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Psychosocial impact of disaster

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Title:
Psychosocial impact of disaster the Baldwin Hills fire
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Quick response research report ;
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22 p. : ; 28 cm.
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English
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Gordon, Norma S., 1926-
University of Colorado, Boulder -- Natural Hazards Research and Applications Information Center
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Disaster victims -- Mental health -- California -- Los Angeles   ( lcsh )
Wildfires -- Psychological aspects -- California -- Los Angeles   ( lcsh )
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non-fiction   ( marcgt )

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Includes bibliographical references (p. 20-22).
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Norma S. Gordon...et al..
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oclc - 281327899
usfldc doi - F57-00008
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NaturalHazardsResearchandApplicationsInformationCenterCampusBox482UniversityofColoradoBoulder,Colorado 80309-0482 PSYCHOSOCIALIMPACTOFDISASTER:THEBALDWINHILLSFIRENormaS.GordonCarlA.MaidaAlanSteinberg GailGordon1987QuickResponseResearch Report#08 "'41,.,. This publication is partofthe Hazards Research&Applications Information Center's ongomg Quick Response Research Report Series. htlp:/Jwww.colorado.edu/hazardsInstituteofBehavioralScience#6 (303) 492-6818

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-2-ThisstudywassupportedbyagrantfromtheNationalScienceFoundationandtheNaturalHazardsResearchCenter.TheauthorsgratefullyacknowledgetheassistanceofThePublicHealthFoundationofLosAngelesCounty,Inc.andtheseCityofLosAngelesleaderswhosecooperationmadethisstudypossible:TomBradley,Mayor,CityofLosAngelesPatRussell,PresidentoftheCityCouncil,CityofLosAngeles

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-3-1.THEEVENTOnJuly18,1985,theCityofLosAngeles was declaredaFederalDisasterAreaasaresultofthefiresinBaldwinHillsin which approximately50homes were totallydestroyed.AtthetimetheFederalEmergencyDeclaration was made,thethreatofmorewidespreaddamage was stillverygreat.ThepopulationofBaldwinHillsispredominantlymiddletoupperincomeBlackfamilies.Thetargetedsamplepopulationforthisstudyincludedthose whose homes were totallydestroyedandthose whose homes were leftintact with perhapssomefireorsmokedamage.AccordingtoFederalEmergencyManagementAgencyreports,147familiesregisteredforassistanceattheDisasterAssistanceCenter.TheCenterclosedafter twoweeks offieldoperations. Follow upinterviews were conducted with theRedCrossand with otheremergencyagenciespriortotheinceptionofthestudy.RedCrossspokespersonsprovidedthese 50homes were destroyed;2shelters were opened;38people were providedovernightshelter;200receivedassistanceonthefirstdayalone;1960individualvictimsreceivedmasscareduringa 2-week period;108familiesreceivedhelpfromtheRedCross,101of whomwere homeowners;975inquiriesforinformation were received;4receivedrentalassistance;49children were reportedattheRedCrossshelters.2.METHODOLOGYA.Instruments:ThemajorinstrumentusedinthisstudyistheDisasterSupplementtotheNationalInstituteofMentalHealthDiagnosticInterviewSchedule(DIS/DS).It was modifiedforuseinthisprojectto

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-4-specificallydocumentreactionsbyourrespondentstotheBaldwinHillsfire.ThisinstrumentincludesseveraldiagnosticsectionsoftheDiagnosticInterviewSchedule(Robins,Helyer,etaI,1981),includingpost-traumaticstressdisorder,dysthymicdisorder,sexualdysfunction,obsessive-compulsivedisorder,somatizationdisorder,andmajordepressivedisorder,aswellasquestionsrelatingtopreviouslifeevents,health,mentalhealthandsocialserviceutilization,coping,socialnetworks,andsocialsupportresources.Therearealsoavarietyofotherquestionsrelatingtoopinionsaboutthemediacoverageoftheevent,responsibilityfortheevent,andpersonalandcommunityharmcausedbytheevent.Aftereachinterview,theDIS/OSformwascheckedbytheinterviewerforcompleteness.Adetaileddescriptionoftherespondent'slocationatthetimeofthefire,whatwaswitnessed,andthelossessustainedwasrecordedforeachcase.Interviewstookplaceinavarietyofsettings.Forthosewhosehomesweredestroyed,theinterviewwasconductedattheirtemporaryresidences,includingthehomesoffriendsorrelatives,hotelsandrentedapartments.Inaddition,theImpactofEventScale(HorowitzetaI,1979;ZilbergetaI,1982),a15itemselfreportscaleformeasuringsubjectivestressduetoacatastrophicevent,wasalsocompletedbyeachrespondent.Forthoseitemsexperienced,ratingsaremadeforfrequency(rarely,sometimes,often).Thescaleyieldsatotalsubjectivestressscoreandtwosubscoresrelatingtointrusionandavoidance.

