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Post-traumatic symptoms among younger and elderly evacuees in the early stages following the 1995 Hanshin-Awaji earthquake in Japan
Abstract
We assessed the frequency of short-term, post-traumatic symptoms among evacuees of the Hanshin-Awaji earthquake. A total of 67 younger subjects (under 60 years) and 75 elderly subjects (60 years or above) were interviewed during the third week after the earthquake, and 50 and 73 subjects, respectively, were interviewed during the eighth week. All subjects were assessed using the Post-Traumatic Symptom Scale. During the first assessment, subjects from both age groups experienced sleep disturbances, depression, hypersensitivity and irritability. During the second assessment, the percentage of younger subjects experiencing symptoms did not decrease, while elderly subjects showed a significant decrease in 8 of 10 symptoms. This may have been due to such factors as decreased psychological stress, extensive social networks, and previous disaster experiences in the case of the elderly subjects.
... One to two months after the seismic disaster, various mental health surveys revealed that approximately 60% of the local residents experienced some form of insomnia. [1][2][3][4] In normal circumstances, 20-30% of adults experience insomnia symptoms such as difficulty initiating sleep (DIS), nocturnal awakening, early arousal, or deteriorated sleep quality. 5 However, during large-scale disasters, the frequency of these symptoms increases sharply two-or three-fold, at least temporarily. ...
... 5,[8][9][10][11][12] Chronic sleep disorders reduce the quality of life 13 and cause personal and socioeconomic losses such as increases in long-term absence from work, reductions in work efficiency, loss of productivity, greater frequency of industrial accidents, and higher medical expenses. [1][2][3][4][14][15][16][17] Insomnia also often coexists with mental illnesses such as mood and anxiety disorders. [18][19][20] Further, chronic insomnia is a prodrome of the depression phase 21 and a risk factor for the onset and recurrence of depression. ...
... 2 In addition, Kato et al reported that depressive symptoms were frequently observed in the younger age group immediately after the Hanshin-Awaji earthquake in Japan. 3 Although the reason for this high prevalence of postdisaster insomnia among the younger age group is not clear, we speculate that the psychological distress of rebuilding their lives and their families, besides finding new employment, may have been greater for the younger age group than for the older age group, who are retired and financially stable with pensions. As for the effect of employment status on insomnia, we speculate that this effect was reflected in the skewed age distribution, as the unemployed included more persons from the older age group and the employed included more from the younger age group. ...
Purpose:
Large-scale natural disasters have an enormous physical and mental impact, immediately after they occur, on people living near the central disaster areas. It is known that, in the early stages, a seismic disaster triggers high rates of symptoms for insomnia, depression, and anxiety. However, little information is available about their medium- to long-term clinical outcomes. In this study, we conducted a repeated cross-sectional nationwide questionnaire survey to clarify changes in the prevalence of insomnia and its background factors after the Great East Japan Earthquake, a huge earthquake with a moment magnitude of 9.0 that occurred on March 11, 2011.
Methods:
We conducted a repeated cross-sectional survey in November 2009 (pre-earthquake, 1224 participants), July 2011 (4 months post-earthquake, 1259 participants), and August 2012 (18 months post-earthquake, 1289 participants) using stratified random sampling from 157 Japanese sites.
Results:
Compared to 2009, the prevalence of insomnia statistically increased nationwide immediately post-disaster (11.7% vs 21.2%; p < 0.001) but significantly decreased in 2012 compared to immediately after the earthquake (10.6% vs 21.2%; p < 0.001). In 2011, insomnia was most frequent in the central disaster area. Multivariable logistic regression models demonstrated the association between the following factors and increased risk of insomnia: being a woman (odds ratio [OR] 1.48, 95% confidence interval [CI]: 1.00-2.19), being employed in 2009 (OR 1.74, 95% CI: 1.15-2.62), and being of younger age group (20-64 years) in 2011 (OR 1.64, 95% CI: 1.12-2.42) and 2012 (OR 2.50 95% CI: 1.47-4.23). Post-earthquake, the prevalence of insomnia symptoms in men increased, while the gender difference decreased and was no longer statistically significant. Additionally, insomnia was associated with psychological distress (scores ≥5 on the Kessler Psychological Distress Scale) in 2011 and 2012.
Conclusion:
This study demonstrated that the prevalence of insomnia was significantly higher after the earthquake. Moreover, individuals with insomnia were more likely to experience psychological distress after the earthquake that continued until 2012.
... Pooley et al. (2006)'s argument is reinforced by other researchers (e.g. Kato et al., 1996;Wisner et al., 2004). Blaikie et al. (1994) pointed out that people who have access to social support cope better than their counterparts. ...
... Blaikie et al. (1994) pointed out that people who have access to social support cope better than their counterparts. Similarly, Kato et al. (1996), conducted research on the Japanese evacuees of the 1995 Kobe Earthquake and found that elderly participants experienced less emotional distress, which made them more resilient than the younger ones. The researchers clarified that this stemmed from the fact that elderly participants, having lived in the community for a longer period of time, had the benefit of being able to speedily establish support-networks in the shelter (Kato et al., 1996). ...
... Similarly, Kato et al. (1996), conducted research on the Japanese evacuees of the 1995 Kobe Earthquake and found that elderly participants experienced less emotional distress, which made them more resilient than the younger ones. The researchers clarified that this stemmed from the fact that elderly participants, having lived in the community for a longer period of time, had the benefit of being able to speedily establish support-networks in the shelter (Kato et al., 1996). ...
Through political ecology and pragmatism, this thesis aims at capturing the complexity of flood hazard and the expansion of the range of choice. Empirical data suggest that although the locals view flooding as an unwelcome normal occurrence, changes in people’s lifestyles have altered how they perceive flooding. Elements such as political conflicts and climate change have, additionally, weakened local response mechanisms. In its attempts to deal with flooding, even after the 2011 Mega-Flood, the government has been inclined towards resorting to technological fixes and policies meant to generate wealth for offsetting losses. Social, political, historical, and cultural aspects have been ignored. Participants, however, incorporate these elements into their responses.
By engaging with the participants, it became apparent that to expand the range of choice and to strengthen resilience, it is important to encourage preparedness, promote traditional knowledge, highlight the role of religion, and enhance the role of local government.
... Some previous studies found contrary results, after the Sichuan 2008 earthquake elders were found to have a higher risk for PTSD [14]. Yet, other studies did neither nd any age differences after natural disasters [38,39] either, and some also found that elders had over time a signi cant decrease in symptoms compared to a younger group [40]. Their explanation that experiences with previous disasters might help the elder subjects to deal with the catastrophe might be one explanation for or ndings [40]. ...
... Yet, other studies did neither nd any age differences after natural disasters [38,39] either, and some also found that elders had over time a signi cant decrease in symptoms compared to a younger group [40]. Their explanation that experiences with previous disasters might help the elder subjects to deal with the catastrophe might be one explanation for or ndings [40]. ...
Background
The Turkish and Syrian earthquake on February 6th 2023 was the deadliest earthquakes in the last decade. It affected approximately 26 million people and left at least 50.000 dead. In this paper, we analyzed the psychological impact and the relationship between mental health factors, earthquake related experiences and stressors and resources related to the earthquake, four months after the event
Methods
We conducted an analytical cross-sectional study, applying a survey to 320 adults (1–93 years old) in Adiyaman, Turkey. PTSD-Symptoms, general psychiatric morbidity, suicidality and drug abuse, as well as post traumatic growth were assessed via the PC-PTSD, GHQ-12 together with questions focusing on the earthquake experience, related stressors and support received.
Results
We found a high prevalence of general mental health symptoms including those of PTSD. Fear of aftershocks and the loss of close family members were found to be risk factors for such symptoms. We didn’t find significant differences in the GHQ or the PTSD symptom scores when considering ethnicity, religion or income.
Conclusions
High levels of psychiatric stress and PTSD symptoms were found four months after the earthquake, as could be expected, and need to be addressed in all groups independent from religious, social or ethnic background. Results indicate a large psychiatric and material burden on the entire sample and indicated some priority needs.
... In response to continuous psychological impacts that lead to mental disorder, post-disaster management, particularly in mental health, should be accomplished appropriately. It is due to natural disasters impacts might persist less than a year [15,23,25,29], but it might be more than a year [9,13,17,23,24]. Chen et al. [13] find that the Chi-Chi earthquake victims remained indications of PTSD (20.9%) and psychiatric morbidity (39.8%) 2 years after the disaster. ...
... Individuals with young age belong to the prone-mental health group caused by exposure to disasters [19,23]. Emotional and psychological recovery for the younger group is more complicated than the older group due to different levels of social networks and previous disaster experiences [29]. Those who are married are classified as the stronger group in dealing with disasters than those who are not married. ...
This study aims to analyse the impact of the 2006 Yogyakarta earthquake on the mental health and welfare of victims in Bantul and to examine whether disasters they experienced before might increase or decrease their mental health when facing indirect exposure to repeated disasters. This study employs several methods: descriptive analysis; logit; a combination of propensity score matching; and difference in differences. The results find that 7 people (1.78%) in 2007 and 31 people (7.89%) in 2014 have experienced symptoms of depression. Age is confirmed as a significant factor in increasing this probability. The results of this study reveal that direct exposure to the 2006 Yogyakarta earthquake increased the average mental disorder score and decreased the victims’ education expenditure 1 year after the disaster. The direct exposure to the 2006 Yogyakarta earthquake also affected the increase in mental disorder score and decrease in household expenditure of victims 1 year after the disaster, although the effects were insignificant.
... Previous naturalistic studies have indicated that stressful events, in the form of natural disasters such as earthquakes or hurricanes, or events such as war, can disrupt sleep [13][14][15][16]. The ongoing COVID-19 pandemic may represent one such stressful life event. ...
... In further support of an online delivery model, recent studies have also demonstrated that sleep extension does not occur in the context of acute insomnia [30,31]; therefore, incorporating sleep restriction is not necessary. This intervention may also aid the prevention of sleep problems in individuals with good sleep, where the stress of a naturalistic event can still cause sleep disturbances [13][14][15][16]. Therefore, this study will examine if an online self-help leaflet is effective in reducing symptoms of acute insomnia in poor sleepers. ...
Background
Theoretical models of insomnia suggest that stressful life events, such as the COVID-19 pandemic, can cause acute insomnia (short-term disruptions to sleep). Early interventions may prevent short-term sleep problems from progressing to insomnia disorder. Although cognitive behavioural therapy for insomnia (CBT-I) is effective in treating insomnia disorder, this can be time and resource-intensive. Further, online interventions can be used to deliver treatment to a large number of individuals. The objective of this study is to investigate if an online behavioural intervention, in the form of a leaflet, which has been successfully used alongside CBT-I for acute insomnia, can reduce symptoms of acute insomnia in poor sleepers.
