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Sattler, David N.
Hurricane Iniki :
b psychological functioning following disaster : final report /
David N. Sattler and Charles Kaiser.
Boulder, Colo. :
Natural Hazards Research and Applications Information Center,
12 p. ;
Quick response research report ;
Includes bibliographical references (p. 11).
Also issued online as part of a joint project with the Louis de la Parte Florida Mental Health Institute (FMHI) Research Library's disaster mental health initiative.
Hurricane Iniki, 1992
x Psychological aspects.
University of Colorado, Boulder.
Natural Hazards Research and Applications Information Center.
t Natural Hazards Center Collection
HAZARD HOUSE :c: N J>;;0o ::c o c: C/)Inno-0 -<
HurricaneIniki:PsychologicalFunctioningFollowingDisasterByDavidN.SattlerandCharlesKaiserQUICKRESPONSERESEARCHREPORT#671994This pUblication is partofthe Natural Hazards &Applications Information Center'songoing QUIck Response Research Report Series. http://www.colorado.edu/hazardsTheviewsexpressedinthisreportarethoseoftheauthorsandnotnecessarilythoseoftheNaturalHazardsCenterortheUniversityofColorado.
Final Report Hurricane Iniki: Psychological Functioning Following Disaster David N. Sattler and Charles Kaiser DepartmentofPsychology CollegeofCharleston Charleston, South Carolina This project was funded by the Natural Hazards Research and Applications Information Center, UniversityofColorado, Boulder, Colorado, 10/13/92.
IntroductionOnSeptember 11, 1992, hurricane Iniki struck the Hawaiian islandofKauai with sustained windsof165 mi1es-per-hour. Hurricane Iniki damaged homes and businesses across the island (Kite, 1992). Property damage was estimated to be $1.8 billion, approximately 1,400 homes were destroyed, and at least 5,000 homes were significantly damaged. Three persons were killed as a direct resultofthe hurricane. Hurricane Iniki was the costliest hurricane in Hawaiian history, and it was the strongest storm to hit Hawaii this century (Rappaport&Lawrence, 1992). The populationofKauaiisestimated to be 51,000. The populated areas are located along the coast, due to the mountainous interior. Kauai is33miles long and 25 miles wide. The present study assessed the reactionsofpersons who survived the hurricane seven weeks after the storm. The subjects participating in the study either had severe damage to their home and were living with other families or had damage to their home but were still living in their homes. The objective was to obtain information about the subjects' psychological and psychophysiological distress, coping responses, useofmental health services, assistance received from various agencies, lossofproperty, and preparation for the hurricane. MethodSample and ProcedureSeven weeks after hurricane Iniki, 380 persons were asked to complete the questionnaires, and 322 persons (119 male, 203 female) agreed to do so--a participation rateofapproximately85%.The subjects were131(59male, 72 female) adults who completed the surveyintheir homes,112(32male, 80 female) students at Kauai Community College, 49(13male, 36 female) 10th grade high school students, and 30(15male,15female) 12th grade high school students. We visited the communitiesofEle-Ele, Hanapepe, Poipu, and Princeville, went door to-door, and asked people living in their homestocomplete the questionnaire. We asked each adult who was home to complete the questionnaire. There were occupants in approximately two-thirdsofthe homes. The four communities sustained significant damage. We also visited Kauai Community College and a high school. The high school students and college students completed the questionnaire in their class. The questionnaires were administered on five consecutive days: Friday, October 30, 1992 though Tuesday, November 2, 1992, from 9:00 a.m. to 7:00 p.m. The interviewers were two undergraduate students and a social psychologist. Table 1 presents the demographic characteristicsofthe sample. The majorityofthe sample was female, single, had a high school education, and had an annual incomeofless than $40,000. Thirty-two percentofthe subjects did not report their annual income. The average ageofthe subjects was 22 years, with a range from14to 87 years. The subjects lived in their city for an averageof9 years, with a range from less than 1 year to 72 years. The majorityofthe sample had been through a natural disaster other than hurricane Iniki (68%).1
