Psycho-Social Impact of Natural Disaster

(This is part of my assignment on types of disaster and psycho-social impact of disaster, references are given at the end)

1. Impact of Disaster

2. Social Impact of Disaster

3. Psychological Impact of Disaster

4. Psychosocial Impact of Disaster

1. IMPACT OF DISASTER
Disaster impacts comprise physical, health, economic, social and psychological impact. This paper focuses on the psycho-social aspect, so before we go into the details, let’s take a look at the other kind of impact (i.e. physical, health and economic aspect) that a disaster can have.

• The physical impacts of disasters include casualties (deaths and injuries) and property damage which leave the survivor homeless, and both vary substantially across hazard agents. The physical impacts of a disaster are usually the most obvious, easily measured, and first reported by the news media. 
• Health Impacts of disaster lies in the number of injuries which occur from the event itself, and which followed later on in the form of different virus and diseases. In the short-term, the major health concern is on the injured, and the disturbances of supply of basic amenities like clean drinking water, food, medicines, medical treatment, etc. to prevent an outbreak of diseases. In the long-run, the major health concerns include provision of health facilities, exposure to the environment due to lack of proper shelter and clothing, and an outbreak of malnutrition and famine due to the disaster.
• Economic Impacts of disaster will include loss of property and economic establishments like shops, farms etc., damaged social infrastructure, loss to trade and business, and disturbance to livelihood activities.

1.1 COMMUNITY OR SOCIAL IMPACT OF DISASTER
Disasters directly affect their individual victims. But beyond that disasters create tears in the tissue of social life. Sometimes this is direct and total, as when disaster forced people to leave their land and migrate elsewhere. In other cases, the rapid influx of helpers, the presence of government officials, press, and other outsiders (including mere curiosity seekers), and the flood of poor people from outside the disaster area into a disaster area seeking their own share of the food and other supplies relief agencies are providing to disaster victims, combine to further disrupt the community.
Even when the formal structure of a community is maintained, the disaster can disrupt the bonds holding people together, in families, communities, work groups, and whole societies. When those bonds are destroyed, the individuals comprising the affected groups lose friends, neighbours, a community, a social identity. These collective effects of disaster may ultimately be as devastating as the individual effects. The consequences of disaster for families, neighborhoods, communities, and societies are many:

• Change in Family Dynamics: Disaster-produced deaths or disabilities, family separations, and dependency on aid givers and intervention by outsiders that may upset or challenge traditional child rearing practices, traditional patterns of male-female relationships, traditional line of authority and hierarchy, or in simple term, may force people out of traditional roles or into new ones.
• Increase in Family/Community Violence: In the wake of disaster, marital conflict and distress rises; increases in marital conflict, parent-child conflicts, intra-family violence (child abuse, spouse abuse) are reported to be rampant.
• Change in Community Dynamics: Disasters may physically destroy important community institutions, such as schools and institutions, and traditional patterns of authority are disrupted along with customary social controls on individual behaviour. Disasters can also disrupt the ability of communities to carry out customary or traditional livelihood activities central to people’s individual, community, and social identity, ranging from work and recreational activities to accustomed rituals.
• Change in Societal Role Dynamics: Disasters place a strain on traditional community social roles, patterns of social status, and leadership. In the wake of disaster, new leaders may emerge in a community, due to the role of these people in responding to the disaster.
• Increase in Anti-social Elements: Several studies have shown an increase in the rates of community violence, looting, riots, agitation, aggression, drug and alcohol abuse, and rate of legal convictions in the wake of disaster.
• Change in Community Source of Livelihood: Disasters disrupt the ability of communities to carry out customary or traditional livelihood activities. Some of these disruptions are temporary, but others are hard to reverse. This may be limited to personal possessions or may lead to permanent loss of tools, animals, and land.
• Change in Productive patterns: Disaster may lead, directly or indirectly, to permanent changes in productive patterns, especially patterns of land ownership and use. Shifts from subsistence agriculture to wage labor, land looting, migration and uprooting and resettlement play a role.
• Change in Community Cohesion: Schisms may appear in a community, as cohesion is lost. One danger is that of scape-goating, either of individuals or using traditional divisions in the community (e.g., along religious or ethnic lines).

The social impact of disaster can progress at a very slow pace and develop over a long period of time and can be difficult to assess when they occur. Despite the difficulty in measuring these social impacts, it is nonetheless important to monitor them, and even to predict them if possible, because they cause significant problems for the long-term functioning of specific types of households and individual member of an affected community.

