences of processing the disaster: A comfortable life
“I needed help to sort things out, because it was bad for my night-time sleep and my concentration at work. I contacted a health professional and made a few appointments with him, and that sorted it out.”	Good help to being able to speak about the disaster	A challenging, yet accomplished life
“I enjoy physical activity. Is that a flight and a distraction, or is it a pleasure? I’m not entirely sure, but as long as it gives me something, I do not need to have the answer to that.”	Could physical activity be a flight or distraction?	A challenging, yet accomplished life
“In the period after the avalanche I was not very keen on skiing in the winter, but I did go again a few years later.”	Not keen on skiing, but did it anyway	A challenging, yet accomplished life
“I do not like the mountains anymore. I prefer them at a distance.”	Mountains on a distance	A demanding life
“During the first year aftermath there was a lot of drinking […] I think it was to forget everything”	Drinking to forget	A demanding life
“I said nothing, or very little about it.”	Not talking about the disaster	A demanding life

Table

Patterns and Trajectories	Definition of patterns
Resistance (Norris et al., 2009)	Is defined as experiencing no symptoms of mental illness or only mild symptoms post-disaster.
Resilience (Norris et al., 2009, Bonanno, 2004)	Pattern where symptoms are transiting and do not cause reduced psychosocial functioning following exposure to a TE.
Recovery (Norris et al., 2009, Bonanno, 2004)	Pattern where symptoms are prominent following exposure to a TE, and shows gradual improvement with time.
Chronic (Norris et al., 2009, Bonanno, 2004)	Pattern where symptoms tend to persist across time. This course is only found in relative small proportion of survivors of a TE.
Delayed (Bonanno, 2004)	Pattern where the symptoms are not very severe or prominent during the first 6 months following exposure to a TE, but tend to increase later (late-onset).
U-Shaped (Macleod, 1994, Port et al., 2001)	Pattern where there is high levels of negative mental health symptoms immediately after trauma, then declining during the years of work life but possibly returning as the survivors cope with age-related issues and transition into retirement.

Table

Coping strategies (1–5)	Definition
1. Problem solving	This domain includes categories of Cognitive Decision Making (i.e., Strategizing and Planning), logical analysis of a problem, instrumental action towards a problem, persistence, effort and determination.
2. Seeking social support	This domain includes a wide array of targets of support such as family, friends, peers, professionals, religious figures and/or others to solicit help, contact, advice, comfort, and/or instrumental help such as money or goods.
3. Avoidance	This domain includes efforts to stay away and/or disengage from stressful transaction/situation (mentally and/or physically). Includes denial, avoidant actions, cognitive avoidance, and engaging in wishful thinking.
4. Distraction	This domain refers to different active attempts to deal with a stressful situation. Distraction includes a broad variety of alternative activities where the persons engage in pleasurable activities, such as reading, hobbies, watching television, exercising, seeing friends, working, and substance abuse.
5. Positive cognitive restructuring	This domain refers to active attempts to change one’s view of a stressful situation in order to see it in a more positive light. Here the individuals focus on the positive rather than the negative by positive thinking, optimism, and minimization of negative consequences or distress.

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