Methods
A total of 124 self-reported good and poor sleepers will be enrolled in an online stratified randomised controlled trial. After baseline assessments (T1), participants will complete a 1-week pre-intervention sleep monitoring period (T2) where they will complete daily sleep-diaries. Poor sleepers ( n = 62) will be randomly allocated to an invention or wait-list group, where they will receive the intervention (T3), or will do so after a 28-day delay. Good sleepers ( n = 62) will be randomly assigned to an intervention or no intervention group. All participants will complete a 1-week post intervention sleep monitoring period using daily sleep diaries (T4). Participants will be followed up at 1 week (T5), 1 month (T6) and 3 months (T7) post intervention. The primary outcome measure will be insomnia severity, measured using the Insomnia Severity Index. Secondary outcome measures will include subjective mood and subjective sleep continuity, measured using sleep diaries. Data will be analysed using an intention-to-treat approach.
Discussion
It is expected that this online intervention will reduce symptoms of acute insomnia in self-reported short-term poor sleepers, and will also prevent the transition to poor sleep in good sleepers. We expect that this will demonstrate the feasibility of online interventions for the treatment and prevention of acute insomnia. Specific advantages of online approaches include the low cost, ease of administration and increased availability of treatment, relative to face-to-face therapy.
Trial registration
ISRCTN43900695 (Prospectively registered 8th of April 2020).
... A previous report showed that older adults (aged >60 years) in Japan were better protected from distress following a disaster than did younger adults (Kato et al., 1996). Depression was also different between those groups (Kato et al., 1996). ...
... A previous report showed that older adults (aged >60 years) in Japan were better protected from distress following a disaster than did younger adults (Kato et al., 1996). Depression was also different between those groups (Kato et al., 1996). Therefore, in this study, the participants were divided into non-older and older age groups based on a cut-off of 60 years. ...
Depression associates closely with autonomic nervous system and physical activity, however, there have been no studies on the relationship between depression and the coordination of heart rate variability (HRV) and physical acceleration (PA). Ninety-five adult women were divided into non-older and older groups. The non-older group comprised 50 adulte women (below 60 years), and the older group comprised 45 women (above 60 years). HRV and PA data were simultaneously obtained every minute for 24 h during the free-moving day by using the ActiveTracer accelerometer. The ratios of low frequency/high frequency and high frequency were used as HRV indices, indicating sympathetic and parasympathetic nervous activities, respectively. Lag time was determined as the time difference indicated by the maximum absolute cross-correlation coefficients obtained from the analysis between the HRV components and the PA. We defined %Lag0 as the % frequency of the lag = 0 min between HRV and PA in 1 h. The General Health Questionnaire 28 (GHQ28) was used to evaluate the effects of psychological distress, including depression. In the hour before the night’s sleep, %Lag0 was significantly lower in older women with depression (GHQ28 subscale D) than in older women without depression (p <0.05). However, no significant difference between %Lag0 and depression status was observed in the hour after waking in older women. The results suggest that impairments in coordination between HRV and PA are associated with depression in older women, particularly in the hour before a night’s sleep on free-moving days.
... We present a few examples below. First, the emotional maturity hypothesis posits that older adults show less severe reactions to stressful life events and recover faster from these stressors (Kato et al. 1996;Ticehurst et al. 1996). Second, the socio-emotional selectivity theory suggests changes in emotion regulation with age which predict higher positive and lower negative affect, resulting in improved emotional well-being (e.g. ...
... This implies that old age per se may influence subjective well-being positively, and that decreases in evaluative well-being between age categories might be linked to objective challenges faced by older adults. These findings resonate with a range of theories from the psychology of aging, such as the emotional maturity hypothesis (Kato et al. 1996;Ticehurst et al. 1996), the socio-emotional selectivity (e.g. Carstensen 1995;Carstensen et al. 1999), or the selective optimization with compensation theory (Baltes and Baltes 1990). ...
This study assesses the relationship between age and two dimensions of subjective well-being—evaluative and emotional—among mature adults from five low-and middle-income countries. We use data from the World Health Organization’s Study on Global AGEing and Adult Health to contrast the associations of age with subjective well-being when controlling only for gender with the corresponding partial associations when including a richer set of covariates. Adjusting only for gender, we find negative associations of age with evaluative well-being, while the corresponding age gradients for emotional well-being are relatively flat. By contrast, adjusting for further socio-demographic factors results in positive associations of age with both evaluative and emotional well-being. Oaxaca-Blinder decompositions allow us to explore the roles of two factors to account for any unadjusted age differences in subjective well-being: age-group differences in individual characteristics and life circumstances, and age-specific associations of individual characteristics and life circumstances with subjective well-being. While adverse circumstances such as poor health and low income contribute to lower levels of evaluative well-being among older adults, age per se is—ceteris paribus—positively associated with subjective well-being. Even in poorer countries, older age does not need to be a time of low subjective well-being. Policies aimed at preserving income and limiting or compensating old-age disability appear to be key for maintaining subjective well-being among older adults.
... Sleep quality problems in individuals with PTSD is an area very well documented in literature, and several studies from natural disasters show that individuals with sleep quality problems are associated with PTSD [17][18][19][20][21][22][23]. However, there are few studies regarding sleep quality problems in individuals exposed to a specific natural disaster such as an avalanche [24]. ...
... to emphasize that the majority of previous short-term, and some long-term follow-up studies of natural disasters such as earthquakes, hurricanes and floodings report higher proportions of sleep quality problems in survivors [17][18][19][20][21][22][23]. ...
Study objectives: Sleep quality problems are a core feature of posttraumatic stress disorder (PTSD). The aims of this study were to describe and evaluate possible differences regarding sleep quality problems and hyperarousal symptoms between exposed and unexposed survivors after an avalanche. Further, we wanted to describe any association between avalanche exposure and survivors’ self-reported sleep quality problems and posttraumatic stress (disorder) symptoms with and without hyperarousal symptoms.
Method: The participants were soldiers who had survived an avalanche (n = 12) and a sample of unexposed soldiers (n = 9). Subjective sleep quality problems and posttraumatic stress (disorder) symptoms were assessed using well-validated measures: Pittsburgh Sleep Quality Index (PSQI), Posttraumatic Symptom Scale-10 (PTSS-10), and Impact of Event Scale-15 (IES-15). Hyperarousal symptoms were assessed using a 3-item hyperarousal-index from PTSS-10 (PTSS-10/Hyp index).
Results: No significant difference in sleep quality problems was revealed between the exposed and unexposed groups. There was a significant association between those with PTSS-10 ≥ 4 combined with hyperarousal symptoms and sleep quality problems (p = .046), 30 years after the avalanche. Likewise, no significant associations was revaled between those with sleep quality problems and IES-15 ≥ 26 with and without hyperarousal. Binary logistic regression showed that those with sleep quality problems (PSQI > 5) 30 years post-disaster, had 2.5 times greater odds (OR = 2.49, 95%CI [0.95–6.55], p = .064) of having hyperarousal symptoms during the whole follow-up period compared to those without sleep quality problems.
Conclusion: Our findings may indicate an association between sleep quality problems (PSQI > 5) and hyperarousal symptoms in soldiers with scores above cut-off point for posttraumatic stress (disorder) symptoms.
... A previously conducted study by Kato et al. (1996) investigated posttraumatic stress disorder (PTSD) in younger and older individuals after an earthquake in Japan. Their results revealed that older people manage stress more easily, compared to those who were younger. ...
... The older generation tends to exhibit more ability to think positively and handle depressive situations more appropriately. Previously conducted studies by Kato et al. (1996) also support the present findings. They investigated posttraumatic stress in younger and older people after a dire earthquake in Japan. ...
... A previously conducted study by Kato et al. (1996) investigated posttraumatic stress disorder (PTSD) in younger and older individuals after an earthquake in Japan. Their results revealed that older people manage stress more easily, compared to those who were younger. ...
... The older generation tends to exhibit more ability to think positively and handle depressive situations more appropriately. Previously conducted studies by Kato et al. (1996) also support the present findings. They investigated posttraumatic stress in younger and older people after a dire earthquake in Japan. ...
... Studies of the course of posttraumatic stress reactions among prisoners of war (POWs) indicate that PTSD is prevalent and persistent over many years. [4][5][6][16][17][18] Engdahl et al. [19] reported that 45-50 years after the trauma, 84% of POWs held by the Japanese met lifetime criteria for PTSD, with 59% meeting current criteria. A study following the psychological effects of Indian Ocean Tsunami (2004) found that 1-year later, children displayed symptoms of anxiety, withdrawal, fearfulness, acting out, and trauma. ...
Introduction: Natural disasters have the potential to affect psychological health. In June 2013, a multi-day cloudburst caused devastating floods and landslides in the North Indian state of Uttarakhand. Objective: This study aimed to assess the prevalence of posttraumatic stress disorder (PTSD) symptoms in the population of Uttarkashi, Tehri, and Pauri Garhwal 1-year after the cloudburst and flash flood-June 2013. Materials and Methods: PTSD checklist, civilian version (PCL-C) and Diagnostic and Statistical Manual of Mental Disorders Fourth Edition Text Revision (DSM-IV TR) were used as a screening tool. This cross-sectional study after 1-year of the disaster conducted in three districts of Uttarakhand between July and October 2014. Frequencies, percentage, and Chi-square methods were used to calculate the results. Results: Each case adopted for the study was similar on its basic profile. Participants included in the study fell in the symptoms severity range of 5-2 scores of PCL-C. On a match with both criteria-DSM-IV TR criterion and cutoff point of PCL-C Scoring prevalence of PTSD symptoms was found 70.93% in Tehri, Uttarkashi, and Pauri (n = 1651 with average age of 41 years). A higher prevalence has been noted in female population (Tehri 55.85%, Uttarkashi 55.66%, and Pauri 63.68%) in comparison to male population (Tehri 44.15%, Uttarkashi 44.34%, and Pauri 36.32%). Conclusion: (1) PTSD in disaster victims is as prevalent and persistent in Tehri, Uttarkashi, and Pauri districts of Uttrakhand state in India as elsewhere, (2) the risk of developing PTSD in subjects with lower initial exposure to disaster trauma should not be ignored, (3) remarkably fewer diagnoses of PTSD were made by using both DSM-IV-TR criteria and PCL-C, and (4) Female stress response for natural disaster trauma is comparatively higher than males.