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-5-B.InterviewersandInterviewerTraining:Twointerviewers,bothBlackresearchassociatesatUCLA, whohadbeenfullytrainedbytheLosAngelesEpidemiologicCatchmentAreaProject(HoughKarnoetal,1983)andexperiencedintheadministrationoftheDISconductedallfieldinterviews.SpecialtrainingwasprovidedforadministeringtheDisasterSupplementtotheDIS.Thetrainingincludedmockinterviewsandpracticesessionstomaketheinterviewersfamiliarwiththisinstrument.C.RecruitmentofSubjects:AlistofvictimsoftheBaldwinHillsfirewascompiledfrompublicagenciesandnewspaperreports.Theinitialcontactwasmadebymaildescribingtheproject.MailtoindividualswhohadlosttheirhomesinthefirewasforwardedbythePostOffice.Theletterexplainedthepurposesofthestudy.Itincludedaformtobereturned,orphonenumbertobecalled,ifanindividualwishedtovolunteertoparticipate.Thosewhorespondedwerecontactedbyphonetoarrangeforaninterview.Beforeeachinterview,theinformedconsentformwasdiscussed,andconsentwasobtained.Allinterviewswereconductedbetweentwoandfourmonthsafterthefire.3.RESULTS A.SociodemographicCharacteristicsThestudypopulationconsistedof25individuals,mostofwhomrespondedtothemailing.Otherswerecontactedbyreferralbythoseinterviewed.AlloftherespondentswereBlackhomeowners,

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-6-witha meanageof57years. We interviewed14womenand11men. Theeducationallevelofthisgroupaveraged15.6yearswith48%havingcompleted17yearsofeducation;householdsaveraged2.7members;theemploymentstatusofthesampleconsistedofemployedpersons(56%),retirees(12%), homemakers (8%),part-timeemployedpersons(20%),andothers(4%). Thesamplerepresentsaresiden-tiallystablepopulationwitha meanlengthofresidenceof15years.B.PostTraumaticStressSymptomsTableIpresentsarankorderingofthefrequencyofpost-traumaticstresssymptomsforthesampleasmeasuredbytheDIS/DS.Thesesymptomswerereportedasoccurringwithinthefourmonthsfollowingthefire.TABLEI RankOrderingofPost-TraumaticStressSymptomsFortheTotalSample(N-25)SymptomsTroubleSleepingJumpiness,EasilyStartledAvoidanceofRemindersTroubleConcentratingNightmares,Dreams,RememberingRe-ExperiencingEventInterpersonalDistanceAshamedofBeingAliveC.DepressiveSymptomsPercent32241612 1284oTableIIpresentsarankorderingofdepressivesymptoms,asmeasuredbytheDIS/DS.Thesesymptomswerereportedashavingoccurredwithinthe4monthssincethefire.

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-7-TABLEIIRankOrderingofDepressiveSymptomsFortheTotalSample(N-25)SymptomsTroubleSleepingTroubleConcentratingLossofAppetiteFeelingTiredAlltheTimeFeelingRestlessThoughtsComing MoreSlowlyMovingAlltheTimeGainingWeightTalkingofMoving MoreSlowlyFeelingDepressedLossofWeightSleepingToo MuchLossofInterestinSexFeelingWorthless,Sinful,GuiltyThoughtsAboutDeathWantingtoDieThoughtsofSuicideAttemptedSuicideD.TheImpactofEventScalePercent40202020161612 121288 4o oooooTableIIIpresentsarankorderingofmeanscoresfortheImpactofEventScaleforthesubjects.TheinstrumentisscoredonaLikertScalewith"rarely"weightedI,and"often"weighted4.TABLEIIIRankOrderingofMeanScoresforImpactofEventScaleItems(N 25).ItemOtherthingskeptmakingmethinkaboutit.Ithoughtaboutitwhenrdidn'tmeanto.rhadwavesofstrongfeelingsaboutit.Picturesaboutitpoppedintomymind.Anyreminderbroughtbackfeelingsaboutit.Iavoidedlettingmyselfgetupsetevenwhenrthoughtaboutitorwasremindedofit.rtriedtoremoveitfrommemory.rhadtroublefallingasleeporstayingasleep.2.722.522.48 2.482.38 2.362.322.32

