ArticlePDF Available

Psychological Impairment in the Wake of Disaster: The Disaster–Psychopathology Relationship

American Psychological Association
Psychological Bulletin
Authors:
Anthony V. Rubonis
Anthony V. Rubonis
Anthony V. Rubonis
  • This person is not on ResearchGate, or hasn't claimed this research yet.
Leonard Bickman at Vanderbilt University
Leonard Bickman
Download full-text PDF
Read full-text
Download citation

Abstract

The present review examines the relationship between disaster occurrence and psychopathology outcome for 52 studies that used quantitative measures of such a relationship. Descriptive and inferential techniques were used to examine relationships among four sets of variables: (a) the characteristics of the victim population, (b) the characteristics of the disaster, (c) study methodology, and (d) the type of psychopathology. A small but consistently positive relationship between disasters and psychopathology was found. The distribution of effect-size estimates was significantly heterogeneous, and this heterogeneity was partially accounted for by methodological characteristics of the research. When controlling for methodology, victim and disaster characteristics also contributed variance to the disaster-psychopathology relationship. Implications for future research are outlined in view of these results.
Content uploaded by Leonard Bickman
Author content
All content in this area was uploaded by Leonard Bickman
Content may be subject to copyright.
A preview of this full-text is provided by American Psychological Association.
Learn more
Content available from Psychological Bulletin 
This content is subject to copyright. Terms and conditions apply.
... Earthquakes, classified as natural disasters, are recognized as traumatic events due to their widespread impact, causing loss of life and destruction on a large scale. A key distinction between earthquakes and other disasters is that affected individuals must continue to live with the persistent risk of recurrence [1]. ...
Post-traumatic stress disorder in earthquake survivors living in temporary shelter areas in Hatay central districts: a cross-sectional study
Article
Full-text available
  • May 2025
  • BMC PSYCHIATRY
Background The 2023 Kahramanmaraş earthquakes resulted in extensive destruction, significant loss of life, and widespread displacement, with Hatay province being the most severely affected region. Earthquake survivors residing in temporary shelters face an elevated risk of long-term psychological consequences, particularly post-traumatic stress disorder (PTSD) and depression. This study aims to assess the prevalence of PTSD and depression among earthquake survivors in temporary shelter areas within the central districts of Hatay and to identify associated risk factors contributing to PTSD. Methods This cross-sectional, population-based study was conducted among 400 adult earthquake survivors following the 2023 Kahramanmaraş earthquakes. Participants were selected using a multistage cluster sampling method. Data on participants’ sociodemographic characteristics, earthquake experiences, and psychiatric history were collected through self-report questionnaires. PTSD was assessed using the PTSD Checklist for DSM-5 (PCL-5), while depression was evaluated using the Beck Depression Inventory. Results PTSD was identified in 29.0% of participants, while depression was observed in 38.8%. Key risk factors for PTSD included unemployment (OR = 2.590, p = 0.004), the loss of a family member (OR = 2.351, p = 0.017), a pre-existing psychiatric diagnosis prior to the earthquakes (OR = 2.245, p = 0.007), alcohol use (OR = 2.310, p = 0.019), smoking (OR = 1.663, p = 0.044), and experiencing a high level of fear during the earthquakes (OR = 2.151, p = 0.002). Conclusions These findings highlight the critical need for large-scale psychosocial support and intervention programs in the post-disaster period. Identifying risk factors for PTSD may aid in the development of targeted treatment strategies and preventive interventions for affected individuals.
View
... Several research have been carried out to study the relationship between various natural changes and components associated with psychological discomfort. For example, Substantial research has been done on the harmful impact that natural catastrophes have on mental health [17,18]. Much attention has been placed on post-disaster mental health issues such as depression and PTSD, with earthquakes functioning as a basis [19]. ...