Characteristic Table 1 Demographic Characteristicsofthe Sample Percent Gender Males 119 37 Females 20363Marital Status Single 19863Married 100 32 Separated/Divorced186 Education Did not complete elementary school 3 1 Completed elementary school186 Some high school 74 23 Completed high school 142 45 Earned college degree6521Graduate degree155 Annual Income Less than $10,0006120 $10,000 $19,999 43 14 $20,000 $39,999 5517$40,000 $59,000 26 8 $60,000 or more 20 6 Do not know 106 32 Persons in Household 1 person113 2-3 persons 100 34 4-6 persons 162517ormore persons1515Employment Status Full-time9329 Part-time 5216Unemployed 4514Student 130412
MaterialsThe questionnaire had three sections. The first section asked for demographic information, extentofpreparation for the impending storm, subjects' location when the hurricane struck, andextentofproperty damage. The second section contained questions about useofcoping strategies, visits to mental health professionals, and assistance received from people in various organizations. Useofcoping strategies was assessed with the COPE inventory (Carver, Scheier,&Weintraub, 1989). Subjects were asked to indicate how much each item described them since the hurricane. The 60-item COPE inventory has adequate reliability, convergent validity, and discriminant validity (Carver et al., 1989). The subjects used a 5-point scale(1=not at all to 5=extremely) to indicate their answers to the questions in the second section. The third section was the Symptom Check List (SCL-90-R) (Derogatis, 1983). The 90-item SCL-90-R assessed the intensityofpsychological and somatic symptoms during the seven days prior to completing the questionnaire. The subjects used a 5-point scale(0=not at allto4=extremely) to indicate their answers. The questionnaire took approximately 40 minutes to complete. ResultsPreparationfortheHurricaneWhen the hurricane warning came, about halfofthe sample took the hurricane warning seriously (49%), and about half were prepared with food, water, and supplies (43%). The majorityofthe subjects did not evacuate their homes (67%). Correlations were performedtoexplore the relationship between taking the hurricane warning seriously and demographic variables. Taking the hurricane warning seriously was significantlypositivelycorrelatedwith higher education level(r=.18, 12 <.05), being married(r=.22, 12 <.01), and being older(r=.28, 12 <.01), but it wasnot significantly correlatedwith gender(r=.01, 12 >.05).PropertyLossandPersonalHarmThe majorityofsubjects were able to live in their home after the storm(81%),and19%could not live in their home due to severe damage. The subjects were without electric power for an averageof21days, with a range from 1to70 days. The subjects were without running water for an averageof6 days, with a range from 0 to64days. The subjects returned to work after an averageof16days, with a range from 0 to 43 days. Twenty-one percentofthesample lost their job due to the storm. Less than one-fifthofthe subjects were physically injured(13%)or had a family memberorclose friend who was physically injured (19%)during the hurricane or clean-up. About one-quarterofthe sample had seen a medical doctor since the storm(23% ). The majorityofthe sample had property insurance coverage for their house and possessions (60%), whereas13%hadnocoverage and 30% did not know.3
