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Trauma Signature Analysis of the Great East Japan Disaster: Guidance for Psychological Consequences

Published online by Cambridge University Press:  26 March 2013

James M. Shultz ,
David Forbes ,
David Wald ,
Fiona Kelly ,
Helena M. Solo-Gabriele ,
Alexa Rosen ,
Zelde Espinel ,
Andrew McLean ,
Oscar Bernal  and
Yuval Neria
James M. Shultz*
Affiliation:
Center for Disaster and Extreme Event Preparedness (DEEP Center), University of Miami Miller School of Medicine, Miami, FL
David Forbes
Affiliation:
Australian Centre for Posttraumatic Mental Health, Department of Psychiatry, The University of Melbourne, East Melbourne, Australia
David Wald
Affiliation:
US Geological Survey and Colorado School of Mines, Golden, Colorado, USA
Fiona Kelly
Affiliation:
Clinical and Health Psychology, University of Edinburgh, Scotland
Helena M. Solo-Gabriele
Affiliation:
Department of Civil, Architectural, and Environmental Engineering, University of Miami, College of Engineering, Coral Gables, Florida, USA
Alexa Rosen
Affiliation:
Center for Disaster and Extreme Event Preparedness (DEEP Center), University of Miami Miller School of Medicine, Miami, FL
Zelde Espinel
Affiliation:
Center for Disaster and Extreme Event Preparedness (DEEP Center), University of Miami Miller School of Medicine, Miami, FL
Andrew McLean
Affiliation:
Department of Neuroscience, University of North Dakota School of Medicine and Health Sciences, Fargo, North Dakota, USA
Oscar Bernal
Affiliation:
Public Health Programs, University of the Andes, Bogota, Colombia, USA
Yuval Neria
Affiliation:
Trauma and PTSD Program, Columbia University, and Department of Psychiatry, The New York State Psychiatric Institute, New York, New York, USA
*
Address correspondence and reprint requests to James M. Shultz, MS, PhD, Center for Disaster and Extreme Event Preparedness (DEEP Center), University of Miami Miller School of Medicine, 251 174 St, #2319, Sunny Isles Beach FL 33160 (e-mail: [email protected]).
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Abstract

Objectives

On March 11, 2011, Japan experienced the largest earthquake in its history. The undersea earthquake launched a tsunami that inundated much of Japan's eastern coastline and damaged nuclear power plants, precipitating multiple reactor meltdowns. We examined open-source disaster situation reports, news accounts, and disaster-monitoring websites to gather event-specific data to conduct a trauma signature analysis of the event.

Methods

The trauma signature analysis included a review of disaster situation reports; the construction of a hazard profile for the earthquake, tsunami, and radiation threats; enumeration of disaster stressors by disaster phase; identification of salient evidence-based psychological risk factors; summation of the trauma signature based on exposure to hazards, loss, and change; and review of the mental health and psychosocial support responses in relation to the analysis.

Results

Exposure to this triple-hazard event resulted in extensive damage, significant loss of life, and massive population displacement. Many citizens were exposed to multiple hazards. The extremity of these exposures was partially mitigated by Japan's timely, expert-coordinated, and unified activation of an evidence-based mental health response.

Conclusions

The eastern Japan disaster was notable for its unique constellation of compounding exposures. Examination of the trauma signature of this event provided insights and guidance regarding optimal mental health and psychosocial responses. Japan orchestrated a model response that reinforced community resilience. (Disaster Med Public Health Preparedness. 2013;0:1-14)

Keywords

traumadisastertrauma signature analysisTSIGdisaster mental healthpsychosocialresilienceevidence-based intervention
Type
Special Focus
Information
Disaster Medicine and Public Health Preparedness , Volume 7 , Issue 2 , April 2013 , pp. 201 - 214
Copyright
Copyright © Society for Disaster Medicine and Public Health, Inc. 2013 

