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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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11 Conclusions


The results of this study indicate that survivors of the 2004 tsunami still suffer from traumatic stress symptoms two and a half years after the disaster. If a cut- off score of 24 is used for the IES-R, almost three fourths of the affected popu- lation still suffered from clinical PTSD symptoms at the time of data collection. The psychometric scales used were validated for Western, industrialized samples, but the factor analyses for this sample revealed satisfactory results. Satisfactory factor solutions were found and the Cronbach’s alphas were quite high. It can be assumed that in spite of cultural differences, there were no prob- lems in using these five questionnaires in this Indian sample. Perceived social support, in particular, decreased the level of traumatic stress, and a strong sense of coherence mitigated psychological distress. How- ever, both social support and SOC decreased the amount of avoidance coping employed, a finding whose interpretation is open to speculation, since avoid- ance coping is postulated to be efficient in this collectivistic setting. In the tsu- nami-affected group, both coping styles are significantly positively correlated with IES-R as well as BSI scores. However, correlations do not give infor- mation about causality, and this last finding could also indicate that the more people suffer from symptoms of traumatic stress, the more they engage in cop- ing efforts. In the total group, however, approach coping increases the level of traumatic stress and avoidance coping reduces it. Therefore, the assumption that avoidance coping is the more efficient...

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