... Stress can affect sleep (Altena et al., 2016;Lo Martire et al., 2020), and it is well established from a range of naturalistic studies that stressful events, including earthquakes, hurricanes and war, are shown to have a deleterious effect upon sleep (Askenasy & Lewin, 1996;Kato et al., 1996;Mellman et al., 1995). The COVID-19 pandemic, which has been ongoing since March 2020, represents one such stressful event, and potentially represents a stressor of unknown duration, accompanied by a wide range of societal and lifestyle changes (Altena et al., 2020). ...
Stress and sleep are very closely linked, and stressful life events can trigger acute insomnia. The ongoing COVID-19 pandemic is highly likely to represent one such stressful life event. Indeed, a wide range of cross-sectional studies demonstrate that the pandemic is associated with poor sleep and sleep disturbances. Given the high economic and health burden of insomnia disorder, strategies that can prevent and treat acute insomnia, and also prevent the transition from acute insomnia to insomnia disorder, are necessary. This narrative review outlines why the COVID-19 pandemic is a stressful life event, and why activation of the hypothalamic-pituitary-adrenal axis, as a biological marker of psychological stress, is likely to result in acute insomnia. Further, this review outlines how sleep disturbances might arise as a result of the COVID-19 pandemic, and why simultaneous hypothalamic-pituitary-adrenal axis measurement can inform the pathogenesis of acute insomnia. In particular, we focus on the cortisol awakening response as a marker of hypothalamic-pituitary-adrenal axis function, as cortisol is the end-product of the hypothalamic-pituitary-adrenal axis. From a research perspective, future opportunities include identifying individuals, or particular occupational or societal groups (e.g. frontline health staff), who are at high risk of developing acute insomnia, and intervening. From an acute insomnia treatment perspective, priorities include testing large-scale online behavioural interventions ; examining if reducing the impact of stress is effective and, finally, assessing whether "sleep vaccination" can maintain good sleep health by preventing the occurrence of acute insomnia, by preventing the transition from acute insomnia to insomnia disorder.
... Insomnia is a sleep disturbance present in 30% of the adult population, and is defined as difficulties in initiating and maintaining sleep, frequent nocturnal awakenings and/or suffering from nonrestorative sleep [16,17]. Notably, sleep disturbances were found to be the most prevalent symptoms amongst those surviving other traumatic events such as the earthquake in Japan in 1995 and the Jewish Holocaust [18,19]. Not only do people exposed to disasters show high rates of sleep disturbances, but also frontline and emergency workers who provide support and assistance to survivors. ...
... The prescription rate of hypnotics-sedatives in the victim group was 22% higher than that in the non-victim group after the disaster. Sleep disorders are reportedly one of the most common psychiatric conditions diagnosed after a disaster, which presumably explains the high prescription rate [25,26]. Another potential reason for the prevalence of hypnotics-sedatives is that these medications are more widely prescribed in Japan than in most other countries because of Japan's unique demographics and its health insurance system [7]. ...
Purpose
Natural disaster has an impact on mental health. The 2018 Japan Floods, which took place in July 2018 were one of the largest water disasters in Japan’s recorded history. We aimed to evaluate the change in the number of benzodiazepine prescriptions by physicians before and after the disaster.
Methods
A retrospective cohort study based on the National Database of Health Insurance Claims was conducted in the flood-stricken areas between July 2017 and June 2019. The subjects were divided between victims and non-victims according to certification by local governments. Members of both groups were then categorized into three groups based on their pre-flood use of benzodiazepines: non-user, occasional user, and continuous user. Difference-in-differences (DID) analysis with a logistic regression model was conducted to estimate the effect of the disaster among victims by comparing the occurrence of benzodiazepine prescriptions before and after the disaster.
Results
Of 5,000,129 people enrolled, 31,235 were victims. Among all participants, the mean prescription rate for benzodiazepines in victims before the disaster (11.3%) increased to 11.8% after the disaster, while that in non-victims (8.3%) decreased to 7.9%. The DID analysis revealed that benzodiazepine prescription among victims significantly increased immediately after the disaster (adjusted ratio of odds ratios (ROR) 1.07: 95% confidence interval 1.05–1.11), and the effect of the disaster persisted even 1 year after the disaster (adjusted ROR 1.2: 95% confidence interval 1.16–1.24).
Conclusion
The flood increased the number of benzodiazepines prescriptions among victims, and the effect persisted for at least 1 year.
... Following the 1995 earthquake in Hanshin, Japan, Kat et al. (11) interviewed 143 people to study what effects the event had on them. The authors highlighted that sleep disturbances were the most common and frequently experienced symptom: 63% of the sample experienced it 3 weeks after the event, and 46% still 8 weeks later. ...
Besides affecting 8% of the general population, nightmares are one of the most frequent symptoms of traumatized individuals. This can be a significant factor in the treatment of post-traumatic disorders; indeed, several studies demonstrated its strong predictive and prognostic value. Sleep disorders, nightmares in particular, could be very distressing for individuals and need targeted interventions, especially if they are associated with a PTSD diagnosis. To date, the best technique for the treatment of traumatic sleep disturbances seems to be Imagery Rehearsal Therapy (IRT), an empirically supported method. Through a review of the literature on this matter, this article aims to outline the incidence and consequences of nightmares in PTSD, illustrate how IRT could prove useful in their treatment, and investigate its clinical applications.
... However, sample sizes, in particular, small sample size can compromise the internal and external validity of a study, as a result, influencing research findings [46].Findings are in line with previous studies which reported high levels of PTSD among middle-aged and older adults 9,11 . However, in a study conducted in Hanshin-Awaji Japan, a decrease in PTSD symptoms was reported among the population older than 60 years of age 47 . As for children and adolescents, in a study conducted in the 2008 Sichuan (China) earthquake, the prevalence rate for PTSD was estimated to be 12.4% among survivors 15 . ...
Background: In 2015, Nepal was struck by two massive earthquakes with magnitudes over the 7.0 Richter Scale, imposing short- and long-term mental health risks. This review aims to: (a) evaluate mental health risk among the earthquake survivors; and, (b) identify factors that influence it. Methods: The following databases: Scopus and PubMed were searched to identify studies published from 2015 to July 2020 on the mental health risk among the Nepali populations. Inclusion criteria were: (a) primary research related to mental health after the 2015 earthquakes in Nepal, (b) English language articles, (c) access to full-text literature, and (d) studies conducted on the general population of Nepal. Exclusion criteria were: (a) newspaper articles or other forms of popular media, (b) grey records and reviews or, (c) studies carried out among patients in a clinical setting. Key features and risk of bias factors were extracted from each study to obtain necessary characteristics for further analysis of results. Results: The initial search produced 134 articles, however, a total, 14 studies fulfilled the inclusion criteria and were explored for this review. Ten of these articles were obtained from established databases, and four additional studies were obtained from other sources. Findings indicate that post-traumatic stress was mostly present among earthquake survivors with rates varying from 4.9% to 51%. Mental health risks for children and adolescent were mostly high with rates greater than 23% across studies. However, the adult prevalence rate for mental health risk was lower than that of children and adolescents, with most rates across studies lower than 20%. Socio-demographic factors (such as gender and age) and methodological heterogeneities such as variations in study design and mental health tools used to assess rates were associated factors that potentially influenced the findings. Conclusion: Mental health risks are present among earthquake survivors in Nepal. Various factors have been identified as potential mental health risk rate influencers including sex, with females presenting as the higher at-risk group for mental health relative to males. Methodological issues such as a wide range of mental health assessment instruments employed across studies can potentially impact rates.
... Insomnia is a sleep disturbance present in 30% of the adult population, and is defined as difficulties in initiating and maintaining sleep, frequent nocturnal awakenings and/or suffering from nonrestorative sleep [16,17]. Notably, sleep disturbances were found to be the most prevalent symptoms amongst those surviving other traumatic events such as the earthquake in Japan in 1995 and the Jewish Holocaust [18,19]. Not only do people exposed to disasters show high rates of sleep disturbances, but also frontline and emergency workers who provide support and assistance to survivors. ...
Wildfires present a serious risk to humans as well as to the environment. Wildfires cause loss of lives, economic losses, expose people to personal as well as collective trauma, and compromise the mental health of survivors. Sleep disturbances are highly prevalent following a traumatic event; however, their prevalence is not well established amongst those confronted by natural disasters such as wildfires. The aim of this systematic review is to synthesise the empirical findings pertaining to wild-fires and the prevalence of sleep disturbances in the general community affected by this natural disaster. We searched EBSCO, PsychINFO, Medline, SpringerLink, CI-NAHL Complete, EMBASE, PubMed, Scopus and Cochrane Library between January 2012 and March 2021. Five studies met the inclusion criteria. Findings from this sys-tematic review suggest that sleep disturbances, assessed one to ten months following the fires, are highly prevalent in wildfire survivors, with insomnia (ranging between 63-72.5%) and nightmares (ranging between 33.3–46.5%), being the most prevalent sleep disturbances reported in this cohort. Results also highlight the significant associations between sleep disturbances and post-traumatic symptoms following the trauma of wildfires. There is a possible link between sleep disturbance prevalence, severity of, and proximity to fires.
... Many surveys have reported that PTSD is often observed after earthquake disasters 19,20) . After the 1995 Hanshin -Awaji Great Earthquake in Japan, many survivors exhibited PTSD symptoms 21,22) . In a survey conducted sixteen months after the earthquake, the prevalence of PTSD among office workers in the disaster area was 3.1%, while 10.1% of the workers were not diagnosed with PTSD but had some PTSD symptoms 23) . ...
The Great East Japan Earthquake severely damaged the Tohoku and Kanto districts, and Fukushima Prefecture faced a subsequent nuclear disaster. Few studies have reported the effects of socioeconomic stressors on individuals’ mental status following disasters. We analyzed the responses of 60,704 adult residents of a designated restricted area to the PTSD Checklist-Stressor-Specific Version (PCL-S). The relationships between the PCL-S scores and demographic, socioeconomic, and damage-related variables were analyzed using regression analysis to predict participants’ severity of PTSD symptoms. Approximately 14.1% of evacuees had severe PTSD symptoms (PCL-S ≥50) eighteen months post-earthquake. The PCL-S scores were higher among women, older adults, less educated people, those with a history of mental illness, and those living outside Fukushima Prefecture. The PCL-S scores increased with participants’ scores on the Kessler Psychological Distress Scale. The number of trauma-exposure stressors and socioeconomic stressors were associated with 1.52 and 3.77 increases in the PCL-S score, respectively. Furthermore, psychological distress, unemployment, decreased income, house damage, tsunami experience, nuclear power plant accident experience, and loss of someone close due to the disaster were associated with the prevalence of severe PTSD symptoms. The complex triple disaster of a major earthquake, tsunami, and nuclear accident created significant socioeconomic changes that may be important determinants of PTSD among residents of restricted access areas in Fukushima.