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-8-Itriednottothinkaboutit.Myfeelingsaboutitwerekindofnumb. I wasawarethatIstillhadalotoffeelingsaboutit,butdidn'tdealwiththem.Ifeltasifithadn'thappenedoritwasn'treal.Istayedawayfromremindersaboutit.Ihaddreamsaboutit.Itriednottotalkaboutit.2.242.201.961.871.76 1.72 1.68The meanscoreontheImpactofEventsScaleforthissamplewas33.04,witharangeof15-54.E.SelectedPsychosocialResponsesAdditionalfindingspertainingtoselecteditemsthatwereincludedfromtheDIS/DSwere:1)MediaCoverage:Inresponsetothequestion "What didyouthinkofthenewscoverageoftheevent?", 16% ofthesamplefeltthattherehadnotbeenenoughpublicityaboutthefireascomparedwith 76% whofelttherehadbeentherightamount.Fourpercentfelttherehadbeentoomuchcoverage.Inregardtohowthemediareportedtheevent, 52% feltthemediawassympathetictothevictimsand 48% hadnoopinionorweremixedintheirfeelings.2)Blame:Inregardtothequestionsaboutwhowastoblameforthefire, 76% ofthesampleattributedblametoalocaluniversitywhichownedtheadjacentlandwherethefirestarted.Inaddition, 56% feltthatthecitywasalsoresponsible.EightpercentfeltthattheFireDepartmentwas

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-9-toblameforthefire.Incontrast,only12%blamedthearsonistalone.3)EffectsoftheCommunity:Ninety-twopercentofthesamplefeltthattheircommunityhadsustainedagreatdealofharmand100%feltthatthecommunitywasnotbacktonormalupto4monthsafterthefirewhentheywereinterviewed.)FinancialHelp:Questionswereaskedabouthelpreceivedfrompublicandprivateagencies.Thirty-sixofthesamplefeltthatneedingfinancialhelporhelpwithclothingwasembarrassingtopeopleintheircommunity.Fifty-twopercenthadreceivedfinancialhelpfromprivateinsuranceand12%fromtheSmallBusinessAdministration.Sixty-fourhadreceivedsomefinancialcompensationfortheirlosses.Seventy-twopercentofthesamplingreportedreceivinghelpfromRedCross,16%receivedassistancefromotherpublicagencies.Intermsoffinancialcompensation,48%feltthatthevictimsofthefirewerenotreceivingasmuchfinancialcompensationastheydeserved,24%felttheywerereceivingtherightamount.Theremaining28%wereequivocal.Nooneexpressedtheviewthattoomuchfinancialassistancewasgiven.

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-10-5)Medication:Fortypercentofthesamplereportedtakingmedicationbecauseofbeingupsetbythefire.Noonereportedtheuseofalcoholforthispurpose.Forty-fourpercentsaidthattheysoughthelpfromadoctor,otherhealthprofessional,oracounselorbecauseofbeingupsetbythefire.Fifty-twopercentsoughthelpfromfamilyorfriends.6)PersonalandHouseholdHarmSixty-fourpercentratedtheirhouseholdashavingsustainedagreatdealofharmfromthefire.Sixtypercentfeltthattheirhouseholdhadnotrecoveredfromtheeffectsofthefire.Inregardtothequestionsofpersonalhealthproblemscausedbythefire,36%ofthesamplereportedexperiencingstressasaresultofthefire,12%sufferedafall,12%reportedfirerelatedphysicalinjuriesincludingburnsandsmokeinhalation,and8%reportedgainingweight.7)ComparisonofSubjectsbyExposuretotheEventTwogroupswereformedfromoursampleonthebasisofexposuretotheevent,i.e.,thosewhowereintheareawhenthefireoccurredandwhowitnessedthefire(40%),andthosewhowereoutofthearea(60%).Thesetwogroupsdonotdiffersignificantlyinsociodemographicmakeup. We comparedthesegroupsinrelationtothemeannumberofpost-traumaticsymptomsreported.TableIVpresentstheresultsofthiscomparison.

