Lesson 2

Question 1

Define Stress Reactions

Answer 1

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.

Question 2

Stressors of Disaster Survivors

Answer 2

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.

Question 3

Implications for Understanding and Assessing Survivors’ Reactions

Answer 3

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

Question 4

Survivor’s unique background or experience in the following areas:

Answer 4

• 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

Question 5

Factors Associated with Disaster Stress

Answer 5

• 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

Question 6

Vicarious Traumatization

Answer 6

relationships with traumatized individuals can create much distress for others.

Question 7

The role delineation model (Taylor and Frazier, 1989)

Answer 7

• 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

Question 8

Post-traumatic Stress Reactions: A Common Response to Disaster

Answer 8

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.

Question 9

Stress reactions come from anecdotal evidence

Answer 9

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.

Question 10

four relatively distinct phases of predictable pattern from the onset of the disaster

Answer 10

a. Heroic
b. Honeymoon
c. Disillusionment
d. Restabilization

Question 11

Define Heroic

Answer 11

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.

Question 12

Define Honeymoon

Answer 12

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.

Question 13

Disillusionment

Answer 13

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.

Question 14

Restabilization

Answer 14

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.

Question 15

Acute Stress Disorder

Answer 15

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.

Question 16

Post-Traumatic Stress Disorder

Answer 16

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.

Question 17

Disaster Experiences Associated with Chronic PTSD

Answer 17

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.

Question 18

Survivor guilt

Answer 18

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.

Question 19

Performance Guilt

Answer 19

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.

Question 20

Shame

Answer 20

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.

Question 21

Resilience

Answer 21

Is seen as the ability to resist developing serious negative reactions in response to
traumatic experience.

Question 22

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:

Answer 22

 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

Question 23

Posttraumatic growth

Answer 23

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)

Question 24

After assessing survivors of diverse kinds of distressing events, they identify five realism of possible
growth:

Answer 24

 Relating to to others
 New possibilities
 Personal strength
 Spiritual change
 Appreciation of life

Question 25

Extreme Peritraumatic Stress Reactions

Answer 25

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:

Question 26

factors associated with disaster stress

Answer 26

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

Question 27

Stress Reactions/Disorders

Answer 27

Acute Stress Disorder
Post-Traumatic Stress Disorder
Chronic PTSD
Extreme Peritraumatic Stress Reactions

Question 28

Disaster Experiences Associated with Chronic PTSD

Answer 28

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

Question 29

Other Factors Associated with Chronic PTSD

Answer 29

Children whose parents are persistently psychologically impaired
Children whose parents experience significant peritraumatic stress

Question 30

People at highest risk for extreme peritraumatic stress include those who experience:

Answer 30

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

Question 31

Common stress reactions to disaster

Answer 31

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 )