The psychological impact of a catastrophic earthquake: a retrospective study 50 years after the event

'I cannot see ahead': psychological distress, doomscrolling and dark future among adult survivors following Mw 7.7. and 7.6 earthquakes in Türkiye

BACKGROUND

The earthquakes, which occurred on 6 February 2023, affecting a total of eleven provinces in Türkiye, with magnitudes of 7.7 and 7.6, and killing around 50,000 people, caused the greatest loss of life compared to previous earthquakes in Türkiye. In this study, we analyse the psychological status of the adult individuals who experienced the earthquakes three months after the earthquakes in terms of different variables.

METHODS

In this research, an analytical cross-sectional study was conducted by applying face-to-face and online questionnaires to 402 adult individuals who had experienced the earthquake. The Depression, Anxiety and Stress Scale (DASS-21), the Dark Future Scale and Doomscrolling Scale were applied. The relationships between variables are discussed in this study using the predictive correlational model.

RESULTS

The results revealed that the participants had very high levels of future anxiety and moderate levels of doomscrolling after the earthquake. Although their psychological distress levels were relatively low, as the psychological distress levels of adult individuals who experienced the earthquake increased, their doomscrolling also increased. In addition, as individuals' future anxiety increases, their doomscrolling increases similarly. The mediation analysis reveals that the mediating role of future anxiety between psychological distress and doomscrolling is significant (p < .001).

CONCLUSION

Individuals are more exposed to negative news streams in negative life events that occur beyond their control and they need to search for information. Increased levels of depression, anxiety and stress lead to more exposure to this flow. In addition, future anxiety is also an important trigger of this behaviour. The effects of psychological distress on individuals who survived the earthquake are discussed in the context of the literature.

Resource loss, coping strategies and post-traumatic stress disorder symptoms in survivors of the 2020 Croatia earthquake

BACKGROUND

Conservation of resources theory (COR) establishes a link between resource loss and the stress response. The aim of this study was to assess the contribution of resource loss in the form of home damage and the choice of active or passive coping strategies to PTSD symptoms in survivors of the 2020 Petrinja (Croatia) earthquake.

METHODS

A total of 374 adults (29.9% men) aged 18-64 years living in the counties surrounding the epicenter of the Petrinja (Croatia) earthquake participated in an online cross-sectional survey. The questionnaire included the PTSD Checklist for DSM-5 (PCL-5), the Coping Inventory, and the binary item assessing whether or not the participants' home was damaged.

RESULTS

Hierarchical regression analysis showed that home damage was a significant predictor of PTSD symptoms. Participants whose homes were damaged by the earthquake were significantly more likely to use passive coping strategies, namely avoidance and emotional venting, and one active coping strategy, action, than those whose homes were spared. Finally, more frequent use of passive coping was associated with a higher risk of PTSD symptoms.

CONCLUSIONS

The study corroborates the COR theory link between resource loss and the stress response, as well as the general consensus that passive coping is a less adaptive strategy than active coping. In addition to passive coping, individuals who lacked resources may have been inclined to take some active steps because they either needed to repair or relocate their homes and because most buildings were only moderately to minimally damaged in the Petrinja earthquake.

Moderating Effect of Personal and Community Resilience on the Relationship Between Disaster Trauma, Disaster Conflict, Economic Loss, and Post-traumatic Stress Disorder

OBJECTIVE

This study aimed to investigate the effects of disaster trauma, disaster conflict, and economic loss on posttraumatic stress disorder (PTSD), and to verify the moderating effect of personal and community resilience in these relationships. The data of 1914 people, aged 20 or above, who had experienced natural disasters (earthquake, typhoon, flooding) were used.

METHODS

Hayes's (2013) PROCESS macro (Model 1) was conducted to verify the moderation effect of personal and community resilience between PTSD and disaster trauma, disaster conflict, and economic loss.

RESULTS

Disaster trauma, disaster conflict, and economic loss were found to be positively related to PTSD. Personal and community resilience were negatively related to PTSD. Resilience had a moderating effect on the relationship between disaster trauma, economic loss, and PTSD. However, there was no moderating effect on the relationship between disaster conflict and PTSD. Community resilience had a moderating effect on the relationship between economic loss and PTSD. However, there was no moderating effect on the relationship between disaster trauma, disaster conflict, and PTSD.