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References

1. Office for the Coordination of Humanitarian Assistance. Japan Earthquake and Tsunami, Situation Report 1; March 11, 2011. http://reliefweb.int/node/391666. Accessed February 20, 2012.Google Scholar
2. Center for Excellence in Disaster Management and Humanitarian Assistance. Japan earthquake and tsunami update, Monday, March 12, 2011. http://reliefweb.int/node/391694. Accessed February 20, 2012.Google Scholar
3.Keim, M. The public health impact of industrial disasters. Am J Disaster Med. 2011;6(5):265-274.Google Scholar
4.Boyarsky, I, Shneiderman, A. Natural and hybrid disasters—Causes, effects and management. Top Emerg Med. 2002;24(3):1-25.Google Scholar
5.Shultz, JM, Marcelin, LH, Madanes, SB, Espinel, Z, Neria, Y. The “trauma signature:” understanding the psychological consequences of the 2010 Haiti earthquake. Prehosp Disaster Med. 2011;26(5):353-366.Google Scholar
6.Shultz, JM, Kelly, F, Forbes, D, etal. Triple threat trauma: evidence-based mental health response for the 2011 Japan disaster. Prehosp Disaster Med. 2011;26(3):141-145.CrossRefGoogle ScholarPubMed
7.Shultz, JM, McLean, A, Herberman Mash, HB, etal. Mitigating flood exposure: reducing disaster risk and trauma signature. Disaster Health. 2012;1(1):1-15.Google Scholar
8.Norris, FH, Friedman, MJ, Watson, PJ, Byrne, CM, Diaz, E, Kaniasty K: 60,000 disaster victims speak: part I. an empirical review of the empirical literature, 1981-2001. Psychiatry. 2002;65(3):207-239.Google Scholar
9.Norris, FH, Friedman, MJ. Watson PJ: 60,000 disaster victims speak: part II. summary and implications of the disaster mental health research. Psychiatry. 2002;65(3):240-260.CrossRefGoogle Scholar
10.Norris, FH. Range, Magnitude, and Duration of the Effects of Disasters on Mental Health: Review Update 2005. Hanover, NH: Dartmouth Medical School and National Center for Posttraumatic Stress Disorder.Google Scholar
11.Andrulis, DP, Siddiqui, NJ, Gantner, JL. Preparing racially and ethnically diverse communities for public health emergencies. Health Aff (Millwood). 2007;26(5):1269-1279.Google Scholar
12.Shultz, JM, Espinel, Z, Galea, S, Reissman, DB. Disaster ecology: implications for disaster psychiatry. In: Ursano RJ, Fullerton CS, Weisaeth L, Raphael B (eds). Textbook of Disaster Psychiatry. Cambridge, UK: Cambridge University Press; 2007:69-96.CrossRefGoogle Scholar
13.Shultz, JM, Espinel, Z, Flynn, BW, Cohen, RE, Hoffmann, Y. DEEP PREP: All-Hazards Disaster Behavioral Health Training. Tampa, FL: Disaster Life Support Publishing; 2007.Google Scholar
14.Kessler, RC, McLaughlin, KA, Koenen, KC, Petukhova, M, Hill, ED. The importance of secondary trauma exposure for post-disaster mental disorder. Epidemiol Psychiatric Sci. 2012;21:35-45.Google Scholar
15. Centre for Research on the Epidemiology of Disasters. EM-DAT: The International Disaster Database. http://www.emdat.be. Accessed August 24, 2012.Google Scholar
16. World Association of Disaster and Emergency Medicine (WADEM). Health Disaster Management: Guidelines for Evaluation and Research. http://www.wadem.org/guidelines.html. Accessed August 24, 2012.Google Scholar
17.Kim, Y. Great East Japan Earthquake and early mental-health response. Psychiatry Clin Neurosci. 2011;65:539-548.Google Scholar