MENTAL HEALTH ISSUES FOLLOWING A DEVASTATING EARTHQUAKE 2023: SOCIO-ECONOMIC AND STRUCTURAL DETERMINANTS
Article
Full-text available
  • May 2024
There is little study in Turkey on how a large earthquake affects mental health. Among people who had been impacted by the 7.6-magnitude "Kahramanmaras" earthquake that struck Turkey on February 6, 2023, we sought to examine the factors that were linked to depressive and anxious symptoms. A preliminary cross-sectional examination of the general population was conducted from February 9 th to 1 st March, 2023. An online questionnaire was used as data collection tool that included the (DASS 21). By leveraging logistics regression, researchers tested the relationship between health behavior change aggregate score and depression, stress, and anxiety. Physical earthquake injuries, a little food shortage, and exhaustion were all linked to anxious feelings. Many individual and socioeconomic factors contributed to the emergence of depression, stress and anxiety indicators after the Turkey earthquake of 2023.
View
... PTG has been researched in psychological and criminological literature in a variety of traumatic events ranging from natural disasters (Joseph & Yule, 1993;Nolen-Hoeksema & Morrow, 1991;Rubonis & Bickman, 1991), battles with medical diagnoses (Jordan, 2000;Bower et al., 1998;Affleck et al., 1987), combat and war (Elder & Clipp, 1989;Powell et al., 2003), the unexpected death of a loved one (Calhoun & Tedeschi, 2001;Davis & Lehman, 1995;Miles & Crandell, 1983;Nerken, 1993), sexual assault (Burt & Katz, 1987;Draucker, 1992;Frazier & Glaser, 2001), immigration (Berger & Weiss, n.d), genocide (Brendler, 1995;Berghs, 2021), severe injuries (Grace et al., 2015), and more (Tedeschi & Calhoun, 2004, p 1). As the scholarship around PTG increases, there will be a need for even more context-specific investigations into the phenomenon (Heid et al., 2022). ...
"Crawling Out of the Pits of Hell": Exploring Indigenous Resilience and Post-Traumatic Growth After Experiences of Incarceration
Thesis
Full-text available
  • Mar 2025
This research explores the intersections of incarceration, colonialism, and Indigenous resilience within settler-colonial nations such as Canada, where the over-representation of Indigenous peoples in prisons demonstrates the enduring legacies of historical violence, dispossession, and cultural erasure. While criminological scholarship has extensively documented the devastating impacts of colonial policies on Indigenous communities, this study shifts the focus toward Indigenous cultural resilience and post-traumatic growth (PTG) following incarceration as a form of colonial state violence. Through qualitative interviews with three First Nations participants (Cree, Mi'kmaq, and Nakota/Dakota), this research examines how Indigenous individuals navigate and reclaim cultural identity and intergenerational knowledge after imprisonment. Findings reveal that resilience, PTG, and nurturing the soulflame (healing) are central to participants’ journeys, with cultural reconnection, community support, and ancestral ties playing pivotal roles in fostering personal and collective transformation. Despite systemic barriers and the disruption of intergenerational knowledge due to colonialism, participants demonstrated remarkable strength, hope, and pride, highlighting the potential for growth and healing even in the face of ongoing colonial oppression. This study advocates for a strength-based, decolonial approach to understanding incarceration, emphasizing the importance of integrating Indigenous methodologies, cultural practices, and community-led interventions to support healing and resilience. By centering Indigenous voices and experiences, this research contributes to broader efforts to address colonization's unfinished business and honour the enduring legacy of Indigenous survivance. Keywords: Post-traumatic growth, Indigenous resilience, intergenerational knowledge, incarceration
View
... Substantial research has explored the psychological affect of natural and man-made dsaster (Rubonis & Bickman, 1991); however, few studies have examined the immediate and distant effect of serious acts of terrorism. Disaster has the potential for evoking a cluster of symptoms that comprise Posttraumatic Stress Disorder and Acute Stress Disorder (Green, 1991(Green, , 1995, including hyperarousal, dissociation, intrusion, and a wide range of affective symptoms. ...
Stress Symptoms of Two Groups before and after the Terrorist Attacks of 9/11/01
Article
Full-text available
This study investigated stress symptoms before and after the September 11, 2001 terrorist attack on the World Trade Center. Responses to the Smith Stress Symptoms Inventory were compared for Chicago area college students assessed 1 to 5 weeks after 9/11 (n = 149) and a comparable sample tested up to 5 months prior to 9/11 (n = 320). Post-9/11 participants scored higher on Attention Deficit. Contrary to prior research, post-9/11 participants did not score higher on distress, including Worry, Autonomic Arousal/Anxiety, Striated Muscle Tension, Depression, and Anger. It is suggested that those indirectly exposed to a terrorist attack may display traditional symptoms of distress and arousal (as suggested by previous research). Later symptoms of attention deficit and distancing may emerge. This work was based on independent pre- and post-9/11 samples and must be replicated longitudinally as a test-retest to draw conclusions regarding change over time.
