Feelings, Thoughts, and Behaviors During Disaster

Immediate and evolving emotions among directly exposed survivors 7 years after the Oklahoma City bombing

The Oklahoma City bombing in 1995 was one of the most devastating incidents of terrorism in America at that time. Existing research has not examined changes in emotional responses outside of psychopathology to disaster over time. The sample for this study consisted of adult participants randomly selected from a state registry of survivors who were directly exposed to the 1995 bombing in Oklahoma City. The Disaster Supplement to the Diagnostic Interview Schedule was used to collect participants' demographic information and qualitative details of their disaster experience, perceptions, and feelings. A total of 315 items resulted from the coding of responses pertaining to emotions (125 immediately after the disaster event, 140 in the following week, and 50 at approximately seven years postdisaster). The most common emotions in the immediate postdisaster period were shock, fear, and anxiety. In the following week, the most common were sorrow and anger. At seven years, sorrow was the most frequently expressed of all emotions. Understanding the progression of these feelings across time enhances the ability to anticipate responses at different postdisaster timeframes and to intervene in a timely manner.

PTSD risk factors in earthquake survivors and their families: a systematic review

Background: Exposure to earthquakes can cause adverse effects on the mental health of survivors, including an increased risk of PTSD.Objective: This systematic review aims to analyse the previous secondary studies to identify the risk factors for PTSD from children to elderly earthquake survivors. In addition, it aims to consider the complexity of the joint effects of the individual, relational, and contextual risk factors, to also detect the most at-risk families.Method: After reviewing and screening studies from the literature search through PubMed, Web of Science, Scopus, and EBSCO under the guidance of PRISMA guidelines, ten eligible secondary studies were identified that examine the risk factors for PTSD in individuals (from children to elderly) affected by worldwide earthquakes.Results: The analysis of the included studies allowed the identification of a series of socio-demographic, pre-traumatic, peri-traumatic, and post-traumatic PTSD risk factors in children, adolescents, youth, adults, and elderly survivors. The results represent the complexity of the joint effects of these risk factors at individual, relational, and contextual levels.Conclusions: The consideration of the PTSD risk factors highlights the importance of individual characteristics and the type of experiences and exposure in the period before, during, and after the earthquake. This knowledge could allow the early identification of at-risk individuals of different ages and families and the implementation of intervention programmes.

Adolescents' Tsunami Exposure and Mental Health Consequences: Protective Role of Cultural Coping Strategies

There is a knowledge gap regarding the link between disaster exposure and adolescent mental health problems in developing countries. This study examines the case of Sri Lanka to investigate (a) the immediate and long-term mental health impact of the 2004 tsunami disaster on adolescents and (b) the potential moderating effects of unique cultural and family practices that prevail in Sri Lanka. This study used a random sample of 160 adolescents (ages 12-19) and their mothers who were exposed to the tsunami disaster while living in a southern Sri Lankan village and provided prospective data immediately after the disaster (2005) and three years later (2008). A cross-culturally validated instrument assessed adolescent-mother dyads' tsunami exposure, stressful loss, family cultural rituals and familism, and adolescent mental health. Structural equation modeling analysis showed that exposure and perceptions of tsunami-induced stressful experiences were associated with early and later mental health problems in adolescents. In addition, this study found that unique cultural practices and familism moderated the link between adolescent tsunami exposure, stressful experiences, and levels of PTSD and depressive symptoms. The findings of this study could be utilized to develop prevention and intervention programs that are contextually and culturally valid and empirically supported, which would be more effective for trauma-exposed adolescents in developing countries.

Exploring Volunteer Pharmacists' Experiences in Responding to 2023 Türkiye Earthquakes: A Qualitative Phenomenological Study

OBJECTIVE

Pharmacists are vital in disaster response efforts, dispensing essential medications, managing pharmacy services, consulting, and educating survivors regarding their medications. Their contributions, however, are often underrepresented in scientific literature. This study aimed to explore the experiences of pharmacists who provided pharmacy services to meet the pharmaceutical needs of the survivors after 2 major earthquakes in Türkiye in 2023.

METHODS

This study adopted a phenomenological approach. Data were collected using semi-structured interviews. Purposive sampling was used to invite pharmacists who provided pharmacy services to survivors. Interview transcripts were analyzed following an inductive, reflexive thematic analysis.

RESULTS

In total, 15 pharmacists were interviewed. Four main overarching themes "response to the earthquake," "preparedness for the earthquake," "experiences during service delivery," and "mental and physical experiences" were developed.

CONCLUSIONS

From participants' experiences, it is essential to expand the clinical responsibilities of pharmacists and train them in providing wound care, administering immunization, and prescribing. Pharmacists should be integrated as essential members of disaster health teams. International health organizations, nongovernmental organizations, and governments are encouraged to work collaboratively and develop disaster management plans including pharmacists in early responders. This might help mitigate the deficiencies and overcome challenges in health-care systems to provide effective patient-centered care by health professionals and respond effectively to disasters.