... Major earthquakes are associated with an increased prevalence of psychiatric morbidities [1,2], sleep disorders [3,4], and dizziness [5][6][7][8][9][10]. The Kumamoto earthquakes on April 14 and 16, 2016 (Fig 1, moment magnitude = 9.0; Shindo = 7) included several high-magnitude vibrations and aftershocks without secondary disasters. ...
This study aimed to examine the types and causes of dizziness experienced by individuals after a major earthquake. This cross-sectional study enrolled healthy participants who experienced the 2016 Kumamoto earthquakes and their aftershocks. Participants completed a questionnaire survey on their symptoms and experiences after the earthquakes. The primary outcome was the occurrence of dizziness and the secondary outcome was the presence of autonomic dysfunction and anxiety. Among 4,231 eligible participants, 1,543 experienced post-earthquake dizziness. Multivariate logistic regression analysis revealed that age (≥21, P < .001), female sex ( P < .001), floor on which the individual was at the time (≥3, P = .007), tinnitus/ear fullness ( P < .001), anxiety ( P < .001), symptoms related to autonomic dysfunction ( P = .04), and prior history of motion sickness ( P = .002) were significantly associated with the onset of post-earthquake dizziness. Thus suggesting that earthquake-related effects significantly affect inner ear symptoms, autonomic function, and psychological factors. Earthquake-induced disequilibrium may be further influenced by physical stressors, including sensory disruptions induced by earthquake vibrations, changes in living conditions, and autonomic stress. This study increases our understanding of human equilibrium in response to natural disasters.
... In our study, most of the respondents (69.22%) belonged to the 21-40 age group, and there was no significant relationship between age and IES-R scores. A few studies have shown that PTSD is more prevalent in younger adults than in older adults (Kato et al., 1996;Lee, 2019). However, the relationship between age and the extent of PTSD is inconsistent with studies reporting higher levels of PTSD symptoms after an earthquake among middle-aged and older people with respect to younger ones (Ali et al., 2012;Chen et al., 2007;Wu et al., 2006). ...
To study the impact of the 2019 Albania on the socio-demographic profiles of a cohort of survivors and its association with probable post-traumatic stress disorder (PPTSD). A sample of 221 residents of temporary shelter camps and permanent homes in Albania who were affected by the earthquake on November 26, 2019, was assessed using The Impact of Event Scale-Revised (IES-R) to evaluate the probable PTSD (PPTDS), two weeks after the earthquake. Of the 221 participants (age: 14–63 years), 55 (24.89%) were males and 166 (74.11%) were females. About 50% were married and three-quarters had completed high school/university level education. The earthquake rendered 46.6% (n = 103) homeless, 95 participants (43.0%) became unemployed. The mean IES-R values were significantly higher in survivors who suffered personal injury, witnessed injury or death of another survivor or lost someone close to them compared to those who were not exposed these situations. All earthquake exposures and socio-demographic factors (except age and number of children) showed a significant negative correlation with the IES-R score. The prevalence of PPTSD from the impact of earthquakes was 66.1% (IES-R score ≥ 33). Survivors with low income had significantly higher scores and educational level (both self and spouse) showed a significant negative association with IES-R score. This initial study identified factors that could contribute to the development of PPTSD and suggests interventions for the survivors with low income, less education and who witnessed death of another person or someone close to them on priority basis to circumvent the development of PPTSD.
... Finally, PTSD is a common diagnosis for individuals who have experienced natural disasters (Kar & Bastia, 2006). In a study following the Hanshin Awaji earthquake, researchers examined the frequency of short-term, posttraumatic symptoms on evacuee victims, using the Posttraumatic Symptom Scale (Kato et al., 1996). They found that the evacuees displayed sleep disturbance, hypersensitivity, and irritability. ...
In the face of traumatic events, people often draw on their religious or spiritual resources to cope with their struggles. Spiritual fortitude (SF) refers to one’s ability to draw consistently on spiritual resources to transcend and endure negative emotions in the face of stressors (Van Tongeren et al., 2019). In this article, we present data from a study of 274 participants who lived in Baton Rouge, Louisiana during the 2016 Louisiana flood. Nine and 18 months after the flooding, participants completed measures of resource loss, SF, search for and presence of meaning, depression, anxiety, and posttraumatic stress disorder (PTSD) symptoms. SF buffered the deleterious relationship between disaster-related resource loss and future search for meaning, and search for meaning mediated the relationship between resource loss and SF on subsequent mental health symptoms (i.e., anxiety, depression, and PTSD symptoms). We discuss areas for future research and implications for practice.
... In this part of the study, we analyzed factor structure and reliability for the scales for mothers' psychological responses ( Table 2, Panel A), children's psychological responses ( Table 2, Panel B), and mothers' radiation protection behavior ( Table 2, Panel C). To assess the concurrent validity of the scale for mothers' psychological responses, mothers were asked to complete the following measures: the Japanese editions of the Kessler Screening Scale for Psychological Distress (K6) [20], and Post-Traumatic Symptom Scale (PTSS-10) [21], and the Screening Questionnaire for Disaster Mental Health (SQD) [22]. Further, to evaluate the concurrent validity of the scale for children's psychological responses, mothers were asked to complete the Q3. ...
It has been almost 10 years since the accident at Tokyo Electric Power Co., Inc.’s Fukushima Daiichi Nuclear Power Plant in March 2011. This study elucidates changes in the mental states of mothers and children residing in low-dose radiation contaminated regions within Fukushima Prefecture over a five-year period after the Fukushima Daiichi accident. From 2011 to 2015, questionnaire surveys assessing psychological symptoms, including posttraumatic stress disorder-related responses, depressive responses, and stress responses, and radiation protection behaviors were conducted with 18,741 mothers of children aged four, 18, and 42 months. Mothers’ and children’s psychological symptoms and mothers’ radiation protection behaviors were highest in 2011, immediately following the nuclear accident, but decreased over time. However, even in 2015, psychological symptoms and radiation protection behaviors were higher for children and mothers within Fukushima Prefecture than for those in a control group living in regions outside the area, which were minimally affected by the accident. The results suggest that the psychological effects in mothers and children living in low-dose radiation contaminated areas continued for at least five years after the accident. Furthermore, psychological effects in children born after the incident were likely to have been triggered by the parental behavior of mothers who were negatively affected by anxiety and stress. This finding raises concerns regarding the accident’s long-lasting psychological effects in mothers and children living in low-contamination regions.
... However, old age may not always result in lower levels of subjective well-being, as suggested by several theories such as the socio-emotional selectivity theory (Carstensen 1995;Carstensen et al. 1999), the emotional maturity theory (Kato et al. 1996;Ticehurst et al. 1996), or the selective optimization with compensation theory (Baltes and Baltes 1990) as well as corresponding empirical work on this topic (Blanchflower and Oswald 2008;Stone et al. 2010;Carstensen et al. 2011;Dolan et al. 2017;Kieny et al. 2020). By contrast with the double jeopardy hypothesis, the age as leveler hypothesis argues that gender inequalities may be decreasing in old age, as all individuals suffer from the physical effects of age (Markides and Black 1996). ...
Using data from the World Health Organization’s Study on Global AGEing and Adult Health (SAGE), we evaluate the relationship between gender and several measures of subjective well-being among older adults in developing countries. Furthermore, we contrast the partial associations of gender with these well-being measures when controlling only for age (age-adjusted analyses) with the corresponding partial associations when including individual characteristics and life circumstances as controls (multivariable-adjusted analyses). While age-adjusted analyses reveal that older women have lower levels of evaluative well-being than older men, multivariable-adjusted analyses show that - given similar life circumstances - they have equal or slightly higher evaluative well-being. This suggests that the gender gap in evaluative well-being may be explained by less favorable life circumstances of older women. Age-adjusted results also show that older women tend to have lower levels of emotional well-being. However, we find no reversal, but merely an attenuation of these gender differences in emotional well-being when controlling for additional individual characteristics and life circumstances. Finally, we perform Oaxaca-Blinder decompositions to disaggregate the gender gaps in well-being into explained parts - attributable to gender differences in individual characteristics and life circumstances - and unexplained parts - related to gender differences in the association between life circumstances and subjective well-being. These results further corroborate our findings that women tend to be disadvantaged in terms of both evaluative and emotional well-being, and that this disadvantage is mostly driven by observable factors related to the explained part of the decomposition, such as gender differences in socio-economic status and health.
... The 15-Item Post-Traumatic Stress Symptom Scale for Children The PTSSC-15 is a self-rating questionnaire of stress responses in children after a disaster. It consists of the 10item Post-Traumatic Stress Symptom Scale (PTSS-10), which was used as a screening tool after both the 1995 Great Hanshin Earthquake and the 2004 Indian Ocean Earthquake and Tsunami, 27,28 and an additional five questions believed to reveal important psychosomatic characteristics after a disaster (flashbacks, appetite loss, somatic reactions such as headaches and abdominal pain, attention deficits, and anxiety). The PTSSC-15 was developed in Japan. ...
Introduction:
Natural disasters such as earthquakes can cause substantial damage and trauma, especially to children. The aim of this study was to examine the effects of disaster experience on psychological symptoms, suicide risk, and associated factors in junior high school students 5 years after the Great East Japan Earthquake (GEJE). The hypothesis of this study was that psychological symptoms and suicide risk of junior high school students are associated with disaster experience.
Methods:
A cross-sectional survey consisting of questionnaires and face-to-face interviews with students at two junior high schools in Ishinomaki city, Miyagi Prefecture, Japan, about psychological symptoms, disaster situations, and their current environment 5 years after the GEJE was conducted. In total, data from 264 (117 boys [44.3%] and 147 girls [55.7%]) students were analyzed.
Results:
There were no associations between disaster experience and PTSSC-15, DSRS-C, and SCAS scores. Those with evacuation experience and still living in temporary housing had significantly higher scores on the oppositional defiant behavior inventory (ODBI). Of these students, 29 (11.0%) were considered to have suicide risk 5 years after the GEJE. The presence of depressive symptoms was the only factor related to suicide risk; no associations were found with sex, post-traumatic stress disorder (PTSD) symptoms, or other factors reported in previous studies, including disaster experience.
Conclusions:
Disaster experience was not associated with psychological symptoms (PTSD, depression, anxiety) and suicide risk in junior high school students 5 years after the GEJE. The suicide risk appears to be the same as that in the general population in Japan. However, attention should be paid to externalization problems and depressive symptoms, an important suicide risk factor, even 5 years after the GEJE.
