Disaster-Related Trauma

Disaster-related traumatic stress reactions occur when an individual experiences an event that presents a serious threat to self and/or others and the response to the event includes intense fear, helplessness, or horror. Traumatic reactions may range from short term (e.g., traumatic stress; acute stress disorder) to prolonged and severe (e.g., posttraumatic stress disorder). Whether the disaster is human caused or natural, the ability to resolve traumatic stress reactions is complicated by many factors. These complicating factors affect the intensity and duration of traumatic stress reactions. Interventions must be appropriate to disaster survivors’ level of stress reaction.

All disasters are stressful owing to factors related to preparedness, response, and recovery. These factors include evacuation, sheltering or temporary relocation, repair of damages or rebuilding homes, replacement of personal property, the process for securing funds for rebuilding (i.e., insurance, publicly funded disaster programs), and damage or destruction of community (including neighborhoods, schools, businesses, public services) and infrastructure (water, sewer, power, traffic lights). Although disasters in general contain factors related to stress, not all disasters contain the elements that meet the definition of trauma, which includes a response of intense fear, helplessness, or horror. For example, Person A lives in a hurricane-prone area that floods during heavy storms, is prepared (ready kit, evacuation route, flood insurance), and evacuates with family upon warning. Person A experiences disaster stressors related to recovering from the event but does not experience intense fear, helplessness, or horror. Person B, caught in fast-rising water and fearful of drowning, experiences intense fear, helplessness, and horror when exposed to gruesome and grotesque scenes while waiting for days to be rescued. Person B must deal with the same recovery issues as Person A and cope with the symptoms of posttraumatic stress—reexperiencing the event via intrusive thoughts and images, difficulty sleeping, difficulty concentrating, hypervigilance, and numbing of emotions. Person A experienced disaster stress, while Person B experienced traumatic stress.

It is interesting to note that most people recover from disaster-related events. As reported in Interventions Following Mass Violence and Disasters.

Although 95% of individuals exposed to some traumatic material reported some posttraumatic psychological distress, only 29% experienced reactions deemed serious from a clinical perspective. Most reactions were transient with symptom dissipation within a month for 42% and within a year for an additional 23%; only 30% experienced chronic symptoms lasting longer than a year (Ritchie et al., 2006, p. 8).

To further understand the distinction in level of reaction, disasters may be categorized by three types: natural (e.g., hurricane, tornado, flood), human-caused accidental (e.g., human error causing transportation incident or structural collapse), and human-caused intentional (e.g., terrorism). As discussed by Glenn Schiraldi in the Post-Traumatic Stress Disorder Sourcebook, human-caused intentional disasters such as the September 11 terrorist attack (the second-most expensive disaster in U.S. history) are the most difficult of the three types from which to recover. Associated factors include feelings of degradation, shame, stigmatization, and loss of faith and trust in humanity. The most expensive disaster in U.S. history is Hurricane Katrina. This natural disaster, which hit the Gulf Coast from Louisiana to Florida, included human error: levee failure in New Orleans. In both the September 11 attack and Hurricane Katrina (New Orleans), citizens wanted to know who was responsible and why. Elspeth Cameron Ritchie and colleagues report data indicating that the prevalence of psychological distress after the September 11 terrorist attack was higher than that for natural disasters.

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