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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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2 Description of Post-Traumatic Stress Disorder (PTSD)


When a life-threatening event occurs, it is normal to react with distress, anxie- ty, and fear. This reaction enables people to survive and these emotions en- hance the memory of the traumatic event, so that they can recognize and avoid similar situations in the future. For some individuals, however, this natural re- action to a traumatic situation becomes uncontrollable and exaggerated, and they develop symptoms of PTSD. The nature and severity of the trauma as well as personal characteristics determine the severity and duration of the symptoms (Breslau, 2001b). When one’s life is in danger, one reacts to this situation of extreme stress by, for example, denying what has happened or giving the impression of losing contact with reality. Many people cannot quickly integrate what has happened and refuse to accept reality. They may feel numb and focus on insignificant de- tails. Others feel guilty and in some way responsible for the tragedy. Fear of the reoccurrence of the event is also common. These are normal reactions to ab- normal situations that help people survive (Revel, 1996). 2.1 Historical Development of the PTSD Construct Psychiatrists’ and psychologists’ understanding of PTSD has undergone a se- ries of changes throughout the last 150 years. The diverse social, biological, and psychological processes associated with it were initially believed to have only physical causes. In 1866, the term “railway spine” was first used to indicate a symptom group associated with events such as railway collisions, producing shock, fright and emotional disturbance. The opinion of...

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