... A previous report showed that older adults (aged more than 60 years) in Japan were better protected from distress from a disaster compared with younger adults. Depression was also different from those groups [26]. Therefore, in this study, we divided the participants into younger and older age groups based on a cut-off of 60 years old. ...
Background
We investigated the relationship between psychological distress and the coordination of heart rate variability (HRV) and physical acceleration (PA) during free-moving days in women.
Methods
Ninety-five adult women were divided into younger and older groups. The younger group comprised 50 women (22–59 years), and the older group comprised 45 women (≥ 60 years). HRV and PA data were simultaneously obtained every minute for 24 h during the free-moving day. The ratios of low frequency/high frequency and high frequency in normalized units were used as HRV indices. We defined %Lag0 as the % frequency of the lag = 0 min between HRV and PA in 1 h. The General Health Questionnaire 28 (GHQ28) was used to evaluate the effects of psychological distress and depression.
Results
In the hour before the night’s sleep, %Lag0 was significantly lower in older women with depression (GHQ28 subscale D) than in older women without depression (p < 0.05). However, no significant difference between %Lag0 and depression status was observed in the hour after waking in older women.
Conclusions
The results suggest that impairments in coordination between HRV and PA are associated with depression in older women, particularly in the hour before a night’s sleep on free-moving days.
... Additionally, they were unwilling to take sleep medication out of fear of being rendered unable to escape further disasters (e.g., aftershocks) based on the impressions of a healthcare worker who visited evacuation shelters [8]. Regarding the long-term effect of evacuation on sleep, the prevalence of sleep disturbance was 58% (<60 years old) and 68% (≥60 years old) after three weeks [9]. These sleep disturbances are considered an acute stress reaction, insomnia caused by anxiety and/or stress, and so on. ...
We aimed to evaluate sleep and sleep-related physiological parameters (heart rate variability and glucose dynamics) among evacuees by experimentally recreating the sleep environment of evacuation shelters and cars. Nine healthy young male subjects participated in this study. Two interventions, modeling the sleep environments of evacuation shelters (evacuation shelter trial) and car seats (car trial), were compared with sleep at home (control trial). Physiological data were measured using portable two-channel electroencephalogram and electrooculogram monitoring systems, wearable heart rate sensors, and flash glucose monitors. Wake after sleep onset (WASO) and stage shift were greater in both intervention trials than the control trial, while rapid-eye movement (REM) latency and non-rapid eye movement (NREM) 1 were longer and REM duration was shorter in the evacuation shelter trial than the control trial. Glucose dynamics and power at low frequency (LF.p) of heart rate variability were higher in the car trial than in the control trial. It was confirmed that sleep environment was important to maintain sleep, and affected glucose dynamics and heart rate variability in the experimental situation.
... According to the National Health Service of the United Kingdom, PTSD is an anxiety disorder caused by very stressful, frightening, or distressing events [9]. After the 1995 Great Hanshin-Awaji Earthquake, PTSD among adolescents was reported [10]. In Ishinomaki City, a survey was conducted eight months after the 2011 disaster to identify relationships between traumatic symptoms and environmental damage conditions. ...
This study evaluated the impact of a disaster education program implemented by the fourth-grade students at an elementary school affected by tsunami one year after the 2011 Great East Japan Earthquake and Tsunami disaster. Called the “Reconstruction Mapping Program”, it applied a town-watching and map-making approach to disaster education in the disaster reconstruction phase. Emphasizing positive aspects of reconstruction in consideration of the disaster affected children's mental care, the aim of the Program was set as developing children's attitudes towards contributing to the community. The study used mixed methods of qualitative and quantitative analyses to examine the fourth-grade children's responses to the Program before and after the implementation in 2013 and 2014, and 2018. The study found that the Program was a promising approach for the students who had experience disaster because even after walking around the community that was destroyed by the 2011 tsunami, children kept their affection for their community and they became motivated to contribute to the community's reconstruction. The study also found that the ninth-grade students in 2018 who participated in the Program in 2013 perceived the Program experience positively because they thought that working in groups and keeping records of reconstruction were important. The Program experience impacted the ninth-grade students' willingness to contribute to the community for the longer term. However, not much impact was seen for their disaster preparedness and mitigation behavior. The Program helped to foster children as “agents of change” to make a disaster-resilient community.
... Previous studies have also found high prevalence of insomnia symptoms among children and adolescent trauma survivors. For instance, 8 weeks after the 1995 Hanshin-Awaji earthquake, Kato et al. [34] reported that the prevalence of difficulty sleeping was 46% among young evacuees. Furthermore, 3 years after the 2013 Lushan earthquake, Tang et al. [9] reported that the prevalence rates of difficulty falling asleep and difficulty staying asleep among 6132 children and adolescent survivors were 33% and 24%, respectively. ...
Background
We aimed to explore insomnia symptoms among 2299 children and adolescents after an earthquake and their bidirectional relationship to somatic complaints and posttraumatic stress disorder (PTSD).
Methods
The Patient Health Questionnaire-15 scale, the Children’s Revised Impact of Event Scale, and three questions evaluating insomnia symptoms (including difficulty falling asleep, difficulty staying asleep, and early morning awakening) were administered to child and adolescent survivors 3 and 6 months after the Lushan earthquake.
Results
The prevalence rates of insomnia symptoms among children and adolescents were 52 and 40% 3 and 6 months after the Lushan Earthquake, respectively. Insomnia symptoms evaluated after 3 months could significantly predict subsequent PTSD (odds ratio (OR), 1.476; 95% confidence interval (CI), 1.133–1.924) and all somatic symptoms, except for dizziness, evaluated after 6 months. PTSD (OR, 1.633; 95%CI, 1.315–2.027) and headache (OR, 1.545; 95%CI, 1.223–1.953) evaluated after 3 months significantly predicted insomnia symptoms evaluated after 6 months.
Conclusions
Insomnia symptoms, which were commonly seen after the earthquake, could longitudinally predict the development of PTSD and various somatic symptoms, and PTSD and headache could longitudinally predict the developments of insomnia symptoms among children and adolescent earthquake survivors. These findings highlight the importance of assessing and addressing insomnia symptoms in children and adolescents following a traumatic event.
... Sleep disturbances, including difficulty falling asleep, frequent awakenings, short sleep duration, poor sleep quality, and daytime sleepiness, are very common among survivors in the immediate and long-term aftermath of traumatic events, such as natural disasters (Mellman et al. 1995;Kato et al. 1996), industrial disasters (Grievink et al. 2007;Realmuto et al. 1991), terrorist attacks (Chemtob et al. 2008;Schuster et al. 2001), combat exposure, and other human-related disasters (Seelig et al. 2010;Sharon et al. 2009). In the WEAHC study, adolescents' sleep disturbances were measured at 12 months after the Wenchuan Earthquake using five core items (sleep duration, difficulty initiating sleep, difficulty maintaining sleep, sleep quality, and daytime functioning) from the Pittsburgh Sleep Quality Index (PSQI). ...
China is one of the countries most affected by earthquakes. Since the devastating magnitude 8.0 Wenchuan Earthquake in Sichuan Province, there has been growing concern over the mental health sequelae for children and adolescents exposed to seismic events. This chapter introduces epidemiological characteristics of the effects of earthquake exposures on mental health problems, as well as on other health-related problems among Chinese children and adolescents. Psychosocial, biological, and genetic factors related to post-earthquake adaptation are described, and implications for post-earthquake mental health services are discussed.
... This was a paper-based survey with self-rating questions about traumatic symptoms to assess stress reactions in children after a disaster. Five questions that are believed to reveal important psychosomatic characteristics after a disaster (flashbacks; appetite loss; somatic reactions, such as headache and abdominal pain; attention deficit; and anxiety) were added to the 10-item Post-Traumatic Stress Symptoms (PTSS-10) questionnaire used after the Great Hanshin earthquake and the 2004 Southeast Asia tsunami (Hafstad et al., 2012;Kato et al., 1996). PTSSC-15 consisting of 15 questions was constructed in Japan (Tominaga et al., 2002). ...
Background: The Great East Japan Earthquake (GEJE) and tsunami of March 11, 2011 left behind many survivors, including children. This study aimed to assess changes in traumatic symptoms with time among kindergarteners who experienced GEJE as infants and to discuss the relationship between these symptoms and the disaster experience.
Methods: The 15-item Post-Traumatic Stress Symptoms for Children (PTSSC-15) questionnaire were distributed to the parents of kindergarteners (children aged 4–5 years) at 8, 20, 30, and 42 months after GEJE. Questionnaires regarding environmental damage conditions affecting the children were distributed to teachers 8 months after the tsunami.
Results: The number of kindergarteners was 262, 255, 236, and 202 at 8, 20, 30, and 42 months after the disaster. The PTSSC-15 total score was not different between kindergartners with and without environmental damage conditions. After 8 and 20 months, the PTSSC-15 total score of children who usually ate breakfast was significantly higher than that of children who did not. Moreover, after 30 and 42 months, the PTSSC-15 total score of kindergarteners who usually ate breakfast was not significantly higher than that of kindergarteners who did not.
Conclusions: The traumatic symptoms of kindergarteners were not related to disaster experiences.
... Sleep disturbance (i.e. trouble falling or staying asleep) is the most common problem described by survivors immediately after industrial [4] and devastating natural disasters [5][6][7]. A majority of affected individuals are resilient and do not develop mental health disorders; however, post-disaster stress exposure can potentially lead to sleep disturbances even among this group [8]. ...
Study Objective
To determine longitudinal effects of experiences related to the Fukushima nuclear disaster on March 11, 2011, on insomnia risk among workers of nuclear power plants on identified disaster-related potential risk factors for the subtypes of insomnia.
Methods
We included a total of 1403 workers who responded to a questionnaire on insomnia-related symptoms measured by the Athens Insomnia Scale from 2011 to 2014 and on disaster-related experiences in 2011. We examined the longitudinal relationships between disaster-related experiences and insomnia using mixed-effect logistic regression models. We also used path analysis to examine the potential effects of disaster-related experiences on the subtypes of insomnia (i.e. initial, sleep maintenance, and early morning awakening).
Results
All disaster-related experiences were significantly associated with insomnia, except death of a family member or colleague. We found that most of these types of traumatic exposure were associated with the risk of insomnia in a time-independent way. However, the effect of experiencing life-threatening danger decreased with time. Based on the results of the path analysis, we found that life-threatening experiences, such as experiences of life-threatening danger or witnessing the explosion, may conjure up disturbing scenes that hamper sleep initiation. On the other hand, early morning awakening may be related to life uncertainty. We found that social discrimination/slurs was associated with all three types of insomnia and was also influenced by other experiences, such as life-threatening danger, property loss, and colleague death.
