Lesson 2 Flashcards
Define Stress Reactions
Result from a variety of shocking events. Before, during, or in the aftermath of a disaster, survivors may have experienced additional traumas such as life-threatening accidents, sexual or physical abuse or assault, living or serving in the military in a war zone, kidnapping or torture, or the witnessing of terrible things happening to other people.
Stressors of Disaster Survivors
Financial difficulties related to vocational problems, unemployment, and/or problems associated with relocation, rebuilding, or repairing a home.
Other long-term stressors may include resulting marital and family discord, medical illness, or chronic health problems.
Seeking and receiving help for these various issues can result in additional stress for survivors.
Implications for Understanding and Assessing Survivors’ Reactions
Personal and cultural differences and pre,- intra-, and post-disaster experience.
It is important to make a rapid, sensitive, and nonintrusive assessment.
Before judging or classifying a particular pattern of stress response, consider what is observable, what is disclosed, and what remains to be known
Survivor’s unique background or experience in the following areas:
- Ethnocultural traditions, beliefs, and values
- Community practices, norms, and resources
- Family heritage and dynamics
- Individual socio-vocational resources and limitations
- Individual biopsychosocial resources and vulnerabilities
- Prior exposure to traumatic experiences
- Specific stressful or potentially traumatic experiences during/since disaster
Factors Associated with Disaster Stress
- Personal injury
- Injury or fatality of loved ones, friends, associates
- Property loss/relocation
- Pre-existing stress
*Level of personal and professional preparedness - Stress reactions of significant others
- Previous traumatization
- Self-expectations
- Prior disaster experience
- Perception/interpretation of causal factors
- Level of social support
Vicarious Traumatization
relationships with traumatized individuals can create much distress for others.
The role delineation model (Taylor and Frazier, 1989)
- Primary victims: people directly exposed to the elements of the disaster
- Secondary victims: people with close family and personal ties to primary victims
- Tertiary victims: people whose occupations require them to respond to the disaster
- Quaternary victims: concerned and caring members of communities beyond the impact area
Post-traumatic Stress Reactions: A Common Response to Disaster
A common pattern of behavioral, biological, psychological, and social responses among individuals exposed directly or vicariously to life-threatening events. This response pattern is known as post-traumatic stress syndrome.
Stress reactions come from anecdotal evidence
It has been repeatedly observed that the normative post-disaster biopsychosocial reaction occurring in individuals and communities forms a relatively predictable pattern from the onset of the disaster through the following 18-36 months.
four relatively distinct phases of predictable pattern from the onset of the disaster
a. Heroic
b. Honeymoon
c. Disillusionment
d. Restabilization
Define Heroic
This phase is characterized by individuals and the community directing inordinate levels of energy into the activities of rescuing, helping, sheltering, emergency repair, and cleaning up. This increased physiological arousal and behavioral activity lasts from a few hours to a few days.
Define Honeymoon
Despite the recent losses incurred during the disaster, this phase is characterized by community and survivor optimism. Survivors begin to
believe that their home, community, and life as they knew will be restored quickly without complications.
Disillusionment
Fatigue, irritating experiences, and the knowledge of all that is required to restore their lives combine to produce disillusionment. Complaints about betrayal, abandonment, lack of justice, bureaucratic red tape, and incompetence are ubiquitous. Symptoms related to post-traumatic stress intensify and hope diminishes.
Restabilization
The groundwork laid during the previous months begins to produce observable changes. Applications have been approved, loans worked out, and reconstruction begins to take place.
Some individuals within this phase can regain equilibrium within 6 months. For others, it may take between 18 and 36 months. For some individuals, the first anniversary of the disaster precipitates or exacerbates post-traumatic stress symptoms.
Acute Stress Disorder
Symptoms include anxiety that occurs within one month of exposure to a traumatic stressor. Acute Stress disorder is characterized by five major response patterns: dissociation or a subjective sense of emotional numbing, a re-experiencing of the event, behavioral avoidance, increased physiologic arousal and social-occupational impairment; meeting the DSM-V diagnostic
criteria.
