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Warsini 2014 Impacto Psicosocial de Desastres Naturales Revisión Integrativa
Warsini 2014 Impacto Psicosocial de Desastres Naturales Revisión Integrativa
James Cook University, School of Nursing, Midwifery and Health Nutrition, Cairns, Australia
While previous literature reviews on this subject have been conducted, the last review, conducted in 2002 (Norris et al., 2002),
explored empirical research on a variety of survivor groups including children, adults, and recovery workers, and other publications (Galea, Nandi, & Vlahov, 2005; Neria, Nandi, & Galea,
2008) were focused on specific issues, such as PTSD. Therefore, it was considered timely to undertake an update on the topic
area.
AIM
The aim of this integrative review was to identify the evidence
related to the psychosocial impact of natural disasters on adult
(over the age of 18 years) survivors.
The specific research questions were:
What is the psychosocial impact of a natural disaster on
survivors?
Does the psychosocial impact of natural disasters on survivors differ among types of disasters?
METHOD
This literature review was conducted using an integrative approach, a method that draws on a diverse range of studies and
methodologies to summarise the main points of past research
and to delineate what is known about a topic (Whittemore &
Knafl, 2005). A systematic search was conducted using the
keyword terms/phrases psychosocial impact and natural disaster, psychological impact and natural disaster. and mental health impact and natural disaster. The databases searched
included PsycInfo, CINAHL, Proquest, Ovid SP, Scopus, and
Science Direct. The search was limited to articles written in
English, reviewed and published in the period of 20022012.
This time frame was selected as appropriate as a previous review conducted by Norris et al. (2002) included articles up until
2001.
A total of 1642 abstracts and articles were obtained during
the first search. Preliminary screening identified articles that
420
421
Inclusion Criteria
Exclusion Criteria
Screening
Identification
Records identified
through database
searching (n = 1633)
Hand search (n = 9)
Eligibility
Included
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TABLE 1
Inclusion and Exclusion Criteria
Records excluded
(n = 1518)
FIGURE 1 PRISMA Flow Chart (adapted from Moher, Liberati, Tetzlaff, Altman, & Group, 2009).
422
S. WARSINI ET AL.
TABLE 2
Natural Disasters and Psychological Impact Review Articles
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Authors
Event
Time Frames
(pre- and/or
post-disaster)
Sample Size
Study Type
Measurement Tool
Ali
Earthquake; 8
et al.
October
(2012)
2005
(Pakistan)
30 months
(2.5 years)
postdisaster
Earthquake
survivors from
Mansehra,
Hazara, and
Abbotabad
districts
(n = 300)
Cross
sectional
Aslam
Earthquake; 8
&
October
Tariq
2005
(2010)
(Pakistan)
1 year postdisaster
Basoglu Marmara
et al.
Earth(2004)
quake;
August &
November
1999
(Turkey)
14 months
postdisaster
Survivors from
the most
affected
districts
(Mansehra,
Muzaffarabad,
and Bagh) and
unaffected
areas (Attock,
Hejlum, and
Mirpur)
(n = 600)
Participants form
Degirmendere
and Avcilar
(n = 650)
Cross
sectional
Davidson Trauma
Scale
Traumatic Stress
Symptoms
Checklist (TSSC)
Main Finding
Possible PTSD case:
41.3%. Predictor
factors: gender
(female), age
(elderly), marital
status (unmarried),
role in family (head of
family), occupational
status (jobless),
housing (impermanent
house). Protective
factors: higher social
economy status and
spirituality.
Predictor factors for
PTSD, depression, and
stress are geographic
proximity to disaster
site and marital status.
Gender became a
significant factor for
stress whereas, for
anxiety, geographic
proximity area was.
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TABLE 2
Natural Disasters and Psychological Impact Review Articles (Continued)
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Authors
Event
Time Frames
(pre- and/or
post-disaster)
Sample Size
Study Type
Measurement Tool
Main Finding
Cao
Yun Nan
et al.
Earth(2003)
quake;
1988
(China)
5 months
postdisaster
Participants from
affected area
(Shang Yun,
Lang Cang, and
Meng Lian) and
from unaffected
area (Lu Nan)
(n = 2202)
Case
control
Carroll
Carlisle
et al.
Flood;
(2009)
2005 (UK)
1013
months
postdisaster
Participants in
Carlisle city
(n = 40)
Chae
Flood;
et al.
