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Mental Health in Sumatra After the Tsunami
Abstract
We assessed the levels and correlates of posttraumatic stress reactivity (PTSR) of more than 20,000 adult tsunami survivors by analyzing survey data from coastal Aceh and North Sumatra, Indonesia.
A population-representative sample of individuals interviewed before the tsunami was traced in 2005 to 2006. We constructed 2 scales measuring PTSR by using 7 symptom items from the Post Traumatic Stress Disorder (PTSD) Checklist-Civilian Version. One scale measured PTSR at the time of interview, and the other measured PTSR at the point of maximum intensity since the disaster.
PTSR scores were highest for respondents from heavily damaged areas. In all areas, scores declined over time. Gender and age were significant predictors of PTSR; markers of socioeconomic status before the tsunami were not. Exposure to traumatic events, loss of kin, and property damage were significantly associated with higher PTSR scores.
The tsunami produced posttraumatic stress reactions across a wide region of Aceh and North Sumatra. Public health will be enhanced by the provision of counseling services that reach not only people directly affected by the tsunami but also those living beyond the area of immediate impact.
... Bencana adalah ancaman terhadap kesejahteraan populasi yang menghambat kemajuan sosial ekonomi membebani jaring pengaman sosial dan membutuhkan bantuan dan intervensi pemulihan (Frankenberg et al., 2008). Mulai dari tempat tinggal hancur sehingga harus mengungsi, kehilangan anggota keluarga atau mengalami kekerasan selama di pengungsian dapat menimbulkan traumatis. ...
Indonesia's territory which is located at the confluence of three major tectonic plates in the world, causes Indonesia to experience frequent natural disasters such as earthquakes. Three areas in Indonesia that experienced major earthquakes in the last 10 years are Aceh, Mataram / Lombok, and Palu. The earthquake not only caused material damage but also psychological trauma. Post-disaster trauma is vulnerable to children and adolescents. Problems experienced from a disaster have an impact on various aspects of life so that they can affect the quality of life of the victim. Quality of life is very important especially for adolescents, because adolescents who have higher quality of life tend to have low physical and psychological problems. Therefore, this study aims to describe the quality of life of adolescents in earthquake areas. Participants in this study were 437 senior high school students aged 12-19 years. All participants came from Aceh (NAD), Mataram (NTB), and Palu (Central Sulawesi). Data collection was carried out through a survey with WHOQOL-BREF questionnaire which consisted of 4 aspects, namely physical, psychological, social, and environmental. Data analysis used descriptive statistical techniques which is processed using the IBM 22.0 version of the SPSS (Statistical Product and Service Solutions) computer program and the LISREL 8.80 program. Data collection was carried out before the COVID-19 Pandemic occurred. The results showed that the quality of life of adolescents in terms of physical, psychological, social, and environmental aspects in Aceh, Mataram and Palu was classified as moderate. The results of this study can be used as a first step in designing interventions related to the quality of life of adolescents in earthquake areas. Posisi wilayah Indonesia yang terletak pada pertemuan tiga lempeng tektonik utama di dunia menyebabkan Indonesia sering mengalami bencana alam seperti gempa bumi. Daerah di Indonesia yang mengalami gempa besar dalam 10 tahun terakhir yaitu Aceh, Mataram/Lombok, dan Palu. Gempa tersebut tidak hanya memberikan dampak berupa kerusakan materiil tetapi juga trauma psikologis. Trauma pasca bencana ini rentan dialami oleh anak-anak dan remaja. Masalah yang dialami dari satu peristiwa bencana berdampak pada berbagai aspek kehidupan sehingga dapat memengaruhi kualitas hidup korban. Kualitas hidup sangat penting khususnya bagi remaja karena remaja yang memiliki kualitas kehidupan yang tinggi cenderung rendah mengalami permasalahan fisik dan psikologis. Oleh sebab itu, penelitian ini bertujuan untuk mengetahui gambaran kualitas hidup remaja di daerah gempa. Partisipan dalam penelitian ini adalah 437 siswa SMA sederajat berusia 12-19 tahun. Partisipan berasal dari Aceh (NAD), Mataram (NTB), dan Palu (Sulawesi Tengah). Pengumpulan data menggunakan metode survei melalui kuesioner WHOQOL-BREF yang terdiri dari 4 aspek yaitu fisik, psikologis, sosial dan lingkungan. Analisis data menggunakan teknik statistik deskriptif dengan bantuan komputer program SPSS (Statistical Product and Service Solutions) versi IBM 22.0. Pengambilan data dilaksanakan sebelum terjadinya pandemi Covid-19. Hasil penelitian menunjukkan bahwa kualitas hidup remaja ditinjau dari aspek fisik, psikologis, sosial, dan lingkungan di Aceh, Mataram, dan Palu tergolong sedang. Hasil penelitian ini dapat digunakan sebagai langkah awal dalam merancang intervensi terkait kualitas kehidupan remaja di daerah gempa.
