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Impact of Exposure to Trauma on Posttraumatic Stress Disorder Symptomatology in Swedish Tourist Tsunami Survivors
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Psychiatry, Ulleråker, University Hospital. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, National Center for Disaster Psychiatry.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Psychiatry, Ulleråker, University Hospital. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, National Center for Disaster Psychiatry.
Department of Medical Epidemiology and Biostatistics, Karolinska Institutet.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, National Center for Disaster Psychiatry.
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2009 (English)In: Journal of Nervous and Mental Disease, ISSN 0022-3018, E-ISSN 1539-736X, Vol. 197, no 5, 316-323 p.Article in journal (Refereed) Published
Abstract [en]

The aim was to examine long-term mental health and posttraumatic stress symptomatology in a Swedish tourist population after exposure to the 2004 Southeast Asian tsunami. Data from 4822 returned questionnaires 14 months after the disaster were analyzed. Respondents were categorized into 3 subgroups: (1) danger-to-life exposure group (having been caught or chased by the waves), (2) nondanger-to-life exposure group (exposed to other disaster-related stressors), and (3) low exposure group. Main outcome measures were General Health Questionnaire-12 and Impact of Event Scale-22-Revised. Danger-to-life exposure was an important factor in causing more severe posttraumatic stress symptoms and in affecting mental health. Female gender, single status, and former trauma experiences were associated with greater distress. Other factors related to more severe symptoms were loss of relatives, physical injuries, viewing many dead bodies, experiencing life threat, and showing signs of cognitive confusion. Disaster exposure has a substantial impact on survivors, which stresses the need for long-lasting support.

Place, publisher, year, edition, pages
2009. Vol. 197, no 5, 316-323 p.
Keyword [en]
Natural disaster, tsunami, exposure, life threatening danger, bereavement, posttraumatic stress, IES-R, GHQ-12
National Category
Medical and Health Sciences
Research subject
Psychiatry; Psychology
Identifiers
URN: urn:nbn:se:uu:diva-119833DOI: 10.1097/NMD.0b013e3181a206f7ISI: 000266047900005PubMedID: 19440104OAI: oai:DiVA.org:uu-119833DiVA: diva2:301042
Available from: 2010-03-05 Created: 2010-03-02 Last updated: 2017-12-12Bibliographically approved
In thesis
1. Traumatic Exposure, Bereavement and Recovery among Survivors and Close Relatives after Disasters
Open this publication in new window or tab >>Traumatic Exposure, Bereavement and Recovery among Survivors and Close Relatives after Disasters
2010 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

International studies of disasters indicate the risk for developing posttraumatic stress reactions among survivors is high. Modern life implicates increased traveling. During the last decades a large number of Swedish citizens were confronted with disasters taking place outside of their country.

The prevalence of trauma reactions in a population that does not  normally  experience natural disasters, but are able to return to a community unaffected by the catastrophe, is not well studied. In addition, the effects of bereavement after traumatic circumstances have not been satisfactorily explored. Longitudinal studies on the effects of natural disasters are underrepresented and there are few studies investigating the course of recovery after traumatic exposure.

The aim for this thesis was to examine long-term post-traumatic stress reactions, mental health, and complicated grief after disaster exposure and traumatic bereavement.  Data from returned questionnaires were analysed from bereaved Italian and Swedish relatives 18 months after the Linate airplane disaster 2001, and at 14 months and three years from Swedish travelers returning from Southeast Asia after the 2004 tsunami disaster, and from home staying bereaved relatives within the second year after the tsunami disaster. The main outcome measures were GHQ-12, IES-R and Inventory of Complicated Grief.

The findings indicated many survivors were resilient and had ability to recover, but severe exposure to a disaster had considerable impact on psychological distress. Life threat was associated with higher levels of post-traumatic stress reactions, and increased the risk for affected mental health and suicidal ideation. Loss in combination with severe life threat exposure indicated a further increased risk of posttraumatic stress reactions and for complicated grief; this should be considered a substantial risk factor for general mental health. Loss of close relatives, especially loss of children, was associated with higher levels of posttraumatic stress and created a greater risk for complicated grief. Many survivors recovered over time; however, severe exposure and traumatic loss appeared to slow the recovery process. The findings have implications for government and health agencies, regarding the importance of knowledge and awareness of these risks for health, and for organizational structure, training, and accessibility of support and adequate treatment.

Place, publisher, year, edition, pages
Uppsala: Acta Universitatis Upsaliensis, 2010. 69 p.
Series
Digital Comprehensive Summaries of Uppsala Dissertations from the Faculty of Medicine, ISSN 1651-6206 ; 533
Keyword
Natural disaster, traumatic exposure, life threat, traumatic bereavement, psychological distress, posttraumatic stress reactions, PTSD, general mental health, suicidal ideation, complicated grief, social support, resilience, recovery
National Category
Psychiatry
Research subject
Psychology; Psychiatry
Identifiers
urn:nbn:se:uu:diva-120200 (URN)978-91-554-7744-8 (ISBN)
Public defence
2010-04-23, Sal X, Universitetshuset, Övre Slottsgatan, Uppsala, 09:15 (Swedish)
Opponent
Supervisors
Available from: 2010-03-31 Created: 2010-03-09 Last updated: 2010-03-31

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Bergh Johannesson, KerstinMichel, Per-OlofArnberg, FilipLundin, Tom

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