This paper describes the establishment and activities of the Information and Support Centres developed in Norway in the aftermath of large-scale accidents and disasters between 1980 and 1990. The function of these Centres is to provide rapid, authoritative information and psychosocial support services for the next-of-kin of disaster victims, including the families of those missing. By gathering together those affected by a particular event, the Centres provide a setting in which individuals and families can support each other. The activities of the psychosocial team include triage for mental-health emergencies, orienting survivors to immediately available local services, communication with family, friends, and community, and other forms of psychological first aid. The psychosocial team also provides linkages to local health, clergy, and other local resources that are near to the family's home and could provide continued care if necessary.
A sample of 1,624 Norwegian veterans from the UNIFIL (United Nations Interim Force in Lebanon) was investigated on average 6.6 years after service, completing a questionnaire focusing on stress exposure and posttraumatic stress reactions. The prevalence of posttraumatic stress disorder (measured by the Posttraumatic Symptom Scale [PTSS-10]) was 5% overall, but 16% in the subgroup of personnel having been prematurely repatriated from UNIFIL. Multiple regression analyses showed that the following variables made separate and significant contributions to the explained variance of the PTSS-10: Service stress exposure, perceived lack of meaningfulness with respect to the military mission, and stressful life-events in life after service. These factors explained 25% (overall sample) and 37% (repatriated sample) of the variation in the posttraumatic symptom score.
To study changes in religious beliefs and predictors of such changes in a community sample exposed to a natural disaster, and to investigate whether religiosity was linked to post-disaster mental distress or life satisfaction.
An adult population of 1,180 Norwegian tourists who experienced the 2004 tsunami was surveyed by a postal questionnaire 2 years after the disaster. Data included religiosity, disaster exposure, general psychopathology, posttraumatic stress and life satisfaction.
Among the respondents, 8% reported strengthening and 5% reported weakening of their religious beliefs. Strengthening was associated with pre-tsunami mental health problems (OR: 1.82, 95% CI: 1.12-2.95) and posttraumatic stress (OR: 1.62, 95% CI: 1.22-2.16). Weakening was associated with younger age (OR: 0.98, 95% CI: 0.96-1.00) and posttraumatic stress (OR: 1.72, 95% CI: 1.23-2.41). Two years after the tsunami, 11% of the sample considered themselves to be positively religious. There were no significant differences in posttraumatic stress, general psychopathology or life satisfaction between religious and non-religious groups.
Religion did not play an important role in the lives of Norwegian tsunami survivors in general. Respondents who had the greatest disaster exposure were more likely to report changes in religious beliefs in both directions. Religious beliefs did not prevent post-disaster long-term mental distress, and religiosity was not related to higher levels of life satisfaction.
Cites: Tidsskr Nor Laegeforen. 2000 Jan 30;120(3):346-810827526
Surveys investigated the perceived threat of radioactive fallout and public coping following a "silent disaster" (Chernobyl) across Europe. Survey data from national representative samples in 12 European countries are compiled, 6 months and 2 years after the accident, across 12 countries. Exposure to information about the accident, and perception of the consequences of Chernobyl as a health threat, were significantly related to the level of fallout in each country. Another significant relationship was found between the level of fallout in these 12 countries and the proportion of respondents who reported having taken countermeasures. Information challenges for the authorities are highlighted.
We examined nonparticipation in a 2-year postdisaster mail survey of Norwegian tourists evacuated from countries affected by the 2004 tsunami. One hundred seventy-one persons out of a random sample of 330 nonparticipants were telephone interviewed concerning disaster exposure, current posttraumatic stress reactions, and reasons for not participating. Fewer nonparticipants than participants had been in a place directly affected by the tsunami. Nonparticipants reported less perceived threat of death and lower levels of posttraumatic stress reactions. Reasons for not participating were "lack of interest or time" (39.2%), "lack of relevant experiences" (32.2%), and "too personal or emotionally disturbing" (15.2%). Our findings suggest that postdisaster studies may be biased in the direction of more severe disaster exposure and pronounced posttraumatic stress reactions.