... Furthermore, clients from marginalized populations who are affected by natural disaster may have to overcome the realities of cultural mistrust and oppression before feeling safe starting counseling services. It is important to note that individuals from marginalized populations, such as racial minorities, children, the elderly, and lower socioeconomic status (SES) are more likely to display negative outcomes after experiencing a natural disaster (Frankenberg et al., 2008). Minorities face a unique situation after experiencing a natural disaster, as they are challenged with navigating racism while also being exposed to the trauma of natural disaster (Boyd-Franklin, 2008). ...
... Although PTSD symptoms and diagnostic criteria has been frequently measured in Indonesian populations post-trauma (e.g. Frankenberg et al., 2008;Grayman, et al., 2009), studies often show low-level estimates of both symptoms and PTSD caseness. For example Hidayat's (2010) investigation of trauma survivors also from the 2006 Yogyakarta/East Java earthquake, estimated PTSD prevalence rates of essentially the same magnitude as this study, approximately 1 or 2%. ...
This study evaluates the utility of the Threat to Conceptual Self (TCS) model’s extension
of Ehlers and Clark’s cognitive model of PTSD in a Javanese village population three and
a half years after the 2006 Yogyakarta/East Java earthquake. Extending Jobson and
colleague’s previous works, this study assessed the impact of cognitive appraisal styles of
trauma on subsequent psychological adjustment in eighty-five trauma-exposed Javanese
adults’ post-trauma using narrative and questionnaire measures in Indonesian language.
Contrary to predictions made by the TCS model, both relatedness (religious) appraisals
and autonomous appraisals mental defeat and permanent change predicted PTSD
symptom severity and clinical relevance of symptoms. Disparities in results for narrative
and self-report methodologies are accounted for by potential mediators/moderators such
as cultural etiquette, linguistic or trauma-related factors. These disparities may also
explain the failure of other relatedness appraisals of social connectedness/alienation and
social-role failings to predict PTSD symptom severity and clinical relevance of
symptoms, and should be considered as useful additions to the TCS model. The findings
suggest the TCS model should be expanded, particularly to consider how autonomous
appraisals threaten the interdependent conceptual-self’s relatedness goals and the process
by which specific cognitive appraisals predict certain PTSD symptom clusters.
... Although PTSD symptoms and diagnostic criteria has been frequently measured in Indonesian populations post-trauma (e.g. Frankenberg et al., 2008;Grayman, et al., 2009), studies often show low-level estimates of both symptoms and PTSD caseness. For example Hidayat's (2010) investigation of trauma survivors also from the 2006 Yogyakarta/East Java earthquake, estimated PTSD prevalence rates of essentially the same magnitude as this study, approximately 1 or 2%. ...
