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  1. Home
  2. Books
  3. Mental Health and Disasters
  • Cited by 54
Publisher:
Cambridge University Press
Online publication date:
May 2010
Print publication year:
2009
Online ISBN:
9780511730030
DOI:
https://doi.org/10.1017/CBO9780511730030
Subjects:
Psychiatry and Clinical Psychology, Medicine, Psychiatry
Information

Book description

Since the attacks of September 11, 2001, disaster preparedness and response has developed into a discrete subspecialty in medicine, and the paramount health care initiative of the US Government. The mental health component of disaster response is a serious subject of study, as trauma is associated with a substantial and long-lasting psychologic burden, both on an individual and community level. The psychopathologies associated with disaster are also quite broad, varying from several different types of post-traumatic stress and anxiety disorders to acute variations of grief-associated depression. This book is the definitive reference on mental health and disasters, focused on the assessment and treatment of the full spectrum of psychopathologies associated with many different types of individual disasters. The logistics for utilizing pre-existing community-based mental health services, as well as the development of new programs, are covered in depth. Case studies and perspectives for improving care, incorporating lessons from Hurricane Katrina and 9/11, are included in detail.

Reviews

'All of the chapters are excellent, but 2 are exceptional … This book is must reading for anyone involved in planning the mental health response to disasters … Mental Health and Disasters is encyclopedic in its coverage of essential topics.'

Source: Journal of the American Medical Association

'… I liked the fact that the book has a forward-looking perspective … I commend this book without reservation. It is well written and the editors have achieved a good balance among the chapters. The authors are rigorous in their critical analysis of the research from which the data are derived, and they identify fruitful opportunities for researchers, practitioners and policy makers.'

Source: The British Journal of Psychiatry

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Contents

Page 2 of 2

Contents
  • 20 - Evidence-Based Long-Term Treatment of Mental Health Consequences of Disasters among Adults
    pp 336-349
  • View abstract

    Summary

    This chapter reviews the historical background on the construct of psychological trauma. It then considers recent empirical studies on individual differences in response to potentially traumatic events (PTEs). Most of the variability can be captured by four prototypical trajectories: chronic dysfunction, delayed reactions, resilience, and recovery. Major advances in theory and research on resilience to adversity came from developmental psychologists and psychiatrists during the 1970s. These pioneering researchers documented the large number of children who, despite growing up in harsh socioeconomic circumstances, nonetheless evidenced healthy developmental trajectories. Evidence for widespread resilience among survivors of the severe acute respiratory syndrome (SARS) epidemic has been reported. Resilience to trauma following disaster has been associated with male gender, older age, and greater education. Developmental theorists have for years argued that resilience to aversive childhood contexts results from a cumulative mix of person-centered variables and sociocontextual risk and protective factors.
  • 21 - Mental Health Care for Children in the Wake of Disasters
    pp 350-365
  • View abstract

    Summary

    This chapter focuses on social and cognitive theories that have gained significant empirical support in predicting mental health consequences of disaster. Social cognitive theory (SCT) offers a construct for community response to natural disasters. The challenge of operationalizing SCT within the disaster recovery environment is finding ways to measure the bidirectional relationships between environmental conditions, self-evaluative appraisals, and behavior across time. Behavioral assessments of coping rely on noncontextualized assessments of coping strategies that are thought to cut across stress domains. The transactional theory of stress is a theory directly addressing the interactive process between environmental stress demands and the individual. Conservation of resources (COR) theory emphasizes that both individual and environmental factors are predictive of stress. The social support deterioration deterrence (SSDD) model is a dynamic picture of the interplay between social resources that flow into disaster affected communities and the availability of social support perceived by the individual.
  • 22 - Utilization of Mental Health Services after Disasters
    pp 366-384
  • View abstract

    Summary

    This chapter considers the various postdisaster social dynamics in considerable depth, with particular focus on social support. Social support is most often referred to as social interactions that provide individuals with actual assistance and embed them into a web of social relationships perceived to be loving, caring, and readily available in times of need. The chapter summarizes existing empirical research on the mobilization of support in the aftermath of disasters; this is the research that descends most directly from the early observations of Kutak, Fritz, Barton, and other disaster sociologists. The chapter also summarizes research on deterioration of support in the aftermath of disasters, an observation that emerged later in disaster studies, but just as prominently, that sense of community was sometimes destroyed by catastrophic events. It describes the impact of received and perceived social support on the mental health of disaster survivors.
  • 24 - Advances in Our Understanding of Earthquake Trauma and Its Treatment:
    pp 396-418
  • a Self-Help Model of Mental Health Care for Survivors
  • View abstract

