Lessons from the 2004 Asian tsunami: Epidemiological and nosological debates in the diagnosis of post-traumatic stress disorder in non-Western post-disaster communities

Rajkumar, Anto P.; Mohan, Titus; Tharyan, Prathap

doi:10.1177/0020764011423468

Cited by 26 publications

(40 citation statements)

References 26 publications

(33 reference statements)

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“…Results of the current study corroborate a growing body of prior disaster mental health research, which found that post-disaster life stressors and traumas (Brewin et al, 2000; Cerda et al, 2012, in press; Kessler et al, 2012; Norris & Uhl, 1993; Norris et al, 2002a; Norris et al, 2002b; Tracy et al, 2011), including financial losses (Acierno et al, 2006; Galea et al, 2008; Rajkumar et al, 2011, in press; Su et al, 2010), are linked to severity, probable diagnoses, and chronicity of PTSD and related disorders. The finding that greater education was negatively related to a chronic symptom trajectory also accords with previous studies demonstrating the protective effect of this variable on risk for disaster-related PTSD and related mental disorders (Armenian et al, 2000; Norris et al, 2002a; Norris et al, 2002b; North et al, 2012; Yuan et al, 2012, in press).…”

Section: Discussionsupporting

confidence: 85%

Trajectories of posttraumatic stress symptomatology in older persons affected by a large-magnitude disaster

Pietrzak

Ness

Fried

et al. 2013

Journal of Psychiatric Research

115

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This study examined the nature and determinants of longitudinal trajectories of disaster-related posttraumatic stress disorder (PTSD) symptoms in older persons affected by a large-magnitude disaster. Two hundred six adults age 60 or older (mean=69, range=60–92) who resided in the Galveston Bay area when Hurricane Ike struck in September 2008 completed telephone interviews an average of 3-, 6-, and 15-months after this disaster. Latent growth mixture modeling was employed to identify predominant trajectories of disaster-related PTSD symptoms over time; and pre-, peri-, and post-disaster determinants of these trajectories were then examined. A 3-class solution optimally characterized PTSD symptom trajectories, with the majority (78.7%) of the sample having low/no PTSD symptoms over all assessments (i.e., resistant); 16.0% having chronically elevated symptoms (i.e., chronic); and 5.3% having a delayed onset course of symptoms (i.e., delayed-onset). Lower education, greater severity of Hurricane Ike exposure (i.e., Ike-related physical illness or injury and high level of community destruction), and greater number of traumatic and stressful life events after Hurricane Ike, particularly financial problems, were associated with a chronic PTSD trajectory. Greater number of traumatic and stressful life events, particularly financial problems after Hurricane Ike, was also associated with a delayed-onset trajectory. These findings suggest that there are heterogeneous trajectories of disaster-related PTSD symptoms in older adults and that these trajectories have common and unique determinants. They also underscore the importance of prevention efforts designed to mitigate the effects of post-disaster stressors, most notably financial distress, in older persons affected by disasters.

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Section: Discussionsupporting

confidence: 85%

Trajectories of posttraumatic stress symptomatology in older persons affected by a large-magnitude disaster

Pietrzak

Ness

Fried

et al. 2013

Journal of Psychiatric Research

115

View full text Add to dashboard Cite

show abstract

“…It is important to consider that the concept of PTSD in non-Western populations with massive exposure to severe and ongoing trauma has been criticized (Rajkumar, et al, 2011; Summerfield, 2001). Without validating the diagnostic constructs under study, it may be possible that we have imposed a western conceptualization of distress on the local community that may not fully fit or missed mental health problems unique to this population (e.g., somatization).…”

Section: Discussionmentioning

confidence: 99%

“…It is important to increase knowledge about the association between PTSD symptoms and functional impairment, because there is an ongoing debate on the controversial value of PTSD diagnosis and allocation of resources for trauma-focused care during and after acute emergencies, particularly in non-Western countries with massive exposure of the population to trauma (Rajkumar, Mohan, & Tharyan, 2011; Summerfield, 2001; Van Ommeren, Saxena, & Saraceno, 2005). …”