Conclusion
Our findings emphasize the importance of comprehensive psychosocial support for workers with disaster-related experiences.
... [4] In various cross-sectional studies of selected subgroups following disasters, the prevalence of psychological distress and mental health problems, in particular, posttraumatic stress reactions, has been estimated to vary between four per cent and 80%. [5][6][7][8][9] These reactions can encompass a wide range of disorders like acute stress disorder (ASD), posttraumatic stress disorder (PTSD), adjustment disorders, depression, alcohol and drug abuse. ...
Background: Introduced in DSM-IV, acute stress disorder (ASD) is a psychiatric diagnosis characterised by severe anxiety, dissociation, intrusive thoughts, and other symptoms occurring within one month of experiencing a traumatic event. Research indicates that ASD may place individuals at increased risk of developing chronic posttraumatic stress disorder (PTSD). There is growing evidence that increased media exposure to traumatic events is a risk factor for the development of posttraumatic symptomatology. Aims: We hypothesised that in the aftermath of a natural disaster, excessive exposure to television and Internet coverage might be a risk factor for ASD. Methods: Using a cross-sectional study design in a sample of 300 medical and nursing college students exposed to an earthquake, ASD was assessed with the Stanford Acute Stress Disorder Questionnaire (SARSQ) and media exposure by an interview to capture exposure to earthquake-related news via television and Internet. Results: Thirty six students developed ASD (12%). The odds of greater exposure to earthquake-related content via television was 1.93 times more (95% CI 1.02-3.66, p-value=0.042) and Internet 2.28 times more (95% CI 1.18-4.41, p-value=0.015) in students who developed ASD than those who did not. Conclusions: Our findings suggest that excessive exposure to earthquake-related media content via television and Internet in its aftermath is associated with a statistically significant risk of developing ASD.
... A marked decline in HIV testing and new ART patient enrollment was observed in Haiti; however, the follow-up of registered ART patients remained very high after the earthquake [21]. Moreover, psychological issues have been reported under disaster conditions [22][23][24][25]. A previous study showed that, following an earthquake, the prevalence of PTSD was 58.2% after 2 months, 22.1% after 8 months, 19.8% after 14 months, 19.0% after 26 months, and 8.0% after 44 months [26]. ...
Introduction
The April 2015 Nepal earthquake resulted in more than 8,700 deaths and 22,000 casualties including damage to health facilities. The impact of this situation on chronic conditions such as human immunodeficiency virus infection and acquired immune deficiency syndrome (HIV/AIDS) may become a long-lasting public health threat. Therefore, the objectives of this study were i) to assess the association of antiretroviral therapy (ART) adherence with mental health problems, and social behaviors, ii) to examine factors affecting treatment failure, and iii) to investigate changes in ART adherence and post-traumatic stress disorder (PTSD) among people living with HIV 6 and 12 months after the disaster.
Methods
Study was conducted 6 months after the earthquake in 2015 with a sample size of 305 earthquake victims with HIV and followed after 12 months of the earthquake. A logistic regression analysis was used to examine relationships, while a paired t-test analysis was conducted to assess changes in adherence to ART and PTSD level at 6 months and 12 months after earthquake.
Results
In the earthquake, 5.2% of the participants lost their family member. Approximately 44% of participants had earthquake-PTSD symptoms and 50% experienced HIV stigma. PTSD and HIV status disclosure were significantly associated with adherence to ART, while HIV stigma and religion were associated with treatment failure. PTSD and adherence levels to ART were significantly improved over the 6-month period.
Conclusion
Awareness programs for general public to eliminate HIV stigma; promote psychosocial counseling to earthquake victims living with HIV in order to reduce PTSD will contribute to maintaining optimal ART adherence and to prevent treatment failure.
This handbook is the first to comprehensively study the interdependent fields of environmental and conservation psychology. In doing so, it seeks to map the rapidly growing field of conservation psychology and its relationship to environmental psychology. The Oxford Handbook of Environmental and Conservation Psychology includes basic research on environmental perceptions, attitudes, and values; research on specific environments, such as therapeutic settings, schools, and prisons; environmental impacts on human well-being; and ways to promote a more sustainable relationship between people and the natural environment. This handbook presents an extensive review of current research and is a thorough guide to the state of knowledge about a wide range of topics at the intersection of psychology and the physical environment. Beyond this, it provides a better understanding of the relationship between environmental and conservation psychology, and some sense of the directions in which these interdependent areas of study are heading.
Study Objectives
Stressful life events, such as the COVID-19 pandemic, can cause acute insomnia. Cognitive behavioural therapy for acute insomnia is effective but is both time and resource-intensive. This study investigated if an online behavioural self-help intervention, which has been successfully used alongside sleep restriction for acute insomnia, reduced insomnia severity and improved mood in acute insomnia. This study also assessed good sleepers to explore if a “sleep vaccination” approach was feasible.
Methods
In this online stratified randomised controlled trial, 344 participants (103 good sleepers and 241 participants with DSM-5 acute insomnia) were randomised to receive the intervention/no intervention (good sleepers) or intervention/intervention after 28 days (poor sleepers). Insomnia severity was assessed using the ISI (primary outcome), and anxiety and depression using the GAD-7/PHQ-9 (secondary outcomes) at baseline, one week, one month and three-month follow-up.
Results
In people with acute insomnia, relative to baseline, there were significant reductions in ISI (dz = 1.17), GAD-7 (dz = .70) and PHQ-9 (dz = .60) scores at one week follow-up. ISI, GAD-7 and PHQ-9 scores were significantly lower at all follow-up time points, relative to baseline. Subjective diary-derived sleep continuity was unaffected. No beneficial effects upon sleep or mood were observed in good sleepers.
Conclusions
An online behavioural self-help intervention rapidly reduces acute insomnia severity (within one week), and benefits mood in people with acute insomnia. These beneficial effects are maintained up to three months later. Although the use of the intervention is feasible in good sleepers, their subjective sleep was unaffected.
Cross-sectional studies have found older adults to have lower levels of emotional distress after natural disasters. The maturation hypothesis suggests that older adults are less reactive to stress events, whereas the inoculation hypothesis argues that prior experience with disaster is protective. One hundred and sixty-six adults aged 30 to 102 were interviewed regarding the 1994 Northridge earthquake. Longitudinal data were available on depressed mood before and after the earthquake. The maturation hypothesis was generally not supported. The young–old were least depressed; however, this age difference was present prior to the earthquake. The old–old showed lowest levels of earthquake-specific rumination, but age did not buffer the relationship between damage exposure and rumination. The inoculation hypothesis was supported for depressed mood. Prior earthquake experience was related to lower postearthquake depression scores.
Earthquake-induced landslides can cause enormous damage and numerous casualties in mountainous areas worldwide; consequently, accurate assessment of the potential distribution of earthquake-induced landslides is an important issue. For a national disaster prevention agency, it is desirable to prepare to rapidly evaluate disasters and risks from information that can be scarce or easily available. The present study examined landslides triggered by reverse and strike-slip fault earthquakes, focusing on recent cases in Japan with relatively complete landslide inventories and detailed active-fault information. The landslide distributions and parameters of active faults were compared, and it was found that the skewness and kurtosis of the landslide distribution for each earthquake event was close to zero, indicating that the distributions followed the normal distribution. The mean distance of the landslide distribution from the active fault is negatively correlated with the inclination of the active fault, while the standard deviation is negatively correlated with the fault-top depth of the active fault and positively correlated with the magnitude of the earthquake.
Based on our findings, we conducted a regression analysis of the relationship between the mean distance from the active fault and the inclination of the active fault. The mean distance of the landslide from the active fault increased when the active fault had a lower inclination, and was regarded as zero when the inclination was greater than 60°. In addition, a relationship between the standard deviation, depth of fault top, and earthquake magnitude was established using multiple regression analysis. We thus confirmed the accuracy of the methodology using the actual landslide distributions of recent earthquakes in Japan. The length of the active fault can be used as input for the methodology, to estimate the maximum magnitude of the respective earthquake. Furthermore, the 95% confidence interval appears to cover almost all the large landslides, which enables us to limit the extent of areas that should be considered hazardous for landslides. The Chi-Chi earthquake in Taiwan with similar seismic mechanisms to Japan has been verified and it is in good agreement with the landslide distribution assessed by this methodology. Consequently, the proposed methodology can be applied to estimate the potential distribution of landslides caused by reverse and strike-slip fault earthquakes, based on the parameters of the active faults.
The goal of this work is to develop a complete theoretical framework for the numerical modeling of three‐dimensional prestressed reinforced concrete structural members, soil mixture and their interactions. This numerical formulation is based on the construction of a new composite finite element, in order to tackle the multiscale problem. For this purpose, the mechanical behavior of each microstructure component material will be modeled as follows: I) for the plain concrete and the soil mixture, an anisotropic‐damage‐elastoplastic model equipped with the strong discontinuity approach will be taken into account, II) a polycrystal plasticity model, for the steel rebars and prestrssed tendons will be captured through a new strategy solution of discontinuous bifurcation problem, with the main objective to represent the multi‐cracking phenomenon, III) regarding the mechanical behavior of the aggregates and rocks (skeleton ‐ hydro mechanic problem‐ ) in the plain concrete and soil mixture respectively, an anisotropic‐damage‐double‐poro‐polycrystal plasticity model equipped with softening material will be considered. An advanced failure algorithm based on the marching tetrahedron and the pseudo‐termic problem will be developed. Finally, the zone that characterizes the interaction between the structural member and the soil mixture will be encrusted inside of composite finite element.
This retrospective chart review aimed to examine both the vestibular function and causes of dizziness experienced by individuals following a series of major earthquakes and repetitive aftershocks. All patients with balance disorders who experienced the 2016 Kumamoto earthquakes and their aftershocks completed questionnaires relevant to balance disorders and were enrolled in this study after providing informed consent. There were 2.8 times more patients with balance disorders post the earthquake. Anxiety (P = 0.02), orthostatic dysregulation (P = 0.005), and motion sickness scores (P = 0.03) were all significantly higher after the earthquakes. A subset of participants underwent clinical equilibrium testing, showing significant deteriorations in the equilibrium test results (stabilometry: P = 0.01), cervical vestibular-evoked myogenic potentials (P = 0.04), and head-up tilt (P = 0.03) after the earthquake. The findings of this study also suggest that earthquake-induced disequilibrium may be further influenced by physical stressors, including sensory disruptions induced by earthquake vibrations, changes in the living conditions, and autonomic stress. This study increases our understanding of human equilibrium in response to natural disasters. Moreover, these findings will facilitate the management of dizziness experienced during or after such disasters. Future studies should identify strategies for mitigating autonomic dysfunction to prevent post-earthquake dizziness.