Despite significant contributions in aid, Australia in Indonesian-and in Asia more broadly-has an image problem. This thesis investigates the Partnership in Education and Training of Regional Islamic Institutions (PETRII) as an example of a people-to-people linkage program to assess the propensity of such programs to institute change by fostering a greater understanding and a better relationship between Indonesia and Australia. I employ a narrative methodology to interview five state Islamic Indonesian lecturer program participants (age-range 24-32 years) to assess their representations of Australia/Australians before and after spending twelve months studying in Australia. My results suggest participants' representations prior-to-departure to Australia were characterised by good-West/bad-West essentialisms driven by underlying vulnerabilities relating to their own identity/modernity projects. Although this good-West/bad-West dichotomy was still influential in guiding some representations of Australia following the participants' return to Indonesia, indicating the chronic-nature of participants' vulnerabilities, their representations also involved many aspects that were inconsistent with, and challenged past representations. This thesis employs a Kleinian inspired model of change/no-change to structure and explore both participants' subjective experience and to suggest some of the mechanisms of change in representations of the other. Despite obstacles-specifically cultural differences, access issues and othering and racism-four of the five participants did manage to form significant connections with their Australian other and thereby increase the likelihood they would encounter aspects of Australia/Australians that challenged their prior-to-departure representations. These connections and aspects that challenged their existing representations constituted the principle facilitators of change towards an eclectic and away from reductionist position-type representations of the other. This enabled the four participants to depart from Australia with a greater understanding and appreciation for Australia/Australians. This research contributes to an understanding of the complexities involved in implementing initiatives aimed at improving relations between countries; it also paves the way for further research aimed at policy reform of people-to-people linkage programs such as PETRII. Such programs constitute the beginnings of a solution to Australia's image problem with Asia and have the capacity to foster better relations between different cultures and nations.
Extreme events causing death and property destruction are on the rise across the globe. We document the long-term consequences for population health of exposure to an extreme event, the 2004 Indian Ocean earthquake and tsunami, which killed an estimated quarter of a million people worldwide. Using data from an extremely rich population-representative longitudinal survey, the Study of the Tsunami Aftermath and Recovery (STAR), we explore how this major natural disaster affected survival and psychosocial health of adults in the 15 years after the tsunami. Leveraging the unanticipated nature of the tsunami, contrasts between those who were directly affected by the disaster and those who were not can plausibly be interpreted as causal. We also investigate the impacts of specific exposures and stressors. Results for mortality and post-traumatic stress reactivity establish that a large-scale natural disaster exerts enduring impacts on health and well-being. In communities that were directly affected by the tsunami, survivors are positively selected with respect to characteristics associated with longevity. For some, this advantage dissipates over time as the deleterious effects of their experiences during the tsunami and in its aftermath emerge over the long term, both in terms of subsequent survival rates and psychosocial health.KeywordsExtreme eventDisasterDemographyMortalityPsychosocial healthIndonesiaTsunami
Post-traumatic stress disorder (PTSD) following a disaster could change over time. This study aimed to analyze the risk factors of PTSD among the 2004 Indian tsunami survivors in Aceh and North Sumatra province, Indonesia. It mapped the trajectory recovery pattern of mental illness and examined the medium-term PTSD consequence five and 18 months after the disaster using a large longitudinal survey. Multivariate logistic regression was employed to derive the association between the post-traumatic stress disorder trajectory group and risk factors. The results showed that 15% and 20% of the respondents had persistent medium-term and delayed-onset PTSD, respectively. The vital predictors of persistent PTSD included being female, aged 50 and older, married, and having higher direct trauma exposures to the tsunami. Furthermore, delayed-onset PTSD was associated with negative life events after the tsunami and perceived less social support. The results indicate the necessity to understand the predictors for each PTSD trajectory group's effective intervention regarding mental health after the disaster.
Natural disasters often strike with little to no warning and have devastating effects. The impact of natural disasters can include loss of property, loss of a job, or impairment of psychological functioning for survivors of natural disasters. Counselors are called to understand natural disasters, the impact of natural disasters, and interventions for working with natural disaster survivors. Therefore, the purpose of this paper is to examine the impact of natural disasters on clients, counseling practices for working with survivors of natural disaster, and the impact of natural disasters on counselors. Additionally, implications for counselors and counselor education are discussed.