August
(2005)
2002
(South
Korea)
3 months
pre-disaster
and 4
months
postdisaster
Survivors from
Gangneung city
and from
Gangwon
province
(n = 285)
Chan
Sichuan
et al.
Earth(2012)
quake; 12
May 2008
(China)
7.5 months
postdisaster
Respondents
from Guankou
town and
Jiannan town
(n = 1725)
General Health
Questionnaire
(GHQ), Life Event
Inventory,
Posttraumatic Stress
Disorder section of
Diagnostic
Interview Schedule,
Inventory of The
Impact of Disaster
Phenomeno- The key areas of
logy
questioning were
broadly based on
Tapsell et al.s
(2002) work
Possible psychological
morbidity and PTSD
case in the worst
damage area was 51%
and 1323%. The
average rate of PTSD
among common
population was only
8.9%
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S. WARSINI ET AL.
TABLE 2
Natural Disasters and Psychological Impact Review Articles (Continued)
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Authors
Event
Time Frames
(pre- and/or
post-disaster)
Sample Size
Chan
Wenchuan or
et al.
Sichuan
(2011)
Earthquake; 12
May 2008
(China)
Chen
Chi-Chi
et al.
Earth(2007)
quake; 21
September
1999
(Taiwan)
2 years postdisaster
Survivors from
Nantou county
(n = 6412)
Dorahy Christchurch
&
EarthKannis- quake; 4
Dymand September
(2012)
2010 (New
Zealand)
2 months
postdisaster
Survivors from
Christchurch
suburb of
Avonside and
Hornby North
(n = 124)
Emin
Marmara
et al.
Earth(2006)
quake; 17
August
1999
(Turkey)
3 years postdisaster
Respondents of
Kocaeli City
Centre
(n = 683)
Study Type
Cross
sectional
Measurement Tool
Posttraumatic Stress
Disorder
Self-Rating Scale
(PTSD-SS)
Main Finding
62.6% of victims
diagnosed for PTSD. The
risk factors were marital
status (married), gender
(female), familys victim,
educational level (low),
and property loss.
Cross
Chinese Health
The prevalence rates of
sectional
Questionnaire-12
PTSD and mental health
(CHQ-12); Chinese
illness probability among
Startle,
survivors were 20.9%
Physiological
and 39.8%. The predictor
arousal, anger, and
factors for both problems
numbness (SPANwere gender (female),
C)
level of education (low),
and living place (shelter).
In addition, age (elderly)
became a specific risk
factor for psychiatric
morbidity whereas
property devastation was
risk in PTSD problems.
Comparative Acute Stress Disorder The prevalence rate of
Scale (ASDS);
anxiety and depression in
Patient Health
exposure community
Questionnaire 9
were higher than others,
depression module
but not the acute stress
(PHQ9);
disorder rate.
Generalized
Anxiety Disorder-7
(GAD7)
Cross
General Health
The rate of PTSD and
sectional
Questionnaire 12
Major Depressive
(GHQ-12);
Disorder (MDD) in
Composite
disaster site survivors
International
was 11.7% and 10.5%,
Diagnostic
and they became the
Interview (CIDI);
most common
Beck Depression
post-disaster problem.
Inventory (BDI);
Even though the rates
Traumatic Stress
were decreased over
Symptom Checklist
3 years, there were
(TSSC)
37.5% of victims who
suffered from PTSD and
fulfilled MDD criteria.
(Continued on next page)
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Natural Disasters and Psychological Impact Review Articles (Continued)
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Authors
Event
Time Frames
(pre- and/or
post-disaster)
Sample Size
Study Type
Cross
sectional
Gigantesco LAquila
et al.
Earth(2013)
quake; 6
April 2009
(Italy)
1419
months
postdisaster
Survivors in
LAquila city
(n = 957)
Goto et al.
(2006)
Volcano; 8
July 2000
(Japan)
10 months
postdisaster
Survivors in
Cross
Miyake Island
sectional
(n = 231)
Irmansyah
et al.
(2010)
Southeast
2 months
Asian
postEarthquake
disaster
and
Tsunami;
26
December
2004
(Indonesia)
Survivors from
IDP group
and non IDP
group who
live in Aceh
and North
Sumatra
(n = 783)
Cross
sectional
Measurement Tool
Mini International
Neuropsychiatric
Interview (MINI),
Patient Health
Questionnaire
(PHQ-8)
Main Finding
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Natural Disasters and Psychological Impact Review Articles (Continued)
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Authors
Event
Time Frames
(pre- and/or
post-disaster)
Sample Size
Study Type
Measurement Tool
Main Finding
Kumar
Southeast
et al.
