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PubMed2006

Treating the victims after disaster: physical and psychological effects.

Disaster victims present in waves. The initial presenting group is traditionally suffering from mild physical injuries, and the second wave, usually following 6 h later, typically has more serious trauma. Medical problems typically are not adequately treated when a person has psychological reasons to worry about survival. The third wave of victims from untreated medical problems occurs 6 d after the initial disaster. Triage of the initial waves is important to prevent the system from becoming overwhelmed and to begin looking for those who will suffer long-term psychological sequelae. Early intervention in those at greatest risk for long-term issues is important and can be accomplished.

Disaster Planning↗
PubMed1987

Acute posttraumatic stress disorder in victims of a natural disaster.

Five months after a tornado devastated a rural community in eastern North Carolina, the authors surveyed the mental health status of 116 disaster victims, using the Hopkins Symptom Checklist (HSCL) expanded to include most of DSM-III criteria for posttraumatic stress disorder (PTSD). A total of 69 (59%) victims met the criteria for acute PTSD, 19 of whom had a severe form. Although an inadequate degree of social support was more often noted in victims with severe PTSD, other demographic factors and degree of injury or property damage did not appear to be related to the presence of PTSD. Severity or presence of PTSD was supported by high scores on all HSCL subscale factors. These findings suggest a high incidence of acute PTSD in victims of natural disasters and the potential value of HSCL in screening for PTSD in large populations.

Acute Disease↗
PubMed1995

In search of altruistic community: patterns of social support mobilization following Hurricane Hugo.

Twelve months after Hurricane Hugo, 1,000 disaster victims and nonvictims were asked about social support they exchanged following the hurricane. Victims of disaster received and provided very high levels of tangible, informational, and emotional support. Disaster exposure (loss and harm) was a strong predictor of help received and a modest predictor of help provided. However, postdisaster help was not distributed equally and disaster exposure was more strongly related to social support in some groups than in others. Race, education, and age most consistently moderated the impact of disaster exposure on receipt of postdisaster support. Blacks and less educated victims received less help than similarly affected victims who were white or more educated. Relative disadvantage of being old in receiving support was not the case for those elderly disaster victims who experienced threats to their lives or health. Some subgroups of victims were relied upon disproportionately for providing assistance. Implications for social support research are addressed.

Adaptation, Psychological↗
PubMed1997

Identification by DNA analysis of the victims of the August 1996 Spitsbergen civil aircraft disaster.

Disaster victim identification traditionally relies on the combined efforts of police, dentists and pathologists, comparing ante mortem (AM) information from the missing persons with post mortem (PM) data from the dead bodies. In Western countries, dental evidence has ordinarily played the major role. DNA analysis has been used successfully in a number of large accidents to associate body parts and for purposes of identification, by comparing victims' DNA profiles with those of relatives. However, DNA typing is still not generally regarded as an essential part of disaster victim identification. Facing the August 1996 Spitsbergen aircraft accident in which 141 Russians and Ukrainians died and anticipating scanty ante mortem dental data, it was decided to use DNA profile analysis as the primary identification method. Material collected at the scene from all body parts, and blood sample from relatives were analysed at eight polymorphic microsatellite and minisatellite loci, DNA profile comparisons enabled us to sort the 257 typed body parts into 141 individuals, as well as identifying the 139 victims for whom reference samples were available. Identification by DNA analysis was then followed by comparisons of traditional AM and PM data, and within day 20 of the accident the identities of all victims were confidently established. This investigation indicates that it might be feasible to replace traditional identification efforts with DNA typing.

Aircraft↗
PubMed2006

The course of post-disaster health problems of victims with pre-disaster psychological problems as presented in general practice.

BACKGROUND: Survivors of disaster with pre-disaster psychological problems are believed to be at risk for presenting post-disaster psychological and physical morbidity. Up till now this statement is based on cross-sectional studies with self-reported data and without pre-disaster measurement. OBJECTIVE: To monitor post-disaster health care utilization and morbidity presented in general practice after a man-made disaster by victims and controls with and without pre-disaster psychological problems. METHODS: A controlled cohort study with pre-disaster (1 year) and post-disaster (two-and-a-half years) data. Victims (N = 2518) of an exploding fireworks depot in a residential area and matched controls (N = 2512), representing patients in 30 general practices, were included. Main outcome measures were utilization measured by GP attendances, and psychological and physical problems registered by the GP using the International Classification of Primary Care. RESULTS: Only victims without pre-disaster psychological problems demonstrated a significant increase in utilization in the first half year post-disaster. Victims with pre-disaster psychological problems did not. Being a victim (OR = 6.13; 95% CI = 4.84-7.77) had a greater effect than pre-disaster psychological problems (OR = 4.96; 95% CI = 3.96-6.21) on presenting post-disaster psychological problems. Pre-disaster psychological problems had more effect (OR = 1.93; 95% CI = 1.79-2.08) than the effect of being a victim (OR = 1.25; 95% CI = 1.18-1.32) on the development of post-disaster physical symptoms. CONCLUSION: Post-disaster increases in utilization and psychological morbidity were observed. Post-disaster psychological problems were more influenced by the disaster, while post-disaster physical symptoms were more influenced by pre-disaster psychological problems. GPs should concentrate on the pre-disaster health history of victims of man-made disasters in their practices.