1.2 PSYCHOLOGICAL IMPACT OF DISASTER
Living in a disaster area can be highly stressful. Staying in damaged buildings, relocating to shelters, dealing with the death or injuries of loved ones, as well as the prolonged time and energy involved in recovering from the affects of the disaster can result in feelings of anxiety and depression. Disaster is known to cause a wide range of negative psychological responses in the victims including:

• - psychophysiological effects such as fatigue, gastrointestinal upset, and tics;
• - cognitive effects such as confusion, impaired concentration, attention deficits;
• - emotional effects such as anxiety, depression, and grief;
• - behavioural effects such as changes in sleep and appetite, substance usages;

Although the precise figures vary from situation to situation, up to 90% or even more of victims can be expected to exhibit at least some untoward psychological effects in the hours immediately following a disaster. In most instances, symptoms gradually subside over the weeks following. By twelve weeks after the disaster, however, 20% to 50% or even more may still show significant signs of distress. The number showing symptoms generally continues to drop, but delayed responses and responses to the later consequences of disaster continue to appear. While most victims of disasters are usually relatively free of distress by a year or two after the event, a quarter or more of the victims may still show significant symptoms while others, who had previously been free of symptoms, may first show distress a year or two after the disaster. Anniversaries of the disaster may be especially difficult times for many survivors, with temporary but unexpected reappearance of symptoms which they had thought were safely in the past (Ehrenreich, 2001).
The extraordinary prevalence of such strong physiological, cognitive, and emotional responses to disasters indicates that these are normal responses to an extreme situation, not a sign of ‘mental illness’ or of ‘moral weakness’. Nevertheless, the symptoms experienced by many victims in the days and weeks following a disaster are a source of significant distress and may interfere with their ability to reconstruct their lives. If not addressed and resolved relatively quickly, such reactions can become ongoing sources of distress and dysfunction, with devastating effects for the individual, their family, and their society.

1.3 PSYCHOSOCIAL CONSEQUENCES OF DISASTER
To what extend the disaster will be affect the victims will depend on the context of the individual’s social support system. Secure, supportive relationships are essential for the victims’ processing of the events and the eventual recovery. Those who have no close and supportive social environment are more vulnerable whereas those who are in a supportive environment can more easily cope with the situation.
Psycho-social coping with disasters depends upon the ability of the victims to adjust psychologically, the capacity of community structures to adapt to crisis, and the help available to the victims. The most common psycho-social consequences of disasters are:
(a) Cauldron of Emotions
A cauldron of emotional reactions can come to the boil after a disaster. Beginning with numbness, traversing elation, and relief for having survived, the victims will eventually ride up an ‘anxiety escalator’. Common post-disaster reactions include flashbacks, nightmares, involuntary triggering of memories, panic attacks, etc, often culminating in a proactive ‘avoidance response. Normally, this psycho-social impact of disaster settles down within the first weeks, however, if they remain protracted and intense, they represent a post-traumatic stress disorder .
(b) Disaster Syndrome
The disaster syndrome, as currently known and understood in the social sciences disaster literature, is the human condition characterized by ‘stunned psychological incapacitation’, ‘shock’, and ‘immobility, inability to act rationally, and inability to take care of oneself or others’ in the aftermath of a disaster. This “psychological shock” following disaster impact affects ‘only a small proportion of people’ and when it occurs, the condition is usually ‘short lived, say the sources. In major disaster with high casualty rate, disaster syndrome is often seen in about 25% to 75% of the victims in the first week, but significantly dropped within 10 weeks.
(c) Grief Reactions
Grief is a multi-dimensional syndrome, it can be for love ones, home, treasured possessions, livelihood, or community. The severity of the morbidity is greater when it is associated with personal loss. The emotional reactions of grief include sadness, distress, and anger as well as longing and yearning. Grief reactions usually tape off in 4-6 weeks and recurrences are induced by anniversaries. Psychological morbidity among the bereaved is aggravated by a weak social support systems, particularly in the case of women who have lost children. Intense grief reactions, in fact, can become chronic and lead to severe depression.
These psychological and practical obstacles to a ‘normal’ grief reaction or response to the death of a loved one may contribute to a feeling of lack of closure or permit magical fantasies that the deceased person has not, in fact, died. Any of several abnormal bereavement syndromes may appear[1].

