Coping With Disasters Research Paper

1. Types Of Disasters

Perhaps it is easier to call to mind examples of disasters than it is to precisely define the term ‘disaster.’ The 1999 earthquake in Turkey was a disaster, as was the crash of two Norwegian trains in early 2000. In the United States, a catastrophic event officially qualifies as a disaster based on the amount of damage done and the amount of assistance required. The strength of the event alone is not sufficient; a powerful earthquake in a remote area of a California desert may not be considered a disaster, whereas an earthquake of the same magnitude in the city of San Francisco would qualify because considerable damage would result. In addition to damage sustained, substantial disruption to people’s lives can also be a feature in the definition of ‘disaster.’ Further components of what constitutes a disaster are explained when two types of disasters, natural and technological, are contrasted.

1.1 Coping With Natural Disasters

Natural disasters are caused by intense and powerful natural events such as hurricanes, tornadoes, earthquakes, and floods. They can also occur because of drought and famine. These and other cataclysmic events are some of the most threatening situations a person can experience. In a sudden and uncontrollable manner, natural forces can take lives and dramatically alter the environment.

Natural disasters vary widely in predictability and impact. Earthquakes are virtually unpredictable, whereas hurricanes can be tracked for days before they hit land. However, consequences such as the extent of physical destruction and disruption of daily life often take victims by surprise, even after the more predictable types of events. Months of cleaning and rebuilding can follow initial rescue work and recovery of human remains. Moreover, drawn-out and complicated insurance, litigation, and financial issues may compound adjustment difficulties following disasters (Green et al. 1990).

Cataclysmic natural phenomena are widespread, and long-term psychological effects of natural disasters are being studied in the realm of trauma research. Reactions to trauma vary among individuals, and research has focused on documenting the effects of disasters by comparing groups who had different degrees of exposure to the event and predicting who copes well and who does not. Adjustment to natural disasters has been studied in response to hurricanes, tornadoes, earthquakes, and floods. Severe and long-lasting consequences of natural disasters may be exacerbated by characteristics of their onset. For example, sudden disasters with lack of warning are especially devastating. Disaster characteristics such as duration and intensity also influence how people cope with such events. Even events of short duration, such as an earthquake, may cause disruption and threat that last months beyond the acute phase of the disaster. Other characteristics of the disaster experience include threat to one’s life, witnessing the death of others, injury to oneself or others, loss of social cohesion and resources of the community, loss of possessions and finances, and separation from family.

Anticipation, acute experience, and aftermath of natural disasters all require coping, as does the period of rebuilding. Coping includes strategies or behavior that reduce threat and may take many forms. Direct action involves reducing exposure to the stressor or directly altering the stressor so that it becomes less threatening. For example, evacuating an area where a hurricane is likely to hit can reduce immediate threat to one’s life. Information seeking is another form of coping. Keeping track of a hurricane’s path and wind-speed, for example, may increase a sense of predictability over an impending disaster. Palliative coping includes efforts at reappraising the stressor or reinterpreting the situation to reduce threat. For example, a volcanic eruption could be seen as a way of nature reclaiming land, or a forest fire may be seen as a part of a natural cycle that is necessary for continued growth and differentiation of the forest. Emphasizing the positive aspects of the post-disaster experience, such as increased appreciation for one’s health and family, is yet another way of reappraising the situation.

Seeking emotional and practical assistance from others is another common way of recovering from natural disasters (Smith et al. 1986). Community responses directed at restoring the environment are important in regaining control and coping emotionally. Unfortunately, some cataclysmic events cause social support networks to deteriorate at the time they are most needed. Social support is important in both a practical and an emotional manner. Physical assistance in recovery is often necessary for individuals to cope effectively, and emotional assistance is an important factor in recovering from the trauma. However, disasters often weaken or destroy social ties and cause social disruption that makes the kinds of social support that are so helpful in recovery more difficult to obtain. Disaster disrupts both social support and the ability to perform one’s role in the family (Kaniasty and Norris 1993) and increased demand for support may be stressful for those providing it. Denial, use of alcohol and other drugs, as well as learning to live with the stressor are additional ways in which people cope with cataclysmic events like natural disasters (Lazarus and Folkman 1984).

1.2 Coping With Technological Disasters

Like natural disasters, technological disasters are caused by events that can be intense and sudden. Examples include bridge collapses, dam failures, and industrial, maritime, and aviation accidents. They also include more drawn-out events resulting from breakdown in technology in which highly toxic substances are used or stored. Such situations would include leaking toxic waste dumps, such as Love Canal, or accidents involving release of radiation, such as the Three Mile Island nuclear disaster. With increasingly widespread prevalence of technological systems there will inevitably be an increase in the potential for loss of control over these systems.