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-11-TABLEIV Mean NumberofPost-TraumaticStressSymptomsbyExposuretoEvent(N24)GroupInAreaNotinArea(N9) (N-15)2.60.22.40.7(t-3.55,df-22,p<.Ol)Thoseindividualswhowitnessedthefirereportedsignificantlymorepost-traumaticstresssymptomsthanthosewhodidnot.Asimilarcomparisonofthesegroupsregardingmeannumberofdepressivesymptomsdidnotrevealanystatisticallysignificantdifferences.Thus,exposurewasfoundtobestronglyrelatedtopost-traumaticstresssymptomsandnottodepressivesymptoms.TableV showsthepercentagesofthesamplereportingspecificposttraumaticstresssymptomsaccordingtotheirexposuretotheevent,i.e.,individualsintheareaandthosenotpresentintheareaduringthefire.TABLEVPostTraumaticStressSymptomsRelatedtoPresenceinArea(N 24)TroubleSleepingJumpiness,EasilyStartledAvoidanceofRemindersNightmares,Dreams,RememberingRe-ExperiencingEventTroubleConcentratingDistantAshamedofBeingAliveInArea(9)66.755.644.433.325.022.211.00.0NotInArea(15)6.7 6.70.00.00.06.70.00.0

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-128.ComparisonofSubjectsbyExtentofLossofResidence We alsodividedthesampleonthebasisofextentoflossofresidence.Thefirstgroupwascomprisedof12individualswhosehomesweretotallydestroyedbythefire,thesecondgroupdidnothavetotallossoftheirhome,butratherhadroofdamageorsmokedamage.TableVIindicatesthattherewas asignificantdifferencebetweenthesegroupsinrelationtomeannumberofdepressivesymptoms.TABLEVI Mean NumberofDepressiveSymptomsbyLossGroupTotalLossDamage(N-12)(N-13)2.90.83.11.8(t-2.09,df-23,p<.05)Thosewhosehomesweredestroyedreportedasignificantlygreaternumberofdepressivesymptomsthanthecomparisongroup.Therewerenosignificantdifferencesbetweenthesegroupsinrelationtopost-traumaticstresssymptoms.Thus,losswasstronglyrelatedtodepressivesymptoms,butnottopost-traumaticstresssymptoms.TableVIIIdisplaystheproportionsofdepressivesymptomsreportedbythosewhosehomesweredestroyedcomparedtothegroupwhosustainedonlypropertydamage.

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-13-TABLEVIIFrequencyofDepressiveSymptomsbyExtentofLossDepressiveSymptomsTroubleSleepingFeelingTiredalltheTimeLossofAppetite Weight GainTalkingorMoving MoreSlowlyMovingalltheTimeFeelingRestlessTroubleConcentratingThoughtComing MoreSlowlyFeelingDepressedLossof Weight SleepingToo MuchLossofInterestinSexFeeling Worthless, Sinful,GuiltyThoughtsAboutDeath Wanting toDieThoughtsAboutSuicideAttemptedSuicide4.DISCUSSION58.333.333.325.0 25.025.025.025.016.68.3 8.3 8.30.00.0 0.0 0.00.00.023.17.77.T0.0 0.0 0.07.715.415.47.7 7.70.10.0 0.00.00.0 0.00.0Thisstudypresentsself-reportedpsychologicalsymptomsandotherresponsestoafirethatcausedwidespreadpropertydamage.Consistentwithpriorstudiesofnaturaldisasters,oursamplereportedanarrayofemotional,psychosomaticandphysicalhealthproblems.Thiswastrueofthesampleasawhole,whichincludedindividualswholosttheirhomesandthosewhosehomeswerethreatened.Psychosomaticandphysicalhealthproblemsarereportedaftermanydisasters.Sleepdisturbancesareacommonpsychosomaticreaction(Price,1978;FlynnandChalmers,1980;Bolin,1982).Thedatafromthisstudysupportsthesefindings.Thepredominantsymptom,reported

