{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,11]],"date-time":"2026-03-11T18:02:42Z","timestamp":1773252162653,"version":"3.50.1"},"reference-count":19,"publisher":"Oxford University Press (OUP)","issue":"3-4","license":[{"start":{"date-parts":[[2025,6,6]],"date-time":"2025-06-06T00:00:00Z","timestamp":1749168000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,3,1]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Submarines are challenging environments, where accidents, with fatalities, continue to occur. Nonetheless, available studies suggest low rates of post-traumatic stress disorder (PTSD) following submarine-specific accidents. In September 2023, 7 sailors were washed overboard from a South African submarine, resulting in 3 fatalities. The surviving crew received immediate defusing and ongoing counselling. This study investigated the psychological impact of the accident, assessing post-trauma stress responses at 2 time points.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and Methods<\/jats:title>\n                    <jats:p>Mental health screenings at 7 weeks and 7 months post-accident involved 75 submariners (32 exposed and 43 non-exposed). Measures included sociodemographic information and mental health history, and psychological scales of adjustment, mood, and PTSDs. Data were examined using Chi-square, t-tests, and regression analyses.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>At 7 weeks, 31% of the exposed group met criteria for adjustment disorder, and 19% for major depressive and PTSDs. Previous trauma exposure and family\u2013work interface concerns were significant risk factors. By 7 months, most severe responses had resolved, except for 5 cases associated with pre-accident multiple recent losses or other psychosocial stressors.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Severe post-trauma stress responses declined significantly within 7 months. Early screening was useful to identify submariners requiring additional support and the later screening suggested that readiness assessments should extend beyond 6 months post-accident. The study highlighted the importance of early psychological support, and the protective roles of resilience and pre-accident mental health, in reducing poor outcomes in the event of accidents at sea.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/milmed\/usaf203","type":"journal-article","created":{"date-parts":[[2025,5,3]],"date-time":"2025-05-03T08:07:29Z","timestamp":1746259649000},"page":"e464-e469","source":"Crossref","is-referenced-by-count":0,"title":["Trajectories of Post-trauma Stress Responses After a Submarine Accident"],"prefix":"10.1093","volume":"191","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4793-417X","authenticated-orcid":false,"given":"Charles H","family":"Van Wijk","sequence":"first","affiliation":[{"name":"Department of Industrial Psychology (Mil), Faculty of Military Sciences, Stellenbosch University , Saldanha, Western Cape 7395,","place":["South Africa"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2025,6,6]]},"reference":[{"issue":"6","key":"2026031018422835000_R1","doi-asserted-by":"publisher","first-page":"643","DOI":"10.3357\/asem.2953.2011","article-title":"Post-traumatic stress disorder after a submarine accident","volume":"82","author":"Baert","year":"2011","journal-title":"Aviat Space Environ Med"},{"issue":"1","key":"2026031018422835000_R2","doi-asserted-by":"publisher","first-page":"44","DOI":"10.7205\/milmed.170.1.44","article-title":"Psychiatric symptoms and cognitive appraisal following the near sinking of a research submarine","volume":"170","author":"Berg","year":"2005","journal-title":"Mil Med"},{"issue":"5","key":"2026031018422835000_R3","doi-asserted-by":"publisher","first-page":"427","DOI":"10.1093\/miled.167.5.427","article-title":"Acute stress reactions after submarine accidents","volume":"167","author":"Eid","year":"2002","journal-title":"Mil Med"},{"issue":"8","key":"2026031018422835000_R4","doi-asserted-by":"publisher","first-page":"734","DOI":"10.7205\/milmed.173.8.734","article-title":"Mass casualty in an isolated environment: medical response to a submarine collision","volume":"173","author":"Jankosky","year":"2008","journal-title":"Mil Med"},{"key":"2026031018422835000_R5","article-title":"Trauma in Southern Africa: Understanding Emotional Trauma and Aiding Recovery","volume-title":"Traumatology Services International","author":"Schulz","year":"2000"},{"issue":"3","key":"2026031018422835000_R6","doi-asserted-by":"publisher","first-page":"265","DOI":"10.1111\/acps.131266","article-title":"Measuring ICD-11 adjustment disorder: the development and initial validation of the International Adjustment Disorder Questionnaire","volume":"141","author":"Shevlin","year":"2020","journal-title":"Acta Psychiatr