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Scuba diving PTSD: how common is it, why does it matter and what may be done? – Fit To Dive
How common is scuba diving PTSD?2
Experiencing some lingering distress, mental or emotional issues after a traumatic experience is relatively common. Mostly, the person heals and the problem resolves naturally. However, for a proportion of people this reaction may develop into psychological stress injury or post-traumatic stress (disorder, i.e. PTSD). Divers do occasionally face challenging incidents or circumstances, such as decompression illness, barotrauma, entrapment/entanglement, lost gas events and rapid ascents. So it is reasonable to anticipate that some divers would be affected by psychological trauma issues.
This is likely partly due to the fact that these reports relate to the incident, any rescue and acute medical treatment. Data from longer-term follow up is harder to access. With psychological conditions, the impact of a traumatic event is not always apparent immediately. Also, during an incident and subsequent medical treatment, distress may be a normal response to what has happened. Diagnosis of PTSD would be much later, and so this data is not available for those reports.3
There is one study that specifically examined the psychological impact of accidents on recreational scuba divers. The research was carried out at the hyperbaric chamber in Orkney, which covers diving-related injuries in one of the world’s best known wreck diving locations: Scapa Flow. The study followed up all divers attending the chamber for diving-related conditions across two years. (Issues included: DCI, barotrauma, non-fatal drowning, marine stings, missed deco stops due to buoyancy or lack of gas supply). It measured reported symptoms of psychological trauma in: (a)victims of scuba diving accidents, (b) their buddies, and (c) another member of group who was not (or at least less) involved in the incident. All were measured at 3 months, 6 months and 12 months after the diving medical contact.
A few optional notes on quality of evidence
Before looking at the results of a study, it’s important to check the quality of the design and methods. This one has some good points. First of all, it’s prospective, that means it took a sample of people and followed them to see if there was an issue. (This is different from studying a group of people who are already reporting symptoms, for example). It could be said that to be truly prospective, it would start prior to the incident occurring at all. However, the authors considered this and included assessments of general mental health and a control group. In addition, they considered the statistical power of the study in advance and made sure to get enough participants to be confident that any difference in symptoms was not due to chance. The study also used a reliable and validated measure, one which is also clinically useful.
The study found that quite a substantial portion of the divers reported symptoms of psychological trauma, 3 months, 6 months and (in some cases) 12 months after the event. The victims reported significantly more symptoms than their buddy or the control. Divers were reporting symptoms of trauma on all three domains: avoidance, re-experiencing and arousal. So, we have an estimate that 25 to 50 % of divers are experiencing scuba diving PTSD symptoms after accidents. It is important to be clear that this does not mean that many divers get diagnosable PTSD. Instead, it is the number of the divers who reported some symptoms psychological trauma.
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Scuba diving PTSD