An important difference between natural and technological disasters is that natural disasters often have a ‘low point’ at which it seems that the worst is over. In contrast to this situation, many technological disasters do not have a low point, a situation that can contribute to prolonged distress (Baum et al. 1983). The visible damage that a natural disaster such as flooding leaves behind can serve as a reminder that the event has passed, perhaps allowing a starting point for recovery. It also provides a focus for post-disaster recovery emphasizing constructive responses associated with rebuilding. The ‘low point’ may actually be psychologically beneficial because victims know where they stand in relation to the disaster.

For example, once maximum velocity winds of a hurricane have passed, the worst is probably over. When disasters do not have a low point, these ‘safety’ signals are not available. The exceptions, of course, include situations like airplane crashes and maritime disasters. Catastrophic breakdowns of technology that result in toxic contamination do not necessarily have a point at which the worst is over. Those exposed can wonder and worry for years about the extent of their exposure and its possible consequences.

As Green (1998) noted, it can be difficult to compare disasters because each one is unique. She suggested a continuum of intent as a means of conceptualizing disasters. Natural disasters would be placed on the low end of intent, technological disasters in the middle, and hijacking and other purposeful acts of violence would be placed at the high end of the continuum. In the case of technological disasters, an implicit social contract between citizens and corporations is violated. The assumption is that corporations will not harm their customers, workers, or members of the community where they make their products. When this contract is violated, anger and rage are added to the range of emotional responses to disasters.

Disasters have also been categorized with respect to perceived control. Natural disasters reflect a lack of control over the environment, but technological disasters reflect a loss of control of what was once under control (Baum et al. 1983). A major assumption underlying reliance on technological systems is that they won’t break down. That is, ships are not supposed to sink, and toxic substances are not supposed to leak into the environment. Violations of this implicit assumption can contribute to the distress felt by victims and witnesses of this type of disaster.

Like natural disasters, the onset of technological disaster may be sudden or drawn-out. When the Buffalo Creek dam in West Virginia failed in 1979, there was little if any warning of the impending disaster. Very powerful and overwhelming destruction followed, resulting in hundreds of deaths. While it is possible to gain a semblance of control over disasters like this with regular inspection and evacuation plans, the fact remains that technology was not built to fail and it is extremely difficult to predict when it will. Because this disaster was a failure of a human-made dam, the flood that resulted was less predictable than naturally caused floods.

Research on reactions to the Buffalo Creek disaster identified characteristics that contributed to long-lasting mental health consequences (Green et al. 1990). One of these characteristics was that a mining company was considered responsible for the flooding. Anger, rage, and scapegoating of people and agencies that were not directly involved were some repercussions of the flooding being human-caused. In natural disasters, there is rarely someone to blame. Another factor contributing to the impact was the unusual severity of the flood, which was compounded by the isolated location of the community in a valley. Survivors remained homeless sometimes for weeks because removal of debris was delayed and prolonged. In addition, when temporary housing was arranged, it was not conducive to maintaining social support networks among family and friends, an important component of post-trauma recovery.

2. Types Of Victims

Important distinctions exist among victims of disasters. Some are affected directly because they were present during a disaster event and experienced threat or loss as a result. Others are affected less directly; people who live in an area hit by a tornado, for example, may not have been there when it hit but may have lost property or had family members injured. Another type of victim, the rescue worker, may be exposed to a variety of extreme stressors including hazardous and fatiguing working conditions.

2.1 Coping In Primary Victims

Research on disasters and their effects on mental health have identified a range of outcomes associated with this kind of victimization. Predictors of a disaster’s effect on people and what factors may reduce or modify this impact have also been studied. As a result, advances in understanding and treating posttraumatic syndromes have been made based on studies of victims of natural and technological disasters. For many years this research was focused on the primary victims of disasters. Differences in the extent of threat experienced during the disaster contribute to differences in their post-disaster response. Research after a wide variety of disasters has suggested that loss of resources, perceived control, adaptational demand, and life threat influence the intensity and duration of distress and stress responding in primary victims. This variation in response, together with the fact that the majority of disaster victims appear to cope effectively, suggests that situational and individual factors work together to produce long-term reactions to disasters.

The study of victims of large-scale traumas started with the documentation of responses to war trauma. Wars can be construed as human-made disasters. After the American Civil War and World War I, descriptions of ‘shell shock’ and ‘battle fatigue’ characterized extreme reactions to this type of stress. Following World War II, studies were conducted on the long-term effects of concentration camps and other traumas of war such as the devastation of Hiroshima. Disasters unrelated to war began to be studied intensively in the 1970s. Currently, a wide variety of disasters ranging from earthquakes to nuclear catastrophes are studied with respect to how victims cope over time.

