USF Libraries
USF Digital Collections

Aftermath of a disaster

MISSING IMAGE

Material Information

Title:
Aftermath of a disaster psychological response to the Russelville sic Arkansas mass murder
Series Title:
Quick response research report ;
Physical Description:
13, 6 p. : ; 28 cm.
Language:
English
Creator:
Smith, Elizabeth Mary
North, Carol S
University of Colorado, Boulder -- Natural Hazards Research and Applications Information Center
Publisher:
Natural Hazards Research and Applications Information Center, University of Colorado
Place of Publication:
Boulder, Colo
Publication Date:

Subjects

Subjects / Keywords:
Mass murder -- Psychological aspects -- Arkansas -- Russellville   ( lcsh )
Genre:
government publication (state, provincial, terriorial, dependent)   ( marcgt )
non-fiction   ( marcgt )

Notes

Statement of Responsibility:
Elizabeth Smith, Carol North.
General Note:
"Final field report -- Russellville, Arkansas"--P. 1.

Record Information

Source Institution:
University of South Florida Library
Holding Location:
University of South Florida
Rights Management:
All applicable rights reserved by the source institution and holding location.
Resource Identifier:
aleph - 001985334
oclc - 298994055
usfldc doi - F57-00018
usfldc handle - f57.18
System ID:
SFS0001099:00001


This item is only available as the following downloads:


Full Text
xml version 1.0 encoding UTF-8 standalone no
record xmlns http:www.loc.govMARC21slim xmlns:xsi http:www.w3.org2001XMLSchema-instance xsi:schemaLocation http:www.loc.govstandardsmarcxmlschemaMARC21slim.xsd
leader nam 2200313Ia 4500
controlfield tag 001 001985334
005 20090121175043.0
006 m d s
007 cr bn|||||||||
008 090121s1988 cou s000 0 eng d
datafield ind1 8 ind2 024
subfield code a F57-00018
035
(OCoLC)298994055
040
FHM
c FHM
043
n-us-ar
1 100
Smith, Elizabeth Mary.
0 245
Aftermath of a disaster
h [electronic resource] :
b psychological response to the Russelville [sic] Arkansas mass murder /
Elizabeth Smith, Carol North.
260
Boulder, Colo. :
Natural Hazards Research and Applications Information Center, University of Colorado,
1988.
300
13, [6] p. ;
28 cm.
440
Quick response research report ;
v #24
500
"Final field report -- Russellville, Arkansas"--P. [1].
533
Electronic reproduction.
[Tampa, Fla. :
University of South Florida Libraries,
d 2008].
n Digitized from copy owned by Natural Hazards Center, University of Colorado at Boulder, in a joint project with the Louis de la Parte Florida Mental Health Institute (FMHI) Research Library's disaster mental health initiative.
650
Mass murder
z Arkansas
Russellville
x Psychological aspects.
700
North, Carol S.
2 710
University of Colorado, Boulder.
Natural Hazards Research and Applications Information Center.
776
Original
w (OCoLC)39119351
773
t Natural Hazards Center Collection
049
FHMM
090
HV6534.R87 (ONLINE)
994
C0
FHM
4 856
u http://digital.lib.usf.edu/?f57.18



PAGE 1

HAZARDHOUSECOPY MA\\.O-t+0Ao...LIts-.st"A C S

PAGE 2

NaturalHazardsResearchandApplicationsInformationCenterCampusBox482UniversityofColoradoBoulder,Colorado 80309-0482 AFTERMATHOFADISASTER:PSYCHOLOGICALRESPONSETOTHERUSSELVILLEARKANSASMASSMURDERElizabethSmithCarolNorth1988QuickResponseResearch Report#24This pUblication is partofthe Natural Hazards Research & Applications Information Center's ongoing QUick Response Research Report Series. http://www.colorado.edu/hazardsInstituteofBehavioralScience#6 (303)492

