Fran H. Norris

60,000 Disaster Victims Speak: Part I. An Empirical Review of the Empirical Literature, 1981—2001

Abstract Results for 160 samples of disaster victims were coded as to sample type, disaster type, disaster location, outcomes and risk factors observed, and overall severity of impairment. In order of frequency, outcomes included specific psychological problems, nonspecific distress, health problems, chronic problems in living, resource loss, and problems specific to youth. Regression analyses showed that samples were more likely to be impaired if they were composed of youth rather than adults, were from developing rather than developed countries, or experienced mass violence (e.g., terrorism, shooting sprees) rather than natural or technological disasters. Most samples of rescue and recovery workers showed remarkable resilience. Within adult samples, more severe exposure, female gender, middle age, ethnic minority status, secondary stressors, prior psychiatric problems, and weak or deteriorating psychosocial resources most consistently increased the likelihood of adverse outcomes. Among youth, family factors were primary. Implications of the research for clinical practice and community intervention are discussed in a companion article (Norris, Friedman, and Watson, this volume).

60,000 Disaster Victims Speak: Part II. Summary and Implications of the Disaster Mental Health Research

Abstract On the basis of the literature reviewed in Part I of this two-part series (Norris, Friedman, Watson, Byrne, Diaz, and Kaniasty, this volume), the authors recommend early intervention following disasters, especially when the disaster is associated with extreme and widespread damage to property, ongoing financial problems for the stricken community, violence that resulted from human intent, and a high prevalence of trauma in the form of injuries, threat to life, and loss of life. Meeting the mental health needs of children, women, and survivors in developing countries is particularly critical. The family context is central to understanding and meeting those needs. Because of the complexity of disasters and responses to them, interagency cooperation and coordination are extremely important elements of the mental health response. Altogether, the research demands that we think ecologically and design and test societal- and community-level interventions for the population at large and conserve scarce clinical resources for those most in need.

Received and perceived social support in times of stress: a test of the social support deterioration deterrence model.

The authors evaluated the impact of receiving social support on subsequent levels of perceived social support and psychological distress in 2 independent samples of victims of severe natural disasters: Hurricane Hugo (n = 498) and Hurricane Andrew (n = 404). A social support deterioration deterrence model was proposed that stipulated that postdisaster mobilization of received support counteracts the deterioration in expectations of support often experienced by victims of major life events. LISREL analyses of data collected 12 and 24 months after Hugo and 6 and 28 months after Andrew provided strong evidence for the hypothesized model: Perceived support mediated the long-term effects on distress of both scope of disaster exposure and postdisaster received support. Theoretical and application issues of social support are discussed.

In search of altruistic community: Patterns of social support mobilization following Hurricane Hugo.

Twelve months after Hurricane Hugo, 1,000 disaster victims and nonvictims were asked about social support they exchanged following the hurricane. Victims of disaster received and provided very high levels of tangible, informationa, and emotional support. Disaster exposure (loss and harm) was a strong predictor of help received and a modest predictor of help provided. However, postdisaster help was not distributed equally and disaster exposure was more strongly related to social support in some groups than in others. Race, education, and age most consistently moderated the impact of disaster exposure on receipt of postdisaster support. Blacks and less educated victims received less help than similarly affected victims who were white or more educated. Relative disadvantage of being old in receiving support was not the case for those elderly disaster victims who experienced threats to their lives or health. Some subgroups of victims were relied upon disproportionately for providing assistance. Implications for social support research are addressed.

Stability and change in stress, resources, and psychological distress following natural disaster: Findings from hurricane Andrew

Abstract The stress, resource, and symptom levels of 241 residents of southern Dade County, Florida were assessed 6 and 30 months after Hurricane Andrew. Percentages meeting study criteria for depression and PTSD did not change over time. Whereas mean levels of intrusion and arousal decreased, depressive symptoms remained stable, and avoidance/numbing symptoms actually increased. Intrusion and arousal were associated more strongly with pre-disaster factors (gender, ethnicity) and within-disaster factors (injury, property loss) than with post-disaster factors (stress, resources), but the reverse was true for depression and avoidance. Changes over time in symptoms were largely explained by changes over time in stress and resources. The findings indicate that ongoing services are needed to supplement the crisis-oriented assistance typically offered to disaster victims.