CONCLUSIONS

The results suggest that personal and community resilience could be used for prevention and therapeutic interventions for disaster victims who experience PTSD.

The experiences of dealing with consequences of an avalanche - surviving soldiers' perspectives

Purpose: The aim of the study was to explore and describe experiences of daily life after having experienced an avalanche three decades ago.Method: This paper presents a qualitative study of 12 male survivors of an avalanche during their military service, interviewed 30 years post-disaster.Findings: A comprehensive understanding of the categories led to the latent theme "Finding my own way of managing and dealing with life". Findings revealed three categories describing experiences of daily living: (i) A comfortable life; (ii) A challenging, yet accomplished life; (iii) A demanding life. The first category represents a greater degree of using adaptive coping strategies for managing everyday life compared to the other two categories. The third category represents the group having the most challenging consequences. Among the three, the latter category conveys the most maladaptive coping strategies.Conclusions:The participants had different experiences with regards to their health and how they coped with their everyday life after the avalanche disaster. Insights into coping strategies may provide a guide for appropriate interventions for survivors dealing with traumatic events.

The trajectory of symptom burden in exposed and unexposed survivors of a major avalanche disaster: a 30 year long-term follow-up study

BACKGROUND

Limited research exists concerning the long-term effects of avalanches on survivors' mental health beyond the first years after the accident. The aims of this study were to describe and evaluate possible differences in long-term mental health symptoms after a major avalanche disaster between exposed and unexposed soldiers using a longitudinal design.

METHOD

Present mental health symptoms were examined among avalanche exposed (n = 12) and unexposed (n = 9) soldiers by PTSS-10, IES-15 and STAI-12 in four waves (1986-1987 and 2016).

RESULTS

Binary logistic regression revealed that the odds to score above the cut-off were significantly lower for both groups after one year compared to baseline for PTSS-10 (p = 0.018) and significantly lower after 30 days compared to baseline for IES-15 (p = 0.005). Data did not reveal significant differences between the exposed and unexposed groups regarding adjusted PTSS-10, IES-15 or STAI-12 mean scores compared. Linear mixed model-analyses revealed significant effects of time. The adjusted mean scores declined over time for both groups: PTSS-10 (p = 0.001), IES-15 (p = 0.026) and STAI-12 (p = 0.001), and the time trajectories for PTSS-10 were significantly different between the groups (p = 0.013). Although not significant (all p > 0.05), results indicated that a larger proportion of soldiers in the exposed group experienced posttraumatic stress symptoms (5/12) (PTSS-10 score ≥ 4) and distress symptoms (6/12) (IES-15 score ≥ 26) above cut-off points, 30 years post-disaster.

CONCLUSIONS

The course of mental health symptoms may persist, and even increase, in selected and trained military personnel 30 years after exposure to a natural disaster. These findings may be of great importance for health authorities planning appropriate follow-up.

Dealing With the Aftermath of Mass Disasters: A Field Study on the Application of EMDR Integrative Group Treatment Protocol With Child Survivors of the 2016 Italy Earthquakes

This study explored the effects of the EMDR Integrative Group Treatment Protocol (EMDR-IGTP) on child survivors of the earthquakes that struck Umbria, a region of central Italy, on August 24th and on October 26th 2016. Three hundred and thirty-two children from the town of Norcia and nearby severely disrupted villages received 3 cycles of EMDR-IGTP. The Emotion Thermometers (ET-5) and the Children's Revised Impact of Event Scale (CRIES-13) were administered before (T0) and about 1 week after the conclusion of the third cycle (T3) of EMDR-IGTP. At T3, older children showed a reduction of distress and anger, whereas younger children reported an increase on these domains; moreover, older children reported a greater reduction of anxiety than younger ones. A greater reduction of distress, anxiety, and need for help was evidenced in females, whereas a greater improvement in depressive symptoms was evidenced in males. The effects of the EMDR-IGTP treatment on post-traumatic symptoms were particularly evident in older children, compared to younger ones, and marginally greater in females than in males; moreover, a greater improvement was found in children who had received a timelier intervention, than in those who received delayed treatment. These results provide further evidence for the utility of EMDR-IGTP in dealing with the extensive need for mental health services in mass disaster contexts. Also, these data highlight the importance of providing EMDR-IGTP in the immediate aftermath of a natural disaster, to contribute significantly in restoring adaptive psychological functioning in children, especially in older ones.

