PTSD- A comparison between genocide and natural disasters.

August 24th, 2011

PTSD- A comparison between genocide and natural disasters.

Emotional well-being depends on a nurturing environment that ensures consistent basic material and emotional necessities.

Natural or man-made disasters (such as civil war or genocide) can cause terrible personal loss, injuries, illness, and loss of vital resources.

While the survivors of such tragedies may recover from their physical injuries, the emotional damage may be permanent.

In a study by Dr. Pynoos on 231 children 18 months following the devastating earthquake that occurred in Armenia in 1988, children suffered frequently from “severe post-traumatic stress reaction”, correlating with the proximity to the quake epicenter (The British Journal of Psychiatry 163: 1993).

The authors concluded from their research that following catastrophic natural disasters, PTSD in children may reach epidemic proportions, and jeopardize the well-being of large segments of the population for an extended period.

In an article published in the Journal International Social Work (Volume 52, 2009) Taghi Doostern showed that following the 2003 earthquake in the Iranian city of Bam, children’s grief and distress was compounded by the following adverse elements:

  • Loss of family members, homes and communities
  • Lack of access to information regarding the well-being of family members
  • Uncertainty about the future

There have only been a few longitudinal studies investigating PTSD years following natural disasters:

A prospective study of firefighters after the 1983 Australian bushfires reported rates of PTSD of 30 percent after 30 months (MacFarlane. J Nerv Ment Dis, 1988).

A 14-year follow-up on survivors of the 1972 Buffalo Creek flood showed a 28 percent prevalence of PTSD (Green. Am J Orthopsychiatry, 1990).

Duggan and Gunn, reporting on adults exposed to an array of different disasters, found the frequency of PTSD to be 39 percent within the first year of the event, falling to 23 pecent after 26 months (British J Psychiatry 1995).

During the war in Bosnia and Herzegovina, a study by Nadezda Savjak showed a 42.5 percent risk of PTSD amongst the displaced population in comparison to 26.7 percent for domiciled persons exposed to similar war traumas. The death of a loved one or physical injury was significantly magnified amongst those individuals who were displaced.

This confirms the findings by other investigators that displacement – which represents an accumulative effect of material, psychological, and social loss – is strongly associated with persistent PTSD symptoms among refugees who survive civil war and genocide (Cheung. “PTSD Among Cambodian Refugees in New Zealand.” 1994).

Since reports suggest that PTSD is most intense and enduring in victims exposed to extreme violence, Goenjian and colleagues compared two groups of adults, one group exposed to a severe earthquake, and the other exposed to extreme violence.

78 non-treatment-seeking Armenians were assessed 1.5 years and again 4.5 years following the 1988 Spitak earthquake in Armenia (Am J Psychiatry, June 2000).

In Gumri, the second largest city in Armenia, 50% of the buildings were destroyed and 90% severely damaged. 7% of the population (280,000 people) died. Following the initial devastating earthquake survivors were subject to unremitting stress: impoverished and crowded living conditions, lack of basic necessities such as food, heat, electricity, clothes and medicine.

Flashbacks and trauma recollections experienced by the earthquake victims were dominated by the vivid visual imagery they had experienced.

During the earthquake they had heard screams of trapped individuals, and had witnessed friends, neighbors, or family members burned or trapped under collapsed buildings.

In terms of trauma-triggers: for those exposed to the earthquake: destroyed buildings, shoddy homes, and absence of family members served as trauma-reminders.

The disturbing outcome of this study was that survivors of extreme trauma caused by a natural disaster showed negligible remittance of PTSD symptoms when revisited 3 years after the initial study.

The immediate emphasis of rescue functions following war, terrorism, and natural disasters is to provide survivors with food, shelter, medical treatment, and communication with significant others.”

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