This study used the Disablement Process framework to examine how exposure to the great east Japan earthquake and tsunami on 11 March 2011 was related to elders' experiences of disability—that is, ‘a gap between personal capability and environmental demand’ (Verbrugge and Jette, 1994, p. 1). Data were derived from two waves (2009 and 2013) of the Nihon University Japanese Longitudinal Study of Aging, involving a representative sample of citizens aged 65 or more. Logistic regression was employed to model how the disaster was associated with the prevalence and incidence of disability. A significant relationship was documented between the two. Those impacted by the event exhibited greater odds of reporting a disability in 2013 and developing one between 2009 and 2013. Disasters destroy social infrastructure and disrupt daily life, widening the lacuna between the environment and personal resources. Given the increasing number of disasters, more policy attention should be directed to reducing their adverse consequences for health.
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Recent research in several disciplines suggests the use of the life course paradigm for understanding the effects of natural disasters on people. This study examines the effects of the March 2011 Japanese disaster in the context of the life course paradigm. While all previous studies on the effects of natural disasters have been based on surveys using retrospective measures of disasters and their effects, the present study is unique in that it uses data from surveys completed before and after the Japanese disaster, allowing the assessment of the effects of this disaster from a natural experiment. The findings support the value of the life course paradigm in understanding the processes by which people’s lives are affected by disasters, including their consumption behaviors in response to disasters.
Background:
Currently, few studies have thoroughly investigated the socioeconomic factors related to sleep problems among evacuees following a disaster.
Objectives:
To examine sleep problems in evacuees using data from a large-scale cohort survey of evacuees conducted after the 2011 Great East Japan Earthquake (GEJE).
Methods:
In sum, 73,433 residents who were living in evacuation zones responded to The 2011 Fukushima Health Management Survey. We excluded 16,659 participants who did not answer the question about sleep problems or those younger than 20 years. Thus, data from 56,774 participants (24,959 men and 31,815 women) were used for this analysis. Evacuees' self-reported sleep dissatisfaction was determined based on their response to the question 'Are you satisfied with the quality of your sleep? '. The response options 'Unsatisfied' and 'Very unsatisfied' were considered as the outcome for the present study. Prevalence ratios (PRs) and 95% confidence intervals (CIs) for the prevalence of self-reported sleep disturbance were estimated using modified Poisson regression models.
Results:
Of the qualifying survey respondents, 20.3% (4387 men and 7128 women) reported sleep dissatisfaction. Compared with participants living in their own or a relative's home (PR = 1), those living in temporary housing or rental accommodation had a higher prevalence of sleep dissatisfaction (1.47; 95% CI 1.44-1.50 and 2.16; 95% CI 2.07-2.26 in men; 1.39; 95% CI 1.36-1.41 and 1.92; 95% CI 1.86-1.99 in women). Higher educational attainment was also associated with a higher prevalence of sleep dissatisfaction in men, as were job loss and decreased income in both men and women.
Conclusion:
Self-reported sleep dissatisfaction after the GEJE was associated with a deteriorated socioeconomic status among evacuees. However, future longitudinal studies are warranted.
Past major earthquakes have been associated with an increase in the prevalence of vertigo or dizziness; the 2016 Kumamoto earthquakes on April 14 and 16 (JST, moment magnitude=7.0, Shindo 7 [Japanese seismic scale]) and the large numbers of aftershocks were no exception. Several months after the initial earthquake, significant outbreaks of vertigo or dizziness occurred over a large area surrounding the epicenter of the earthquake. However, it is unclear why major earthquakes cause these symptoms. After the major earthquake in Kumamoto, we conducted a questionnaire and medical records survey to investigate post-earthquake dizziness (PED). This survey covered a total of 575 subjects who complained of exacerbation of vertigo or dizziness after the earthquake and visited the hospital for follow-up before the scheduled dates. Our results showed that the number of patients with vertigo or dizziness who visited the hospital increased after the earthquake, and peaked between 2 and 4 weeks after the earthquake. The timing of onset of vestibular disorders varied according to the underlying disease. This study also suggested that earthquake-related psychological stress or stress resulting from earthquake evacuation could cause the onset of some vestibular disorders. We speculated that PED could be caused by stimulation of the vestibular and visual systems and bathyesthesia, psychological stress, potential effects of autonomic stress on the equilibrium function, and/or sensory mismatch. Our study could contribute to establishing PED as a new concept in the area of vestibular disorders.
In this chapter, we have reviewed an extensive literature supporting the critical role of sleep for several aspects of emotional processing and regulation.
Occurrences of disasters are becoming more frequent and serious. Other than natural disasters, humanity is faced with new challenges of city fires, car accidents, disease outbreak, industrial accidents, radioactive exposure, terrorist attacks, environmental hazards and other unimaginable incidents. Social workers and other city emergency response teams - notably medical teams, firemen, police officers and mental health workers - are all called upon to mitigate and minimize disaster effects. Of course, saving lives is of the utmost importance; saving minds, however, cannot be neglected. This book describes the processes of crisis intervention, community mental health promotion and post traumatic growth. Putting resilience at heart has led to the ACT-R approach which can be learned not just by social workers, but by all response workers.
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Disaster Social Work from Crisis Response to Building Resilience
HC Johnston Wong
Beijing Normal University Hong Kong Baptist University United International College, China
Series: Natural Disaster Research, Prediction and Mitigation
BISAC: SCI026000
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Softcover
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$82.00
Publication Date: December 2018
Status: At Press
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ISBN: 978-1-53614-435-2 Categories: Natural Disaster Research, Prediction and Mitigation, Natural Disasters, Environmental Sciences Tags: 9781536144369, 9781536144352, natural disasters
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Occurrences of disasters are becoming more frequent and serious. Other than natural disasters, humanity is faced with new challenges of city fires, car accidents, disease outbreak, industrial accidents, radioactive exposure, terrorist attacks, environmental hazards and other unimaginable incidents. Social workers and other city emergency response teams – notably medical teams, firemen, police officers and mental health workers – are all called upon to mitigate and minimize disaster effects. Of course, saving lives is of the utmost importance; saving minds, however, cannot be neglected. This book describes the processes of crisis intervention, community mental health promotion and post traumatic growth. Putting resilience at heart has led to the ACT-R approach which can be learned not just by social workers, but by all response workers.
Human beings are resilient and defined by a capacity for psychological and functional adaptation in the face of potential trauma and adversity. We present an integrative temporal framework that conceptualizes resilience as a dynamic process that unfolds over time and consists of the following four key elements: (a) baseline or pre-adversity functioning, (b) the actual aversive circumstances, (c) post-adversity resilient outcomes, and (d) predictors of resilient outcomes. In this way, the integrative framework offers a comprehensive synthesis of the growing body of research on resilience.
Nepal and adjoining areas of India suffered a series of massive earthquakes in April–May 2015. This was followed by a remarkable increase in the patient presenting with vague dizziness like features which could not be attributed to any defined variant of vestibular disorder. Extensive search of literature revealed only scarce information about ambiguous post-earthquake vestibular symptoms and their management. We performed a detailed epidemiological analysis of these patients to analyse the presentation, underlying mechanism and optimal management. The results were scrutinised in light of existing international literature. We observed that earthquake precipitated a psychological stress like event that provoked features of disequilibrium and the neuroanatomical basis of the proposition was explored. We renounce the hypothesis of Secondary BPPV precipitated by earthquake leading to symptoms. The results were interpreted from the perspective of Indian scenario and its utility in post-earthquake disaster management in our country has been highlighted.
Background: Following the earthquake in L'Aquila of 04.06.2009 more than 65,000 people lost their homes. In order to provide rapid accommodation to those people, the Italian Government implemented the CASE project (Complex Anti-seismic Sustainable Environment-friendly), with the construction of 19 "New town" in the surrounding areas of the city. The New towns are built in rural areas, far from the center of the city, without many basic services. The purpose of this study was to evaluate the prevalence of mental disorders, the levels of psychological symptoms and quality of life in a sample of the population living in such reality. Methods: Brief Symptom Inventory (BSI), the Impact of Events Scale-Revised (IES-R), and the Manchester Short Assessment of Quality of Life (MANSA), were used. Results: 107 people were interviewed. The mean scores of the GSI of the BSI were 0.70 (SD=0.55). The total score of the IES-R scale was used and the cut-off represented by the 33 value, was exceeded by 59.81% of the sample. The average value was 37.85 (SD=19.49) (range 0-83). 14 people of them (21.88%) obtained an average value ≥ 60. The mean score on the MANSA was 4.5 (SD=0.98), range 1.8-6.3. Conclusion: From the results, it appears that this housing solution could be an additional element of trauma that overlaps with that suffered during the quake.
Reviews the assessment of posttraumatic stress disorder (PTSD) and other disaster-related psychopathology following natural and human-made disasters. A brief history of disaster research is provided, and instruments used in recent studies are discussed. Data from the author's research on the relationships of several of these measures to clinically assessed PTSD are provided. The importance of multimethod assessment of PTSD and related symptoms is emphasized. Other factors potentially contributing to the development and maintenance of PTSD that should be assessed (i.e., stressors, individual factors, recovery environment) are also noted. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
Disasters can produce significant, lasting psychological sequelae. Much of the disaster work that mental health professionals can do falls outside of the more traditional roles usually taken by mental health professionals. These roles include reaching out to survivors through a variety of modes and rarely waiting for them to seek traditional forms of help. Much of what can be done does not require labeling individuals as disordered but may be done within the overall response of the community to the survivors on a variety of levels. To be most effective, we need to be involved in planning efforts that can be activated when disaster strikes, rather than being reactive to the situation after it has occurred. The potential range of responses can challenge the professional who wants to help his or her community when it has been affected.
This study systematically evaluated the psychological reactions of a nonclinical population to the October 1989 earthquake in the San Francisco Bay Area.
A representative group of about 100 graduate students from two different institutions in the Bay Area volunteered to participate in the study. Within 1 week of the earthquake, the authors administered a checklist of anxiety and dissociative symptoms to the subjects, and 4 months later they conducted a follow-up study with the same checklist.
The participants reported significantly greater numbers and frequency of dissociative symptoms, including derealization and depersonalization, distortions of time, and alterations in cognition, memory and somatic sensations, during or shortly after the earthquake than after 4 months. To a lesser degree they also reported significantly more nonsomatic anxiety symptoms and Schneider's first-rank symptoms at the earlier testing time.
These results suggest that among nonclinical populations, extreme distress may significantly increase the prevalence and severity of transient dissociative phenomena and anxiety. They provide further evidence of the role that dissociation plays in the response to trauma and are of considerable clinical and theoretical importance in view of the lifetime prevalence of traumatic experiences in the general population.