Asian
(2007)
Earthquake
and
Tsunami;
26
December
2004
(India)
Kun
Wenchuan
et al.
Earth(2010)
quake; 12
May 2008
(China)
2 months
postdisaster
Survivors in
Tamil Nadu
(n = 314)
Cross
sectional
Harvard Trauma
Questionnaire
(HTQ)
12.7% of participants
were diagnosed with
PTSD. The risk
factors were gender
(female), injured, and
no revenue.
2,5 months
postdisaster
Respondents
from Beichuan
and Langzhong
in Sichuan
Province (n =
3862)
Cross
sectional
Short Form-12
(SF-12); Harvard
Trauma
Questionnaire
(HTQ)
Kun
Wenchuan
et al.
Earth(2009)
quake; 12
May 2008
(China)
2,5 months
postdisaster
Respondents
from Beichuan
and Langzhong
in Sichuan
Province (n =
450)
Cross
sectional
Harvard Trauma
Questionnaire
(HTQ)
Livanou Parnitha
et al.
Earth(2005)
quake; 7
September
1999
(Greece)
4 years postdisaster
Adult survivors
(n = 157)
Cross
sectional
Screening Instrument
for Traumatic Stress
in Earthquake
Survivors
(SITSES);
Traumatic Stress
Symptom Checklist
(TSSC)
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Authors
Event
Time Frames
(pre- and/or
post-disaster)
Sample Size
Study Type
Measurement Tool
6 months
postdisaster
Flood survivors
(n = 444)
Cross
sectional
Harvard Trauma
Questionnaire
Revised (HTQ-R);
Hopkins Symptom
Checklist (HSC);
Coping Styles
Strategies (CSQ)
Musa
Southeast
et al.
Asian
(2013)
Earthquake
and
Tsunami;
26
December
2004 and
West
Sumatra
Earthquake;
September
2009
(Indonesia)
Naeem Kashmir
et al.
Earth(2011)
quake; 8
October
2005
(Pakistan)
4 years postdisaster
Respondents
from Aceh and
West Sumatra
(n = 200)
Cross
sectional
Depression, Anxiety,
and Stress Scale
(DASS)
18 months
postdisaster
Survivors from
Cross
Muzaffarabad
sectional
city (n = 1298)
Norris
Mexicans
et al.
Flood;
(2004)
1999
(Mexico)
Main Finding
The prevalence rates of
anxiety, PTSD, and
depression were 24.5%,
27.9%, and 35.1%,
respectively. The predictor
factor of those
psychological problems
was gender (female).
The prevalence rate of
depression, stress, and
anxiety were 19%, 22%,
and 51%, respectively.
The predictor factors for
these three psychological
problems were gender
(female), age (younger),
occupational status
(jobless), and marital
status (being single).
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S. WARSINI ET AL.
TABLE 2
Natural Disasters and Psychological Impact Review Articles (Continued)
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Authors
Event
Time Frames
(pre- and/or
post-disaster)
Sample Size
Study Type
North
Great
et al.
Midwestern
(2004)
Flood;
1993
(USA)
4 and 5
months
postdisaster
Participants from
St Charles and
St Louis
Counties (n =
162)
3 and 6
months
postdisaster
People from
South
Yorkshire and
Worcestershire
(n = 2265)
Parslow Bushfire;
et al.
January
(2006)
2003
(Australia)
4 years
before
disaster
and 318
months
postdisaster
First wave (n =
2404) and
second wave (n
= 2085)
Priebe
Earthquake; 4
et al.
September
1997 (Italy)
(2011)
8 years postdisaster
Participants from
Camerino city
(n = 200)
Cross
sectional
Soldatos Earthquake; 7
et al.