PAGE 3

FINALFIELDREPORT--RUSSELLVILLE,ARKANSASOverthe Christmas holiday of 1987, a47year oldmanmurdered fourteenmembersof his family in his ruralhomejustoutside of Dover, Arkansas (pop.circa7,000).Heburiedmostof the bodies in shallow gravesonhis property.Hisactions notyetdiscovered, afewdayslater,onDecember28,heappeared in thequietlittlenearbytownofRussellville,Arkansas (pop.circa15,000). There, thegunmanwentona shooting spreethatlasted35minutes, ashemethodicallyvisitedfour local businessesandshotindividualshewassaid to hold a grudge against (along with otherswhohappenedtobeinhisway). Before giving himselfuptoauthorities,hesucceeded infatallywoundingtwopeopleandleaving four other injured victims in hiswake.Mediaaccounts heldthisevent tobeoneof the biggestmassmurders inmodernAmericanhistory.Thegunmanwasamansaid tobeaheavydrinkerandwife abuser.Itwasalsodiscoveredthathehada long, unstable jobhistory;hehadalso previouslyfledfromanotherstateto escape chargesrelatingtosexual abuse ofhisownyoungdaughter.Hewasamanwhowassaid tobeincreasinglyunhappypriortothe shootings;hehadquithis job afewdays before,disgruntledbywagesandworkhours,andhehadthen unsuccessfully attemptedtoobtainunemploymentbenefits.Co-workers saidthathewasaquietmanwhodidn'tget along well with othersandisolatedhimself, but theyhadnoideathathewascapable ofsuchcarnage. When thegunmanappearedatthe various businessesandbeganshooting, eyewitnesseswereinitiallysosurprisedthatthey could notevenbelieveitwasreal.InthequiettownofRussellvillein a countythatprohibitsthe use of alcohol, eventssuchasthisarepracticallyananachronism.Manywitnessesstatedthattheyinitiallybelieveditwasa joke,andnotuntil

PAGE 4

2theysawtheIlbloodpumpingoutllandpeoplefallingdowndeaddid therealityof thesituationhitthem.Thegunmanskippedfromonebusiness to the next, shooting thoseonhislist,driving to the next locationandtaking care of businessthere.Betweeneach locationhechangedhats.Onewomanhekilledwasawomanhehadworkedwithatoneof the businesses,andshehadresistedsexual advanceshehadmadetoward her, then complained to her boss; thegunmanalso shotandseriouslywoundedthebosswhonowworkedatadifferentlocation.Russellville,Arkansaswasnot prepared for adisasterofthismagnitude. All three of thecitylspolice vehicleswerecalled to the scene of the shootings.Eachtime policeheadedtowardthe source ofanemergencycallreporting agunmanandwoundedindividuals,newcallsin other locations keptcomingin before theofficerscouldevenarriveatlocations of othercalls,andthe policefoundthemselves in a chasearoundtown.Itwasnotuntil the gunmanhadfinished shooting everyoneonhislist(andtwoother individualswhowerein thewrongplaceatthewrongtime)thathewasapprehended,whenhelaiddownhisgunsandaskedemployeesof thelastbusiness tocallauthorities.Thetownwasleftin shock. Individuals reported continuedfearandjumpinessevenafterthegunmanwaslockedawayin another county.Initiallythereseemednorhymeor reason for the violence oritspattern.Authoritiesmovedto piece together information to help explain the event.Mediapersonnelfromacross the nation convergedonRussellville,splashingstoriesandreports acrosstelevisionscreensandfront pages of newspapers across the country. Witnesses interviewedbythemediawereoften angeredwhentheylaterread orsawwhatthey believed tobeabsolute misinformation.Manycomplainedofovert sensationalism.Initiallyanxious to speak with themedia

PAGE 5

3andsharetheirstories,witnesses quickly developeddistrustandresentment ofanyoneremotely resembling media,andrefusedfurthercomment.Itwasintothisatmospherethatwemovedto begin the task of our research.METHODSWefirstlearned of themassmurders throughmediareports.Aphonecalltoa localreporterafewdaysafterthe event yielded informationthattherewereperhapstwodozenwitnesses,andthatthe townspeoplewereafriendlybunchwhohadbeenvery cooperative in sharingtheirinformation withhim.Hestatedthatpeoplewereeasy to reach vialistingsin the local telephonedirectoryandviatheirworkplaces,andheurgedustocomethereassoonaspossibleandstartphoning witnesses, offering hisassistanceifweneeded.Theversion of the Diagnostic Interview Schedule/Disaster Supplement(DIS/OS)used in studying the Indianapolis-RamadaInnjetcrashdisasterwas modifiedslightlytomakeitpertainspecificallyto theRussellvillesituation.EveryeffortwasmadetohavequestionsontheRussellvilleinterviewparallelthoseonthe Indianapolis interview, in order to allowprecisecomparison during dataanalysis.UponarrivinginRussellville,the researchteambeganbyvisitingeach ofthefour businesses involved in the shootings, speaking to the business ownerstoexplain the studyandinvitethemtoparticipate.Twoof the four owners refusedtoparticipateor to permitusto speaktoanyoftheiremployees or giveusnamesofanyclients.or customerswhowerepresent.Thuswithoutthis'initialcontacttherewasnowayofknowingexactlyhowmanyindividualswereinvolved there or.who they were. Subjectswereoften very .waryinitially,appearingdistrustfulandvigilantuntiltheywereassured ofwhowewereandwhatour purposewas.Atfirstweweremistakenforreportersorwrongdoers posing as researchers.Oncewehadgainedtheirtrust,owners

