PTSD symptoms among tsunami exposed mothers in Sri Lanka: the role of disaster exposure, culturally specific coping strategies, and recovery efforts

Wickrama, Thulitha; Wickrama, K. A. S.; Banford, Alyssa; Lambert, Jessica E.

doi:10.1080/10615806.2016.1271121

Cited by 12 publications

(8 citation statements)

References 27 publications

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“…Sample items included: “how often do you practice Bali and how often do you read your horoscope?” Responses to the questions ranged from 1 (very rarely) to 4 (all the time). Cronbach’s alpha was 0.93, which compares favorably to prior studies utilizing this measure [ 20 , 39 ].…”

Section: Methodssupporting

confidence: 64%

Adolescents’ Tsunami Exposure and Mental Health Consequences: Protective Role of Cultural Coping Strategies

Wickrama,

Merten,

Wickrama

et al. 2024

IJERPH

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There is a knowledge gap regarding the link between disaster exposure and adolescent mental health problems in developing countries. This study examines the case of Sri Lanka to investigate (a) the immediate and long-term mental health impact of the 2004 tsunami disaster on adolescents and (b) the potential moderating effects of unique cultural and family practices that prevail in Sri Lanka. This study used a random sample of 160 adolescents (ages 12–19) and their mothers who were exposed to the tsunami disaster while living in a southern Sri Lankan village and provided prospective data immediately after the disaster (2005) and three years later (2008). A cross-culturally validated instrument assessed adolescent–mother dyads’ tsunami exposure, stressful loss, family cultural rituals and familism, and adolescent mental health. Structural equation modeling analysis showed that exposure and perceptions of tsunami-induced stressful experiences were associated with early and later mental health problems in adolescents. In addition, this study found that unique cultural practices and familism moderated the link between adolescent tsunami exposure, stressful experiences, and levels of PTSD and depressive symptoms. The findings of this study could be utilized to develop prevention and intervention programs that are contextually and culturally valid and empirically supported, which would be more effective for trauma-exposed adolescents in developing countries.

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Section: Methodssupporting

confidence: 64%

Adolescents’ Tsunami Exposure and Mental Health Consequences: Protective Role of Cultural Coping Strategies

Wickrama,

Merten,

Wickrama

et al. 2024

IJERPH

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“…By contrast, several practical nonpharmacological strategies, including coping strategies, psychoeducation for anxiety, lifestyle changes, and relaxation techniques, were categorized as first‐line recommendations for the primary treatment of unspecified anxiety disorder. Coping strategies were categorized as the “treatment of choice.” Coping strategies may improve anxiety symptoms due to life events, alleviate stress, and promote positive psychological outcomes 14–17 . Further investigations are needed to clarify the types of coping strategies appropriate for this population.…”

Section: Discussionmentioning

confidence: 99%

Management of unspecified anxiety disorder: Expert consensus

Sakurai

Inada

Aoki

et al. 2023

Neuropsychopharm Rep

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Aims: Treatment guidelines with respect to unspecified anxiety disorder have not been published. The aim of this study was to develop a consensus among field experts on the management of unspecified anxiety disorder. Methods:Experts were asked to evaluate treatment choices based on eight clinical questions concerning unspecified anxiety disorder using a nine-point Likert scale (1 = "disagree" to 9 = "agree"). According to the responses from 119 experts, the choices were categorized into first-, second-, and third-line recommendations.Results: Benzodiazepine anxiolytic use was not categorized as a first-line recommendation for the primary treatment of unspecified anxiety disorder, whereas multiple nonpharmacological treatment strategies, including coping strategies (7.9 ± 1.4), psychoeducation for anxiety (7.9 ± 1.4), lifestyle changes (7.8 ± 1.5), and relaxation techniques (7.4 ± 1.8), were categorized as first-line recommendations. Various treatment strategies were categorized as first-line recommendations when a benzodiazepine | 189 SAKURAI et al.

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“…Primary care physicians evaluated fundamental nonpharmacological treatments over benzodiazepine anxiolytics as the initial line of treatment for unspecified anxiety disorder. These treatments included lifestyle changes, coping strategies, and psychoeducation for anxiety, which have demonstrated safety and efficacy in mitigating stress, alleviating anxious symptoms, and promoting favorable psychological outcomes 21–24 . It is noteworthy that the respondents of the questionnaire are provided with training on basic nonpharmacological treatments for mental disorders at academic conferences and seminars.…”

Section: Discussionmentioning

confidence: 99%

“…These treatments included lifestyle changes, coping strategies, and psychoeducation for anxiety, which have demonstrated safety and efficacy in mitigating stress, alleviating anxious symptoms, and promoting favorable psychological outcomes. 21 , 22 , 23 , 24 It is noteworthy that the respondents of the questionnaire are provided with training on basic nonpharmacological treatments for mental disorders at academic conferences and seminars. Moreover, the specialists of this society are certified based on written examinations, practical examinations, oral examinations, and portfolio evaluations on common clinical practice, including fundamental nonpharmacological interventions and brief psychotherapy for anxiety disorders.…”

Section: Discussionmentioning

confidence: 99%

Clinical practice for unspecified anxiety disorder in primary care

Sakurai

Takeshima

Inada³

et al. 2023

PCN Reports

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AimClinicians face difficulties in making treatment decisions for unspecified anxiety disorder due to the absence of any treatment guidelines. The objective of this study was to investigate how familiar and how often primary care physicians use pharmacological and nonpharmacological approaches to manage the disorder.MethodsA survey was conducted among 117 primary care physicians in Japan who were asked to assess the familiarity of using each treatment option for unspecified anxiety disorder on a binary response scale (0 = “unfamiliar,” 1 = “familiar”) and the frequency on a nine‐point Likert scale (1 = “never used,” 9 = “frequently used”).ResultsWhile several benzodiazepine anxiolytics were familiar to primary care physicians, the frequencies of prescribing them, including alprazolam (4.6 ± 2.6), ethyl loflazepate (3.6 ± 2.4), and clotiazepam (3.5 ± 2.3), were low. In contrast, certain nonpharmacological options, including lifestyle changes (5.4 ± 2.3), coping strategies (5.1 ± 2.7), and psychoeducation for anxiety (5.1 ± 2.7), were more commonly utilized, but to a modest extent. When a benzodiazepine anxiolytic drug failed to be effective, primary care physicians selected the following management strategies to a relatively high degree: differential diagnosis (6.4 ± 2.4), referral to a specialist hospital (5.9 ± 2.5), lifestyle changes (5.2 ± 2.5), and switching to selective serotonin reuptake inhibitor (5.1 ± 2.4).ConclusionPrimary care physicians exercise caution when prescribing benzodiazepine anxiolytics for unspecified anxiety disorder. Nonpharmacological interventions and switching to SSRI are modestly employed as primary treatment options and alternatives to benzodiazepine anxiolytics. To ensure the safe and effective treatment of unspecified anxiety disorder in primary care, more information should be provided from field experts.

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PTSD symptoms among tsunami exposed mothers in Sri Lanka: the role of disaster exposure, culturally specific coping strategies, and recovery efforts

Abstract: The results of this study reveal the differential associations of various coping strategies including rituals used by mothers exposed to the tsunami in Sri Lanka and their posttraumatic stress symptom levels.

Cited by 12 publications

References 27 publications

Adolescents’ Tsunami Exposure and Mental Health Consequences: Protective Role of Cultural Coping Strategies

Adolescents’ Tsunami Exposure and Mental Health Consequences: Protective Role of Cultural Coping Strategies

Management of unspecified anxiety disorder: Expert consensus

Clinical practice for unspecified anxiety disorder in primary care

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