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Psychological Aspects

The Psychological Impacts of the 2004 Indian Ocean Tsunami

By: Kristi Free

How would you feel if you lived through a natural disaster? How would you feel afterwards?  Could you imagine your life being turned around, losing your house, losing your possessions, and losing loved ones in a matter of minutes? Many people faced these questions after the 2004 Indian Ocean tsunami hit and changed their lives as they knew it.  Natural disasters can cause detrimental effects on the health and emotional well being on those who are impacted by them.  The fear that those who survive face after the disaster can cause them to develop psychological problems.  They may feel anxiety, stress, and panic when thinking about the disaster, reflecting back on it, or even just encountering a new situation that is similar to the previous disaster.  Survivors of natural disasters, such as the 2004 tsunami, undergo psychological distress that will harm their mental health and there are certain risks, symptoms, emotional responses, and coping mechanisms that are associated with this distress.

While the majority of survivors recover from disasters with no long lasting effects on their psychological health, a fraction of the survivors will experience long-term psychological distress.  The level of distress is often dependent on both predisaster and postdisaster factors.  Pretrauma psychological symptoms are often good indicators of postdisaster symptoms.  Also, the extent to which the disaster affected you plays a large role in postdisaster symptoms.  Depending on how much financial loss, material destruction, education levels, age, and the level and quality of social support will lead to different amounts of distress after the disaster.  Impaired mental health is also due to the direct impact of the disaster, such as physical injury, the loss of loved ones, and the perception of life threat.  A study was done on a number of tourists who were in Stockholm, one of the hardest hit cities, to determine their psychological distress based on different types of psychological exposure (Wahlsrtom, pg 463-470).  The study was done fourteen months after the tsunami and showed that the more severely exposed groups faced more psychological distress.  It showed that the perception of life threat alone was associated with both general and posttraumatic distress.  Also, the lower the education levels, the higher the percentage of posttraumatic stress.  The younger age groups experienced more general psychological distress while females experienced both types of stress more than males (Wahlsrtom, pg 463-470).

Sumatrans waving to MH-60S Knighthawk

One type of psychological distress that occurs after natural disasters is posttraumatic stress.  Posttraumatic stress disorder is a severe anxiety disorder that can develop after exposure to any event and results in psychological trauma.  Diagnostic symptoms for PTSD include re-experiencing the original trauma through flashbacks or nightmares, avoidance of stimuli associated with the trauma, and increased arousal(Kumar, pg 99-101).  Due to the major destruction of India, the loss of life, and relocations, many people developed this disorder.  A study was conducted in a coastal fishing village in Tamil Nadu, India to determine the prevalence and risk factors that are associated with it.  A community-based household survey was given to the adults in the village.  The survey was given two months after the disaster hit.  The Harvard Trauma Questionnaire was used to assess posttraumatic stress disorder.  The prevalence of the disorder was 12.7 percent.  Some of the most common symptoms those who were facing this disorder experienced were reoccurring thoughts and sleep disturbances.  Less prevalent symptoms included irritability and emotional numbness.  Out of those who sought help from a psychiatrist, 48.9 percent were diagnosed with major depressive disorder and 31.9 percent were diagnosed with posttraumatic stress disorder.  Some of the risk factors for developing PTSD after the tsunami included those with no household incomes, women, those who experienced personal injury, and those who lost a family member due to the disaster (Kumar, pg 99-101).

While most the studies are conducted on adults, the distress and posttraumatic stress in children also need to be analyzed.  About 23-30 percent of children develop full symptoms of posttraumatic stress disorder in the first six months after disasters.  Developing PTSD increases their risk of other disorders and the impairment of psychological functioning.  One of the most critical factors in their chance of developing PTSD is the personal perception of life threat. Other factors include a cultural perspective on the disaster and family support (Brushan, pg 245-257).  A study was conducted one year after the tsunami to determine the prevalence of PTSD in children.  It was conducted in the Akkaraipettai village in India.  The age of the children involved in the study ranged from ten to sixteen years old and they were all in middle school.  The two tests used were the Impact of Events Scale (IES) and the Children’s Revised Impact of Events Scale (CRIES) to identify the prevalence of PTSD.  Also using the Pediatric Emotional Distress Scale (PEDS), the results showed that the disaster caused emotional distress to the children even a year after it occurred.  94.2 percent of males and all females scored high on anxiety withdrawal and scored equally high on fearfulness.  Another study found that 13 percent developed posttraumatic stress disorder while 48 percent reported re-experiencing and arousal symptoms.  It also found that the loss of a family member is a major contributing factor of children developing emotional distress and PTSD (Brushan, pg 245-257).