PAGE 6

4of the othertwobusinessesgaveusawarmreceptionandpermittedusto approachtheiremployeestoinvitethemtoparticipatein the study. Individualswhowerenot available for interviewatworkwerelocatedeitherthroughnewspaperreports orbytheirfellow co-workers.SampleWithin the universe ofallemployeesatthetwoparticipatingbusinesses,15individualshadbeenpresentatthe shootings.Elevenof the15agreed toparticipate.Aswasdonein the Indianapols-RamadaInnjetcrash study,itwaselected to also interviewemployeeswhowereabsentfromthe scene of thedisasterwhenithappened, to provide a comparison group.Often individuals inthis"off-site" group, seven agreed toparticipate.Overall,18individuals out of the possible25participatedin the study, givinganoverall refusalrateof28%(27%of eyewitnessesand30%of those notpresent).Mostpersons interviewed said they agreed toparticipatebecause theywantedtobeof help in a researcheffortwhichthey thought mightbenefitotherswhowouldgothrough a similardisasterin thefuture.Other individuals said theyfeltthattheyneededtotalkabouttheirexperience orthattheysawitwasanopportunity to obtain help personally.Amongthe "on-site" individualsandbusinessownerswhorefused, several indicatedthatitwastoo upsetting totalkabout thedisasterexperience. Others expressed concernthatinspiteofallreassurances about confident iality, a leak of informationmightsomehowimpairjudicialproceedingsandresultin thegunmannot getting the conviction or sentence theyfelthedeserved.Theseindividuals indicatedthattheywouldbemorewilling totalkafterthetrial.Onerefuser indicatedthathebelievedwewerereportersin disguise; anotherstatedthathedidn'twanttobe "studied" orbeapartof

PAGE 7

5anyresearch. Refusers in the off-site"groupwereoften heavily involved inoverwhelmingtasks in thewakeof thedisasterandcould notfurtherextend themselves to help the research.Onesubjectwassimply toobusywith routinedemandsof hisworkschedule. Instruments Subjectswereinterviewed abouttheirpsychiatricandsocialstatususing a modified version of the Diagnostic Interview Schedule/Disaster Supplement(DIS/OS)(RobinsandSmith1983). This interviewwasdesigned for theECAHazards studyfundedbyNIMH(Smithetal.1986)andhasbeenusedbyinvestigatorsin several recentdisasterstudies.Itelicitsinformation about thedisasterexperienceandthe individuals' perceptions of the event, use of formalandinformal support systems, behavioral response to the traumatic event,and15DSM-IIIdiagnoses selected fortheirpotentialrelevance to thedisasterexperience.Inthisstudy only the following diagnostic categorieswereincluded: post-traumaticstressdisorder, depression, somatization disorder, generalized anxiety disorder, panicdisorder,phobic disorders, antisocial personality disorder (adult component), alcohol abuse/dependence,anddrugabuse/dependence.Foreach disorderthatwasascertained tohaveoccurred,ageof onsetandageatlastsymptomwereobtained, thus providing lifetimeaswellascurrentpsychiatricstatus.Onsetandrecency foreachpositivesymptomof the relevant diagnoseswerealso obtained.Thusinformationwasavailableasto the presence or absence ofeachsymptomduring the intervalbetweenthedisasterandthe interview,andpriorto thedisaster.Thedisasterinterview also contained anumberof other measuresthatmightbesensitiveto changes inmentalhealth. includeduseof health servicesandpsychoactive drugs, healthanddisability.status,rolefunction,

