Psychological Distress in Natural Disaster Literature Review

Psychological Distress in a Natural Disaster

Among the many problems that humans encounter following a natural disaster is Post Traumatic Stress Disorder (PTSD). PTSD can result from natural disasters like floods, earthquakes, tsunamis, hurricanes, tornados among other frightening natural events that cause damage and result in serious injuries and loss of life. When humans are exposed to horrific natural disasters they may continue to carry the fearful events in their memories; those realistic recollections can haunt the individual to the point of causing serious psychological disorders. Hence, PTSD can become a very serious emotional problem that requires psychological help from professionals. This paper provides instances of PTSD research following natural disasters -- and studies that delve into the dynamics of PTSD that resulted from natural disasters, including the terrible flooding in Thailand in 2000

Literature Review -- Hat Yi Flood

When severe rains caused a dangerous flood that killed about 32 people in Thailand in November, 2000 (the Hat Yai flood), around 1,700 people were injured. There was certainly tremendous damage to property as well, but the focus of an article in the peer-reviewed journal Stress and Health is on the psychological problems that had a serious impact on citizens. According to the General Health Questionnaire (GHQ) that was given to survivors of the flood, and the Impact of the Event Scale (IES) that was also administered to survivors, about 40% of the 590 respondents who took the GHQ showed mental health issues associated with the flood (Assanangkornchai, 2004, p. 81).

The tests mentioned above were given to the Thai citizens ten weeks after the catastrophe, and it was determined that the health problems faced by these individuals included sleep disturbances and fear -- some people were terrified during the flood because they were not absolutely certain as to when the waters would actually subside (Assanangkornchai, 83). As to the results of the psychological testing, those individuals that had a "…positive GHQ score had a significantly higher mean IES score than those…" that didn't have a significant IES score on their test (Assanangkornchai, 85). What the authors conclude in the Discussion portion of the article is that respondents who believed their "personal loss" was "severe" -- or who knew someone that had lost important personal possessions -- were far more likely to score high on the GHQ, and to also have "higher" IES scores, Assanangkornchai continued (88).

Other studies following natural disasters show the same thing that the authors discovered in this research, and that is the severity of loss is among the most important variables that determines whether a victim is actually suffering from post traumatic stress disorder. Six months after Hurricane Mitch struck Nicaragua people suffered PTSD; hence, this problem of stress following a natural disaster -- in various places around the world -- is very serious and so there should be mental health services available for people following major natural disasters.

Literature Review -- Chi-Chi Earthquake Survivors in Taiwan

The peer-reviewed journal Psychiatry and Clinical Neurosciences published an article that reflects a study of PTSD earthquake survivors in Taiwan three years after the quake. The research originally conducted was done six months after the huge 7.3 magnitude earthquake. In that study, it was determined that 418 of those 1,756 survivors were suffering from PTSD. Three years later, the research shows that 38 of those 418 PTSD sufferers (that is 9.1%) were still showing strong signs of PTSD (Su, 2010, p. 239). And of the original 1,338 survivors that were diagnosed as not having symptoms of PTSD, three years later 40 of those individuals were indeed diagnosed with PTSD (Su, 239).

The authors point out that using DSM-IV diagnostic criteria, there are three "core psychopathologies" associated with PTSD. People tend to "re-experience" the frightening event; individuals experience a kind numbness and "avoidance"; and "hyper arousal" is the third component to PTSD (any event that reminds the person of that traumatic event arouses new fear) (Su, 239). The screening was done using the Disaster-related Psychological Screening Test (DRPST), which consisted of a list of questionnaires that were created by five psychiatrists and two public health officials, Su explains on page 241.

Eight "putative risk factors" were built into the screening by the psychiatrists to help evaluate the reasons for their PTSD diagnoses: a) household destruction; b) being physically injured during the earthquake in Taiwan; c) the loss or serious injury to a member of one's family; d) the emotional issues linked to a family member's death; e) a dramatic decrease in socially-related activities; f) loss of a job because of the quake; g) significant financial losses; and h) impairment on one's memory and attention span (Su, 241). Those eight putative factors were considered by the researchers to be more than just predictors of PTSD; in fact the eight factors were pivotal in determining "unresolved and delayed PTSD" in the group of 1,756 survivors (Su, 242).

Because of the fact that nearly 27% of the survivors had less than a primary school education, those agreeing to be interviewed 6 months and 3 years after the horrific event needed to be helped in terms of filling out the questionnaire (translators were on hand).The bottom line for Su and colleagues -- resulting from their findings three years after the fact -- is that when people are exposed to a massive earthquake, the clinical evaluation should include checking for PTSD symptoms and using the putative risk factors for PTSD (Su, 244). For many of those survivors that were originally evaluated, early mental health intervention may have prevented the continuing presence of PTSD. When PTSD is not resolved at the outset in some meaningful way, continuing pain (both physical and psychological) can result, causing social and personal impairment, Su explains (245).

Literature Review -- Floods and PTSD Studies

An article in the Journal of Family Violence reviews the extent of psychological trauma that was experienced by female victims in 1993 in the flooding of the Mississippi River. The authors invited 564 women to participate 6 months after the flood but only 36.3% were willing to participate. In fact some of the women who withdrew from consideration were told not to be part of the survey by their husbands and significant others (Taft, et al., 2009, p. 391). The assessments were made using the National Women's Study PTSD module, the Dyadic Adjustment Scale (DAS), the Verbal Aggression subscales of the Conflict Tactics Scale (CTS).

The assessments took place at the participants' homes (no male partners were present during the research); the participants filled out the questionnaire on laptop computers, they were verbally de-briefed afterwards by a Masters-level assessor, and were paid $25 for their willingness to participate (Taft, 391). This was a test of how much aggression (physical and psychological) women would experience or dish out following the floods. The results showed that women experienced an 8% rise in physical aggression from their spouses and a 74% rise in psychological aggression as well. But the women in this study also perpetrated aggression, due to the presence of PTSD symptoms, Taft explains on 392-93. Women perpetrated a 9% rise in physical aggression six months after the horrific flooding and a 55% rise in psychological aggression (Taft, 392).

The bottom line in this research is that relationships suffer when a major natural disaster takes place, and when there is a relationship that isn't strong in the first place, a disaster can cause one or both parties (that had suffered from PTSD) to behave very badly and even violently.

Using the Harvard Trauma Questionnaire (trauma and symptoms that are associated with PTSD), and the Hopkins Symptom Checklist (to evaluate anxiety and depression) the authors in a peer-reviewed article (Psychology, Health & Medicine) reported on the results of a survey in England following severe flooding. Four hundred and forty four questionnaires were returned fully completed and of those 27.9% "met criteria" for symptoms that are directly linked to PTSD (Mason, et al., 2010, p. 61). As to anxiety, 24.5% responded that they indeed had serious bouts with anxiety during and after the floods, and 35.1% reported symptoms associated with depression (Mason, 61).

Not surprisingly, women in this research were more susceptible to PTSD than men, which is fairly consistent no matter what the natural disaster happens to be. Mason and colleagues admit that those that were directly affected experienced less negative psychological symptoms than victims of huge earthquakes and tsunamis albeit those that had gone through floods in previous years were more apt to have poor psychological outcomes.

Another article that delves into the psychological aftermath of those same English floods resulted in a study that was published in the Journal of Water and Health (Tunstall, et al., 2006). In this article, the authors employed the General Health Questionnaire and the results showed that some victims of the flood suffered health impacts that were long-term.

Some 983 interviews took place with adults over 18 whose homes had been directly impacted by the rising waters (above floor level) and….....