View
... Все перечисленные факторы были оценены психологическими тестами после травматического события, но их значимость окажется выше, если они будут оценены до переживания травмы [46,74,75]. При тестировании лиц до воздействия травмы была получена иная картина. ...
Современная терапия психических расстройств
Article
Full-text available
  • Jan 2025
44-дневной войны в арцахе. Все пациенты подвергались клинико-психопатологическому обследованию в сочетании с психологическими и психометрическими методами. Были использованы опросник SCL-90-R, миссисипский опросник для боевого ПТСР и личностный опросник Шмишека. Результаты. Представлен алгоритм диагностики посттравматических расстройств, состоящий из четырех блоков. Рассмотрены основные характеристики и критерии психической травмы. Показаны особенности реагирования на травму и разнообразие клинических проявлений боевой травмы. Каждый третий комбатант проявлял симптомы ПТСР в первые дни посттравмы, у каждого четвертого были выявлены острые психотические, аффективные и другие расстройства. Обсуждение и выводы. Критерий «необыденности» травмы теряет свою диагностическую значимость. Хронологические критерии определе-ния острых и посттравматических расстройств далеки от клинической реальности. Границы между клиническими проявлениями посттравмы достаточно аморфны и во многом пересекаются. Это позволяют говорить о «перитравматических расстройствах», которые включают в себя все расстройства, возникающие после неординарной боевой психической травмы. клЮчЕвыЕ СлОвА: посттравматическое стрессовое расстройство, боевая травма, диагностический критерий, перитравматическое стрес-совое расстройство кОНтАкт: Сукиасян Самвел Грантович, doc.sukiasyan@gmail.com, ORCID: 0000-0001-9813-2471 кАк цИтИРОвАть ЭтУ СтАтьЮ: Сукиасян С.Г. Посттравматические или перитравматические расстройства: диагностическая дилемма // Сов-ременная терапия психических расстройств. Summary introduction. The problem of mental trauma and post-traumatic disorders is one of the most urgent problems of psychiatry. The article presents approaches to the interpretation of this concept and to its adequate diagnosis. relevance. There are still no clear theoretical concepts defining approaches to the study of psycho-biological mechanisms of the development of post-traumatic disorders, the problem of specificity of both mechanisms and clinical symptoms of PTSD has not been solved. The aim of the study was to investigate and identify the most significant factors in the development of clinical manifestations of combat trauma. A working hypothesis on the clinical dynamics and transformation of the concept of PTSD is presented. material and methods. The study is based on the analysis of our early studies on this issue and their comparison with the data of the 44-day war in Artsakh. All patients underwent clinical and psychopathological examination in combination with psychological and psychometric methods. The SCL-90-R questionnaire, the Mississippi Questionnaire for Combat PTSD and the Shmishek personality questionnaire were used. results. An algorithm for the diagnosis of post-traumatic disorders, consisting of four blocks, is presented. The main characteristics and criteria of mental trauma are considered. The features of the response to trauma and the variety of clinical manifestations of combat trauma are shown. Every third combatant showed symptoms of PTSD in the first days of post-trauma, every fourth revealed acute psychotic, affective and other disorders. discussion and conclusions. The criterion of «non-routine» injury loses its diagnostic significance. Chronological criteria for determining acute and post-traumatic disorders are far from clinical reality. The boundaries between the clinical manifestations of posttrauma are quite amorphous and overlap in many ways. This allows us to talk about «peritraumatic disorders», which includes all disorders that occur after an extraordinary combat mental trauma.
View
... физической, психической, духовной, социальной. Но эти факторы были оценены психологическими тестами у лиц, которые выжили после травмы [23,50,58]. Иная картина возможна при тестировании лиц до воздействия травмы. ...
