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Tsunami in Kerala, India: Long-Term Psychological Distress, Sense of Coherence, Social Support, and Coping in a Non-Industrialized Setting


Sophia von Lieres

This study assesses the long-term psychological consequences after the 2004 Asian tsunami in Kerala, India. Participants are the inhabitants of Kerala’s coastal regions. The results indicated that the participants who were affected by the tsunami showed significantly greater psychological distress and symptoms of post-traumatic stress disorder (PTSD) than a control group. In addition, it could be shown that protective factors, such as perceived social support, certain coping strategies, and a sense of coherence, could decrease the level of symptoms. Perceived social support, in particular, decreased symptoms of post-traumatic stress disorder and a strong sense of coherence mitigated psychological distress. Avoidance coping was found to be more effective in decreasing levels of traumatic stress in this non-industrialized, collectivistic cultural setting.


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India was the third country severely affected by the tsunami on December 26, 2004, after Indonesia and Sri Lanka, with the overall death toll higher than 16,000. Kerala lost between 150 and 200 people. The present study investigated the long-term psychological consequences, and the role of sense of coherence, perceived social support, and coping after this natural disaster. The sample con- sisted of 407 inhabitants of the fishing villages along the coastline of Alappad, Kerala. Of these, 233 were affected by the tsunami and 174 were not affected. The level of traumatic stress was measured with the IES-R (Weiss & Marmar, 1996), general psychological distress with the BSI (Derogatis, 1993), sense of coherence with the SOC scale (Antonovsky, 1987), coping behavior with the Brief COPE (Carver, 1997), and perceived social support with the Social Sup- port Questionnaire (SOZU-K-22) (Sommer & Fydrich, 1989). The two groups were compared regarding their level of traumatization and their general psychological distress. In addition, it was assessed to what extent protective factors such as perceived social support, a sense of coherence, and specific coping strategies could have mitigated the effects of the disaster. It was revealed that tsunami victims were still suffering from symptoms of traumatic stress two and a half years after the tsunami and that they significantly showed greater psychological distress compared to the not affected control group. So- cial support, in particular, decreased the level of traumatic stress, and a strong sense of coherence mitigated psychological distress. Contrary to studies in Western, industrialized...

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