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Learning From The Past and Planning For The Future
MENTAL HEALTH MOMENT March 5, 2004 "Most people seek after what they do not possess and are enslaved by the very things they want to acquire." - Anwar El-Sadat
Short Subjects
LINKS Rocky Mountain Region
Disaster Mental Health Institute
CONFERENCES AND WORKSHOPS:
CRISES IN RURAL AMERICA
Crisis Interventions And
Critical Incident Stress Management:
Current Status and Future Directions
April 21-24, 2004
Casper, Wyoming
Registration: 1-800-442-2963 ext 2212
Society of Australasian
Social Psychologists 33rd Annual Meeting
April 15 - 18, 2004
Location: Auckland, NEW ZEALAND
27th National AACBT Conference
(Australian Association for
Cognitive and Behavior Therapy)
May 15 - 19, 2004
Location: Perth, Western Australia
AUSTRALIA
Society of Australasian Social Psychologists
33rd Annual Meeting
April 15 - 18, 2004
Location: Auckland, NEW ZEALAND
Contact: SASP@auckland.ac.nz
Deadline for submissions: 1 February 2004WFPHA 10th International Congress on
Public Health: Sustaining Public Health
in a Changing World: Vision to Action
April 19-22, 2004
Location: Brighton, ENGLAND
Contact: Allen K. Jones, PhD
Secretary General World Federation of
Public Health Associations
Email: stacey.succop@apha.orgXIV. IFTA World Family Therapy Congress
March 24 - 27, 2004
Location: Istanbul, TURKEY
14th Biennial Meeting of the Society
for Research in Human Development
(formerly the Southwestern Society for
Research in Human Development -- SWSRHD)
April 1 - 3, 2004
Location: Park City, Utah, USA
7th European Conference on Psychological Assessment
April 1 - 4, 2004
Location: Malaga, SPAIN
Contact: Antonio Godoy
Facultad de Psicologia
Universidad de Malaga
29071 Malaga.( SPAIN)
Tel. (34) 952 13 25 32
Fax (34) 95213 11 00
Email: godoy@uma.esAnnual Conference Society for
Industrial/Organizational Psychology (SIOP)
April 2 - 4, 2004 Location: Chicago, Illinois, USA
Email: lhakel@siop.bgsu.edu3rd Annual Hawaii
International Conference on Social Sciences
June 16 - 19, 2004
Location: Honolulu Hawaii, USA
Contact: social@hicsocial.org
Severe Weather Workshop Underway
As winter begins to give way to spring across the country, it is once again time to make preparations for severe storms and their accompanying threats, flooding and tornadoes. Emergency Management officials from across the county are in Norman, Okla. for the National Severe Weather Workshop. For the Full Story, Go To: http://www.norman.noaa.gov/nsww2004/
Federal Disaster Funds Authorized For Oregon Winter Storms
The head of the U.S. Department of Homeland Security’s Federal Emergency Management Agency (FEMA) announced that federal disaster funds have been made available for 26 Oregon counties to supplement state and local response and recovery costs for a series of severe winter storms that began late last December. Michael D. Brown, Under Secretary of Homeland Security for Emergency Preparedness and Response, said the assistance was authorized under a major disaster declaration issued by President Bush following a review of the agency’s analysis of the state’s request for federal aid. For the Full Story, Go To: http://www.fema.gov/news/newsrelease.fema?id=11188
Security Council calls for access to humanitarian aid throughout Haiti
Members of the United Nations Security Council called for “safe and unimpeded humanitarian access” to vulnerable people in Haiti after the breakdown in law and order there necessitated emergency international assistance to help stabilize the volatile country. For the Full Story, Go To: http://www.un.org/apps/news/story.asp?NewsID=9990&Cr=haiti&Cr1=
Annan's special envoy on Haiti goes to Jamaica, Caribbean Community's chair
United Nations Secretary-General Kofi Annan's Special Envoy to Haiti, John Reginald Dumas, went to Jamaica today for talks on peace-building in Haiti with Jamaican Prime Minister Percival J. Patterson, the chairman of the Caribbean Community (CARICOM). The Security Council approved a resolution on Sunday calling on the UN, CARICOM and the Organization of American States (OAS) to "promote the rebuilding of democratic institutions" and combat poverty in Haiti.For Full Story, Go To: http://www.un.org/apps/news/story.asp?NewsID=9974&Cr=haiti&Cr1=
Venezuela: Dismayed at violence, Annan vows UN support for peaceful solution
Voicing dismay at the violence that has rocked Venezuela over the past week, United Nations Secretary-General Kofi Annan pledged the world body's backing in achieving a peaceful resolution. For the Full Story, Go To: http://www.un.org/apps/news/story.asp?NewsID=9988&Cr=venezuela&Cr1=
UN mission in Western Sahara organizes first family visits in over 25 years
Two groups of Saharans will see their relatives for the first time in 25 years after the United Nations mission for Western Sahara organized two flights to mark the start of its family visits programme in the disputed territory. A plane carrying a group of refugees left Tindouf in Algeria bound for Laayoune in Western Sahara, where they will spend five days meeting relatives they have not seen since the outbreak of war on Spain's withdrawal from the area in the mid-1970s. For the Full Story, Go To: http://www.un.org/apps/news/story.asp?NewsID=9989&Cr=western&Cr1=sahara