ПОСТСТРЕССОВЫЕ РЕАКЦИИ И РАССТРОЙСТВА У УЧАСТНИКОВ ВОЙНЫ В АРЦАХЕ
Article
Full-text available
  • Jan 2025
3 | Հոգեկան առողջության հայկական հանդես 14(2) 2023 Armenian Journal of Mental Health | Армянский журнал психического здоровья Մարտական հետտրավմատիկ սթրեսային խանգարում Combat post-traumatic stress disorder Боевое посттравматическое стрессовое расстройство 1. Центр психосоциального регулирования, Ереван, Армения 2. Армянский государственный педагогический университет им. Х. Абовяна, Ереван, Армения 3. Ереванский государственный медицинский университет им. М.Гераци, Ереван, Армения 4. МРЦ «Артмед», Ереван, Армения 5. Ереванский государственный университет, Ереван, Армения Актуальность. Проблема психической травмы и связанных со стрессом расстройств является ак-туальной проблемой психиатрии, особенно острые стрессовые расстройства (ОСР) и посттравматиче-ские стрессовые расстройства (ПТСР). В условиях современных войн пятого поколения боевая травма приобретает особый смысл, что отражается на характере психических расстройств. Цель. Изучение основных форм и особенностей психопатологических расстройств у участни-ков 44-х дневной арцахской войны, особенностей боевой травмы, факторов риска. Материал и методы. Обследованы 104 участника войны в возрасте 18-50 лет. Исследование про-водилось клинико-психопатологическим, лабораторным, инструментальным, психологическим ме-тодами (SCL-90-R, Миссисипская шкала ПТСР, личностный опросник Шмишека). Результаты. У 77 пациентов (74%) были выявлены ОСР, у 27 (26%)-психотические, депрес-сивные и другие психические расстройства. Из них у 39 комбатанта (37,5%) на самых ранних ста-диях развития патологии было выявлено ПТСР. Статистический анализ выявил значительные раз-личия в выраженности факторов, измеренных с помощью опросников SCL-90-R, Миссисипской шкалой и шкалой Schmishek-а в зависимости от возраста бойцов, типа воинской обязанности, мо-мента поступления в больницу. Выявлены симптомы, имеющие прогностическое значение для раз-вития патологического процесса. Обсуждение. Все формы психопатологических расстройств были следствием необычной бое-вой травмы, которая в условиях арцахской войны характеризуется таким критерием, как «невиди-мость и недосягаемость источника травмы, ее реальность и осязаемость». Границы между клиниче-скими проявлениями посттравмы аморфны и перекрываются, хронологические критерии не соот-ветствуют требованиям МКБ и DSM. Боевая травма выступает как катализирующий фактор для всех расстройств посттравмы. Заключение. Критерий необыденности травмы теряет свою диагностическую ценность. Не соответствуют клинической реальности хронологические критерии ОСР, ПТСР. Возникает проб-лема дифференциации ОСР и ПТСР. Полученные данные позволяют говорить о перитравматичес-ких стрессовых расстройствах, объединяющих все расстройства посттравмы. Ключевые слова: боевая травма, предрасполагающие факторы ПТСР, факторы риска, острое стрессовое расстройство, посттравматическое стрессовое расстройство, перитравматические стрес-совые расстройства
View
... Depreme Maruz Kalan Bireylerde Sanatın Öznel İyi Oluşa Etkisi ve Uygulama ÖrnekleriGiriş Doğal afetler, psiko-sosyal iyilik halini bozması ve ilerleyen dönemlerde kaygı, uyku bozuklukları, kişilerarası ilişkilerde bozulma ve depresyon gibi ciddi sağlık sorunlarına sebep olması nedeniyle önemli bir halk sağlığı sorunu olarak kabul edilmektedir(Ginexi vd., 2000;Rubonis ve Bickman, 1991). Bu nedenle afetlerle mücadele sürecinde fiziksel, ekonomik ve sosyal kayıpların yanı sıra ruh sağlığı değerlendirmesinin de yapılması önem arz etmektedir. ...