Chilean Men Exposed to the Major Earthquake in 2010

The article presents the results of a study involving 18 men, 4 years after one of South America's most powerful natural disasters: An earthquake occurring off the coast of Chile in February 2010. Participants reported having developed new psychological health problems in the months following the catastrophe. The manifestations most frequently reported by participants were the presence of depressive and stress symptoms, as well as sleep disorders. The majority of participants registered scores of 33 and above on the Impact of Event Scale-Revised, indicating that they were suffering from posttraumatic stress. Furthermore, although the majority of interviewed men reported having suffered psychological or physical health problems following the disaster, only a small minority had sought help from professional health services. The article develops insights into the men's social interactions and underlines the importance of supporting further research on red health topics, in particular the help-seeking behavior of men following exposure to natural disasters.

Post-traumatic stress disorder among survivors two years after the 2010 Mount Merapi volcano eruption: A survey study

The Mount Merapi volcanic eruption in October 2010 was one of Indonesia's largest and most recent natural disasters. A cross-sectional study was undertaken to measure the psychosocial impact of the eruption on survivors in two locations in Yogyakarta, Java, Indonesia. The Impact of Event Scale Revised was used to assess participants' symptoms of post-traumatic stress disorder. Post-Traumatic Stress Disorder responses and demographic characteristics were compared in both locations by conducting bivariate analysis using Mann-Whitney and t tests. The relative contributions of demographic variables and psychosocial impact were examined using multiple linear regression analyses. Two years after the eruption, survivors from the area closest to the eruption had significantly higher Impact of Event Scale Revised scores than those in the comparison area. In particular, females, adults between the ages of 18 and 59, and people who owned their own home experienced the highest levels of psychosocial impact. Nurses and other health professionals need to be aware of the impact of natural disasters on survivors and develop interventions to help people adjust to the psychosocial impact of these events.

Psychological distress in survivors of the 2010 Haiti earthquake

Objective:

To investigate the presence of depression and anxiety symptoms in survivors of the Haiti earthquake who were assisted by a healthcare team from the Hospital Israelita Albert Einstein, and to evaluate the impact that losing a family member during this catastrophe could have on the development of these symptoms.

Methods:

Forty survivors of the Haiti earthquake who were assisted by the healthcare team between February and March of 2010 were included in this study. All subjects underwent a semi-structured interview. The group was divided into Group A (individuals who had some death in the family due to the disaster) and Group B (those who did not lose any family member).

Results:

A total of 55% of the subjects had depression symptoms whereas 40% had anxiety symptoms. The individuals who lost a family member were five times more likely to develop anxiety and depression symptoms than those who did not.

Conclusion:

Catastrophe victims who lost at least one family member due to the disaster were more likely to develop anxiety and depression symptoms. To these individuals, as well as others showing psychological distress, should be offered early mental health care to help them cope with the great emotional distress inherent in these situations.

Age, gender and epicenter proximity effects on post-traumatic stress symptoms in L'Aquila 2009 earthquake survivors

BACKGROUND

Earthquakes are among the most frequently occurring natural disasters affecting the general population and inducing Post-Traumatic Stress Disorder (PTSD). Thus, increasing effort has been devoted to explore risk factors for PTSD onset after exposure. The aim of the present study was to investigate the impact of gender, degree of exposure and age on PTSD and post-traumatic stress symptoms in the general population exposed to the L'Aquila 2009 earthquake (Richter Magnitude 6.3).

METHODS

A total sample of 1488 subjects (721 women and 767 men) was assessed by means of the Trauma and Loss Spectrum Self Report (TALS-SR): 939 subjects have been directly and 549 not-directly exposed to the earthquake. We performed a random extraction of units from the population in order to have 8 homogenous comparable subgroups.