Animal diseases could lead to world trade losses of $10 billion in 2004 - UN
Chinese exports forecast to decline by 20% in 2004
With disease outbreaks such as bovine spongiform encephalopathy (BSE) and bird flu affecting about a third of global meat exports, the United Nations Food and Agriculture Organization (FAO) warned today of losses of up to $10 billion in the $33-billion-a-year meat and live animal trade if import bans extend throughout 2004. For Full Story, Go To: http://www.un.org/apps/news/story.asp?NewsID=9940&Cr=bird&Cr1=flu
UNICEF to use horses to reach children in anti-measles campaign in Chad
The United Nations Children's Fund (UNICEF) and Chad's Public Health Ministry will use horses to reach some of the country's most remote areas during a campaign to inoculate nearly 90,000 children - half of them Sudanese refugees - against measles. Launching the campaign in N'Djamena, the Chadian capital, UNICEF said 300 trained staff will travel over 12 days to more than 1,000 villages and other locations in the east of the country where refugees have set up makeshift homes. For Full Story, Go To: http://www.un.org/apps/news/story.asp?NewsID=9991&Cr=chad&Cr1=
UN launches project to achieve universal primary education in Equatorial Guinea
The United Nations Development Programme (UNDP) and Equatorial Guinea have launched a scheme to train enough teachers so that every child in the African country can finish primary school by 2010. Over the next four years the UNDP and Equatorial Guinea have promised to spend $5.2 million training 2,000 teachers, 45 school inspectors and 36 education advisers as part of a scheme dubbed “Education for All,” the agency said. For Full Story, Go To: http://www.un.org/apps/news/story.asp?NewsID=9943&Cr=Equatorial&Cr1=Guinea
UN agency signs accord to help poor States retain young scientists
Seeking to build scientific capacity in poor countries and stem a brain drain to the developed world, the United Nations Food and Agriculture Organization (FAO) has entered into an agreement with the International Foundation for Science (IFS) to provide wide technical information in the fields of agriculture, forestry and fisheries. Coupled with grants from IFS the agreement aims to foster greater technology awareness and enhance domestic research efforts among young scientists within developing countries to prevent their exodus to developed nations. For Full Story, Go To: http://www.un.org/apps/news/story.asp?NewsID=9977&Cr=FAO&Cr1=
Anxiety and Depression Common Among Patients With Restless Legs Syndrome
Patients with restless legs syndrome exhibit relatively high levels of anxiety and depression, according to a report in the February issue of the Journal of Neurology, Neurosurgery, and Psychiatry. For the Article, Go To: http://www.medscape.com/viewarticle/470349?mpid=25413
Bilateral Magnetic Stimulation No Extra Help in Depression Therapy
In a study of a small number of patients with major depression, application of repetitive transcranial magnetic stimulation (rTMS) was no more effective when delivered bilaterally than when applied to one side only, Austrian researchers report in the February issue of the Journal of Neurology, Neurosurgery and Psychiatry. For the Article, Go To: http://www.medscape.com/viewarticle/470157?mpid=25413
Testosterone Decline May Add to Impairment in Alzheimer's and Parkinson's
The age-related decline in plasma testosterone levels is similar in men with Parkinson's disease (PD) and in those with Alzheimer's disease (AD), researchers report. They say testosterone deficiency "may act as a 'second hit' to impair cognitive function in neurodegenerative disease." For the Article, Go To: http://www.medscape.com/viewarticle/469816?mpid=25413
THE MEDICAL MINUTE: PREVENTING DIABETES-RELATED BLINDNESS
The statistics are alarming: individuals with diabetes mellitus are 25 times more likely than the general population to become blind. Diabetes mellitus affects approximately 18 million people in the United States. It is the leading cause of new blindness among adults between 20 and 74 years of age, with 12,000 to 24,000 new cases of blindness occurring each year. Fortunately, according to the latest edition of the Medical Minute, a service of Penn State Milton S. Hershey Medical Center, there is good news in the fight against blindness from diabetes. Early detection combined with appropriate general medical and eye care can significantly reduce the risk of vision loss related to diabetes. Read the full story at http://live.psu.edu/story/5846
SOME CULTURAL ASPECTS OF DISASTERS
Background
The mental health community in the United States was caught unaware after 9/11 with respect to treatment of survivors of terrorist attacks. Because this form of trauma is quite rare in this country, few trauma specialists had extensive experience, or taught regularly on this subject. Because the primary objective of terrorism is the creation of demoralization, fear, and uncertainty in the general population, a focus on mental health from therapeutic and public health perspectives is critically important to successfully resolving such crises.