Sanatın İyileştirici Gücü 4 Farklı Bakış Açılarıyla Sanat ve İyi Oluş
Book
  • Jan 2025
Sanata Fenomenolojik/Politik Bakmak ve Sanatın Araçsal Olamayışı: Mona Hatoum’un Aporetik Dünyası Özlem AYDOĞMUŞ ÖRDEM Eser ÖRDEM Depreme Maruz Kalan Bireylerde Sanatın Öznel İyi Oluşa Etkisi ve Uygulama Örnekleri İrfan Nihan DEMİREL Özel Gereksinimli Bireylerde Sanatın İyileştirici Gücü Gülten CACA Yaratıcı İfadenin Dışsallaştırılması “Uygulamalı Yaratıcı Atölyeler “ İpek T. GİRGİN Nöroestetik ve Sanat Terapisi Bağlantısı Neslihan Dilşad DİNÇ Kübra ŞAHİN ÇEKEN Sanatın İyileştirme ve İnsiyatif Alma Yönü: Sanat Terapidir Platformu Eda ÖZ ÇELİKBAŞ Kübra ŞAHİN ÇEKEN İyileşme İçin Görsel Bir Araç: Terapötik Fotoğrafçılık Pelin ÖZGÜR POLAT Terapötik Rekreasyon Eda ÖZ ÇELİKBAŞ
View
Post-Traumatic Stress Disorder in Earthquake Survivors Living in Temporary Shelter Areas in Hatay Central Districts: A Cross-Sectional Study
Preprint
Full-text available
  • Jan 2025
Background: The 2023 Kahramanmaraş earthquakes resulted in extensive destruction, significant loss of life, and widespread displacement, with Hatay province being the most severely affected region. Earthquake survivors residing in temporary shelters face an elevated risk of long-term psychological consequences, particularly post-traumatic stress disorder (PTSD) and depression. This study aims to assess the prevalence of PTSD and depression among earthquake survivors in temporary shelter areas within the central districts of Hatay and to identify associated risk factors contributing to PTSD. Methods: This cross-sectional, population-based study was conducted among 400 adult earthquake survivors following the 2023 Kahramanmaraş earthquakes. Participants were selected using a multistage cluster sampling method. Data on participants' sociodemographic characteristics, earthquake experiences, and psychiatric history were collected through self-report questionnaires. PTSD was assessed using the PTSD Checklist for DSM-5 (PCL-5), while depression was evaluated using the Beck Depression Inventory Results: PTSD was identified in 29.0% of participants, while depression was observed in 38.8%. Key risk factors for PTSD included unemployment (OR=2.590, p=0.004), the loss of a family member (OR=2.351, p=0.017), a pre-existing psychiatric diagnosis prior to the earthquakes (OR=2.245, p=0.007), alcohol use (OR=2.310, p=0.019), smoking (OR=1.663, p=0.044), and experiencing a high level of fear during the earthquakes (OR=2.151, p=0.002). Conclusions: These findings highlight the critical need for large-scale psychosocial support and intervention programs in the post-disaster period. Identifying risk factors for PTSD may aid in the development of targeted treatment strategies and preventive interventions for affected individuals.
View
Identifying factors associated with mental health status following climate-related disasters: a nationwide longitudinal panel study in Korea
Article
  • Mar 2025
Objectives: Despite the increasing frequency and intensity of climate-related disasters, identifying factors associated with mental health status remains challenging. This study aimed to determine the factors linked to symptoms of depression, anxiety, and post-traumatic stress disorder (PTSD) following heavy rainfall and typhoons. Methods: National data on climate-related disaster victims (n=825 for heavy rainfall and n=1,220 for typhoon) from a longitudinal panel in Korea ("Long-term Survey on the Change of Life of Disaster Victims") and data from individuals unaffected by disasters (n=893) were used. Generalized linear mixed models were employed to evaluate the factors associated with mental health status following climate-related disasters. Results: Greater disaster severity (e.g., experiencing casualties or asset loss) was associated with higher scores for depression (Patient Health Questionnaire-9), anxiety (Generalized Anxiety Disorder-7), and PTSD (Impact Event Scale-Revised). The association between casualty experience and anxiety score was more pronounced among individuals over 65 years (β [log-transformed score]=1.39; standard error [SE], 0.26; p<0.001), female respondents (β=1.20; SE, 0.20; p<0.001), those with a low education level (β=1.18; SE, 0.25; p<0.001), and those with a low income (β=1.45; SE, 0.26; p<0.001) compared to their counterparts. Conclusion: These findings may help guide targeted interventions and shape public health policies and disaster management strategies that prioritize mental health support for the most at-risk populations, ultimately increasing community resilience to climate-related challenges.