    Summary

    This chapter reviews the study samples to highlight potential vulnerability factors that could interact with gender to produce more severe postdisaster mental health outcomes among women. The most informative comparisons of men's and women's experiences of disaster can be drawn from studies of representative samples, which identify participants using methodologies such as random-digit-dial telephone surveys. Disaster exposure, subjective distress, and vulnerability factors increase the risk for depression. Despite few gender differences in reports of objective exposure, exposure had a more pronounced effect on posttraumatic stress disorder (PTSD) symptoms for women than for men. Female gender has also been associated with PTSD risk among survivors of the Taiwan Chi-Chi earthquake. The majority of studies in developing nations find women to have higher rates of postdisaster psychopathology or identify female gender as a significant risk factor. The severity of PTSD symptoms was significantly greater among women than men.
  • 25 - Hurricane Katrina
    pp 419-440
  • View abstract

    Summary

    This chapter deals with disaster mental health research in children, and systematically examines the extant literature, focusing on methodological issues. Children represent the ideal age group to study in order to gain insight into the etiology of psychopathology in the aftermath of disaster. Any postdisaster child assessment should necessarily involve a two-step process, including a detailed characterization of the child's exposure and the possible related reactions. The chapter proposes a three-category disaster typology based on the distribution of different types of disaster exposures. The chapter focuses on reports of reactions related to posttraumatic stress disorder (PTSD) in children after mass traumatic events, with studies being reviewed within the context of the proposed typology. Psychiatric disorders observed in children after large-scale traumatic events include a range of disorders, with PTSD and depression being the most commonly assessed.
  • 26 - The Long-Term Mental Health Impacts of the Chernobyl Accident
    pp 441-453
  • View abstract

    Summary

    This chapter reviews the empirical evidence regarding mental health consequences of disasters in older adults. In addition, important implications for disaster policy and planning for the needs of the aging population are discussed. A recent quantitative review of mental health in a broad range of disaster survivors reported differential protective effects associated with older age in only 2 of 17 distinct samples that included older adults. Two themes of relative deprivation were identified in older adults: the loss of symbolic assets, and the preoccupation with time. The empirical literature on the effects of natural disasters such as floods, hurricanes, and earthquakes on the mental health of older adults is equivocal and varies according to a variety of factors. Compared to natural disasters, much less is known about the effects of human-made catastrophes in the lives of older adults. Technological disasters can be caused by human error or major industrial accidents.
  • 27 - TheExxon ValdezOil Spill
    pp 454-472
  • View abstract

    Summary

    This chapter reviews results from studies that have focused on the effects of disaster on individuals with disabilities. The International Classification of Functioning, Disability and Health (ICF), created by the World Health Organization provides perhaps the most ecumenical definition of disability and uses a biopsychosocial approach to disability. Rooney and White's study of consumers with mobility impairments is one of the few that have obtained data directly from individuals with disabilities. Individuals with sensory disabilities include those who are visually impaired or blind, representing approximately 3% of the U.S. population and those who are auditorally impaired or deaf represent approximately 2.4% of the U.S. population. Individuals with cognitive disabilities include those individuals who are labeled as having autism, developmental disabilities, traumatic brain injury, learning disabilities, or intellectual disabilities. Individuals with preexisting psychiatric disorders may be at additional risk due to events that occur postdisaster.
  • 28 - Enschede Fireworks Disaster
    pp 473-496
  • View abstract

    Summary

    This chapter summarizes the current state of the literature relating to each of the disaster phases across a wide range of variables, including sociocultural factors and environment and community resources. Social networks among racial/ethnic minority cultures can be a significant protective factor against adverse mental health consequences, and the emphasis on social networks among many racial/ethnic minority cultures appears to also influence evacuation efforts. Differences in risk perception between minority and majority populations contribute to differences in disaster exposure. A variety of cultural beliefs appear to affect individuals in pre- and peridisaster phases. Several factors have an impact on marginalized populations' postdisaster mental health outcomes. Environmental and community resources suggest that limited or lack of resources appears to significantly impact disaster-response in marginalized populations. The chapter further discusses the implications for research, disaster-response efforts, and practice.
  • 29 - Eyewitness to Mass Murder:
    pp 497-507
  • Findings from Studies of Four Multiple Shooting Episodes
  • View abstract

    Summary

    This chapter reviews the role of journalists and news media during disasters, and the challenges they face as professional witnesses. It discusses reporters' risk and resiliency with respect to trauma-related psychopathology. News media can provide improvised mechanisms of communication that can help officials and survivors in the immediate aftermath of disaster. Most journalists receive no preparatory training in covering violence, interviewing victims, or experiencing the potential impact of traumatic stress on their own lives. Journalism educators now are showing growing interest in trauma-related curricula. As professional witnesses of trauma, reporters and staff are directly and indirectly exposed to events that qualify as traumatic stressors. Understanding journalists' symptomatic and attitudinal responses to covering traumatic stories, including risk and protective factors, is a vital area of continued study. Conceptual precision in research and analysis can help us understand more about the role and effects of media portrayal of tragedy on the public.
  • 30 - The Oklahoma City Bombing
    pp 508-521
  • View abstract

