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Tuesday September 7,2010

Survivors of Human-Caused and Natural Disasters

Continued

What factors increase the risk of readjustment problems?

Survivors are at greatest risk for severe stress symptoms and lasting readjustment problems if any of the following are either directly experienced or witnessed during or after the disaster:

• Loss of loved ones or friends
• Life threatening danger or physical harm (especially to children)
• Exposure to gruesome death, bodily injury, or dead or maimed bodies
• Extreme environmental or human violence or destruction
• Loss of home, valued possessions, neighborhood, or community
• Loss of communication with or support from close relations
• Intense emotional demands (e.g., rescue personnel and caregivers searching for possibly dying survivors or interacting with bereaved family members)
• Extreme fatigue, weather exposure, hunger, or sleep deprivation
• Extended exposure to danger, loss, emotional/physical strain
• Exposure to toxic contamination (such as gas or fumes, chemicals, radioactivity)

Some individuals have a higher than typical risk for severe stress symptoms and lasting PTSD, including those with a history of:

• Exposure to other traumas such as severe accidents, abuse, assault, combat, rescue work)
• Chronic medical illness or psychological disorders
• Chronic poverty, homelessness, unemployment, or discrimination
• Recent or subsequent major life stressors or emotional strain (such as single parenting)

Disaster stress may revive memories of prior trauma, and may intensify preexisting social, economic, spiritual, psychological, or medical problems.

What can survivors do to reduce the risk of negative psychological consequences and to best recover from disaster stress?

Researchers are beginning to conduct studies to answer this question. Observations by disaster mental-health specialists who assist survivors in the wake of disaster suggest that the following steps help to reduce stress symptoms and to promote postdisaster readjustment.*

Protect: Find a safe haven that provides shelter; food and liquids; sanitation; privacy; and chances to sit quietly, relax, and sleep at least briefly.

Direct: Begin setting and working on immediate personal and family priorities to enable you and your significant others to preserve or regain a sense of hope, purpose, and self-esteem.

Connect: Maintain or reestablish communication with family, peers, and counselors in order to talk about your experiences. Take advantage of opportunities to "tell your story" and to be a listener to others as they tell theirs, so that you and they can release the stress a little bit at a time.

Select: Identify key resources, such as FEMA (Federal Emergency Management Agency), the Red Cross, the Salvation Army, or the local and state health departments, for clean-up, health, housing, and basic emergency assistance.

Taking each day one at a time is essential in disaster's wake. Each day is a new opportunity to FILL-UP:

• Focus Inwardly on what's most important to you and your family today;
• Look and Listen to learn what you and your significant others are experiencing, so you'll remember what is important and let go of what's not;
• Understand Personally what these experiences mean to you, so that you will feel able to go on with your life and even grow personally.

* The construct "Protect, Direct, Connect, Select" was developed by Diane Myers, unpublished manuscript.

Scientific and clinical interest in Post-Traumatic Stress Disorder (PTSD) has grown exponentially in the past 20 years. No longer considered an isolated problem for Vietnam veterans, PTSD is recognized as a major public and behavioral health problem for military veterans and active duty personnel subject to the traumatic stress of war, dangerous peacekeeping operations, and interpersonal violence.

Moreover, due to the surprisingly high prevalence of assault, rape, child abuse, disaster, and severe accidental and violent trauma in the civilian arena, PTSD is a serious public health problem in the general population, estimated to affect more than ten million American children or adults at some point in their lives.

The National Center for PTSD is a world leader in research and education programs focusing on PTSD and other psychological and medical consequences of traumatic stress.