Accidents↗
PubMed2001

Increased alcohol use in a treatment sample of Oklahoma City bombing victims.

Research examining alcohol use in disaster victims has yielded conflicting results. This study of 43 acknowledged alcohol users, taken from a nonrandom volunteer sample of Oklahoma City bombing victims receiving support services, revealed relationships between increased alcohol use and a number of variables--injury, retrospectively reported initial reaction to the explosion, grief, and posttraumatic stress symptomatology. The findings suggest that if alcohol use was motivated by an attempt to alleviate symptoms, it was not effective, as evidenced by an association between increased alcohol use and functional impairment. Increased alcohol consumption may present a problem in disaster victims months after exposure to trauma. Therefore, the use of alcohol should be routinely assessed in those who remain symptomatic over time.

Adult↗
PubMed1997

Radiographic identification of fragmentary human remains from a mass disaster.

Positive identification of human remains is one of the most important tasks in mass disaster management. Here we report on the use of radiography for positive identification of fragmentary human remains recovered from the scene of a terrorist bombing in the Jewish-Argentine Mutual Association Center in Buenos Aires, Argentina, in July 1994. Radiographic examination of all human remains from mass disaster scenes is recommended for identification purposes. Establishing a computerized data bank of antemortem information on missing persons and postmortem findings in disaster victims greatly facilitates and expedites the identification process.

Aged↗
PubMed1989

Victims of crime as victims of disaster.

The gross disparity between the routine attention paid to criminals and that paid to their victims led to the proposition that victims of major crime be treated as victims of disaster. The fresh appraisal might provide the impetus for appropriate services for them as a matter of social policy.

Adaptation, Psychological↗
PubMed1989

An explanatory model of recovery from disaster loss.

The development and testing of an explanatory model of recovery from disaster loss are described. The sample consisted of 155 persons at Time1-1981, 101 persons at Time2-1983, and represented five magnitudes of disaster loss: bereaved of disaster victims presumed dead; bereaved of disaster victims confirmed dead; persons whose permanent homes were destroyed; persons whose recreational property was destroyed; and a no disaster-loss comparison group. Data tested in the model were collected 1 and 3 years following the volcanic eruption of Mt. St. Helens in 1980 on eight variables: magnitude of loss, mass media coverage, negative rating of change, change in income, self-efficacy, social support, satisfaction with financial settlement, and mental distress. Path analysis was selected to estimate the magnitude of hypothesized direct and indirect linkages between variables presumed as causes of variables treated as effects. Results showed an improvement of goodness of fit by testing the model with the 1981 data, respecifying the model, and testing it again with the 1983 data. The greatest explanatory effects on mental distress 3 years postdisaster were mental distress reported 1 year postdisaster and negative ratings of change associated with disaster loss.

Bereavement↗
PubMed1987

A taxonomy of disasters and their victims.

A taxonomy of disasters is presented in which the two major axes of causes and elements are considered adequate for plotting on one grid the different kinds of disaster that occur. Then the disaster victims are differentiated into six groups according to the type of their involvement, their function, their culpability, their self control and certain extraneous factors. The purpose is to integrate different studies of disaster, to elicit common concerns, to offer common remedies, and to generate further research.

Disasters↗
PubMedDate not supplied

Response of the elderly to disaster: an age-stratified analysis.

This article analyzes the effects of chronological age of disaster victims on their responses to stress effects of natural disasters. Previous research is reviewed and major findings of that research are noted. Findings regarding disaster losses, physical impacts, aid utilization patterns, kinship relations, relative deprivation, social-psychological impacts, neglect of elderly disaster victims, and differential recovery rates by age are retested on new data. Data described herein were gathered using survey techniques in two disaster stricken communities in Texas. Elderly victims' responses to the tornadoes are compared to a nonelderly (under sixty years of age) group to assess differences. Findings of previous research were, in many instances, supported although certain divergences between the current findings and preceding findings are noted, particularly in rates of recovery.

Adult↗
PubMed1990

Post-traumatic stress disorder in disaster survivors.

In spite of the difficulties inherent in the study of traumatic stress in disaster victims, the benefit of obtaining more knowledge on the subject is potentially great, especially considering the numbers of individuals affected. Recent estimates of the frequency of world-wide traumatic events have determined that almost two million households annually experience damages and/or injuries from fire, floods, hurricanes, tornadoes, and earthquakes alone. The population that is at risk is expected to grow exponentially with our expanding technology, making it even more vital to acquire knowledge to help the growing number of future disaster victims. Additionally, disaster research can contribute to a better understanding of PTSD and human coping processes that can be generalized to more ordinary stress situations. In the meantime, survivors of major catastrophes who experience acute symptoms of PTSD such as insomnia, nightmares, and jumpiness should be observed for nonresolution of symptoms over time, especially if there is a premorbid history of psychopathology or character problems. Otherwise, survivors may benefit from reassurance that PTSD symptoms are common in the short-term postdisaster period and that they can usually be expected to dissipate with time.

Adaptation, Psychological↗
PubMed1976

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↗