ABSTRACT During the summer of 1984, 14 seamen, the entire crew of a Norwegian ship, were seized upon arrival in Libya. They were kept under arrest for 67 days and subjected to psychological and physical torture because they were suspected of being enemies of the Libyan state. Within the first few days of imprisonment one seaman had been murdered, another had been abducted and was believed to be dead, and a third had been severely physically maltreated.
The immediate reactions to the extreme stress were fear, depression and rage. Not a single seaman gave in to the torture.
Shortly after their release, all the seamen underwent thorough medical examinations. Six of them suffered from clear-cut post-traumatic stress disorder (PTSD) and one more seaman developed the disorder two months later. In spite of comprehensive treatment, the same seven sailors, or 54% of the crew, still suffered from post-traumatic stress disorder six months after their release.
Used in conjunction with clinical interview, general mental status rating scales (GHQ 20, STAI, State Anxiety Inventory), and specific post-traumatic rating scales (Amnesty Score, IES intrusion subscale, PTSS-10) had a high sensitivity and specificity in discriminating between cases and non-cases.
A validated objective measure of the state of psychological function was used to determine the incidence and course of psychological dysfunction in a group of evacuees from Darwin following disaster caused by a cyclone (Cyclone Tracy). While psychological dysfunction was increased initially (58 per cent) and at ten weeks (41 per cent), it had returned to an Australian general population control level (22 per cent) at 14 months.
Factors influencing psychological dysfunction were examined, and it is suggested that the sample faced two different stressors at differing times. Initial psychiatric morbidity was most clearly associated with the experience of thinking that one might die or be seriously injured and therefore conceptualized as a ‘mortality stressor’. Psychiatric morbidity at ten weeks appeared to be most closely associated with what has been conceptualized as a ‘relocation stressor’.
Reasons why psychiatric morbidity decreased to a general population control level are discussed.
During the summer of 1984, 14 seamen, the entire crew of a Norwegian ship, were seized upon arrival in Libya. They were kept under arrest for 67 days and subjected to psychological and physical torture because they were suspected of being enemies of the Libyan state. Within the first few days of imprisonment one seaman had been murdered, another had been abducted and was believed to be dead, and a third had been severely physically maltreated. The immediate reactions to the extreme stress were fear, depression and rage. Not a single seaman gave in to the torture. Shortly after their release, all the seamen underwent thorough medical examinations. Six of them suffered from clear-cut post-traumatic stress disorder (PTSD) and one more seaman developed the disorder two months later. In spite of comprehensive treatment, the same seven sailors, or 54% of the crew, still suffered from post-traumatic stress disorder six months after their release. Used in conjunction with clinical interview, general mental status rating scales (GHQ 20, STAI, State Anxiety Inventory), and specific post-traumatic rating scales (Amnesty Score, IES intrusion subscale, PTSS-10) had a high sensitivity and specificity in discriminating between cases and non-cases.
With the advent of community psychiatry, the pressure of care of the mentally ill will increasingly fall on the family and the community. In order for this transition to succeed, it is important to bear in mind the attitudes of the community and the caregivers. This article reviews the literature on public attitudes and suggestions are made for future research and lessons to be learnt from the experience in North America.
ABSTRACT The breakthrough of Norwegian disaster psychiatry and traumatic stress studies came when the “Board of Norwegian Doctors of 1957” carried out exceptionally thorough and comprehensive studies of former concentration camp prisoners. These studies convincingly demonstrated that chronic mental illnesses could develop in persons who had a harmonious childhood but who had been subject to extreme physical and psychological stress.
During the seventies Norway became the first country in the world to have a University chair of disaster psychiatry. The scope of the field was broadened by the initiation of several studies on traumatic neurosis, industrial disaster and injuries. The support from the Joint Norwegian Armed Forces Medical Services, the University of Oslo, the Norwegian Research Council for Science and the Humanities, and later the Royal Norwegian Council for Scientific and Technical Research, was crucial for this development.
Currently stress and disaster psychiatry has become an integrated part of the care of victims who have suffered individual or collective disaster. Disaster psychiatry is taught in medical schools and is part of the obligatory training for residents in psychiatry.
This paper attempts to draw together some of the current questions related to the methodology of exploring the psychological and psychiatric aspects of human response to disaster. It sets out some of the key areas in which research questions might be mounted. A range of relevant instruments are suggested. The value of a structured interview which can explore issues of relevance to disaster victims is demonstrated. Early screening measures and proposals regarding these, as well as the particular instruments for longer term follow-up and assessment of outcome, are discussed in considerable detail. The article concludes with an overview of the principal issues to be addressed in methodology research, and emphasises the need for a collaborative approach using core items so that studies embracing different disasters and different countries can have some comparative basis.
Two months following the 1987 earthquakes in Ecuador, 150 patients in the primary health care clinics of the area were screened for emotional problems; 40% of them were emotionally distressed. Risk factors included not being married, reporting poor physical or emotional health, and having ill-defined physical complaints. The findings from this research are discussed in relation to a disaster of much greater intensity, whose victims were studied by the authors, utilizing the same instrument and research design. The comparison between these 2 groups of disaster victims revealed that: 1) the prevalence of emotional distress was smaller among the Ecuador victims, but the frequency of symptoms among the distressed was similar for both groups; 2) the symptom profiles were remarkably similar; and 3) the most frequent symptoms and the strongest predictors of emotional distress were very similar. These findings support a focused training of health care workers on selected emotional problems that are regularly present among victims of different disasters.
It is noted that research on the psychological effects of disaster, particularly with regard to rates of impairment, has turned up confusing and sometimes contradictory results. Two sets of dimensions salient to such investigations are noted: those which are aspects of disasters per se and affect actual rates of impairment ("true scores") and those which could be expected to affect estimates of impairment rates ("error variance") following disaster. Dimensions of disasters per se suggested by others are reviewed, and an additional dimension is proposed. Four methodological dimensions affecting reported impairment rates are described (sampling of subjects, level of data, case identification, and time of follow-up). Studies of long term psychological effects of disaster where some estimate of impairment was given are reviewed in order to demonstrate the noncomparability of findings from study to study due to methodological differences.
An international mental health relief programme for children and adults was implemented in Soviet Armenia after the 7 December 1988 Spitak earthquake. This paper presents: (a) the steps considered essential in the selection, preparation and support of mental health workers for the relief work; (b) a method which facilitated the screening and treating of large numbers of students in their classrooms; (c) the rate of post-traumatic stress disorder (74%) and major depressive disorder (22%) of 582 victims clinically evaluated before entering treatment three to six months after the earthquake; (d) clinical observations of significant psychological problems that may be overlooked in brief crisis-orientated psychotherapy; (e) multiple severe post-earthquake adversities (such as the collapse of the social network, the recurrence of after-shocks, the delay of reconstruction and the ongoing political turmoil) which contributed to the psychological problems of the victims and delayed their recovery; (f) the extension of the outreach programme beyond its traditional therapeutic role to an advisory one to other relief organisations.
This study was undertaken 1 1/2 years after the 1988 earthquake in Armenia to assess the frequency and severity of posttraumatic stress reactions among elderly and younger adult victims and to assess the relation of exposure, age, sex, and death of a family member to these reactions.
One hundred seventy-nine subjects of both sexes were evaluated with the Posttraumatic Stress Disorder (PTSD) Reaction Index. A subgroup of 60 individuals were also assessed for PTSD with the DSM-III-R criteria.
There was a strong association between the presence of severe symptoms on the index and a DSM-III-R diagnosis of PTSD. Elderly and younger adult victims in cities closer to the epicenter (higher exposure) had significantly higher index scores than elderly and adult victims in more distant locations. In comparison with previous studies of natural disasters, much greater rates of chronic severe posttraumatic stress reactions were found among the highly exposed individuals. Although there was no difference in total mean score on the Posttraumatic Stress Disorder Reaction Index, a significant difference in symptom profile was found between the elderly and younger adults; the elderly scored higher on arousal symptoms and lower on intrusive symptoms. There was a positive correlation between loss of family members and severity of posttraumatic stress reaction.
These findings indicate that after a major natural disaster with subsequent multiple adversities, a substantial proportion of the adult population may experience severe and chronic posttraumatic stress reactions. The risk factors identified in this study may prove useful in screening exposed individuals for appropriate treatment.
Crisis support was assessed over an 18-month period with survivors of the Jupiter cruise ship disaster. It was found that the support received from family and friends decreased significantly over time. In addition, higher crisis support in the immediate aftermath was found to predict less post-traumatic symptomatology at a later period. The results are thought to have implications for the assessment and treatment of survivors at high risk of disturbance.
Follow‐up study of the residents in villages damaged by the 1983 volcanic eruption in Miyake Island
- Miyake Y.
MIYAKE Y, OZAKI A, MIGUCHI M, KAMIMURA A, YOSHIMATSU K, MINOWA Y. Follow-up study of the residents in villages damaged by the 1983 volcanic eruption in Miyake Island. Jpn J SOC Psychiatry 1991: 14: 254-261 (in Japanese).
Study on psychiatric problems of evacuees of the volcanic eruption of Mt Unzen -factor analysis of General Health Questionnaire (GHQ-30)
- Mine M Honda
OHTA Y, ARAKI K, KAWASAKI N, NAKANE Y, MINE M, HONDA S. Study on psychiatric problems of evacuees of the volcanic eruption of Mt Unzen -factor analysis of General Health Questionnaire (GHQ-30). Jpn J SOC Psychiatry 1995: 3: 109-129 (in Japanese, English abstract).
Post-traumatic stress disorders in elderly and younger adults after the 1988 earthquake in Armenia Dissociative reactions to the San Francisco bay area earthquake of 1989 Post-traumatic stress disorder in vic-tims of disasters
- Goenjian Ak
- Najarian Lm
- Pynoos
GOENJIAN AK, NAJARIAN LM, PYNOOS RS et al. Post-traumatic stress disorders in elderly and younger adults after the 1988 earthquake in Armenia. Am J Psychiatry 11. CARDENA E, SPIEGEL D. Dissociative reactions to the San Francisco bay area earthquake of 1989. Am J Psychiatry 12. GREEN BL, LINDY J. Post-traumatic stress disorder in vic-tims of disasters. Psychiatr Clin North Am 1994: 17: 1989: 79: 74-82. 1994: 151: 895-901. 1993: 150: 474-478. 301-309.
Study on psychiatric problems of evacuees of the volcanic eruption of Mt Unzen ‐ factor analysis of General Health Questionnaire (GHQ‐30)
- Ohta Y.