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-14-bythesampleasawhole,wastroublesleeping.Relatedsleepdisorders,includingnightmaresanddreamsaboutthefire,werealsoreportedbythetotalsample.Inmakingthecomparisonbetweenthosewholosttheirhomeandthosewhosehomeswerenotdestroyed,thisremainedthepredominantsymptom.Thisheldtrueaswellwhenacomparisonwasmadebetweenthosewhowitnessedthefireandthosewhowerenotinthearea.Thesefindingsonthisolderpopulationareconsistentwithoneoftheauthor's(NG)studyofchildrenafterthe1971SylmarearthquakeinSouthernCalifornia(Howard&Gordon,1972)andwithareportbyPynoosetal(1985)ofchildrenafterasniperattackattheirschool.Awiderangeofemotionalreactionstodisasterhavebeendiscussedintheliterature(Richard,1974;Milne,1977;Bolin,1982).Inthissample,atleast20%ofthepopulationreportedsleepdisturbances,jumpiness,troubleconcentrating,lossofappetite,andgenerallethargy.TherewerealsospecificemotionalreactionsthatthesubjectsreportedinresponsetotheImpactofEventScale.Approximatelyone-thirdreportedhavingexperiencedintrusivethoughts,feelingsandimageryregardingtheevent.Severalotheritemswereendorsedbyapproximately25percentofthesample,includingthoseconcernedwithsuppressionofthoughtsandsleepdisturbances. We areparticularlyinterestedintheeffectoflossonsubjects'reportsofpsychologicalfunctioning.Ithasalsobeenindicatedintheliteraturethatlossofhomeissignificantlyassociatedwithincreasedanxietyanddepression.Alloftheliteraturedealingwithresidentiallossanditsmentalhealthconsequences,however,isfound

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-15-inthefieldofforcedrelocationandurbanrenewal(Fried,1963;GIeseretal,1981).Thisstudyisuniqueinthatitcomparesresidentsofthesamecommunity,socio-demographicallymatched,onlossandnon-lossofhome. We foundasignificantdifferencebetweenthesetwogroupsinrelationtothemeannumberofdepressivesymptomsreportedontheDIS/OS.Therewerenosignificantdifferences,however,betweenthesetwogroupsinrelationtopost-traumaticstressreactions.Additionally,therewasatendencyforthosewhosehomesweredestroyedbythefiretoreportagreaternumberofadversehealtheffects,tousemedications,andtoseekhelpfromdoctorsormentalhealthprofessionalstoagreater extent thanthosewhosehomessustainedonlylimiteddamage. We alsoanalyzedourdataaccordingtothepresenceofsubjectsintheareawhenthefireoccurred.TheThreeMileIslandStudyalsodocumenteddifferentlevelsofstressdependingondegreeofexposure.Ourstudyshowsasignificantdifferencebetweenthetwogroupsinrelationtothemeannumberofpost-traumaticstresssymptomsreportedontheDIS/OS.Theexposedgroupreportedtroublesleeping(67%),jumpiness(56%),avoidanceofreminders(44%),andnightmares,dreamsandremembering(33%).Therewerenosignificantdifferences,however,betweenthesetwogroupsregardingthemeannumberofreporteddepressivesymptoms.Additionally,sixty-sevenpercentofthoseintheareaduringthefiresoughthelpfromaphysicianormentalhealthprofessionalinthemonthsfollowingtheevent,ascomparedwiththirty-sixpercentofthosenotpresent.Fifty-sixpercentofthoseexposedusedmedicationaftertheevent,ascomparedwithtwenty-ninepercentofthosewhodidnotwitnessthefire.Sixty-sevenpercentof