RESULTS

A main significant effect of exposure (exposed>non exposed subjects) and gender (women>men) emerged on the TALS-SR domain scores. Further significant interaction effects of exposure(⁎)age and gender(⁎)age emerged with significantly more TALS-SR symptoms being reported in younger with respect to older non-exposed subjects and in younger with respect to older women.

LIMITATIONS

Social support was not examined systematically as well as major depression. Further limitations are the relatively small sample size and the use of lifetime instruments.

CONCLUSIONS

Our results corroborate literature on female gender and proximity to the epicenter being correlated to PTSD after earthquake exposure and suggest a possible secondary effect of age.

Survivors' experiences from a train crash

Rarely described are people's lived experiences from severe injury events such as train crashes. The number of train crashes named disasters with ≥10 killed and/or ≥100 nonfatally injured grows globally and the trend shows that more people survive these disasters today than did so in the past. This results in an increased number of survivors needing care. The aim of the study was to explore survivors' experiences from a train crash. Narrative interviews were performed with 14 passengers 4 years after a train crash event. Qualitative content analysis was used to analyse the interviews. Experiences were captured in three main themes: (1) Living in the mode of existential threat describes how the survivors first lost control, then were thrown into a state of unimaginable chaos as they faced death. (2) Dealing with the unthinkable described how survivors restored control, the central role of others, and the importance of reconstructing the event to move forward in their processing. (3) Having cheated death shows how some became shackled by their history, whereas others overcame the haunting of unforgettable memories. Furthermore, the result shows how all experienced a second chance in life. Experiencing a train crash meant that the passengers experienced severe vulnerability and a threat to life and interdependence turned out to play a crucial role. Focusing on helping other passengers on site was one way to regain the loss of control and kept the chaos at bay. Family, friends, and fellow passengers turned out to be extremely important during the recovery process why such closeness should be promoted and facilitated.

Disaster survivors in their third decade: trajectories of initial stress responses and long-term course of mental health

This study analyzed trajectories of initial stress and long-term mental health after the 1980 North Sea oil rig disaster. A growth-mixture model of the survivors' stress manifestations in the first 8 weeks (Posttraumatic Stress Scale, [PTSS-10]) and general mental health in 1980, 1981, 1985, and 2007 (General Health Questionnaire, [GHQ-20]) was estimated. Survivors' GHQ-scores in 1985 and 2007 were contrasted to those of a comparison group. Four trajectories were identified among survivors. The resilient (n = 43) displayed initially moderate stress that rapidly declined. The recovery (n = 10), chronic (n = 8), and relapse (n = 9) showed initially stable high stress scores, but the long-term mental health differed. Early screening may identify those at long-term risk.

Traumatic bereavement, acute dissociation, and posttraumatic stress: 14 years after the MS Estonia disaster

This prospective longitudinal study aimed to examine posttraumatic stress in survivors 14 years after a ferry disaster, and estimate short- and long-term changes in stress associated with traumatic bereavement and acute dissociation. There were 852 people who perished in the disaster, 137 survived. The 51 Swedish survivors were surveyed with the Impact of Event Scale-Revised (IES-R) at 3 months, 1, 3, and 14 years (response rates 82%, 65%, 51%, and 69%). Symptoms decreased from 3 months to 1 year; no change was found thereafter. After 14 years, 27% reported significant symptoms. Traumatic bereavement, but not acute dissociation, was associated with long-term symptom elevation. Chronic posttraumatic stress can persist in a minority of survivors, and traumatic bereavement appears to hinder recovery.

Tsunami-exposed tourist survivors: signs of recovery in a 3-year perspective

Long-term follow-up after disaster exposure indicates increased rates of psychological distress. However, trajectories and rates of recovery in large samples of disaster-exposed survivors are largely lacking. A group of 3457 Swedish survivors temporarily on vacation in Southeast Asia during the 2004 tsunami were assessed by postal questionnaire at 14 months and 3 years after the tsunami regarding post-traumatic stress reactions (IES-R) and general mental health (GHQ-12). There was a general pattern of resilience and recovery 3 years postdisaster. Severe exposure and traumatic bereavement were associated with increased post-traumatic stress reactions and heightened risk for impaired mental health. The rate of recovery was lower among respondents exposed to life threat and among bereaved. Severe trauma exposure and bereavement seem to have considerable long-term impact on psychological distress and appear to slow down the recovery process. Readiness among health agencies for identification of symptoms and provision of interventions might facilitate optimal recovery.