18. Emergency Disaster Measures Headquarters, National Police Agency of Japan. Damage situation and police countermeasures associated with 2011 Tohoku district – off the Pacific Ocean Earthquake, July 11, 2012. http://www.npa.go.jp/archive/keibi/biki/higaijokyo_e.pdf. Accessed July 16, 2012.Google Scholar
19.Keim, M. The public health impact of tsunami disasters. Am J Disaster Med. 2011;6(6):341-350.Google Scholar
20. United States Geological Survey. Magnitude 9.0 - Near The East Coast Of Honshu, Japan: Summary. http://earthquake.usgs.gov/earthquakes/eqinthenews/2011/. Accessed February 20, 2012.Google Scholar
21. Wikipedia. 2011 Tōhoku earthquake and tsunami. http://en.wikipedia.org/wiki/2011_T%C5%8Dhoku_earthquake_and_tsunami. Accessed February 20, 2012.Google Scholar
22. CATDAT. Japan Tohoku earthquake and tsunami: CATDAT 41 report (October 2, 2011). http://earthquake-report.com/2011/10/02/japan-tohoku-earthquake-and-tsunami-catdat-41-report-october-2-2011/. Accessed February 25, 2012.Google Scholar
23. World Bank. The recent earthquake and tsunami in Japan: implications for East Asia. http://siteresources.worldbank.org/INTEAPHALFYEARLYUPDATE/Resources/550192-1300567391916/EAP_Update_March2011_japan.pdf?cid=EXTEAPMonth1. Accessed February 20, 2012.Google Scholar
24. United States Geological Survey. Earthquake shaking map: M 9.0, Near the East Coast of Honshu, Japan. http://earthquake.usgs.gov/earthquakes/pager/events/us/c0001xgp/onepager.pdf. Accessed February 20, 2012.Google Scholar
25. United States Geological Survey. M 8.9, Near the East Coast of Honshu, Japan: Aftershock Map—Mainshock and 726 Aftershocks. Last Updated: 23 March 2011, 17:39:53 UTC. http://earthquake.usgs.gov/earthquakes/aftershocks/?event=c0001xgp&source=us&title=M8.9%20NEAR%20THE%20EAST%20COAST%20OF%20HONSHU,%20JAPAN. Accessed February 20, 2012.Google Scholar
26. Japanese Geotechnical Society. Geo-hazards During Earthquakes and Mitigation Measures: Lessons and Recommendations from the 2011 Great East Japan Earthquake; July 2011. http://www.geosyntheticssociety.org/Uploads/Japan_Earthquake.pdf. Accessed February 27, 2012.Google Scholar
27.Oh, J-H. A Consideration for the better Preparedness against Mega-Disaster: Lessons from the 2011 Great Eastern Japan Earthquake and Tsunami. Buson, South Korea: Pukyong National University. http://www.kf.or.kr/file/kor_1/Panel_1_Jai-Ho_Oh_%EB%B0%9C%ED%91%9C%EC%9A%94%EC%95%BD%EB%AC%B8.pdf. Accessed February 27, 2012.Google Scholar
28.Norio, O, Ye, T, Kajitani, Y, Shi, P, Tatano, H. The 2011 Eastern Japan Great Earthquake Disaster: overview and comments. Int J Disaster Risk Sci. 2011;2(1):34-42.Google Scholar
29. Kyoto University International Environment and Disaster Management Graduate School of Global Environmental Studies. Mega Disaster in a Resilient Society: The Great East Japan (Tohoku Kanto) Earthquake and Tsunami of 11th March 2011. March 25, 2011.Google Scholar
30.Dauer, LT, Zanzonico, P, Tuttle, RM, Quinn, DM, Strauss, HW. The Japanese tsunami and resulting nuclear emergency at the Fukushima Daiichi power facility: technical, radiologic, and response perspectives. J Nucl Med. 2011;52:1423-1432.Google Scholar
31.Becker, SM. Learning from the 2011 Great East Japan Disaster: insights from a special radiological emergency assistance mission. Biosecur Bioterror. 2011;9(4):394-404.Google Scholar
32. Wikipedia. Fukushima Daiichi nuclear disaster. http://en.wikipedia.org/wiki/Fukushima_Daiichi_nuclear_disaster. Accessed February 27, 2012.Google Scholar
