Psychological impacts of natural disasters

Abstract

The psychological impacts of natural disasters are widespread, expand across a spectrum of severity, extend along a range of duration, and relate to the nature of the disaster event. The psychological consequences of disasters are spawned by, and directly proportional to, the degree of exposure to hazards, loss, and change, the “forces of harm” that characterize natural disasters. High-risk populations in harm’s way, those that are particularly vulnerable to the ravages of disaster and the combination of physical and psychological consequences, can only be partially defined before disaster strikes. Disaster impact, compounded by adversities in the aftermath, “reshuffles the deck” by creating new special populations of persons needing medical and psychological support composed of those who have sustained extreme exposure to trauma and harm. While most persons exposed to disaster rebound quickly from transient distress reactions, others progress to psychopathology including PTSD, major depression, anxiety disorders, and substance abuse. Those who lose loved ones in a natural disaster are likely to grapple with complicated grief. Prevention of psychological consequences of disaster holds great promise but is untried and untested. Early intervention is being redefined as psychological debriefing is supplanted by evidence-informed approaches; psychological first aid is the current contender. A stepped-care approach is advocated for moving survivors through a progression of early to intermediate psychological support and beyond this, for those whose distress is unabated, into psychological and psychiatric treatment. While focus is understandably drawn to timely, empirically based support and treatment for thosewho are impacted psychologically, some of the most affirmative guidance to emerge is that resilience, positive adaptation in the face of disaster’s adversity, is the most common and expectable outcome. Some survivors even emerge from the disaster experience stronger and more vital psychologically, a recently-recognized phenomenon known as posttraumatic growth. This sets the future agenda for the field; integrating disaster mental and behavioral health with the disciplines of public health, public safety, and emergency response to enhance preparedness for future catastrophic events.