Female victimization and intimate partner violence after the May 12, 2008, Sichuan earthquake

This study investigates the impact of the earthquake that occurred on May 12, 2008 in Sichuan, China on stressed families already experiencing domestic violence. We hypothesized that cumulative postdisaster stress would increase marital aggression and that the well-being of victims would deteriorate following the quake. A total of 186 women were recruited for this study. Results show that all types of family violence, including psychological aggression and physical violence between partners, increased after the earthquake. We provided preliminary evidence that psychological aggression was significantly associated with the detrimental effects on victims' mental and physical functioning. The findings support the need for violence assessment among victims of earthquakes, and we recommend that violence prevention be considered as part of the intervention during such natural disasters.

Mental health outcomes and predictors of chronic disorders after the North Sea oil rig disaster: 27-year longitudinal follow-up study

The present study examined long-term mental health outcomes following a major disaster, including the relative risks (RR) of developing psychiatric disorders. Trauma exposure and predisaster vulnerability factors were examined as predictors of chronic psychopathology. Standardized questionnaires measuring psychological distress were completed 5½ months, 14 months, 5 years, and 27 years after the disaster. Twenty seven years after the disaster, 48 (79%) survivors and a matched comparison group of 62 (78%) nondisaster-exposed controls were assessed using the Structured Clinical Interview for DSM-IV, axis I Disorders. The prevalence of posttraumatic stress disorder among the survivors was 6.1%, and the risk of having a psychiatric disorder was more than 3 times higher than in the comparison group (RR = 3.44, 95% confidence interval = 1.6-7.6). Disaster exposure and general neurotic personality predicted chronic psychopathology, which was reported by 20.9% of the participants. Findings from this study suggest that increased risk of psychopathology persists 27 years after disaster. Both disaster exposure and vulnerable personality are important predictors of chronic psychopathology.

A three-year follow-up study of the psychosocial predictors of delayed and unresolved post-traumatic stress disorder in Taiwan Chi-Chi earthquake survivors

AIMS

To predict the longitudinal course of post-traumatic stress disorder (PTSD) in survivors three years following a catastrophic earthquake using multivariate data presented six months after the earthquake.

METHODS

Trained assistants and psychiatrists used the Disaster-related Psychological Screening Test (DRPST) to interview earthquake survivors 16 years and older and to assess current and incidental psychopathology. A total of 1756 respondents were surveyed over the three-year follow-up period.

RESULTS

A total of 38 (9.1%) of the original 418 PTSD subjects and 40 of the original 1338 (3.0%) non-PTSD subjects were identified as having PTSD at the 3-year post-earthquake follow up. Younger age, significant financial loss, and memory/attention impairment were predictive factors of unresolved PTSD and delayed PTSD.

CONCLUSIONS

The longitudinal course of PTSD three years after the earthquake could be predicted as early as six months after the earthquake on the basis of demographic data, PTSD-related factors, and putative factors for PTSD.

Initial stress responses in relation to outcome after three decades

The present study aimed at predicting posttraumatic stress 5 and 27 years after the North Sea oil rig disaster. The predictions were based on the initial levels of stress responses and the early recovery as reported in 1980. The Posttraumatic Stress Scale (PTSS) was used at 3 measure points. From 1980, data from 69 survivors were used in latent growth modeling. Follow-up studies included 65 survivors and 85 matched unexposed oil-rig workers in 1985; and 47 and 62 in 2007. In 1985, the survivors had higher total PTSS scores and more frequent endorsements on most single PTSS-items than the comparison group. In 2007, a few single items remained different. The initial levels of stress responses and the early recovery rate predicted the long-term outcomes after 5 and 27 years. Initial screenings may be helpful in the early detection of posttraumatic stress in the very long-term perspective.