33.Kuwabara, H, Shioiri, T, Toyabe, SI, etal. Factors impacting on psychological distress and recovery after the 2004 Niigata–Chuetsu earthquake, Japan: community-based study. Psychiatry Clin Neurosci. 2008;62:503-507.Google Scholar
34.Lau, JTF, Yu, X, Zhang, J, etal. Psychological distress among adolescents in Chengdu, Sichuan at 1 month after the 2008 Sichuan earthquake. J Urban Health. 2010;87(3):504-523.CrossRefGoogle ScholarPubMed
35.Basoglu, M, Kilic, C, Salcioglu, E. Livanou M: Prevalence of posttraumatic stress disorder and comorbid depression in earthquake survivors in Turkey: an epidemiological study. J Trauma Stress. 2004;17(2):133-144.CrossRefGoogle ScholarPubMed
36.Kato, H. Posttraumatic symptoms among victims of the Great Hanshin-Awaji earthquake in Japan. Psychiatry Clin Neurosci. 1998;52(suppl):S59-S65.CrossRefGoogle Scholar
37.National Center for PTSD. Tsunami and Mental Health: What Can We Expect? Washington, DC: US Department of Veterans Affairs. http://www.ptsd.va.gov/public/pages/tsunami-mental-health.asp. Accessed February 27, 2012.Google Scholar
38.Carballo, M, Heal, B, Horbaty, G. Impact of the tsunami on psychosocial health and well-being. Int Rev Psychiatry. 2006;18(3):217-223.Google Scholar
39.Hollifield, M, Hewage, C, Gunawardena, CN, etal.: Symptoms and coping in Sri Lanka 20-21 months after the 2004 tsunami. Brit J Psychiatry. 2008;192:39-44.Google Scholar
40.Wahlström, L, Michélsen, H, Schulman, A, Backheden, M. Different types of exposure to the 2004 tsunami are associated with different levels of psychological distress and posttraumatic stress. J Trauma Stress. 2008;21(5):463-470.Google Scholar
41.Thienkrua, W, Cardozo, BL, Chakkraband, ML, etal. Symptoms of posttraumatic stress disorder and depression among children in tsunami-affected areas in southern Thailand. JAMA. 2006;296(5):549-559.Google Scholar
42.Souza, R, Bernatsky, S, Reyes, R, de Jong, K. Mental health status of vulnerable tsunami-affected communities: a survey in Aceh province, Indonesia. J Trauma Stress. 2007;20(3):263-269.Google Scholar
43.van Griensven, F, Chakkraband, ML, Thienkrua, W, etal. Mental health problems among adults in tsunami-affected areas in southern Thailand. JAMA. 2006;296(5):537-548.Google Scholar
44.Lommen, MJ, Sanders, AJ, Buck, N, Arntz, A. Psychosocial predictors of chronic post-traumatic stress disorder in Sri Lankan tsunami survivors. Behav Res Ther. 2009;47(1):60-65.Google Scholar
45.Bryant, RA. Recovery after the tsunami: timeline for rehabilitation. J Clin Psychiatry. 2006;67(suppl 2):50-55.Google Scholar
46.MacDonald, R. How women were affected by the tsunami: a perspective from Oxfam. PLoS Med. 2005;2(6):e178.Google Scholar
47.Carballo, M, Heal, B, Hernandez, M. Psychosocial aspects of the tsunami. J R Soc Med. 2005;98(9):396-399.Google Scholar
48.Bhugra, D, van Ommeren, M. Mental health, psychosocial support and the tsunami. Int Rev Psychiatry. 2006;18(3):213-216.Google Scholar
49.Kristensen, P, Weisaeth, L, Heir, T. Psychiatric disorders among disaster bereaved: an interview study of individuals directly or not directly exposed to the 2004 tsunami. Depress Anxiety. 2009;26(12):1127-1133.Google Scholar
50.Neuner, F, Schauer, E, Catani, C, Ruf, M, Elbert, T. Post-tsunami stress: a study of posttraumatic stress disorder in children living in three severely affected regions in Sri Lanka. J Trauma Stress. 2006;19(3):339-347.Google Scholar