View
View
Emotional, behavioral, and physiological effects of chronic stress at Three Mile Island
Article
Full-text available
  • Aug 1983
38 Three Mile Island (TMI) residents (mean age 33.3 yrs) were compared with 32 people (mean age 35.8 yrs) living near an undamaged nuclear power plant, 24 people (mean age 34.1 yrs) living near a traditional coal-fired power plant, and 27 people (mean age 30.9 yrs) living in an area more than 20 miles from any power plant. A number of self-report measures of psychological stress were evaluated by administering the Symptom Checklist-90 and the Beck Depression Inventory more than 1 yr after the nuclear accident. Two behavioral measures of stress were obtained: performances on a proofreading task and an embedded-figures task. Urinary catecholamine levels were assayed to examine chronic stress-related sympathetic arousal. Results indicate that Ss in the TMI area exhibited more symptoms of stress more than 1 yr after the nuclear accident than did Ss living under different circumstances. Although the intensity of these problems appears to be subclinical, the persistence of stress may be cause for some concern. (25 ref)
View
View
A Propositional Paradigm for Estimating the Impact of Disasters on Mental Health
Article
  • Jan 2023
This paper reviews the literature on communitywide disaoters and their relationships to subsequent mental health problems. In addition, it describes the theoretical notions of psychological stress which have guided past research and it outlines the dimensions of a comprehensive stress paradigm. This paradigm is based on an integration of research findings from three separate fields of inquiry: disaster research; studies of psychosocial stress; and, psychiatric epidemiology. The theoretical propositions on which the paradigm is based are outlined and offered as guidelines for future research. The paper concludes with a brief discussion of some of the problems confronting researchers interested in disasters and their mental health sequelae.
View
Lessons learned and forgotten: the need for prevention and mental health interventions in disaster preparedness
Article
  • Jul 1985
Human beings have been subjected to the effects of both natural and man-made disasters for centuries. How humans have coped with catastrophes has been recorded through history. This review proceeds from an examination of the efforts in legislation and disaster research through a brief history of war-time experiences and treatment of combat stress reactions. As warfare changed, so did the ability of soldiers to cope. Likewise, treatment interventions to restore soldiers to effectiveness evolved with the changes in warfare. The treatment principles developed in war and the concepts recognized from the stress literature can be integrated to understand how the treatment interventions work. Examples of the delivery of mental health services are reviewed. The lesson learned during war were often forgotten after the war. It was not until the 1970s that the need for prevention and planning for mental health interventions during and after disasters was legislated. Research efforts are now focusing on planning, implementing interventions, and following survivors/victims for posttraumatic effects.
View
View
View
View
A Typology for the Classification of Disasters
Chapter
  • Jan 1980
Over the past 25 years, a wide spectrum of social psychological literature has been published concerning disasters. Articles have appeared that provide descriptions of the extent of the destruction,6,7,16 assessments of the social and emotional consequences of disasters,5,9,11,13,19,24 and analyses of those intervention services provided to minimize the potentially devastating social and emotional consequences.4,8,10,20,21,25
View
Learned helplessness in humans: critique and reformulation
Article
  • Jan 1978
The learned helplessness hypothesis is criticized and reformulated. The old hypothesis, when applied to learned helplessness in humans, has two major problems: (a) It does not distinguish between cases in which outcomes are uncontrollable for all people and cases in which they are uncontrollable only for some people (univervsal vs. personal helplessness), and (b) it does not explain when helplessness is general and when specific, or when chronic and when acute. A reformulation based on a revision of attribution theory is proposed to resolve these inadequacies. According to the reformulation, once people perceive noncontingency, they attribute their helplessness to a cause. This cause can be stable or unstable, global or specific, and internal or external. The attribution chosen influences whether expectation of future helplessness will be chronic or acute, broad or narrow, and whether helplessness will lower self-esteem or not. The implications of this reformulation of human helplessness for the learned helplessness model of depression are outlined.
View
View