"Not about us without us" - the feelings and hopes of climate-concerned young people around the world

The feelings and hopes of young people around the world are often neglected in policymaking and research, with consequences for both their wellbeing and the effectiveness of humanity's response to the climate crisis. Many of them are distressed by climate change's impacts, the inaction of political and corporate leaders, the ways other people respond to their feelings, and the lack of support they have to share their feelings or get involved in meaningful climate-related work. This paper is written by a group of twenty-three concerned young people from fifteen countries. It provides a first-hand account of our deepest feelings, how these feelings affect our daily lives, the support we want to help us cope, and our hopes for a radically more compassionate future. The results are particularly relevant to policymakers, mental health professionals, journalists, educators, and people working with young people more widely.

Assessing the Emergency Response Role of Community-Based Organizations (CBOs) Serving People with Disabilities and Older Adults in Puerto Rico Post-Hurricane María and during the COVID-19 Pandemic

In Puerto Rico, a host of factors makes the role of community-based organizations (CBOs) critically important in emergency preparedness and response (EPR) and disability-inclusive disaster risk reduction (DiDRR) addressing the needs of people with disabilities and older adults. The territory has been the site of recurring hurricanes, earthquakes, medical crises, and human-made disasters. Political, social, and economic problems unique to the archipelago have historically limited the preparedness and response capacity of governmental authorities, especially for its most at-risk populations. In a context of severe constraints on government resources, CBOs are positioned to play an outsized role in providing services for disabled and older adults before, during, and after emergencies. This study assesses the emergency preparedness and response capacity of CBOs (n = 22) for addressing the needs of people with disabilities and the elderly. Semi-structured, largely closed-ended interviews were conducted in Spanish with key informants at Puerto Rican CBOs. The interviews included questions about emergency preparedness and response training, as well as organizational capacity during COVID-19 and post-Hurricane María. This study posits that conditions in Puerto Rico place CBOs at the forefront of critical responsibilities including emergency preparedness and response, warranting assessment of their practices and resources to assist them in fulfilling their mission.

Remembering the earthquake: intrusive memories of disaster in a rural Italian community

BACKGROUND

Disasters can have long-lasting impacts on mental health. Intrusive memories have been found to be common and persistent in the aftermath of earthquakes.

OBJECTIVE

To explore, using diaries, intrusive memories' presence, content, characteristics, and relationship with probable post-traumatic stress disorder (PTSD) in a small rural community exposed to mass destruction and loss of life.

METHODS

Survivors of the 2016-2017 Central Italy earthquakes (N = 104) were first interviewed to investigate the presence of intrusive memories of the disaster. Those that reported intrusive memories were subsequently asked to complete a 7-day paper-and-pen diary tracking their spontaneous memories of the earthquake events.

RESULTS

Twenty months after the earthquakes, 49% (n = 51) of the sample reported having experienced intrusive memories post-earthquake and 38% (n = 39) reported at least one intrusive memory in their diaries. Memories were rated as being distressing, vivid, and experienced as a mixture of images and thoughts. The content of intrusive memories generally focused on sensations and experiences during the earthquake. Other common categories of content were the material environment and physical objects as well as human loss & death. Several memories had a social focus. A minority of memories contained more positive content as well as content from before and after the earthquake. Some participants (28%) experienced repeated intrusive memories of the same content. Memories of participants with and without probable PTSD did not significantly differ on characteristics or content.

CONCLUSIONS

Intrusive memories can be common, distressing, and persistent occurrences following disasters, even in survivors not suffering from probable PTSD.

HIGHLIGHTS

Intrusive memories were common, distressing, and vivid more than 1-year post-disaster.They captured peri-earthquake sensations, material destruction, death, and social interactions.No difference in content or characteristics was found between participants with and without probable PTSD.

Emotional processing of sadness and disgust evoked by disaster scenes

OBJECTIVE

Disaster scenes produce long-term negative feelings in those who experience them. Previous studies have focused on mitigating disaster impacts through directed forgetting or conscious suppression. However, the initial emotional processing of disaster scenes is not fully understood, hindering the comprehension of long-term disaster impacts. This study aims to investigate how pictures of disaster scenes evoking disgust and sadness are processed via cortical electrical activity.

METHODS

Pictures of grief and mutilation from disasters were used to evoke sadness and disgust, respectively. Event-related desynchronization (ERD) and event-related potentials (ERPs) were used to quantify the intensity and time-course of emotional processing.

RESULTS

The information processing of emotional pictures was stronger than neutral pictures, represented by greater declines of alpha ERD. In the posterior ERP components of N1 and EPN, amplitudes for emotional pictures were larger than those for neutral pictures, which reflected the effects of arousal on visual perception. In the anterior ERP components of P2, P3, and LPP, disgust pictures showed higher attention attraction and enhanced encoding memory processing.

CONCLUSIONS

Disgust disaster scenarios induced long-term prominent LPP, which may correspond with the long-term negative impacts of the disaster.