PAGE 8

6andsocial support. Inaddition to these questions.allofwhichwerepartof theECAinterview. thedisastersection explored thedisasterexperienceandits for the respondents.Allparticipantswereasked to evaluatenewscoverage of thedisaster.onwhomtheyblamedthedisaster.andwhether otherstressfullifeeventshadoccurred in thelastyear. SUbjectswerealso asked to completetwoself-administered forms: theImpactof Events Scale (Horowitzetale 1979). a 15-item questionnairewhichmeasures current subjectivedistressrelatedto experiencing astressfullifeevent;andthe Tridimensional Personality Questionnaire (Cloninger 1986).Themajority of interviewswereconducted in-personandwerecompletedatfour to sixweeksafterthedisasterevent.Forvarious reasons. afewinterviews could notbescheduled in personandwerecompletedbytelephone. Interviewswereconductedbyoneof the authors(CSN)andtwofourth-year psychiatryresidents.Allsubjectswereoffered $10.00 forparticipating.Theinterview tookonaverage approximatelytwohours to administer.DataAnalysisThe"on-site"groupof11subjectswasdefinedasthose employeeswhowerepresentatthe scene of the murders.The" off-sitel'groupwascomposedof employees of thesamebusinesseswhowerenot presentatworkatthe time of thedisaster.Becauseof the limitedsizeof the study sample.testsof significancewerenot performed.Theresultswillbepresented in adescriptivefashion.RESULTSDemographicinformationThesamplewas55%femaleand100%Caucasian. with ameanageof 37.6 years (Table1).Theoff-sitegroupwasover-representedbyfemalesandwasolder(mean.age. 44.3 years) than theon-sitegroup(33.4years).The

PAGE 9

7majority ofsubjectswerein the 25-44 yearagerange. Two-thirds of the samplewasmarried,andthisratioheld for both subgroups.Mostsubjectshadcompleted high school orhadobtained aG.E.D.Almostthree-quartersof the samplehadattendedcollege,andoverallmeanyears of educationwas13.5.Theon-sitegroupwasbetter-educated,reflectedintheirhigherratesof high school/ G.E.D. completion(100%comparedto91%off-site)andcollege attendance(81%comparedto47%off-site),aswellasgreatermeanyears of education (13.7 vs. 13.1off-site).SubjectivedistressandattributionofblameRespondentswereaskedhowupset theyhadbeenafterthe shootings,andhowmuchtheyfelttheyhadbeenharmed.Perceived degree of upset (Table2)wasscored high (livery upsetll)byalmostthree-quartersof the respondents,especiallythose in theon-sitegroup.Themajority of subjects deniedthatthedisasterhadcausedthemagreatdeal ofharm;notoneof theoff-sitesUbjects endorsedthisidea.Overhalffeltthattheyhadcompletely recovered,and100%of those in theoff-sitegroup reportedfullrecovery. All interviewed survivors reportedthattheyhadatleastpartiallyrecovered. -Respondentswere askedifthey thoughtthatthe victims oranyotherindividuals,industries,or government agencieswereinanywayto blame. Respondentsuniversallyblamedthegunman.Onesubject alsofeltthatthe level ofsecurityatworkwasinsufficient,andonesubject placedadditionalblameonlawauthoritiesin anotherstatefornot having apprehended thegunmanonpastfelony charges.PsychiatricImpactAsshownin Table 3, aboutone-fifthof the subjectsmetDSM-IIIcriteriaforatleastoneof fourpsychiatricdiagnoses [including post-traumaticstressdisorder(PTSD),alcohol abuse/dependence, major depression,and