Section: Introductionmentioning

confidence: 99%

The association between posttraumatic stress symptoms and functional impairment during ongoing conflict in the Democratic Republic of Congo

Veling

Hall

Joosse

2013

Journal of Anxiety Disorders

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The Democratic Republic of Congo (DRC) has suffered from a bloody conflict for more than a decade. More than 5,400,000 people died from war-related causes since 1998 and exposure to violence was wide-spread. This study investigated the impact of posttraumatic stress disorder (PTSD) symptoms on perceived health and physical and social functioning, filling an important gap in the current literature. Data were collected from a sample of 93 adults living in Bunia, Eastern Democratic Republic of Congo. Structured in-person interviews included the PTSD section of the Composite International Diagnostic Interview and the World Health Organization Disability Assessment Scale. Additional questions were included to assess social resources. Study recruitment was balanced to achieve equal representation of both sexes and each quarter of town. Forty percent met symptom criteria for probable PTSD. Individuals with PTSD reported poor perceived general health and had high disability scores compared to those without PTSD. Of the three PTSD symptom clusters, hyperarousal was most strongly associated with disability. Individuals with PTSD were significantly more emotionally affected by their health problems than those without PTSD (85% versus 41%), had more difficulties in activities involving social contact (54% versus 16%) and in doing their daily work (54% versus 20%). The impact of war-related violence on mental health is severe in the DRC. Psychosocial interventions developed in conflict areas might be best targeted primarily to supporting social functioning and reducing hyperarousal. Implications for clinical treatment and future directions are discussed.

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“…However, elevating them to the construct of PTSD requires a minimum of three avoidance symptoms, two hyper-arousal symptoms, one re-experiencing symptom, and clinically significant distress or impairment in social, occupational, or other areas of functioning as per Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition. [ 22 23 ] None of the participants with PTSS satisfied these criteria for PTSD, especially functional impairment. This study reports the presence of equal levels of PTSS in both boys and girls.…”

Section: Discussionmentioning

confidence: 99%

“…However, in the absence of functional impairment, elevating them to a psychiatric diagnosis of PTSD is questionable. [ 23 ] The need to intervene to minimize the impact on children at the earliest, using simple psychosocial care by the available community resources, is important.…”

Section: Discussionmentioning

confidence: 99%

Children's Reactions to Flood Disaster in Kashmir

Hassan¹,

Singh²,

Kasi³

2018

Indian Journal of Psychological Medicine

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Background: The flood disaster of 9 th –10 th September 2014 wreaked havoc in the Jammu and Kashmir region of India. Incessant rains and deluge claimed 283 lives and damaged 2.53 lakh houses. This article presents the findings of the psychosocial care team from the National Institute of Mental Health and Neuro Sciences, Bengaluru, India, during the early phase of disaster. Materials and Methods: The team assessed posttraumatic stress symptoms of 64 child survivors from six villages of two districts struck by floods using Children's Revised Impact of Event Scale (CRIES)-8 and qualitative narrations. Results: Children showed high levels of intrusion and avoidance in the aftermath of floods. Both boys and girls showed moderate to severe level of psychological impact on the domains of CRIES-8. The narrations by the children centred on the theme of “water” and “enjoyment in seeing lots of water;” followed by “fearing of the parent's life,” later on “fear of their own life,” and subsequently to avoidance to go near the river and nightmares like “floating in the water.” Conclusion: Disasters immensely impact children because of their particular stage of psychological and social development. This highlights the need for psychosocial interventions to minimize the impact of disasters on children at the earliest using simple psychosocial care techniques by employing available community-based manpower.

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Lessons from the 2004 Asian tsunami: Epidemiological and nosological debates in the diagnosis of post-traumatic stress disorder in non-Western post-disaster communities

Cited by 26 publications

References 26 publications

Trajectories of posttraumatic stress symptomatology in older persons affected by a large-magnitude disaster

Trajectories of posttraumatic stress symptomatology in older persons affected by a large-magnitude disaster

The association between posttraumatic stress symptoms and functional impairment during ongoing conflict in the Democratic Republic of Congo

Children's Reactions to Flood Disaster in Kashmir

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