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-16-thoseintheareasoughthelpfromfriendsandrelativesascomparedwithforty-threepercentofthosenotinthearea.CASEHISTORIES Onecouplewholosttheirhomealsosufferedinjurywiththewifebeingburnedover 60% ofherbody.Atthetimeoftheinterview,aboutfourmonthsafterthefire,theyhadnotreturnedtothesight,andeventuallydecidedtomoveintoanothercommunity.Ininterviewingthewifeofayoungcouple,itwasreportedthatthehusband,whohadbeenathomeduringthefire,experiencedamoreseverestressreactionthanhiswifewhohadbeenatworkthatday.Shenoticedthehelplessnessshefeltatbeingunabletodomoretopreventthedevastationcausedbythefire.Asimilarreactionwasdescribedbya women whoalsohadbeenpresentduringthefire.Shearrivedwhilethefirewasinprogresstoseethehomeononesideofhersexplode(afteragas main wasignited)sendingburningdebrisoverthehousetotheoneontheotherside,settingitonfire.Shewatchedherneighborhoodburndownaroundherwhileshecoulddonothing.Exposuretotheaftermathoftencompoundedthestressreactionsofthevictims.Thebodiesoftwodeceasedneighborsandsomepetswereinthestreetnearonewomen'shome.Onlycharredlotswithchimneysleftstandingwereallthatcouldbeseenwhenlookingupthehill.One woman wasselfconsciousabouttheniceclothesshewaswearingonthedayafterthefirewhileherneighborshadonlytheclothesontheirbacks.Thefeelingwasso

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-17-strongthatshechangedintosomethingmorelike what theothers were wearing.Becauseofthedegreeofdestructiononherblock,ten weeks passedbeforestreetlighting was restored.This womanwas confronteddaily with thisandotherreminders,andbecauseofthis,decidedtomoveoutoftheneighborhood.Herhomehadbeenherdreamhouse,thehomeshehad worked towardsearningformanyyears.Afteronlyoneyearthere,theexperience was toomuchforherandshe was leaving.Theblock where this woman lived was oneofthe worst struck.Oneoftheinterviewers(GG)reportedastartledreactionuponseeingitforthefirsttime.Shedescribeddrivingthrougharesidentialarea,thenarrivingatapoint where allthatcouldbeseen were blackenedbrickchimneysagainstthenightsky.It was likeenteringa war zone.Thatsightleadtoasleeplessnight.Incontrasttothesituation where helplessnessgeneratedstressanddepression, whosewhowere athomewateringdowntheirroof,workingtoextinguishsmallfiresontheirpropertiesandthoseofimmediateneighbors,reportedfeelinggoodabout what theyhaddone.Exercisingsomemeansofcontrolandcontributinginahelpfulmannerproducessomepositivefeelings.Asnotedinthebodyofthisreport,depressionsymptoms werewide-spread andcorrelated with theextentofloss.Otherimportantfactorsmediatingtheresponseincluded:supportsystemsanddegreeofabilitytoreplacelosses.Threesingle womenwere affectedindifferent ways fordifferent

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-18-reasons,butwithsimilareffects.Onedidnotloseherhome;however,herswasthelonehouseonthestreetatthetimeofthefirethatwasnotdestroyedbutsheexperiencedseverestressaboutnotknowingduetonotbeingabletogettoherhouseforseveralhours.Thestreetswereclosedtoincomingtraffic,forcingresidentstowaitforhoursbeforeknowingthestatusoftheirhomesand/orlovedones.Onewomanreportedthatthestresswassogreatthatshefeltshemighthaveaheartattackunlessshegotsomeinformation.Afterthefirewasout,afiremancheckedforherandreportedthatherhomewas,infact,destroyed.Shewasnotsatisfiedanddemandedtoseeforherself.Becauseherhusbandhadbeenanofficialinthefiredepartment,shewasflownbyhelicopteroverthesite.Althoughthehousewasrazed,shereportedfeelingbetterknowingforsure.Anotherwoman whose homewasdestroyedhadlostherhusbandearlierthatyear.Shewasextremelydistraughtoverthelossofsentimentalremindersofhimandthelifetheyhadsharedtogether.Thewomanalsofelttheburdenofhavingtoreplaceimportantdocumentsrelatedtothefamilybusinessandotherassetswhichshewasonlyjustassumingresponsibilityforandbecomingfamiliarwith.Anothermanwhowasadamantaboutgettingtohishomewasturnedawaybythepoliceatgunpoint.Stilldeterminedtoseehishouse,hesnuckbackintotheareathroughbackalleys.Havingagoodsocialsupportsystemandfinancialassetsmadethelossmuchmoremanageableasdemonstratedbyacouplewhohadmaximumfireinsurancecoverageandeachother.Althoughdisturbedbytheloss,theyseemedtobeokay,andsawthisasanopportunitytobuildtheirdreamhouse.Theanalysisofourdatasuggeststhatexposuretotheevent,inthisinstance,operationalizedaspresenceintheareaatthetimeofthefire,