PAGE 10

8generalized anxiety disorder] following thedisaster.Half of these cases occurred in subjectswhohadnopriorhistory of thesamediagnosis,i.e.,incident cases.Althoughon-sitesubjectshadabout twice the prevalence ofpost-disasterdiagnosescomparedtooff-sitesUbjects, examination of only incident casesdoesnotshowthissamepattern--infact,off-sitesubjectshada higher proportion of new-onset disorders.Thus,appearance ofnewpostdisasterpsychiatric disorders did not appear to vary with degree of exposure to thedisaster.SymptomsofPTSDwereamongthemostcommonofsymptomsreported (Table4).Three-fifthsof thesampleacknowledgedexperiencingoneormoresymptomsofPTSD,averaging 2.11symptomsper subject.PTSDsymptomsdid appear in a dose-responserelationshipto degree of exposuretothedisasterwithon-sitevictims averaging.3.00symptomsper sUbject,comparedtolessthanonesymptomper sUbject in theoff-sitegroup. Four-fifths ofon-sitesubjects reported havingoneormorePTSDsymptoms,comparedtoiessthan one-third of theoffsitegroup.ThetwoPTSDsymptomsmostfrequently endorsedwerejumpinessandinsomnia,by half the subjects for each.Almostthree-quarters of theon-sitegroupdescribed feelingjumpyoreasilystartledafterthedisaster,whilenoneof theoff-sitesUbjects endorsedthissymptom.Other dose-relatedsymptomsweredifficultyconcentrating, insomnia,andrecurrent dreams/intrusiverecollections.Overone-third of thesamplereported experiencing recurrent dreams/intrusiverecollections.Nosubjects reported survivorguilt.Almostoneout of fiveon-sitevictims(twosUbjects)metDSM-IIIcriteriaforPTSDafterthedisaster,whilenooff-sitesUbjectsmetcriteria(Table 5).Thesetwocaseswereboth incident cases (Table6).Oneon-site

PAGE 11

9victimmetcriteriafor a pastPTSDepisode,whichdid not recurafterthedisaster.Although the interviewwasnot designed tomakeDSM-IIIRdiagnoses, reportedsymptomswerefitascloselyaspossible intoDSM-IIIRcriteriaforPTSDandthe datawerere-analyzed.NosUbjectsmetDSM-IIIRcriteriaforPTSD,largely because of a general lack of endorsement ofsymptomsof loss ofinterest,detachmentfromothers,numbness,andamnesia.AlthoughitisrecognizedthattheDSM-III/DSM-IIIRcomparisonisnot perfectdueto thedifferentmethodologiesemployedtomakethe diagnoses,itatleastallows aroughcomparison of thetwosetsofPTSDcriteriain thesamepopulation. Therewerenopost-disastercases of alcohol abuse/dependence ineitheron-siteoroff-sitesubjects (Table6),althoughtwoon-sitesubjects admitted tosymptomsconsistent with alcoholabuse(without dependence) in thepast.Itispossiblethatthe location of thetownof Russellville in theIIBiblebeltllandin a dry countymayhaveproducedsufficientcultural influence tolimitthe development of alcohol disorders inthispopulation.Twoon-sitesubjectsandoneoff-sitesubjectweresufferingfromdepression following thedisaster(Table 6);twoof thesewereincident cases(onein each sUbgroup). Therewerenocases of generalized anxiety disorder following thedisaster(Table6)despite apre-disasterhistory of three cases in the onsitegroupandonein theoff-sitegroup.AllsUbjects reported feelingatleastsomesubjective degree of upsetafterthedisaster(Table 7).Tendencytomeetcriteriafor a psychiatric diagnosis did notcorrelatewithhowupset subjects reported theyfelt.Despite the frequent admission ofliveryupsetllfeelings,about three-quarters. deniedmuchharmto themselvesbythedisaster,andtendencytohavea post-

PAGE 12

10disasterpsychiatricdiagnosis did notcorrelatewith degree of perceivedharm.Perceived degree of recovery did,however,predict the likelihood of meetingcriteriafor a psychiatric diagnosis.andthosewhofeltfullyrecoveredwerelesslikelytohavedeveloped a disorder.NosUbjects reportedfailuretorecoveratleastinpart.Oneoff-sitesubjectwhoreportedfullrecovery didmeetcriteriafor apost-disasterdiagnosis of depression (incident case). Predictors ofpost-disasterpsychiatricstatus.Prior to the shootings, almostthree-fourthsof theon-sitesubjectshadexperienced a diagnosablepsychiatricdisaster,while onlyoneoff-sitesubject(14%)had, a50%rateoverall (notshown).Majordepressionandgeneralized anxiety disorder contributed equally to comprise the majority of thesepre-disastercases (three cases each).Itispossiblethatdisaster-relatedsymptomssimilarto those contributing to thesetwodiagnoses sparkedmemoriesof depressionandanxioussymptomsexperienced in thepast.symptomsnotrecalledbyoff-sitevictims. When the analysiswasexpandedto includepost-disasterdisorders incalculationofratesoflifetimediagnosis, the overall percentage of respondents withoneormorelifetimediagnoses rose to61%overall(82%ofon-siteand29%ofoff-sitesUbjects).The50%pre-disasterand61%lifetimeprevalenceratesof psychiatric disorders inthissampleisconsiderably higher than the29-38%lifetimeprevalencerateofoneormoreoffifteenpsychiatricdisorders reported in the findings of the EpidemiologicCatchmentAreaproject.a survey assessing. the prevalence of mental disorders in the general population (Robinsetale 1984).Onlytwo(22%)of the nine subjects with apre-disasterpsychiatricdiagnosismetcriteriafor a diagnosisafterthedisaster(Table8).The