Table 2 presents a rank orderingofthe frequencyoflossofproperty. At least halfofthe sample lost trees or bushesontheir property, home contents, furniture, and clothing. Less than one-tenthofthe subjects lost personal transportation or pets. Table 2 Rank Orderingofthe FrequencyofProperty Loss Item Trees or Bushes on Property Home Contents Furniture Clothing Home Appliances Sentimental Possessions Personal Transportation PetsPsychologicalDistressPercent6760 54 504634105Table 3 presents a rank orderingofthe frequencyofthe SCL-90-R items reported by at least 25%ofthe sampleasthe most distressing symptoms. About halfofthe sample was feeling easily annoyed or irritated and having headaches. About one-thirdofthe sample was worrying too much about things, feeling low in energyorslowed down, and had soreness in muscles. About one-quarterofthe subjects had trouble falling asleep.Anoverall measureofpsychological distress, the Global Severity Index (GSI), was created by totalling the responsestothe SCL-90-R items. The mean GSI score was 55, with astandard deviationof56.CopingResponsesThe responses to the COPE inventory items were evaluated by a principle components factor analysis with varimax rotation. The items were required to load atorabove .50 on a primary factor without loading above.35 on another factor. The results showed that13principle factors were present. We named the first factoractivecopingandplanning;Factor2,seekingsocial suppon foremotionalreasons;Factor 3,acceptance;Factor 4,alcohol-drugdisengagement;Factor 5,useofhumor;Factor 6,turningtoreligion;Factor 7,denial;and Factor 8,restraintandsuppression.Factors 9 to13were not interpretable. Table 4 shows the factor loadings, means, and standard deviations for each item for Factors 18. 4
Table 3 Rank OrderingofMost DistressingPsychological Symptoms SCL-90-R Item Feeling easily annoyed or irritated Headaches Worrying too much about things Feeling low in energy or slowed down Soreness in your muscles Awakening in the early morning Havingtocheck and double-check what youdoFeeling criticalofothers Worried about sloppiness or carelessness Repeated unpleasant thoughts that won't leave your mind Trouble falling asleep Table 4 Percent 48 45 38 36 34 30 30 30 30 30 26 Factor Loadings, Means, and Standard Deviations for COPE Inventory Items Scale name and items LoadingMSD Active coping and planning I have triedtocomeupwith a strategy about whattodo. .80 I have made a planofaction. .76 I have thought hard about what stepstotake. .71 I have taken direct actiontoget around the challenges. .59 I have focused on dealing with the situation, andif.68 necessary let other things slide a little. I have taken additional actiontotryto get ridofthe problems. .56 I have thought about how I might best handle the situation. .56 I have concentratedmyefforts on doing something about .54 the situation.52.70 1.17 2.78 1.23 2.83 1.15 2.61 1.06 2.75 1.21 2.59 1.19 3.34 1.17 3.21 1.18
Table 4, Cont'd Scale name and items LoadingMSD Seeking social support for emotional reasons I have talked to someone about how I feel. .792.561.22 I have discussed my feelings with someone. .67 2.92 1.30 I have let my feelings out. .652.661.20 I have gotten sympathy and understanding from someone..642.901.28 I have felt a lotofemotional distress and I have .63 2.32 1.15 been expressing those feelings a lot. I have tried to get emotional support from friends or relatives. .582.421.21 I have gotten upset and letmyemotions out. .55 2.65 1.17 Acceptance I have accepted that the hurricane has happened and that .83 4.13 1.12 it cannot be changed. I have accepted the realityofthe fact the hurricane happened. .754.121.16 I have learned to live with the situation. .743.771.19 I have done what has to be done, one step at a time. .583.571.13 I have looked for something good in what is happening. .563.301.23 I have learned something from the experience. .553.971.17 I have gotten usedtothe idea that the hurricane happened. .54 3.85 1.19 I have tried to see the situation in a different light, .53 3.23 1.22 to make it seem more positive. Alcohol-drug disengagement I have tried to lose myself for a while by drinking .94 1.33 0.88 alcoholortaking drugs. I have drank alcoholortaken drugs, in order to think .93 1.35 0.89 about the situation less. I have used alcoholordrugstomake myself feel better. .93 1.46 0.99 I have used alcoholordrugstohelp me get through .91 1.38 0.86 the situation. Useofhumor I have made funofthe situation. .78 2.45 1.34 I have kidded around about the hurricane. .87 2.48 1.35 I have made jokes about the situation. .852.361.31 I have laughed about the situation. .832.241.31 Turningtoreligion I have put my trust in God. .853.621.39 I have soughtGod'shelp. .83 3.05 1.43 I have tried to find comfort in my religion. .782.571.35 I have prayed more than usual. .77 2.74 1.39 6