Symptoms of distress following a disaster experience can include shaking, hyperventilation, palpitations, sleep disturbances, intrusive memories, shortness of breath, sweating, and gastrointestinal reactions. Many of these anxiety symptoms are also associated with exposure to toxic substances, which can escalate panic in individuals in proximity of industrial accidents. The considerable variation in the range of responses and the ways in which people cope with their distress over time underscores the complexity of the factors which constitute the severity of post-disaster stress (Baum 1987). Some people report only a minimal emotional response to a disaster, but typically post-disaster effects include anxiety, depression, helplessness, numbness, anger, guilt, and relief. Most disasters appear to have some impact on the mental health of witnesses and victims, and sometimes these negative effects last for years. The profound effect disasters can have on people is evidenced by many studies on post-traumatic stress disorder (PTSD) in victims of a wide variety of disasters. For example, survivors of the Buffalo Creek disaster exhibited anxiety, depression, withdrawal, numbness, anger, nightmares, and other stress-related physical symptoms for years after the accident (Gleser et al. 1981).

Coping behavior is an important part of the stress response. Coping responses to disasters consist of attempts to remove the source of stress or insulate oneself from its effects. If coping is successful, the person returns to normal physiological and psychological arousal as the threat is eliminated or minimized. The victim can adapt cognitively by reducing awareness of the stressor or by changing their perception of threat. The individual can also cope behaviorally by removing or reducing the threat. People may have particular coping styles or habitual ways of responding to stress. For example, people may use problem-focused coping, or do wishful thinking about a stressful situation, or they may seek and use social support, avoid thoughts about the stressor, or use self-blame coping to different degrees.

Lazarus and Folkman (1984) proposed that stress responses can take manipulative or accommodative forms. They may include direct action responses, where the individual tries directly to manipulate or alter his or her relationship to the stressful situation. Changing the stressor by direct action would include solving a problem that was creating distress or leaving the scene. Flexible coping styles, where the person tailors their strategy to the situation and can manipulate and change their coping, can be especially effective in a changing environment following disasters.

Chronic stress following disasters may affect how primary victims cope with additional stressors, and these acutely stressful events may in turn feed into and maintain the chronically stressed state. Schaeffer and Baum (1984) studied stress-related consequences of living near Three Mile Island (TMI), site of a nuclear accident in the United States in 1979. Uncertainty involving the long latency of radiation’s effects on the body, the potential for cancer, uncertain locations of safe and unsafe areas and amount of exposure, and the lack of scientific information on the effects of low-level exposure were all characteristics making this disaster chronically stressful. In fact, higher blood pressure and higher levels of stress hormones were observed in residents of TMI compared with a control sample living 80 miles from the site. Major stressors like the TMI disaster can have negative effects on health (Baum 1987) but relatively little systematic and long-term investigation of health-related variables in disasters have been reported. Evidence of blood pressure, hormonal, and changes in immune system functioning that could be considered intermediate to health effects has been found, and sustained changes in these functions could predispose people to illnesses.

2.2 Coping In Rescue Workers

Major aspects of disaster-related trauma include threat to life, witnessing death and injury, and making difficult choices like risking one’s own life to save that of another. Other stressors operating during disasters include high levels of uncertainty, lack of clear leadership, and lack of control. Lack of warning also contributes to long lasting effects of those exposed, regardless of whether they were primary victims or rescue personnel. There are qualities of responding to disasters that are more specific or unique to rescue workers, however. Emergency personnel respond to a wide range of events, including large-scale catastrophes like earthquakes and airplane crashes. They must search for and help survivors as well as recover human remains and personal effects. These workers face long hours, unpleasant or gruesome working conditions, and exposure to body fluids and other hazardous materials. Exposure to dead or mutilated bodies from a disaster is a potent stressor (Ursano and McCarroll 1994). Studies have investigated emergency workers and their reactions to the stress of body handling and victim identification. These studies agree that disaster workers experience considerable distress but methods and measures used have been different across studies, resulting in findings of varying stress duration and intensity. Rescue and clean-up activities following natural and technological disasters have been associated with symptoms of PTSD, including recurrent intrusive thoughts and distressing dreams. However, it is difficult to predict long-lasting psychological consequences because many rescue workers exposed to trauma do not experience lasting distress.

Predicting long-term distress is difficult partly because of variability in rescue workers’ responses. Some studies have reported consistent negative effects of disaster work, and others have failed to find long-lasting distress in rescue workers. After the 1988 Piper Alpha oil rig disaster, Alexander and Wells (1991) found no differences in distress when comparing police officers with more or less previous experience dealing with human remains. Anxiety was actually reduced after body handling, reflecting that many of the officers found the anticipation to be more distressing than the actual body handling. Other studies using different rescue workers and disasters did in fact find differences in distress depending on prior experience. In a situation that involved extensive body handling, rescue workers who recovered human remains after the crash of Flight 427 showed persistent symptoms of chronic stress and intrusive thoughts related to their experience at the crash scene. Workers who did not expect to see remains but who did in fact come into contact with them were more distressed than those prepared for the recovery activities (Delahanty et al. 1997).