• Inhibited Grief: The bereaved exhibits a pattern characterized by psychic numbing, over-control and containment of emotions, little display of affect. They may be seen as “coping well,” yet this pattern is associated with later depression and anxiety.
• Distorted Grief: The bereaved shows intense anger and hostility which dominate over their sadness and guilt. This anger may be directed at anyone the bereaved associates with the deceased’s death (e.g., relief workers).
• Chronic Grief: The feelings of sadness and loss do not dissipate. Frequent crying, pre-occupation with the loss are unremitting.
• Depression: The bereaved lapses into depression, with prolonged grief, despair, and a sense that life is not worth continuing. Sleep and appetite disturbances may appear. The bereaved may have active fantasies of being reunited with the deceased and suicidal ideation or attempts may occur.
• Excessive Guilt: The bereaved may show excessive self-recrimination and guilty pre-occupations, which eclipse their sadness. Self destructive, yet not overtly suicidal behaviors, such as frequent accidents or excessive drinking may occur.

(d) Post-Traumatic Stress Disorder (PTSD)
Battle fatigue like feeling typically numb at first but later, depression, excessive irritability, recurrent nightmares, flashbacks to the traumatic scene, over reaction to sudden noises, feeling of guilt because significant others are dead while the individual is still surviving are some sign that the survivor is under Post-Traumatic Stress Disorder. The characteristic symptoms of Post Traumatic Stress Disorder include:

• Persistent re-experiencing of the traumatic event: Recurrent and intrusive recollections of the events of the disaster; recurrent distressing dreams in which the disaster is replayed; intense psychological distress or physiological reactivity on exposure to internal or external cues that symbolize or resemble an aspect of the traumatic event; or experiences in which the victim acts or feels as if the event is actually re-occurring.
• Persistent avoidance of stimuli associated with the trauma and continued numbing of general responsiveness: Efforts to avoid thoughts or feelings or conversations about the disaster; efforts to avoid activities, places, or people that remind the victim of the trauma; inability to recall important parts of the disaster experience; markedly diminished interest or participation in significant activities; feelings of detachment or estrangement from others; restricted range of affect; or a sense of a foreshortened future, without expectations of a normal life span or life.
• Persistent symptoms of increased arousal: Difficulty falling or staying asleep; irritability or outbursts of anger; difficulty concentrating; hyper-vigilance; exaggerated startle response.

This general cluster of symptoms has been reported in every part of the world. In less industrialized parts of the world and among people coming from these areas, the avoidance and numbing symptoms have been reported to be less common and dissociative and trance-like states, in which components of the event are relived and the person behaves as though experiencing the events at that moment, may be more common.

(e) Post-Traumatic Syndrome (Post-Traumatic Depression)
Psychological effects of the disaster may persist for many months; from acute phase if they move onto chronic phase, they tend to suffer from posttraumatic syndrome. Though the symptoms of posttraumatic syndrome generally appear soon after the trauma, in some cases there is an “incubation period”. Some of the important symptoms are: difficulty in falling or staying sleep, Irritability or outbursts of anger, difficulty in concentration, hyper vigilance, exaggerated startle response almost similar to panic attack, etc.

Post Traumatic Depression: Protracted depression is one of the most common findings in studies of acutely or chronically traumatized people. It often occurs in combination with Post Traumatic Stress Disorder. Trauma can produce or exacerbate already existing depression. Common symptoms of depression include sadness, slowness of movement, insomnia (or hypersomnia), fatigue or loss of energy, diminished appetite (or excessive appetite), difficulties with concentration, apathy and feelings of helplessness, anhedonia (markedly diminished interest or pleasure in life activities), social withdrawal, guilty ruminations, feelings of hopelessness, abandonment, and irrevocable life change, preoccupations with loss, and irritability. In some cases, the person may deny being sad or may complain, instead, of feeling “blah” or having “no feelings.” Some individuals report somatic complaints, including widespread aches and pains, rather than sadness. Suicidal ideation or attempts may appear. With children, somatic complaints, irritability, social withdrawal are particularly common.

In some cultures, depression may be experienced largely in somatic terms, rather than in the form of sadness or guilt. Complaints of “nerves”, headaches, generalized chronic pain, weakness, tiredness, “imbalance,” problems of the “heart,” feelings of “heat,” or concerns about being hexed or bewitched may appear.

(See my next post for the other part of this assignment)

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[1] Note: Different cultures vary widely with respect to the ‘expected’ reaction in situation of grief. [For further information on this, please refer to John H Enrenreich’s Coping with Disaster.