Table 4, Cont'd Scale name and items LoadingMSD Denial I have acted as though it has not even happened..75I have pretended that the hurricane has not really happened..74I have refusedtobelieve that the hurricane has happened..66Restraint and Suppression I have forced myself to wait for the right timetodo something ..69I have made sure not to make things worse by acting too soon..62I have tried hard to prevent other things from interfering.56withmyefforts at dealing with this. I have gone to moviesorwatched TV, to think about the.54situation less. Responses Related to the Impactofthe Hurricane1.75 1.50 1.42 2.43 2.62 2.53 2.31 1.06 1.00 0.96 1.13 1.16 1.09 1.28The responses to the impactofthe hurricane items were evaluated by a principle components factor analysis with varimax rotation. The items were required to load atorabove.50on a primary factor without loading above.35on another factor. The results showed that10principle factors were present. We named the first factor helpful personnel; Factor2,self-denigration; Factor3,receiving assistance; Factor4,active rebuilding; and Factor5,blaming government. Factors 6-10were not interpretable. Table 5 shows the factor loadings, means, and standard deviations for each item for Factors15.Table5Factor Loadings, Means, and Standard Deviations for Responses Related to the ImpactofHurricane Items Scale name and items Helpful personnel I believe that social workers have been helpful. I believe that the police have been helpful. I believe that insurance adjusters have been helpful. I believe that strangers have been helpful. I believe that government officials have been helpful.7Loading M.80 3.39 .71 3.12 .69 3.29 .66 3.44 .56 3.60SD1.30 1.34 1.30 1.30 1.23
Table 5, Cont'd Scale name and items Loading M SD Self-denigration I have done things that Idonot liketoget supplies. .77 1.28 0.72 I believe that Iamhurting more than other people. .64 1.51 1.02 I have gonetoa psychic ortoa fortune teller. .62 1.12 0.56 I have bribed someonetoget the supplies that I need. .62 1.22 0.65 I have avoided news reports about the hurricane and .57 1.53 1.02 the clean-up. I have paid moretoget supplies. .52 1.72 1.08 I believe that itismyfault that there are not enough supplies. .50 1.28 0.74 Receiving assistance I have known at least one person who has sought .73 1.68 1.15 counseling duetothe hurricane. I have spoken with a mental health professional about .72 1.21 0.67 howI'mfeeling. I believe that people who are feeling like I am should .60 1.841.15speak:with a mental health professional. Active rebuilding I have helped others clean-up from the storm. .59 3.44 1.22 I have takenonmore responsibilities. .57 3.24 1.33 I believe the military personnel have been helpful. .56 4.53 0.89 I believe thatmyfamily has become closer. .54 3.77 1.29 I have been busy rebuildingmylife. .50 2.94 1.34 Blaming government I believe that the governmentisfavoring certain .76 2.17 1.36 groupsofpeople by givingthemmore supplies. I believe that the governmentistoblame for the situation. .74 1.53 1.02 I believe that the scarcityofsupplies could have been .59 2.73 1.44 preventedifthe governmenthadplanned better.RelationshipbetweenPsychologicalDistressandOtherVariablesCorrelations were performedtoexplore the relationship between distress, coping responses, useofmental health services, lossofproperty, and demographic variables. The correlation coefficients ranged from -.26 to .63. Table 6 shows that distress was significantlypositively correlated with property loss, active coping and planning factor, seeking social support for emotional reasons factor, alcohol-drug disengagementfactor, turning to religion factor, denial factor, self-denigration factor, receiving assistance factor, 8