Scand"},{"issue":"541","key":"2026031018422835000_R7","first-page":"650","article-title":"Diagnosing depression in primary care using self-completed instruments: UK validation of PHQ-9 and CORE-OM","volume":"57","author":"Gilbody","year":"2007","journal-title":"Br J Gen Pract"},{"issue":"2","key":"2026031018422835000_R8","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2020.36733","article-title":"Diagnostic accuracy and acceptability of the primary care posttraumatic stress disorder screen for the Diagnostic and Statistical Manual of Mental Disorders (fifth edition) among US veterans","volume":"4","author":"Bovin","year":"2021","journal-title":"JAMA Netw Open"},{"key":"2026031018422835000_R9","doi-asserted-by":"crossref","DOI":"10.1176\/appi.books.9780890425596","volume-title":"Diagnostic and Statistical Manual of Mental Disorders","author":"American Psychiatric Association","year":"2013","edition":"5th ed"},{"key":"2026031018422835000_R10","first-page":"32","volume-title":"Solutions in Sport Psychology","author":"Clough","year":"2002"},{"issue":"1","key":"2026031018422835000_R11","doi-asserted-by":"publisher","first-page":"1","DOI":"10.5787\/50-1-1256","article-title":"Psychological profiles of resilience in extreme environments: correlating measures of personality and coping and resilience","volume":"50","author":"Van Wijk","year":"2022","journal-title":"Sci Mil South Africa J Mil Stud"},{"issue":"2","key":"2026031018422835000_R12","doi-asserted-by":"publisher","first-page":"164","DOI":"10.1002\/smi.2447","article-title":"Are adolescents with high mental toughness levels more resilient against stress?","volume":"29","author":"Gerber","year":"2013","journal-title":"Stress Health"},{"key":"2026031018422835000_R13","doi-asserted-by":"publisher","first-page":"71","DOI":"10.1027\/1614-0001\/a000224","article-title":"Do individual differences in emotion regulation mediate the relationship between mental toughness and symptoms of depression?","volume":"38(2)","author":"Mutz","year":"2017","journal-title":"J Individ Differ"},{"issue":"6","key":"2026031018422835000_R14","doi-asserted-by":"publisher","first-page":"1019","DOI":"10.1002\/jts.20271","article-title":"Psychometric analysis and refinement of the Connor-Davidson Resilience Scale (CD-RISC): validation of a 10-item measure of resilience","volume":"20","author":"Campbell-Sills","year":"2007","journal-title":"J Trauma Stress"},{"issue":"5","key":"2026031018422835000_R15","doi-asserted-by":"publisher","first-page":"353","DOI":"10.1002\/smi.2627","article-title":"Psychological resilience of workers in high-risk occupations","volume":"30","author":"De Terte","year":"2014","journal-title":"Stress Health"},{"key":"2026031018422835000_R16","doi-asserted-by":"publisher","DOI":"10.3389\/fpsyt.2022.780498","article-title":"Resilience and post-traumatic stress disorder in the Swiss Alpine Rescue Association","volume":"13","author":"Mikutta","year":"2022","journal-title":"Front Psychiatry"},{"key":"2026031018422835000_R17","doi-asserted-by":"publisher","first-page":"169","DOI":"10.1146\/annurev-publhealth-032013-182435","article-title":"Mental health consequences of disasters","volume":"35","author":"Goldmann","year":"2014","journal-title":"Annu Rev Public Health"},{"issue":"12","key":"2026031018422835000_R18","doi-asserted-by":"publisher","first-page":"2190","DOI":"10.1016\/j.socscimed.2009.03.043","article-title":"Looking for resilience: understanding the longitudinal trajectories of responses to stress","volume":"68","author":"Norris","year":"2009","journal-title":"Soc Sci Med"},{"key":"2026031018422835000_R19","doi-asserted-by":"publisher","DOI":"10.2174\/0117450179301661240528064329","article-title":"Prevalence estimate for adjustment disorders in the South African Navy","volume":"20","author":"Van Wijk","year":"2024","journal-title":"Clin Pract Epidemiol Ment Health"}],"container-title":["Military Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/milmed\/article-pdf\/191\/3-4\/e464\/63446251\/usaf203.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/milmed\/article-pdf\/191\/3-4\/e464\/63446251\/usaf203.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,3,10]],"date-time":"2026-03-10T22:42:34Z","timestamp":1773182554000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/milmed\/article\/191\/3-4\/e464\/8157865"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,6,6]]},"references-count":19,"journal-issue":{"issue":"3-4","published-online":{"date-parts":[[2025,6,6]]},"published-print":{"date-parts":[[2026,3,1]]}},"URL":"https:\/\/doi.org\/10.1093\/milmed\/usaf203","relation":{},"ISSN":["0026-4075","1930-613X"],"issn-type":[{"value":"0026-4075","type":"print"},{"value":"1930-613X","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2026,3]]},"published":{"date-parts":[[2025,6,6]]}}}