September
(2006)
1999
(Greece)
3 weeks postdisaster
Subjects of
Athens
Metropolitan
Area (n = 102)
Cross
sectional
Measurement Tool
Longitudinal DSM-III-R
Diagnostic
Interview
Schedule/Disaster
Supplement (DIS
III-R)
Comparative General Health
Questionnaire -12
(GHQ 12);
Generalized
Anxiety Disorder
(GAD7); Patient
Health
Questionnaire
(PHQ9); PTSD
Checklist
Comparative Goldberg Depression
and Anxiety Scores;
Eysenck Personality
QuestionnaireRevised (EPQ-R);
Trauma Screening
Questionnaire
(TSQ)
Mini International
Neuropsychiatric
Interview (MINI),
Brief Symptom
Inventory (BSI),
Impact of Event
Scale Revised
(IESR),
Manchester Short
Assessment of
Quality of Live
(MANSA)
International
Statistical
Classification of
Diseases (ICD 10)
Main Finding
Four months post-flood,
22% participants had
PTSD and a month
later it declined to
16%.
People who were
exposed to flood
disaster (South
Yorkshire city) were
diagnosed to have
psychological distress,
anxiety, depression,
and PTSD two to five
times higher than
unexposed people.
Only 5% of participants
diagnosed with PTSD
symptoms. The risk
factors of PTSD were
gender (female),
educational level
(low), mental health
condition (poor), and
higher levels of
neuroticism.
Based on MINI results,
7.5% respondents
diagnosed with a
mental disorder.
However, the victims
symptoms levels were
not high and their
quality of live was
positive.
Approximately 85% of
respondents were
diagnosed to have
Acute Stress Disorder,
and 43% of the
victims met the PTSD
criteria.
(Continued on next page)
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Authors
Event
Stratta LAquila
et al.
Earth(2012) quake; 6
April 2009
(Italy)
Time Frames
(pre- and/or
post-disaster)
1 year postdisaster
Tang
Southeast
6 months
(2006) Asian
postEarthquake
disaster
and
Tsunami;
26
December
2004
(Thailand)
Tang
Southeast
2 weeks & 6
(2007) Asian
months
Earthquake
postand
disaster
Tsunami;
26
December
2004
(Thailand)
Chi-Chi
Tsai
Earthet al.
(2007) quake; 21
September
1999
(Taiwan)
Tuason Hurricane
et al.
Katrina;
(2012) August
2005.
(USA)
6 months &
3 years
postdisaster
More than
4 years
postdisaster
Sample Size
Study Type
Measurement Tool
Main Finding
People from
LAquila
district
(affected) and
unaffected
district
(n = 984)
Cross
sectional
9 participants
Consensual
qualitative
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TABLE 2
Natural Disasters and Psychological Impact Review Articles (Continued)
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Authors
Event
Time Frames
(pre- and/or
post-disaster)
Sample Size
Study Type
Measurement Tool
van
Southeast
2 months & 9 Displaced and
Grivensen Asian
months
non-displaced
et al.
Earthquake
postparticipants
(2006)
and
disaster
from Phang
Tsunami;
Nga and
26
non-displaced
December
persons from
2004
Krabi and
(Thailand)
Phuket (n =
1038).
Wang
Wenchuan or
et al.
Sichuan
(2009)
Earthquake; 12
May 2008
(China)
3 months
postdisaster
Survivors from
Yongan Town
and Leigu
Town (n =
1563)
Cross
sectional
Weems Hurricane
et al.
Katrina;
(2007)
August
2005.
(USA)
2 months
postdisaster
Participants from
New Orleans,
Greater New
Orleans, and
the Mississippi
Gulf Coast
(n = 386)
Cross
sectional
Xu &
Wenchuan or
Liao
Sichuan
(2011)
Earthquake; 12
May 2008
(China)
1 year postdisaster
Adult survivors
from 19
counties in
Sichuan
province (n =
2080)
Cross
sectional
Main Finding
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Authors
Event
Yang
Chi-Chi
et al.
Earth(2003) quake; 21
September
1999
(Taiwan)
Time Frames
(pre- and/or
post-disaster)
3 months
postdisaster
Sample Size
Study Type
Survivors from
Pu Li town (n
= 663)
Cross
sectional
Survivors from
earthquake (n
= 1181)
Cross
sectional
Residents in
Yushu county
(n = 505)
Cross
sectional
3-4 months
postdisaster
RESULTS
The articles reviewed address the psychosocial impact from a
number of different types of natural disasters. The psychosocial
impacts included in this review were posttraumatic stress disorder (PTSD), depression, anxiety, acute stress disorder, and suicide ideation. Quality of life also was measured in some studies.