BACKGROUND: Few studies have explored the long-term mental health consequences of disaster losses in bereaved, either exposed to the disaster themselves or not. This study examined the prevalence and predictors of mental disorders and psychological distress in bereaved individuals either directly or not directly exposed to the 2004 tsunami disaster. METHOD: A cross-sectional study of 111 bereaved Norwegians (32 directly and 79 not directly exposed) was conducted 2 years postdisaster. We used a face-to-face structured clinical interview to diagnose current posttraumatic stress disorder (PTSD) and depression (major depressive disorder, MDD) and a self-report scale to measure prolonged grief disorder (PGD). RESULTS: The prevalence of psychiatric disorders was twice as high among individuals directly exposed to the disaster compared to individuals who were not directly exposed (46.9 vs. 22.8 per 100). The prevalence of disorders among the directly exposed was PTSD (34.4%), MDD (25%), and PGD (23.3%), whereas the prevalence among the not directly exposed was PGD (14.3%), MDD (10.1%), and PTSD (5.2%). The co-occurrence of disorders was higher among the directly exposed (21.9 vs. 5.2%). Low education and loss of a child predicted PGD, whereas direct exposure to the disaster predicted PTSD. All three disorders were independently associated with functional impairment. CONCLUSIONS: The dual burden of direct trauma and loss can inflict a complex set of long-term reactions and mental health problems in bereaved individuals. The relationship between PGD and impaired functioning actualizes the incorporation of PGD in future diagnostic manuals of psychiatric disorders.
This paper discusses how psychological stress disturbs decision making during technological crisis and disaster, and how to prevent this from happening. This is exemplified by scientific studies of a Norwegian large scale accident involving hazardous material, and of handling the far-off effects of the nuclear disaster at Chernobyl. The former constitutes an operative level of crisis management, whereas the latter involves crisis management at the strategic and political level. We conclude that stress had a negative effect on decision making in both cases.
Bereavement following disasters is a devastating experience for family members. The aim of this study was to examine the long-term mental health effects of losing a loved one in a natural disaster.
Ninety-four Norwegians aged 18-80 years who lost close family members in the 2004 Southeast Asian tsunami were evaluated 2 and 6 years after the disaster. The participants were either staying in an affected area at the time of the disaster (i.e., directly exposed) or not (i.e., not directly exposed). The prevalence of psychiatric disorders was assessed by the MINI International Neuropsychiatric Interview (M.I.N.I). Prolonged grief disorder (PGD) was self-reported using the Inventory of Complicated Grief (ICG), and functional impairment was self-reported using the Work and Social Adjustment Scale (WSAS).
We did not identify a significant decrease in the prevalence of PGD, posttraumatic stress disorder (PTSD), or major depressive disorder (MDD) from 2 to 6 years. Approximately, one-third of the bereaved (36%) had a psychiatric disorder 6 years after the tsunami. The most common disorder was PGD (12%) followed by general anxiety disorder (GAD, 11%), agoraphobia (11%), and MDD (10%). The prevalence of PTSD and MDD was higher among family members who were directly exposed to the disaster compared to those who were not (21 vs. 0%, and 25 vs. 3%). PGD was associated with functional impairment independent of other disorders.
Loss of a close family member in a natural disaster can have a substantial adverse long-term effect on mental health and everyday functioning.
Victims of violent assault experience diverse post-event emotional problems such as post-traumatic stress disorder (PTSD), and they may have multiple emotional problems. The aim of the present study was to evaluate the prevalence and predictors of PTSD in a longitudinal design.
The levels of physical injury, perceived life threat, prior experience of violence, peritraumatic dissociation (PD), acute PTSD, perceived self-efficacy and perceived social support are considered possible predictors. This study had a single group (N = 70), longitudinal design with three repeated measures over a period of 12 months. Questionnaires used were: Impact of Event Scale-15 and 22 (IES-15 and 22), Post-Traumatic Symptom Scale-10 (PTSS-10), Peritraumatic Dissociation (PD) 7-item self-report measure, Social Provisions Scale (SPS) and Generalized Self-Efficacy scale (GSE).
Results showed a high prevalence and severity of PTSD on all outcomes, for instance 31% scored as probable PTSD-cases and 14% as risk level cases by IES-15 at T3. Either injury severity or prior experience of being a victim of violence predicted PTSD in this study. Early PTSD predicted subsequent PTSD, and perceived life threat was a predictor of PD. Furthermore, lack of perceived social support was a predictor of PTSD symptoms at T3. In addition, low perceived self-efficacy was a predictor of PTSD and influenced perceived social support at T1.
Our results showed that experience of non-domestic violence may cause serious chronic emotional problems, and therefore it is important to be aware of early symptoms indicating needs for special follow-ups.