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An empirical evaluation of eye movement desensitization and reprocessing (EMDR) with survivors of a natural disaster.

Controlled studies of treatments effective with victims of natural disasters are almost nonexistent. This is a small study conducted under difficult conditions to test the effectiveness of Eye Movement Desensitization and Reprocessing (EMDR) in treating trauma related reactions following Hurricane Andrew. The results were positive in that EMDR produced significant improvement over wait list controls in perceived posttraumatic avoidance behaviors and thoughts as measured by changes in the Impact of Event Scale and significant improvement in subjective aversive reactions to representative experiences of the hurricane. These results suggest and support other studies that EMDR can be an effective therapeutic intervention for trauma reactions.

Adaptation, Psychological↗

Identity, place, and bystander intervention: social categories and helping after natural disasters.

The authors developed a Self-Categorization Theory (SCT) approach to bystander behavior. Participants were 100 undergraduates at an English university. The authors made either a European or a British identity salient. Participants then rated their likelihood of offering both financial and political help after natural disasters in Europe and South America. When European (but not British) identity was salient, participants were less likely to offer help for disasters in South America than Europe. They were also more likely to offer financial help after disasters in Europe when European non-British identity was salient. There were no differences in levels of emotional response to disasters by identity salience. Results indicate that social category relations rather than geographical proximity or emotional reaction are most important in increasing helping behavior after natural disasters.

Adult↗

The study of natural disasters, 1977-1997: some reflection on a changing field of knowledge.

As part of a series of papers to mark the 21st year of publication of Disasters, it is opportune to consider some of the changes that have occurred in the field it has covered so diligently for the last two decades. The paper begins with a brief review of the major natural disasters during this period and assesses their impact. It then considers the problem of how to define two key concepts: natural disaster and vulnerability, which remains an open question. The latter is one of the key determinants of the former. Next comes a review of what has occurred in the disasters field since the journal began publication, including some notes on the rise in vulnerability, the information technology revolution and the dilemmas of hazard mitigation. The following two sections assess, respectively, what hoped-for developments did not occur during the period studied and what assets were lost in the name of progress. For example, on the theoretical front, academic over-specialisation has predominated, while on the practical side there has been insufficient transfer of technology to where it is needed. The paper concludes that analyses of disaster need to become more sophisticated and multi-disciplinary and must take account of several forms of context within which developments take place.

Disaster Planning↗

The city of Calgary plan for natural disaster.

THE DETAILS OF A PLAN TO COPE WITH ANY NATURAL DISASTER IN THE CITY OF CALGARY OR SURROUNDING AREA ARE PRESENTED IN TERMS OF: (1) the method of alerting personnel, (2) the mobilization of hospital authorities, additional hospital personnel, Civil Defence volunteers and Emergency Service facilities to deal with large numbers of injured victims; and (3) arrangements for the collection, feeding, clothing and temporary rehousing of those rendered homeless and deprived of the basic essentials of life.

Civil Defense↗

Psychiatric morbidity following a natural disaster: an Australian bushfire.

This study investigated the prevalence of mental health problems after a major bushfire in Australia and examined the validity of the General Health Questionnaire (GHQ) (Goldberg 1978) against the Anxiety, Affective and Post-Traumatic Stress Disorder modules of the Diagnostic Interview Schedule (DIS; Robins et al. 1981). Study 1 was carried out 12 months after the Ash Wednesday bushfires and sought to include all the victims of the fires. Study 2 was conducted 20 months after the fires and included a sample of victims who had experienced major losses in the fires. Twelve months after the fires, 42% (n = 1,526) of the victims were defined as a potential psychiatric case using the GHQ. This rate indicated a significantly greater level of morbidity than found in communities that have not experienced a natural disaster. Twenty months after the fires, 23% (n = 43) were defined as "cases". The 28-item GHQ was found to be a valid instrument for defining the presence of psychiatric disorder in a disaster-effected community. The findings demonstrated that lasting psychiatric morbidity is associated with natural disasters.

Australia↗

Natural disaster potential and counterdisaster planning in Australia.

Counterdisaster planning for mass fatalities begins with an analysis of the types of disasters likely in a given area and the vulnerability of the area to those disasters. Mass-fatality disasters can be classified as man-made or natural. A historical list of the major man-made disasters in Australia is provided. Potential natural, disasters in Australia, such as bush fires, floods, cyclones, and earthquakes, are discussed. The Australian Bureau of Meteorology provides warnings in many of these situations. Counterdisaster planning in Australia is primarily a state responsibility. The Natural Disasters Organisation of the Federal Department of Defence operates an Australian Counter-Disaster College.