Post-Traumatic Stress Disorder
Is a prolonged post-traumatic stress response. There may be much greater personality and social impairment than evidenced in the common stress reactions survivors experience following a disaster; meeting the DSM-V criteria.
Disaster Experiences Associated with Chronic PTSD
Severe stress reactions during or immediately following a disaster occurrence are key warning signs.
The research literature suggests that certain types of trauma exposure or post
disaster experiences also place survivors at high risk for delayed or chronic trauma-related psychological problems.
Survivor guilt
Comes from trying to
understand why one lived when
others died, or why one’s losses
were less severe than another
people. Compare one’s good fortune with the misfortune of others, it’s characterized by an uncomfortable interplay between relief at one’s own relatively positive outcome and compassion for others who weren’t so lucky.
Performance Guilt
The belief that one could and should have done better - been better prepared, acted more bravely, rescued more people, and so on. They would often distort or exaggerate perceptions of their performance via a kind of magical
thinking or fantastic belief.
Shame
Involves judging the core self as weak, worthless, or powerless in the eyes of others, unable to take action or protect oneself or loved ones.
Herman (2007) describes shame as a relatively wordless state in which speech and thought are inhibited. The person feels small, ridiculous, and exposed. It engenders a desire to hide, escape, or lash out at the person in whose eyes one feels ashamed.
Resilience
Is seen as the ability to resist developing serious negative reactions in response to
traumatic experience.
Another major report (Norris et al., 2002), which combined results from numerous studies of disaster survivors, found that resilience was associated with the
following characteristics:
Membership in the majority culture
Previous experience of a less serious disaster
Professional training
Stable, calm personality
Perception of social support
Belief in own coping capacity
Posttraumatic growth
It is characterized by not maintaining or returning to their pre-trauma level of functioning but eventually experiencing an actual increase in functioning in one or more realms, researchers Tedeschi and Calhoun (1996)
After assessing survivors of diverse kinds of distressing events, they identify five realism of possible
growth:
Relating to to others
New possibilities
Personal strength
Spiritual change
Appreciation of life
Extreme Peritraumatic Stress Reactions
Those symptoms which occur during or immediately after the traumatic disaster experience. they are of sufficient intensity to cause significant impairment in reality orientation, communication, relationships, recreation and self-care, or work and education:
factors associated with disaster stress
Personal Injury
Injury or fatality of loved ones, friends, associates
Property loss/relocation
Pre-existing stress
Level of personal and professional preparedness
Stress reactions of significant others
Previous traumatization
Prior disaster experience
Perception/interpretation of causal factors
Level of social support
Stress Reactions/Disorders
Acute Stress Disorder
Post-Traumatic Stress Disorder
Chronic PTSD
Extreme Peritraumatic Stress Reactions
Disaster Experiences Associated with Chronic PTSD
Survivors/witnesses of mass destruction or death
Unresolved bereavement
Loss of Home or community
Survivors with prior history to trauma
Survivors who experience major life stressors
Survivors of Toxic contamination
Other Factors Associated with Chronic PTSD
Children whose parents are persistently psychologically impaired
Children whose parents experience significant peritraumatic stress
People at highest risk for extreme peritraumatic stress include those who experience:
Life-threatening
Extreme loss or destruction of their homes, normal lives and community
Intense emotional demands
Prior psychiatric or marital/family problems
Prior significant loss
Common stress reactions to disaster
Emotional Effects (Shock, Anger, Despair, Emotional Numbing, Guilt)
Physical Effects ( Fatigue, Insomnia, Sleep Disturbance, Hyperarousal, Somatic Complaints )
Cognitive Effects ( Impaired Concentration, Impaired decision-making ability, Confusion, Decreased Self-efficacy, Self-blame )
Interpersonal effects (Alienation, Social Withdrawal, Vocational impairment, school impairment, increased conflict within relationships )