In studies on coping in rescue workers, talking about their experiences to other workers was found to be beneficial for dealing with distressing thoughts and feelings. Following the 1981 Hyatt-Regency skywalk collapse where 144 people were killed and 188 were injured, rescue workers’ distress scores were consistently higher but not significantly different from the controls (Miles et al. 1984). Sharing stories as well as the experience of identifying with the dead were forms of coping commonly endorsed by these workers. Less healthy forms of coping included increased use of tobacco, caffeine, and alcohol. In a review of the literature on handling the dead after disasters, Ursano and McCarroll (1994) highlighted the aspects of disaster work that may contribute to stress or help rescue workers cope with stress. They discussed rescue and recovery work in terms of phases, including anticipation, active duty, and post-duty experiences. Preparation of workers so that they know what to expect at the disaster site is beneficial. Identification with the victims, personalization, and emotional involvement heighten the trauma and increase perceived threat, however. As a consequence of this type of research, intervention efforts and critical incident debriefing sessions have been started for rescue workers responding to a variety of disasters. However, research on the effectiveness and specific mechanisms behind such intervention efforts is in its beginning stages.

3. Summary And Conclusions

Disasters can be defined by their origins as well as their consequences. Interactions among the nature of the stressor, degree of exposure, types of victims, and coping result in the individual’s experience of traumatic stress. Natural disasters such as floods and technological disasters such as nuclear accidents and plane crashes are unpredictable and powerful threats that affect generally all of those touched by them. As a threat to life, property, and assumptions people hold about the world, disasters can cause substantial life changes. Cataclysmic events and disasters can have a sudden, powerful impact and almost universally elicit a stress response. These events usually require a great deal of effort for effective coping. Although evidence suggests that disaster stress varies according to the type of disaster experienced, research has shown that responses to disasters in primary victims and rescue workers can share a relatively predictable trajectory. Early shock and anxiety are often followed by combinations of anger, depression, distress, and posttraumatic stress. Coping is part of the stress response and is involved in changing the perceived level of threat from the stressor. Consequently, recovery from the disaster experience is intimately tied to the coping process.

Bibliography:

1. Alexander D A, Wells A 1991 Reactions of police officers to body handling after a major disaster: A before and after comparison. British Journal of Psychiatry 159: 547–55
2. Baum A 1987 Toxins, technology, and natural disasters. In: Vanden Bos G R, Bryant B K (eds.) Cataclysms, Crises, and Catastrophes: Psychology in Action. American Psychological Association, Washington, DC, pp. 247–51
3. Baum A, Fleming R, Davidson L M 1983 Natural disaster and technological catastrophe. Environment and Behavior 15: 333–54
4. Delahanty D L, Dougall A L, Craig K J, Jenkins F J, Baum A 1997 Chronic stress and natural killer cell activity following exposure to traumatic death. Psychosomatic Medicine 59: 467–76
5. Gleser G C, Green B L, Winget C N 1981 Prolonged Psychosocial Effects of Disaster: A Study of Buffalo Creek. Academic Press, New York
6. Green B L 1998 Psychological responses to disasters: Conceptualization and identification of high-risk survivors. Psychiatry Clinical Neuroscience 52(suppl): S57–S73
7. Green B L, Grace M C, Lindy J D, Gleser J C, Leonard A C, Kramer T L 1990 Buffalo Creek survivors in the second decade: Comparison with unexposed and non-litigant groups. Journal of Applied Social Psychology 20: 1033–50
8. Kaniasty K, Norris F H 1993 A test of the social support deterioration model in the context of a natural disaster. Journal of Personality and Social Psychology 64: 395–408
9. Lazarus R S, Folkman S 1984 Stress, Appraisal, and Coping. Springer, New York
10. Miles M S, Demi A S, Mostyn-Aker P 1984 Rescue workers’ reactions following the Hyatt Hotel disaster. Death Education 8: 315–31
11. Schaeffer M A, Baum A 1984 Adrenal cortical response to stress at Three Mile Island. Psychosomatic Medicine 46(3): 227–37
12. Smith E, Robins L, Przybeck T, Goldring E, Solomon S 1986 Psychosocial consequences of disaster. In: Shore J H (ed.) Disaster Stress Studies: New Methods and Findings. American Psychiatric Press, Washington, DC, pp. 49–76
13. Ursano R J, McCarroll J E 1994 Exposure to traumatic death: The nature of the stressor. In: Ursano R J, McCaughey B G, Fullerton C S (eds.) Individual and Community Responses to Trauma and Disaster: The Structure of Human Chaos. Cambridge University Press, Cambridge, UK