active rebuilding factor, and blaming government factor; it was significantlynegatively correlatedwith age; but it wasnot significantly correlatedwith gender, marital status, income, education, acceptance factor, useofhumor factor, and helpful personnel factor. SummaryofFindings1.Taking the hurricane warning seriously was significantly positively associated with higher education level, being married, and being older. 2. The majorityofsubjects were abletolive in their home after the storm(81%), and19%could not live in their home duetosevere damage. 3. The subjects were without electricity for an averageof21days, and they were without running water for an averageof6 days. 4. The subjects returnedtowork afteranaverageof16days, and about one-quarterofthe subjects lost their job duetothe storm. 5. Less than one-fifthofthe subjects were physically injured or had a family memberorclose friend who was physically injured during the hurricane or clean-up. 6. At least halfofthe sample lost trees or bushesontheir property, home contents, furniture, and clothing. 7. About halfofthe sample was feeling easily annoyed or irritated and having headaches. About one-thirdofthe sample was worrying too much about things, feeling low in energy, and had soreness in muscles. About one-quarterofthe subjects had trouble falling asleep. 8. Psychological distress was significantly positively associated with property loss, active copingand planning, seeking social support for emotional reasons, alcohol-drug use, turning to religion, self-denigration, receiving assistance, actively rebuilding, and blaming the government; it was significantly negatively correlated with age; it was not significantly correlated with gender, marital status, income, education, acceptance,oruseofhumor.9
Table 6 Correlations Between GSI and Other VariablesVariable 1 2345 6 7 8 9 1011121314 151617181920---l.GSI2. Gender .06 3. Age -.17** -.08 4. Marital status -.05 .02 .52** 5. Annual income .04 -.08 -.23** -.26** 6. Education -.04 -.06 .28** .31 ** -.24** 7. Property loss .18** -.04.01-.05 -.01 .05 8. Active coping .15* -.07 .10 .18** -.13* .30** .14* 9. Seeking social .37** .16* -.01 .13* -.07 .16** .12* .56** 10. Acceptance .09 .03 -.07 .05 -.20** .22** .08 .63** .43** 11. Alcohol-drug .24** -.13* -.14* -.09 .13* -.08 .19** -.01 .03 -.05 12. Useofhumor .08 -.09 -.25** -.20** .12* -.02 .06 .26**.19**.36**.24** 13. Religion .22** .26** -.03 -.05 -.07 -.01 -.01 .17** .31** .18** -.07 .03 14. Denial factor .32** -.05 -.14* -.09 .15* -.18** .03 .07 .25** -.10 .13*.01.20** 15. Restraint factor .25**.00-.05.00.03 .00 .18** .48**.46**.35** .08 .15**.24** .30** 16. Helpful factor -.01 -.02 .00.08-.11.15* -.10 .36** .30** .40** -.06 .15** .18** .00 .20** 17. Self-denigration .48** -.08 -.21** -.15* .18** -.19** .12** .05 .13* -.10 .31**.14** .15* .45** .24** -.05 18. Assistance .38** -.11 .04.11.01 .13* .18**.41**.47** .21** .16**.15** .13* .26** .31**.18**.36** 19. Active rebuilding .20** .03 -.08 .07 -.10.11.14* .53**.41**.53** .02 .05 .18** .06 .34** .46** .03 .23** 20. Blame govern. .14* -.04 -.18**-.16** .07 -.16** .07 .00 .00 -.02 .21** .04 .02 .21** .12* -.08 .30**.09.10-* l! <.05 ** l! <.01
References Carver, C. S., Scheier, M.F.,&Weintraub, J.K.(1989). Assessing coping strategies: A theoretically based approach. JournalofPersonality and Social Psychology, 56, 267-283. Derogatis,L.R. (1983). SCL-90-R: Administration. scoring and procedures manual-II (2nd ed.). Baltimore, MD: Clinical Psychometric Research. Kite, R. (1992, September 25). Hurricane Iniki Conditions and Response. Hawaii DepartmentofHealth. Rappaport, E. N.,&Lawrence, M.B.(1993). Eastern pacific hurricanes. Weatherwise,47,25-29.11
Acknowledgements This project was supported by a grant from the Natural Hazards Research and Applications Information CentertoDavid N. Sattler and Charles Kaiser. We gratefully acknowledge the assistanceofBeverly A. Hamby and Jacqueline M. Winkler for serving as interviewers, Jerome SattlerofSan Diego State University, Harlan Whiteofthe Hawaii DepartmentofHealth, Jim McFarlane and the students and facultyofKauai Community College, and the peopleofKauai for their participation in the project. Correspondence concerning this project should be addressed to DavidN.Sattler, DepartmentofPsychology, CollegeofCharleston, Charleston, South Carolina 29424.12