The articles considered the psychosocial impact of seven types
of natural disasters: earthquake, flood, tsunami, hurricane, landslide, volcano, and bushfire.
Earthquakes
The most-studied type of natural disaster identified in this
review is the earthquake. Among the 23 articles analysed in
Measurement Tool
Main Finding
Chinese Health
Questionnaire 12
(CHQ-12);
Posttraumatic
symptom checklist
according to
DSM-IV; Simple
Personality
Inventory (SPI)
this review, nine papers were from China (studying three earthquake events), three were from Italy (studying two events), three
each were from Taiwan (focusing on the Chi-chi earthquake in
September 1999) and Pakistan (focusing on the Kashmir earthquake in October 2005), two were from Greece (focusing on
the Parnitha earthquake in September 1999) and Turkey (Marmara earthquake in August 1999), and one article was from New
Zealand (focusing on the Christchurch earthquake in September
2010).
In total, 17 papers discussed the incidence of PTSD in
earthquake survivors. PTSD, however, was measured at different intervals and using different measuring scales. Seven
articles discussed PTSD experienced by survivors in the aftermath (less than six months) after the disaster. Of these
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S. WARSINI ET AL.
articles, five indicated that PTSD manifested in earthquake survivors at a rate above 30% (33.762.6%) (Chan et al., 2011; Kun
et al., 2009; Soldatos, Paparrigopoulos, Pappa, & Christodoulou,
2006; Wang, Zhang, Shi, & Wang, 2009; Z. Zhang, Wang, Shi,
Wang, & Zhang, 2012). Two papers, by Yang et al. (2003) and
Cao et al. (2003), contradicted these findings as they found less
than 23% of survivors experienced PTSD. However, the partial
prevalence of PTSD in the research of Yang et al. (2003) is quite
high at 32%. Research conducted by Soldatos et al. (2006) assessed the incidence of PTSD soonest after the disaster hitthat
is, three weeks after the earthquakeand the research indicated
survivors were experiencing PTSD at a rate of 43%.
The prevalence of PTSD declines as time passes after a disaster. This assertion is reflected in longitudinal research by Tsai
et al. (2007) in Taiwan, which found that six months after the
Chi Chi earthquake survivors were experiencing PTSD at a rate
of 23.8% and three years after the event, the PTSD rate had
fallen to 4.4%.
In the longer term, the prevalence of post-earthquake PTSD
varies between 56.8% and 4.1%. These rates also are influenced
by the survivors losses. In Chan et al.s (2012) study, survivors
who lost family members suffered PTSD at a rate of 50.2%
and those who had not lost family members reported suffering
PTSD at the much lower rate of 27.1%.
Interestingly, researchers studying the psychological effects
felt by earthquake survivors reported very different results, even
if they were conducting research with survivors of the same
earthquakes. Some of these differences can be explained easily.
Studies were undertaken within varying time frames pre- and
post-disaster and used a range of measuring instruments. Not all
discrepancies are easily explained, however. For example, two
researchers working with survivors of the Wenchuan earthquake
measured PTSD rates one year after the earthquake and came
up with very different figures. The prevalence of PTSD in Y.
Zhang and Hos (2011) research subjects was 26.3%, while in
Xu and Liaos (2011) study the figure was twice that amount at
56.8%. Similarly, great differences in the measured PTSD rates
were noted in research conducted after the Chi Chi earthquake.
Tsai et al. (2007) reported 4.4% prevalence of PTSD three years
after the earthquake while Chen et al. (2007) reported a 20.9%
rate two years after the earthquake.
More consistency can be seen in research studies conducted
in Pakistan, Turkey, and Greece. In Pakistan, the prevalence
of PTSD between 1.5 and 2.5 years after the earthquake was
41.3% (Ali, Farooq, Bhatti, & Kuroiwa, 2012) and 46.6%
(Naeem et al., 2011), while in Turkey the prevalence of PTSD
was 19.2% after three years (Basoglu, Kilic, Salcioglu, &
Livanou, 2004) and 12% after four years (Emin, Tural, Aker,
Cengiz, & Erdogan, 2006).
A difference in results also was obvious in studies on
earthquake-related depression. The prevalence of depression in
survivors 7.5 months after the Wenchuan earthquake was 55.8%
(Chan et al., 2012), but according to Y. Zhang and Ho (2011),
depression was experienced by 49.6% of survivors one year after
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