Man searching through rubble in Meulaboh

Children who are indirectly exposed to natural disasters will show emotional responses to them.  One way to cope with such disasters is through art therapy.  One study used sandplay to visually see the emotional responses of a group of immigrant and refugee preschoolers living in South Asia only two weeks after the tsunami hit.  Flooding is a dangerous disaster because it can occur without any warning and is very destructive.  Preschoolers typically demonstrate regressive behaviors, such as clinging, thumb sucking, bedwetting, whimpering, loss of appetite, frightened facial expressions, and night terrors (Lacroix, pg 99-113).  This study examined how children relive trauma through play.  Although they were indirectly exposed to the disaster, their parent’s reactions greatly influenced theirs, but very few children are at risk of developing posttraumatic stress disorder.  Also, the media’s portrayal of the event has a negative impact on the children’s emotional responses because they absorb the visual images and information without cognitively processing it.  One attempt to allow children to cope with the disaster is sandplay, in which they can master their feelings by creating scenes in a sand tray using human characters, religious figures, animals, and objects.  In this experiment, 29 percent of the children represented the tsunami.  9 percent directly represented it, with the tsunami itself, devastating floods, and babies who ended up in trees and rooftops.  20 percent indirectly represented the tsunami with sea monsters devouring people and animals and other cars and houses hidden in the sand.  Some of the verbal representations included, “This is a tsunami,” “Everyone is dead,” and “People died in the water.”  The children were enthusiastic about their creations but the main negative emotions were sadness, followed by anxiety.  Sandplay helps the children to come to terms and understand the disaster (Lacroix, pg 99-113).

Adults also had very profound emotional responses to the tsunami.  In a village of Tamil Nadu, emotional responses were obtained by the survivors.  They varied based on their occupation, how the tsunami affected their daily lives, and if they or someone they loved was injured or lost.  One fisherman reported that the worst of his losses was the loss of his trust over the all-providing mother sea.  Both men and women considered that the loss of their pride had more psychological impact than anything else.  Parents who lost children were inconsolable in their anguish and widows felt widowship symbolized their fall from grace and loss of security.  After the tsunami many people’s attitudes changed towards life.  Many housewives felt that men were more fatalistic after the disaster.  Parents believed that the tragedy shattered their dreams about their children’s career.  Also, their financial standings changed and many felt they became more economical and now have to plan for their finances. Teenager’s attitudes also changed as some believed they now have to be more serious and responsible rather than easygoing (Rajkumar, pg 844-853).

Woman & child in Meulaboh

Survivors of natural disasters explore several coping methods to try to resolve their psychological distress.   A study was conducted in a coastal village of Tamil Nadu to gain insight on the coping mechanisms used by the local communities nine months after the tsunami.  Participants were selected based on their social roles and included fisherman, housewives, community leaders, and members of the youth.  The survivors valued their unique, individual, social and spiritual coping strategies more than formal health services.  They had a tendency to collectivize their personal sorrow.  They viewed themselves as an integral part of a larger traumatized society and not as lonely sufferers.  The village has frequent social gatherings to remember the deceased.  Those who lost loved ones adopted a custom of planting and caring for coconut saplings to remember them.  They offered foods favored by their loved ones who died to the saplings.  Many children sacrificed school to help earn livelihoods for their families.  Also, the community expressed four themes in their spiritual coping strategies: requiems, rituals, religious beliefs, and spiritual seeking.  Grief and mourning were loud and publicly demonstrated.  Requiems were held with traditional music and social customs.  They believed in the existence of an immortal soul that would re-incarnate them into higher forms of life.  Most people claimed that their religious beliefs were the most important factor contributing to their survival. Therefore their religious practices were strengthened by the tsunami.  This study showed that coping mechanisms are shaped by ethno-cultural variations (Rajkumar, pg 844-853).

The 2004 tsunami that hit the Indian Ocean had detrimental effects on the psychological health on those who survived the disaster, and even those who heard about it through the media.  Anxiety, psychological distress, and even posttraumatic stress disorder became prevalent in those who were affected.  The degree in which they were affected was dependent on many factors.  Those who were more severely emotional hurt were those who had lower education levels, less financial support, less family and social support, women, youth, those who were personally injured, or those who lost love ones because of the tsunami.  Many coping mechanisms are available for those who experience psychological distress, including art therapy, religious beliefs, community gatherings, and professional help.

Works Cited

Bhushan, B. and Kumar, J. S. (2007). Emotional distress and posttraumatic stress in children surviving the 2004 Tsunami. Journal of Loss and Trauma, 12, 245-257.

Kuman, S. (2007). Prevalence of Posttraumatic Stress Disorder in a Coastal Fishing Village in Tamil Nadu, India, After the December 2004 Tsunami. American Journal of Public Health, 99-101.

Lacroix, L. (2007). Immigrant and Refugee Preschoolers’ Sandplay Representations of the Tsunami. Science Direct, 99-113.

Rajkumar, A. and Premkumar, T. and Tharyan, P. (2008). Coping with the Asian tsunami: Perspectives from Tmail Nadu, India on the determinants of resilience in the face of adversity. Science Direct, 844-853.

Wahlstrom, L. and Backheden, M. (2008). Different Types of Exposure to the 2004 Tsunami Are Associated With Different Levels of Psychological Distress and Posttraumatic Stress. Journal of Traumatic Stress, 463-470.


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