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

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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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3 Risk Factors and Predictors of PTSD

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The question arises, “What turns a stressful experience into a traumatic one?” Different people deal with similar experiences in different ways, and only a small percentage of people suffer from enduring psychological distress. Wheth- er someone develops PTSD or not depends on internal and external processes, which are influenced by aspects of the traumatic experience, as well as person- ality and situational factors (Krüsmann & Müller-Cyran, 2005). Given that approximately 50 percent to 60 percent of the U.S. population is exposed to traumatic stress but only 5 to 10 percent develop PTSD, which sys- tematic risk factors identify who will or will not develop PTSD (Ozer, et al., 2003)? Various factors can increase the risk of developing PTSD after experienc- ing a trauma. Examples are the subjective experienced loss of control or the expectation of adverse consequences (Maercker, Schützwohl & Beauducel, 2000). Not only cognitive, but also demographic and personality factors in- crease the probability of suffering from PTSD, such as low intelligence or a lack of education, being female, a pre-existing psychiatric illness or being young (meta-analysis by Brewin, Andrew & Valentine, 2000), or old age (Maercker, 1998; Phifer & Norris, 1989). Peri- and post-traumatic factors (e.g. severity of the trauma, social support, and additional stress of everyday life) play a greater role than pre-traumatic factors (e.g. education, age, gender, pre- existing mental illness) (Brewin et al., 2000; Maercker, 2003). Loss of re- sources (such as feeling of control over one’s life, a sense of optimism, or feel- ing independent)...

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