PAGE 13

11othertwosubjects witha'post-disasterdiagnosishadnopriorhistoryofsymptomsconsistentwith apsychiatricdiagnosis. Thus,post-disasterdisordersappearedasfrequently in subjects withpriorpsychopathology as they did in sUbjects without.Priortothedisaster,three individuals(17%)hadreceivedpsychiatrictreatment,andthesethreeindividualswereallan-sitesubjects.Oneof thesehadrequiredhospitalization.Onlyoneindividual, in theon-sitegroup,wasreceivingpsychiatriccareafterthedisaster(Table9).Almosttwo-thirds of theon-sitevictims took advantage of the group or individual counseling offeredafterthe murders, whilelessthanhalfof theoff-sitegroup tookpart.Mostof the sUbjectswhoreceived the counseling did notmeetcriteriafor apost-disasterpsychiatricdisorder. Coping. Victims almost universallycopedbyturningtofamilyorfriendsforsupport,especiallyin theon-sitegroup(Table 10). One-third received additional supportfroma doctor or counselor,especiallyin theon-sitegroup, inwhichalmost half soughtthiskind ofassistance.Veryfewdependendedonmedication or alcoholtohelpthemcope,andallthosewhodidwereunder the care of a doctor or counselor.CONCLUSIONSTheevent of theRussellvillemassmurderswasmarkedbyconsiderable horrorandterror,elements thought tobeassociated with high degrees of upset in survivors.Ina sense,itwasaparticularshocktothehistoricallypeacefulcommunityinwhichitoccurred, since events ofthisnature are almost anachronistic to smallclose-knitcommunitieslikeRussellvilleinrural,alcohol-prohibiting,"Bible belt"settings.Theanachronistic nature of the shootings inthistowncoupled with thetotalunexpectedness of the event,mayhaveserved to diminish the impact of the horrorandterrorof the

PAGE 14

12immediatedisasterexperience.Infact,the victims frequently reported thinkingitwasn't real oritwasa jokeuntilitwasover. Oddly,manyof these sUbjectswerethesameonesreportingpersistentsymptomsof jumpiness, hypervigilence,and dreamsorrecollections.Further,reportsofPTSDsymptomsoccurred in a dose-responserelationshipto the degree of exposure to thedisaster,beingfarmorecommoninon-sitevictims than in thoseoff-site.Animportant elementthatwasabsent withthisdisasterwasthatof secondary complications. This event did notresultin loss of jobs orhomes,or death of close familymembersfor the survivors. Also, the smallcommunityralliedimmediately to provide support for the victims,whichmayhavefurtherreduced the impact of thedlsaster.Ingeneral, theon-sitevictimsfeltmoreupsetandless recovered than theoff-sitegroup;whichgenerally described themselvesasrecovered. disasterpsychiatric disorders appeared toshowa dose-responserelationshipto the degree of exposure to thedisaster,butwhenonly incident caseswereconsidered,thisdoseresponserelationshipvanished.Itturned outthatalmostthree-quartersofon-sitesubjectshadapre-disasterhistoryofpsychiatricillness,andnoneof theoff-sitesUbjectshadsuchahistory.Thus, theon-siteandoff-sitevictims differedfromthestartonavariableknowntocorrelatewithpost-disasteradjustment.Finally,thisdisasterrepresented awillfulhumanact,andconsiderable emotionwasvisiblethroughout thecommunityregarding thedispositionof thegunman.Fromthissingle event,itisnot possible to tease outwhichof theabovecharacteristicsofthisparticulardisastercontribute to the varioushumanresponses toit.Comparisonof data withthatfromother kinds ofdisastersin othersettingsmayhelpclarifytheseissues.Withinthis

PAGE 15

13sample,numbersare too small to make statisticalcomparisons of responsesbetweentheon-siteandoff-sitegroups. Addition of datafromotherdisastersmayhelp provide thepowertosortouthowmuchthe actual experience of thedisasterevent contributes tooutcome,versus the contribution of secondary of the event.