    Summary

    This chapter explains the potential impact of disaster response on uniformed first responders, including police officers and firefighters. A minority of responders may continue to experience psychological distress following disaster response, including symptoms of posttraumatic stress disorder (PTSD), depression, alcohol use, and other anxiety disorders. Trauma-exposed first responders are also at risk of developing other psychiatric symptoms and conditions such as depression, substance abuse, and other anxiety disorders. Degree and type of interaction with survivors and bereaved family members are linked to the level of distress among rescue workers. Peritraumatic reactions are shown to be strongly associated with PTSD symptoms. The participants receiving the cognitive-behavioral therapy (CBT) treatment showed a significantly greater decline in PTSD symptoms, with large effect sizes. Promising strategies for immediate management of acute stress disorders include the use of adrenaline-blocking medications and cognitive behaviorally informed antipanic interventions for peritraumatic distress.
  • 32 - The Psychological Consequences of the London Bombings
    pp 538-557
  • View abstract

    Summary

    This chapter reviews the evidence for psychological and pharmacological approaches to treating people with adverse psychological reactions after disaster. Posttraumatic stress disorder (PTSD) is the most commonly identified, and the disorder is characterized by three clusters of symptoms, including reexperiencing of the traumatic event, avoidance and numbing, and hyperarousal. Rates of PTSD are high in the initial months after a disaster, but most become noncases in the subsequent months. Short-term interventions are primarily designed to promote safety, assist coping, and stabilize the individual and their environment. Psychological debriefing has been the model approach to reducing the risk for chronic PTSD after disasters. The chapter also reviews the available evidence on treating posttraumatic disorders that can arise in the intermediate phase after a disaster. The World Wide Web is providing some promising avenues to provide cognitive-behavior therapy (CBT) to people who cannot access formal mental health services.
  • 33 - Psychological Responses to Terrorism in Israel: 2000–2004
    pp 558-576
  • View abstract

    Summary

    This chapter discusses the evidence base for long-term treatment of the most common outcomes following disaster and the gaps in that knowledge base. In the past decade or two there has been a growing body of research on psychological interventions for the treatment of posttraumatic stress disorder (PTSD) following disaster. Randomized clinical trials have established the efficacy of cognitive-behavioral therapy (CBT) for the treatment of PTSD following many types of trauma. The chapter describes the dissemination of evidence-based treatments and the training and credentialing of mental health providers. Gaps in the treatment outcome literature are compounded by problems with the dissemination and acceptance of the clinical science literature by both patients and mental health practitioners in the community. The chapter illustrates the clinical presentation of symptoms and the development of treatment plans several years after a trauma.
  • 34 - Methodological Challenges in Studying the Mental Health Consequences of Disasters
    pp 579-593
  • View abstract

    Summary

    Studies examining the transportability of efficacious treatments into community settings point to the vast differences between research and practice conditions. This chapter reviews the research literature on postdisaster trauma treatments for children and adolescents. The randomized controlled studies of trauma-focused (TF)-cognitive-behavioral treatments (CBT) with sexually abused children and the nonrandomized studies supporting cognitive-behavioral treatments suggest promising approaches for children affected by other types of trauma. The Child and Adolescent Trauma Treatments and Services (CATS) project extended these findings by demonstrating that these trauma-specific cognitive-behavioral approaches can be successful with youth exposed to a mass disaster. The study suggests that community clinicians can be trained effectively on CBT approaches even in postdisaster situations. To more fully advance the field of study, future investigations must find ways to employ a range of rigorous research designs that can provide some flexibility for examining delivery of targeted mental health interventions in postdisaster environments.
  • 35 - Disaster Mental Health Research:
    pp 594-610
  • Current State, Gaps in Knowledge, and Future Directions
  • View abstract

    Summary

    This chapter reviews empirical findings on the correlates of mental health care use among disaster victims, organized within the behavioral model of health care use. It presents background literature on correlates of mental health care use among victims of traumatic events and theoretical models used to explain treatment utilization. Evidence from national community samples of civilians and military personnel also supports a relationship between both posttraumatic stress disorder (PTSD) diagnosis and severity with mental health care utilization. Several models explaining health care utilization have been proposed, including the illness behavior model, health belief model, and others, all of which are relevant to mental health care utilization. The chapter also reviews the literature on correlates of mental health care use among disaster-affected persons in particular. The statistical analysis of mental health care utilization data is associated with several issues that are often difficult to overcome, limiting previous investigations' findings.

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