51.Armagan, E, Engindeniz, Z, Devay, AO, Erdur, B, Ozcakir, A. Frequency of post-traumatic stress disorder among relief force workers after the tsunami in Asia: do rescuers become victims? Prehosp Disaster Med. 2006;21(3):168-172.Google Scholar
52.Dodgen, D, Norwood, AE, Becker, SM, Perez, JT, Hansen, CK. Social, psychological, and behavioral responses to a nuclear detonation in a US city: implications for health care planning and delivery. Disaster Med Public Health Prep. 2011;5(suppl 1):S54-S64.CrossRefGoogle Scholar
53.Slovic, P. Perception of risk from radiation. Radiat Prot Dosimetry. 1996;68(3/4):165-180.Google Scholar
54.Becker, SM. Emergency communication and information issues in terrorist events involving radioactive materials. Biosecur Bioterror. 2004;2(3):195-207.Google Scholar
55.Becker, SM. Communicating risk to the public after radiological incidents. BMJ. 2007;335(7630):1106-1107.Google Scholar
56.Christodouleas, JP, Forrest, RD, Ainsley, CG, Tochner, Z, Hahn, SM, Glatstein, E. Short-term and long-term health risks of nuclear-power-plant accidents. N Engl J Med. 2011;364:2334-2341.CrossRefGoogle ScholarPubMed
57.Auf der Heide, E. Common misconceptions about disasters: panic, the “disaster syndrome,” and looting. In: O'Leary MR, ed. The First 72 Hours: A Community Approach to Disaster Preparedness. Bloomington, IN: iUniverse; 2004:340-380.Google Scholar
58.Drury, J, Cocking, C, Reicher, S. Everyone for themselves? a comparative study of crowd solidarity among emergency survivors. Br J Soc Psychol. 2009;48(pt 3):487-506.Google Scholar
59.Becker, SM. Protecting public health after major radiation emergencies: nuclear crisis in Japan is a powerful reminder of past lessons. BMJ. 2011;342:717.Google Scholar
60.Chernobyl Forum: 2003-2005. Chernobyl ‘s Legacy: Health, Environmental and Socioeconomic Impacts. Vienna: International Atomic Energy Agency; 2006.Google Scholar
61.Saenko, V, Ivanov, V, Tsyb, A, etal. The Chernobyl accident and its consequences. Clin Oncol (R Coll Radiol). 2011;23(4):234-243.Google Scholar
62.Bromet, EJ, Havenaar, JM, Guey, LT. A 25-year retrospective review of the psychological consequences of the Chernobyl accident. Clin Oncol (R Coll Radiol). 2011;23(4):297-305.Google Scholar
63.Beehler, GP, Baker, JA, Falkner, K, etal. A multilevel analysis of long-term psychological distress among Belarusians affected by the Chernobyl disaster. Public Health. 2008;122(11):1239-1249.Google Scholar
64.Havenaar, JM, de Wilde, EJ, van den Bout, J, Drottz-Sjoberg, BM, van den Brink, W. Perception of risk and subjective health among victims of the Chernobyl disaster. Soc Sci Med. 2003;56(3):569-572.Google Scholar
65.Havenaar, JM, Rumyantzeva, GM, van den Brink, W, etal. Long-term mental health effects on the Chernobyl disaster: an epidemiologic survey in two former soviet regions. Am J Psychiatry. 1997;154:1605-1607.Google Scholar
66.Butler, AS, Panzer, AM, Goldfrank, LR. Institute of Medicine Committee on Responding to the Psychological Consequences of Terrorism Board on Neuroscience and Behavioral Health. Preparing for the Psychological Consequences of Terrorism: A Public Health Approach. Washington, DC: National Academies Press; 2003.Google Scholar
67.Raphael, B, Taylor, M, McAndrew, V. Women, catastrophe and mental health. Aust NZ J Psychiatry. 2008;42:13-23.Google Scholar