Aircraft↗

Prevalence, risk factors and aging vulnerability for psychopathology following a natural disaster in a developing country.

OBJECTIVES: This study explored the psychopathological reactions to a natural disaster and their respective risk factors among the elderly in Honduras and their vulnerability as compared to other adults. STUDY SUBJECTS AND SAMPLE: Eight hundred respondents of both genders aged 15 years and above, of which 103 were 60 and over, were selected from high, middle and low residential status areas in Tegucigalpa that had suffered high and low exposure to the devastating effects of Hurricane Mitch. RESEARCH INSTRUMENTS: CIDI was used to diagnose PTSD and the Impact of Events Scale was administered as a measure of severity of post-traumatic reaction. Depression and alcohol misuse were examined using screening instruments. The SRQ was used as both a measure of emotional distress and dichotomized to screen for probable psychiatric disorder. RESULTS: PTSD, depression and SRQ-case were found, respectively in 13.6%, 18.8%, and 21.4% of the elderly. Their reactions did not differ in frequency than of those of younger adults. Among the elderly, pre-hurricane psychological problems and the intensity of exposure were associated with increased risk for all outcomes measured except for alcohol misuse. CONCLUSION: No evidence was found for a differential vulnerability on the part of the elderly as compared with younger adults. Among the elderly increasing age was not a factor.

Adolescent↗

Post-traumatic stress disorder, depression and generalised anxiety disorder in adolescents after a natural disaster: a study of comorbidity.

BACKGROUND: Information on mental health sequel in adolescents following natural disasters from developing countries is scant. METHOD: Around one year after a super-cyclone, proportion of adolescents exhibiting post-traumatic psychiatric symptoms, prevalence of post-traumatic stress disorder (PTSD), major depression and generalized anxiety disorder, comorbidity and impairment of performance in school were studied in Orissa, India. Mini International Neuropsychiatric Interview for children and adolescents was used for evaluation and diagnosis. The criteria for diagnoses were based on Diagnostic and Statistical Manual of Mental Disorders-IV. RESULTS: Post-disaster psychiatric presentation in adolescents was a conglomeration of PTSD, depression and anxiety symptoms. The prevalences of PTSD, major depressive disorder and generalised anxiety disorder were 26.9%, 17.6% and 12.0% respectively. Proportion of adolescents with any diagnosis was 37.9%. Comorbidity was found in 39.0% of adolescents with a psychiatric diagnosis. Adolescents from middle socioeconomic status were more affected. There were gender differences in the presentation of the symptoms rather than on the prevalence of diagnoses. Prolonged periods of helplessness and lack of adequate post-disaster psychological support were perceived as probable influencing factors, as well as the severity of the disaster. CONCLUSION: The findings of the study highlight the continuing need for identification and intervention for post-disaster psychiatric morbidities in adolescent victims in developing countries.

Journal Article↗

Family functioning and overprotection following a natural disaster: the longitudinal effects of post-traumatic morbidity.

The longitudinal impact of a natural disaster on the patterns of interaction in families with latency-aged children is examined. An 11-item questionnaire was developed and two factors were isolated: irritable distress and involvement. A group of 183 disaster-affected families were contrasted with 497 families who had not been exposed to the disaster. Eight months after the disaster, the interaction in the disaster-affected families was characterised by increased levels of conflict, irritability and withdrawal. Maternal overprotection was also a common feature of the pattern of care in these families. Post-traumatic morbidity in parents was the major determinant of the observed changes in family functioning and the overprotection.

Child↗

Natural disasters.

This article presents the health effects of some of the more important acute natural disasters and outlines requirements for effective medical response to these events (table 7). In summary, although all disasters are unique in that they affect regions of the world with differing social, economic, and health backgrounds, there are similarities among disasters, which, if recognized can optimize the management of health relief and the use of resources.

Adolescent↗

Community perceptions of natural disasters and post-disaster mental health services.