PAGE 16

Tablel.DemographicsOn-site Off-siteAll(N=11)(N=?)(N=18)SexMale5 (45%) 5 (71%) 10 (56%) Female6 (55%) 2 (29%) 8 (44%) RaceWhite11 (100%) 7 (100%) 18 (100%) Black0 0 0Agegroups<252 (18%) 1 (14%) 3 (17%) 25-449 (81%) 4 (36%) 13 (72%) 45-640 1 (14%) 1 (6%) >641 (14%) 1(6%)Meanage(years)33.4 44.3 37.6Marital StatusMarried7(64%)5(71%)12(67%)Divorced/3(27%)1(14%)4(22%)Separated Single1(9%)0 1(6%)Widowed0 1(14%)1(6%)EducationHSgradorGED11(100%)10(91%)17(94%)Somecollege9(81%)4(57%)13(72%)Mean(Years)13.7 13.1 13.5

PAGE 17

Table 2. Perceived upset,harm,anddegree of recovery On-site Off-siteAll(N=l1)(N=7).(N=18)UpsetVery9(81%)4(57%)13(72%)Somewhat2(18%)3(43%)5(28%)Notverya a aNoinfo.aHarmGreat deal 4(36%)a4(22%)Notmuch7(64%)7(100%)14(78%)RecoveryFull 3(27%)7(100%)10(56%)Partial 8(73%)a8(44%)Nonea a a

PAGE 18

Table 3.*Subjects withoneormorepsychiatric diagnosesafterthedisaster(prevalence versus incidence) Subjects withoneor mote On-Site Off-SiteAlldiagnosis(N=1?)(N=12)(N=46)Allcasesafterdisaster3(27%)1(14%)4(22%)(prevalence)Newcases 1(9%)1(14%)2(11%)sincedisaster(incidence)*IncludesPTSD(byDSM-IIIcriteria),alcohol abuse/dependence, depression,andgeneralized anxiety disorder.

PAGE 19

Table4.PTSDSymptomsOn-siteOff-siteAll(N=l1)(N=?)(N=18)PTSDSymptomdreams/ 5(45%)2(29%)7(39%)recollectionhappeningagain 1(9%)a1(6%)numbness2(18%)a2(11%)jumpy8(73%)a8(44%)insomnia 6(55%)2(29%)8(44%)survivor gUilta aaconcentration 5(45%)a5(28%)avoid reminders 2(18%)a2(11%)remindersmake4(36%)1(14%)5(28%)worsemeannumberofsymptoms3.00 0.71 2.11 SUbjects with 9(81%)2(29%)11(61%)>1symptom

PAGE 20

Table5.Post-disaster rates ofPTSDdiagnosisbyDSM-IIIversusDSM-IIIRcriteriaRatesof On-site Off-siteAllPTSDDiagnosis(N=l1)(N=7)(N=18)ByDSM-III2(18%)a2(11%)cri-teri aByDSM-IIIRaacriteria

PAGE 21

Table6.Ratesof Psychiatric DiagnosisAllcases sincedisaster(Prevalence) On-site Off-siteAllDiagnosis(N=l1)(N=?)(N=18)PTSD*2(18%)a2(11%)Alcoholabuse/a a adependenceDepression2(18%)1(14%)3(17%)Generalizeda aaanxiety disorderNewCasesSince Disaster (Incidence) On-site Off-siteAll(N=l1)(N=7)(N=18)PTSD*2(18%)a2(11%)Alcoholabuse/a o. adependenceDepression 1(9%)1(14%)2(11%)Generalizeda a aanxiety disorder Diagnosis Present BeforeandAfter Disaster (Persistence) On-site Off-siteAll(N=l1)(N=7)(N=18)PTSD*a a aAlcoholabuse/a a0(9%)dependenceDepression 1(9%)a1(6%)Generalizeda aaanxiety disorder*DiagnosismadebyDSM-IIIcriteria.