Psychological distress following criminal victimization in the general population: cross-sectional, longitudinal, and prospective analyses.

Samples of 105 violent crime victims, 227 property crime victims, and 190 nonvictims provided normative data regarding levels of psychological distress following criminal victimization. At points approximately 3 months, 9 months, and 15 months postcrime, symptoms of depression, somatization, hostility, anxiety, phobic anxiety, fear of crime, and avoidance were assessed. Although crime victims showed substantial improvement between 3 and 9 months, thereafter they did not. Over the course of the study, violent crime victims remained more distressed than did property crime victims who, in turn, remained more distressed than nonvictims. Regression analyses revealed that the effects of crime could not be accounted for by precrime differences between victims and nonvictims in either social status or psychological functioning. However, lasting effects were often contingent on the occurrence of subsequent crimes.

Help-Seeking Comfort and Receiving Social Support: The Role of Ethnicity and Context of Need

Examined help-seeking comfort and receiving social support among Latinos, African Americans, and European Americans across two contexts: in a communitywide emergency (Hurricane Andrew) and 2 years later in a nonemergency situation. In general, help-seeking comfort was a strong predictor of received support. Notwithstanding many similarities between the groups, the effects of ethnicity differed according to the context. In emergency, all groups reported similarly high levels of help-seeking comfort and received support. In nonemergency, help-seeking comfort declined for blacks and whites but not for Latinos. Although all ethnic groups reported receiving less social support in nonemergency, the decline in received support across contexts was most dramatic for Latinos. Situational, cultural, and differential resource loss explanations are offered to account for the findings.

Sex Differences in Symptoms of Posttraumatic Stress: Does Culture Play a Role?

If gender differences in posttraumatic stress disorder follow from culturally-defined roles and rules, they should be greater in societies that foster traditional views of masculinity and femininity than in societies that adhere to these traditions less rigidly. Data were collected 6 months after Hurricanes Paulina (Acapulco; N = 200) and Andrew (Miami; White n = 135; Black n = 135). In regression analyses predicting scores on the Revised Civilian Mississippi Scale, Sex × Cultural Group interactions emerged for the total scale and for subscales of Intrusion, Avoidance, and Remorse. Only a sex main effect (women higher) emerged for Arousal. Overall, the results indicated that Mexican culture amplified, whereas African American culture attenuated, differences in the posttraumatic stress of male and female disaster victims.

Social support and victims of crime: Matching event, support, and outcome

Investigated the buffering properties of six types of social support (three perceived, three received) with regard to four psychological consequences (depression, anxiety, fear of crime, hostility) of criminal victimization (violent crime, property crime). These relationships were examined using longitudinal data collected from a sample composed of representative subsamples of victims and nonvictims. Effects of the perceived support measures (perceived appraisal support, perceived tangible support, self-esteem) were more pervasive than those of the received support measures (received informational support, received tangible support, received emotional support). Perceived support consistently exhibited buffering effects, protecting both violent and property crime victims against various symptoms they would have otherwise experienced. The stress-buffering capabilities of received support were limited to informational and tangible help protecting victims of violence from experiencing excessive fear. These findings are discussed in the context of recent theoretical developments concerning the stress-support matching hypothesis.

Social support, life events, and stress as modifiers of adjustment to bereavement by older adults.

As part of a larger panel study, interviews were obtained from 3 samples of older adults: 45 persons who had recently lost a spouse, 40 who had lost a parent or child, and 45 who were not bereaved. Assessments were conducted before and after the deaths. In the widowed sample, health remained quite stable, but depression increased sharply, then remained elevated. Changes were minimal in the sample who had lost a parent or child and in the nonbereaved sample. Multiple regression procedures were used to identify factors that contribute to depression and health 9 months after the spouses death. Postbereavement depression was associated with higher prebereavement depression, higher financial pressures, higher global stress, fewer new interests, and lower social support. Health was a function of prebereavement health, new interests, financial pressures, and global stress. In general, life events and resources had stronger effects in the widowed sample than in the comparison samples.