Aceh is one of the many areas affected by the disaster. In recent years, Aceh has caught the attention of most countries in the world because Aceh has just passed two major human tragedies. The first tragedy was the 30-year political conflict between the Government of Indonesia and the Free Aceh Movement (GAM), while the second human tragedy included the earthquake and tsunami disaster on 26 December 2004. There were many different responses to disaster management. Most children who survive have strong feelings after a traumatic event but recover from trauma; others have more difficulty recovering and will need additional assistance. The children who were exposed to traumatic experiences about 15 years ago are now adults. The hope is that these adult children will no longer experience trauma and be able to deal with problems properly. Therefore, this study attempts to investigate what factors influence the ability of the Acehnese people to recover and rise from traumatic experiences. The ability that an individual has to 'bounce back' from traumatic experiences is known as the resilience factor. Furthermore, in this study, the researcher intends to analyze not only how individuals cope with traumatic experiences, but also how they grow and develop after exposure to psychological trauma.
Disasters have become a common threat to many societies across the globe. In developing communities, there is severe impact as disasters tend to wash away the little gains they have made. As much as there are community level effects, disasters leave significant individual impacts that deserve attention. This qualitative study study used the phenomenological approach to explore the lived experiences of 13 victims of the 3 rd June, 2015 flood/fire disaster in Accra, Ghana. It was found that victims perceive the cause of the disaster to include engineering failures and anti-environmental behaviours. Their experiences include biographical disruption such as disfigurement, death and loss of property, and psychological impacts such as anxiety, behavioural changes and mood effects. Participants’ adjustment experiences involve societal, and family level intervention, spiritual support and post disaster vulnerability issues. It is concluded that the struggles of disaster victims in Ghana are real and that there is the need for comprehensive intervention and support for victims. The implications of the findings regarding are discussed.
Mental health professionals have debated whether posttraumatic stress disorder (PTSD) can be qualitatively distinguished from normal reactions to traumatic events. This debate has been fueled by indications that many trauma-exposed individuals evidence partial presentations of PTSD that are associated with significant impairment and help-seeking behavior. The authors examined the latent structure of PTSD in a large sample of male combat veterans, Three taxometric procedures-MAMBAC, MAXEIG, and L-Mode-were performed with 3 indicator sets drawn from a clinical interview and a self-report measure of PTSD. Results across procedures, consistency tests, and analysis of simulated comparison data all converged on a dimensional solution, suggesting that PTSD reflects the upper end of a stress-response continuum rather than a discrete clinical syndrome.
A sample of 935 participants from the general population completed a mail‐out questionnaire containing the Trauma Symptom Inventory (J. Briere, 1995) and the Traumatic Events Survey (D. M. Elliott, 1992). The lifetime seif‐reported prevalence of natural disasters in this sample was 22%. Although time from the last disaster to involvement in the study was an average of 13 years, previous disaster was associated with significantly higher scores on 6 of 10 symptom scales. Disaster characteristics (especially the presence of physical injury, fear of death, and property loss) were better predictors of symptomatology than was disaster type. Disaster exposure continued to predict symptomatology after controlling for interpersonal violence history, although interpersonal violence accounted for more overall symptom variance.
The psychometric properties of the PTSD Checklist (PCL), a new, brief, self-report instrument, were determined on a population of 40 motor vehicle accident victims and sexual assault victims using diagnoses and scores from the CAPS (Clinician Administered PTSD Scale) as the criteria. For the PCL as a whole, the correlation with the CAPS was 0.929 and diagnostic efficiency was 0.900 versus CAPS. Examination of the individual items showed wide ranging values of individual item correlations ranging from 0.386 to 0.788, and with diagnostic efficiencies of 0.700 or better for symptoms. We support the value of the PCL as a brief screening instrument for PTSD.
This article describes the implementation of mental health intervention programs for children, adolescents,and their families exposed to natural disaster and violence. Recommendations are made regarding needed levels of organization, methods of screening and triage, training and supervision of mental health staff, design and implementation of treatment approaches, and longitudinal monitoring of course of recovery and intervention outcome.