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-19-hasadistinctpsychologicaleffect,namelypost-traumaticstresssymptoms.Witnessingatraumaticeventresultsinpersistent,invasivethoughts.Thelonger-termeffectsofthistrendwouldrequirefurtherfollow-upofthesubjects.Thelossofresidenceandpossessions,ontheotherhand,appearstoresultindepressivereactionsandsymptomology.Atthetimeoftheinvestigation,allofthesubjectswhohadlosttheirhomeswereresidingintemporaryhousingandwereverymuchinvolvedinpreparingforthereconstructionphase.Theageofthesamplepopulationisclearlyafactorinrelationtoourfindingswithregardtoresidentialloss.Havingresidedinthesamecommunityfora meanlengthof15years,theprospectofrebuildingpresentsmanyproblemstothisgroupdueto,amongotherconsequences,theeffectsofinflationonreplacementcosts.

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-20-REFERENCESBolin,R.,"Long TermFamilyRecoveryFromDisaster,"BoulderInstituteofBehavioralScience,UniversityofColorado,1982Bromet,E.;Dunn,L.,"MentalHealthofMothersNineMonthsAfterThreeMileIslandAccident,"UrbanandSocialChangesReview,1981;14:(2),12-15Flynn,C.andChalmers,J.A.,"TheSocialandEconomicEffectsoftheAccidentatThreeMileIsland:FindingstoDate,"Washington,D.C.,OfficeofNuclearRegulatoryResearch,U.S.NuclearRegulatoryCommission,1980Fried,M.,"GrievingforaLostHome,"In:Duhl,L.J.,ed."TheUrbanCondition:PeopleandPolicyintheMetropolis,"NewYork:BasicBooks,1963,151-171Glesser,G.C.;Green,B.L.&Winget,C.,"ProlongedPsychologicalEffectsofDisaster:AStudyofBuffaloCreek,"NewYork,AcademicPress,1981Horowitz,M.;Wilner,D.&Alverly, W., "ImpactofEventScale:AMeasureofSubjectiveStress,"PsychosomaticMedicine,41:3,209-218,1979 Hough,R.;Karno,M.; Burnham,A.;Escobar,J.&Timbers,D.M.,"TheLosAngelesEpidemiologicCatchmentAreaResearchProgramandtheEpidemiologyofPsychiatricDisordersAmongMexican-Americans,"JournalofOperationalPsychology,1983;14:42-51

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-21-Howard,S.J.&Gordon,N.S.,"FinalProgressReport:mentalHealthInterventioninaMajorDisaster,"Van Nuys,CA,SmallResearchGrantMH21649-01,SanFernandoValleyChildGuidanceClinic,1972Kilijanek,T.S.&Drabek,T.E.,"AssessingLong-TermImpactsofaNaturalDisaster:AFocusontheElderly",TheGerontologist10:6,555-556,1979Milne,G.,"CycloneTracy:SomeConsequencesoftheEvacuationofAdultVictims,"AustralianPsychologist12:1,39-54,1977Pynoos,R.S.;Frederick,C.;Nadar;Arroyo,K.;Eth,S.;Steinberg,A.M.;Fairbanks,L.,"LifeThreatandPostTraumaticStressinSchoolAgeChildren,"PresentedattheAmericanPsychiatricAssociationAnnualMeeting,Dallas,1985Price,J.,"SomeAge-RelatedEffectsofthe1974BrisbaneFloods,"AustralianandNewZealandJournalofPsychiatry12:1,55-58,1978Richard, W,C" "CrisisInterventionServicesFollowingNaturalDisaster:ThePennsylvaniaRecoveryProject,"JournalofCommunityPsychology2:3,211-218,1974Robins,L.N.;Helger,J.E.;Croughan,J.;Ratcliff,K.S.,"NationalInstituteofMentalHealthDiagnosticValidityandGeneralPsychiatry,"1981,38:381-389.

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-22Zilberg,N.J.;Weiss,D.S.&Horowitz,M.J.,"ImpactofEventScale:ACross-ValidationStudyandSomeEmpiricalEvidenceSupportingaConceptualModelofStressResponseSyndromes,"JournalofConsultingandClinicalPsychology,50:3,407-414,1982


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