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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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4 Protective Factors

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Protective factors can be considered reversed risk factors. In this way, abundant material and social resources, above-average intelligence or self-enhancing, positive experiences during childhood can reduce the risk of developing PTSD (Butollo & Hagl, 2003). Moreover, a permanent positive relationship with at least one primary caregiver, growing up in an extended family, high intelli- gence, a robust, sociable and active temperament, secure attachment behavior, social support, reliable and supportive people to relate to in adulthood, and oth- er constant social relationships are seen as protective factors throughout the life span, according to Egle, Hoffmann and Joraschky (1996). 4.1 Resilience, Hardiness, and Sense of Coherence in the Salutogenesis Model In the 1970s, the main focal point of interest shifted from pathology to compe- tence or resilience in the face of adverse situations. The correlation between stressful events and illness is typically only .30. Therefore, the emphasis on “stress and illness” research has begun to shift toward the study of “resistance and resources” that can mitigate the effects of stressors (Antonovsky, 1979). Such resources might include constitutional strengths (e.g. little history of family illness), social support (e.g. social contacts and status), health practices (e.g. jogging), and personality dispositions (Kobasa, Maddi & Kahn, 1982). In the empirical literature, three main factors are often mentioned as effi- cient coping mechanisms for dealing with traumatic stressors: resilience, har- diness and sense of coherence. Resilience is a combination of the aforemen- tioned factors and an ability to deal with stressors in a flexible way (for PTSD: Flach, 1990)...

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