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A Canadian Air Transat plane with its emergency slides deployed, sits on the tarmac of Lages airport in the Azores Terceira island, after an emergency landing, Friday, Aug, 24, 2001, in the north Atlantic Portuguese archipelago. (HUMBERTA AUGUSTO/AP)
A Canadian Air Transat plane with its emergency slides deployed, sits on the tarmac of Lages airport in the Azores Terceira island, after an emergency landing, Friday, Aug, 24, 2001, in the north Atlantic Portuguese archipelago. (HUMBERTA AUGUSTO/AP)

Air Transat near-disaster aids understanding of PTSD Add to ...

Thirteen years ago next week marks what could have been a grim anniversary: Air Transat Flight 236, bound for Lisbon from Toronto, crash-landed on an island in the Azores off Portugal after running out of fuel over the Atlantic. While all 306 passengers and crew survived the dead-stick landing, those on board had spent a harrowing 30 minutes as the crippled plane glided over the ocean, not knowing whether they would live or die.

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Their hair’s-breadth escape on Aug. 24, 2001, not only turned potential tragedy into celebration, it also provided researchers with a unique opportunity to study the effects of trauma and the role that memory plays in dealing with such an ordeal.

In a study published online Wednesday in the journal Clinical Psychological Science, researchers had 15 passengers who’d been on the flight relay their memories of the event, as well as those related to the Sept. 11 attacks in the U.S. that occurred soon after.

Something else about the study was also likely unprecedented: Margaret McKinnon, one of the researchers, was a passenger on that flight, travelling with her husband to Lisbon for a honeymoon.

McKinnon, now a psychologist in the mood disorders program at St. Joseph’s Hospital in Hamilton, said she remembers the flight crew’s announcement that the plane was going to have to ditch in the ocean and that passengers should don life jackets. Shortly after, the oxygen masks above the seats dropped down as the cabin began depressurizing.

“There were countdowns until that would happen,” she said of the excruciating half-hour as occupants inside the darkened plane waited for their expected crash into the water. Then somebody – she isn’t sure if it was a passenger or crew member – yelled that land had been sighted, “and they sounded quite surprised.”

Pilot Captain Robert Piché was able to glide the plane into a hard landing on an island airstrip. “The passengers all cheered,” she said, then everyone evacuated the aircraft using emergency chutes and ran as the plane’s blown-out wheels caught fire. “I think for me during those 30 minutes, I sort of imagined that this was likely to be the end. I know not everyone felt that way, but I did,” said McKinnon, then a 26-year-old graduate student at the University of Toronto. “So it sort of gave you time to prepare for that.”

The 15 passengers who took part in the study each had their own set of memories from the event, said senior study author Brian Levine, a senior scientist at Baycrest Health Science’s Rotman Research Institute in Toronto.

Tapping into their recall of events as they unfolded moment to moment, the researchers were able to probe both the quality and accuracy of passengers’ memories along with those of two other events – Sept. 11, 2001, and a neutral event from the same time period – and relate their findings to the presence or absence of post-traumatic stress disorder, or PTSD.

Compared with the Sept. 11, 2001, attacks and the neutral event, the amount of information recalled around Flight TS236 “was very rich,” Levine said.

“For example, when we asked these same people to recall 9/11, they produced between 100 and 150 details; when they recalled the Air Transat event, they produced anywhere from 250 to 350.”

Researchers were not surprised by this finding because emotionally charged events typically produce greater recall. What was not expected was a finding that passengers who subsequently developed PTSD and those who didn’t showed no difference in the amount of detail they remembered or its accuracy.

“We thought people with PTSD might have more vivid recall because they have more intrusions, they’re thinking about it more, ruminating about it more,” he said. “But that was not the case.” However, those affected by PTSD relayed more “external” details – comments that were not specific to the event, but might involve thoughts or perceptions, such as, “Wow, I never thought we were going to make it,” or, “I’ve never flown Air Transat again.”

This pattern was observed across all events tested, suggesting it is not just memories of the trauma itself that are related to PTSD, but rather how a person processes memory for events in general.

“What our findings show is that it is not what happened but to whom it happened that may determine subsequent onset of PTSD,” said Levine, adding that an inability to shut out external details is related to mental control over memory recall.

“The big question here is why – when you’ve got this plane full of people, at least in our sample – half got PTSD and half didn’t?

“To me, that’s the most important finding of the study,” he said, noting the findings add to a growing body of evidence suggesting altered memory processing may be a vulnerability factor for PTSD.

Dr. Ruth Lanius, a professor of psychiatry at Western University in London, Ont., who specializes in PTSD, said the study shows that memories of a traumatic nature are more vivid than other memories, consistent with other research findings.

“A lot of people who have had traumatic memories experience them in the form of flashbacks, they’re experienced in a timeless form,” said Lanius, who was not involved in the study.

Lanius said in order to help a person heal from a traumatic event, the nature of their memories needs to be changed. “We don’t want people to be haunted by the memories; we want people to experience them as normal memory of the past that you recall but not relive.”

McKinnon, who was not one of the study subjects, said she developed post-traumatic symptoms as a result of her experiences aboard the Air Transat flight.

“I had nightmares. I was very vigilant, I startled easily – you know, typical symptoms of PTSD,” said McKinnon, who was able to address them through treatment, a step she advises others to pursue. The research project may also have helped her, as well as some of her fellow passengers. “The study was a unique opportunity to turn this into something positive.”

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