68.Kim, Y, Abe, Y, Araki, H, etal. Guidelines for Local Mental Health Care Activities after a Disaster. Tokyo, Japan: National Institute of Mental Health, National Center of Psychiatry and Neurology; 2004. http://www.ncnp.go.jp/nimh/seijin/EnglishDisasterMentalHealth.pdf. Accessed February 25, 2012.Google Scholar
69.Takeda, M. Mental health care and East Japan Great Earthquake. Psychiatry Clin. Neurosci. 2011;65:207-212.Google Scholar
70.Suzuki, Y, Kim, Y. The Great East Japan earthquake in 2011: toward a sustainable mental health care system. Epidemiol Psychiatric Sci. 2012;21:7-11.Google Scholar
71.Shultz, JM, Marcelin, LH, Espinel, Z, Madanes, SB, Allen, A, Neria, YA. Haiti earthquake 2010: psychosocial impacts. In: Bobrowsky P (ed). Encyclopedia of Natural Hazards. New York, NY: Springer Publishing, 2013 (in press).Google Scholar
72.Shultz, JM, Neria, Y, Espinel, Z, Marcelin, LH, Madanes, S. Trauma signature analysis: rapid post-impact/pre-deployment guidance for mental health response. Presented at: International Society for Traumatic Stress Studies (ISTSS) 26th Annual Meeting; November 5, 2010; Montreal, Quebec, Canada.Google Scholar
73.Shultz, JM, Espinel, Z, Kelly, F, Neria, Y. Examining the trauma signature of the Japan tsunami/nuclear crisis. Presented at: Social Bonds and Trauma Through the Life Span: International Society for Traumatic Stress Studies (ISTSS) 27th Annual Meeting; November 4, 2011; Baltimore, MD.Google Scholar
74.Shultz, JM, McLean, AJ, Rosen, A, Youngs, GA, Jensen, J, Neria, Y. A tale of two cities: flooding and effects on community resilience [poster]. Presented at: 2nd International Preparedness and Response to Emergencies and Disasters (IPRED II) Conference; January 16-17, 2012; Tel Aviv, Israel.Google Scholar
75.Shultz, JM, Bueno Ramirez, AM, Espinel, Z, etal. Displaced within borders: Colombia's humanitarian crisis. Presented at: 2nd International Preparedness and Response to Emergencies and Disasters (IPRED II) Conference; January 16-17, 2012; Tel Aviv, Israel.Google Scholar
76.Shultz, JM, Herberman Mash, HB, Rosen, A, Espinel, Z, Kelly, F, Neria, Y. The trauma signature of the 2011 U.S. super tornado outbreak. Presented at: 2nd International Preparedness and Response to Emergencies and Disasters (IPRED II) Conference; January 16-17, 2012; Tel Aviv, Israel.Google Scholar
77.Migline, V, Shultz, JM. Psychosocial impact of the Russian invasion of Georgia in 2008. Presented at: 17th World Congress on Disaster and Emergency Medicine; June 1, 2011; Beijing, China.Google Scholar
78.Shultz, JM, Neria, Y, Espinel, Z, Kelly, F. Trauma signature analysis: evidence-based guidance for disaster mental health response. Presented at: 17th World Congress on Disaster and Emergency Medicine; May 31, 2011; Beijing, China.Google Scholar
79.Shultz, JM, Kelly, F, Espinel, Z, Neria, Y. Rapid evidence-based guidance for post-impact disaster mental health response: Trauma signature (TSIG) analysis. Presented at: Social Bonds and Trauma Through the Life Span: International Society for Traumatic Stress Studies (ISTSS) 27th Annual Meeting; November 2, 2011; Baltimore, MD.Google Scholar
80.Shultz, JM. Trauma signature analysis. Presented at: Innovation and Results: Surviving the Times. The Joint Commission 2012 Accreditation Standards Update; November 16, 2011; Lombard, IL.Google Scholar