This research was designed to examine the cognitive and affective responses of residential dwellers in the aftermath of a natural disaster (a flood). In a 2 X 3 factorial design, the effects of fear (High, Medium, and Low) and sex on perceptions of the disaster were assessed. The results indicated that respondents who were highly fearful of the disaster were more likely than moderate or low fear respondents to believe that: a) additional flooding would occur in their vicinity, and b) that they resided closer to the flood zone than they actually did. The policy implications of the results suggested that post-disaster mental health services might have to be extended to include residents of geographical areas not directly affected by natural or man-made disasters.

Arizona↗

Short- and long-term association between uric acid and a natural disaster.

OBJECTIVE: This paper analyzes the longitudinal relationship between serum uric acid level and a natural disaster. METHODS: The sample consists of factory workers who were participating in a longitudinal epidemiological study of coronary heart disease risk factors. Participants were seen in 1975 (baseline), 1980 (5 year follow-up), and 1987 (12 year follow-up). The 5 year (1980) follow-up examination was interrupted by a major earthquake and resumed 2 weeks after the quake. At this examination, participants seen after the quake had, on the average, significantly lower serum uric acid than those seen before the earthquake. In 1987 (7 years after the quake), participants were questioned whether or not (in their own perception) they were still suffering from damages due to the 1980 earthquake. RESULTS: At the examination in 1987, participants who reported suffering from damage due to the 1980 quake showed on the average significantly increased serum uric acid compared with participants who reported not suffering from damages due to the 1980 quake. The analyses of the data of 578 individuals who participated in all three examinations confirmed these findings and showed that they were independent from levels of uric acid measured prior to the disaster. CONCLUSIONS: The reason for this apparent different association with uric acid and acute and long-term exposure to the quake remains to be clarified but these findings are consistent with the existence of diverse patterns of physiologic response to different stressors.

Adaptation, Psychological↗

Mental health problems and natural disaster: tornado victims.

Twenty-six tornado victims were interviewed to determine the mental health consequences of a natural disaster. The results, based on retrospective accounts indicated that approximately three-fourths of the victims suffered increased psychological discomfort of a subjective nature five months later. This discomfort was characterized by anxiety, nervousness, and mild somatic complaints. Disruptions in interpersonal relationships among family members were less frequently reported. The disaster did not produce severe emotional impairment and few of the victims felt the need for professional mental health assistance.

Adult↗

First-aid training and capabilities of the lay public: a potential alternative source of emergency medical assistance following a natural disaster.

Basic first-aid skills can be useful in treating minor injuries that commonly result from natural disasters in the United States. Yet there has been insufficient research on training and competence in first-aid skills among community residents. This study utilises panel data for 414 adults in Los Angeles, California, who were interviewed within three years of the 1994 Northridge earthquake and re-interviewed in 1999 after the El Ninõ winter of 1997-98. Descriptive, bivariate and multivariate analyses were performed. Results showed that 24 percent of the members of the sample had received first-aid training since their Northridge earthquake interview. First-aid training, particularly recent training, was associated with greater perceived first-aid skills, as well as with increased expected and actual employment of those skills. With the appropriate training and skill retention, lay members of the public can potentially contribute to a post-disaster medical response.

Adult↗

Health related response to natural disasters: the case of the Bangladesh cyclone of 1991.

This paper evaluates the health related response to large natural disasters using the example of the recent Bangladesh cyclone of 1991. After providing a description of the extent of the health response, it focuses on three major issues: (i) assessment of needs (ii) coordination of major groups involved in health relief and rehabilitation efforts and (iii) appropriateness and effectiveness of the health response in terms of definable outcome criteria. The conclusions are that in the case of the Bangladesh cyclone: (a) the assessment of needs was more reactive rather than anticipatory and was not based on any systematic data gathering from the field; (b) in contrast to previous disaster situations there was excellent coordination of the major groups involved in the aid process (the government, the armed forces and non-governmental organizations) and (c) given the caveat of inadequate baseline information, it appears that the health response was prompt and effective in preventing any increase in mortality from diarrheal diseases and measles. The reasons for the deficiencies and successes of the health response are analysed and finally a list of detailed recommendations to facilitate future disaster/cyclone management and response is provided.

Bangladesh↗

Somatic symptoms after a natural disaster: a prospective study.

The authors prospectively examined the prevalence of somatization symptoms among community respondents after a natural disaster in Puerto Rico. Exposure to the disaster was related to a higher prevalence of medically unexplained physical symptoms, particularly gastrointestinal ones (abdominal pain, vomiting, nausea, excessive gas) and pseudoneurological ones (amnesia, paralysis, fainting, unusual spells/double vision).

Disasters↗