Surveys following 9/11 showed unequivocally that symptomatology related to the attacks were found in hundreds of thousands of people, most of whom were not escapees or the families of the deceased. Soon after 9/11, Marshall & Suh (2003) formed a collaboration with other academic sites in Manhattan to rapidly increase capacity for providing state-of-the-art training and treatment for trauma-related psychiatric problems. Their experience suggests that evidence-based treatments such as Prolonged Exposure Therapy have proven successful in treating 9/11-related PTSD. However, special clinical issues arose, such as the influence of culture on clinical presentation and treatment expectations in a multiethnic community.
Disasters can have profound effects on a community, on families, and, specifically on children and adolescents. Pre-existing health risk factors can affect health care during and after a disaster. Disasters cause disruptions to normal patterns resulting in behavioral reactions to disaster, including posttraumatic stress. The relationship between the disaster experience and the traumatic responses of the individual is not a direct one. It is mediated by the perception of the disaster as a risk and a threat to the community at the individual level. It is also mediated by culture which determines the coping styles in case of loss, the social networks and resources.
Some Cross-cultural Examples
Canino, Bravo, Rubio-Stipec, & Woodbury (1990) examined effects of the 1985 floods in Puerto Rico on mental health symptoms and diagnoses to determine the extent to which such effects were influenced by demographics and previous symptoms. They studied 912 people between the ages of 17-68 using a Spanish version of the Diagnostic Interview Schedule. They found that the onset of depression, generalized anxiety and PTSD was significantly more common among those exposed to a disaster than among those not exposed. They suggested that the increase in stress-related disorders in exposed Ss indicated that the stress of disaster increased their mental morbidity.
In another study, Escobar, Canino, Rubio-Stipec & Bravo (1992) interviewed 375 individuals before and after severe floods and mudslides in Puerto Rico. They used a Spanish version of the Diagnostic Interview Schedule to study the prevalence of somatization symptoms. 139 individuals were classified as having been exposed to disaster and 236 as not exposed. They found that exposure to disaster was related to a higher prevalence of medically unexplained physical symptoms. The most prevalent symptoms were gastrointestinal (abdominal pain, vomiting, nausea, excessive gas) and pseudoneurological (amnesia, paralysis, fainting, unusual spells, etc).
Guarnaccia (1993), in the first community based study of ataques de nervios (attacks of nerves), discussed the issue of categorizing it as a culture-bound syndrome. He conducted a psychiatric epidemiology survey using 912 subjects between the ages of 17-68 in Puerto Rico. This study was performed in 1987 to measure the psychosocial effects of a disaster which occurred on the island in 1985. He also had access to earlier data from a survey done in 1984. Guarnaccia identified stressful situations surrounding ataques. They were correlated with other psychiatric diagnoses and it was found that Ss who reported ataques de nervios were more likely to meet criteria for depression, dysthymia, generalized anxiety disorder, panic disorder, and PTSD. Guarnaccia suggests that the term "popular illness" is a better descriptive term for the syndrome than is "culture-bound syndrome".
The 1985 floods and mudslides in Puerto Rico caused considerable damage and death. As part of a major study (Guarnaccia, Canino, Rubio-Stipec, & Bravo, 1993) an additional question was added to the Diagnostic Interview Schedule/Disaster Supplement concerning ataques de nervios. Using this, researchers studied the category using a representative, community based sample of 912 people. 145 reported an ataque de nervios. Of these most were female, older, less educated, and formerly married. They were also more likely to meet criteria for anxiety and depressive disorders than those who had not experienced an ataque.
Perilla, Norris & Lavizzo (2002) studied a sample of 404 residents of southern Florida who were interviewed in their own homes six months following Hurricane Andrew. The sample was composed of equal numbers of Hispanics, non-Hispanic blacks, and Caucasians. Ethnic groups differed strongly in the prevalence of posttraumatic stress disorder (PTSD). Caucasian disaster victims showed the lowest rate (15%), Spanish-preferring Latinos showed the highest rate (38%), and African-Americans showed a rate (23%) between these two extremes. Additional analyses attempted to explain these symptom differences in terms of differential exposure and differential vulnerability to trauma. Both explanations had merit but neither completely accounted for observed ethnic differences. Cultural-specific responses to Hurricane Andrew suggested the need to view psychological symptoms in light of the possible adaptive nature of the behaviors due to political, social, economic, and historical perspectives.
Apfelbaum (2000) examined the disturbing conditions of uprootedness which now mark most people's cultural lives, and focused on the extreme case of genocide to emphasise that however inevitable the sense of loss, exile and unfamiliarity, it remains vital at the same time to retain narratives of cultural filiation and affiliation. She argues that genocides go well beyond their primary goal of physically annihilating a social group in its entirety. Ultimately, they also eradicate the very cultural roots by which this group has historically established and maintained its identity. Being a 'survivor' (or child of a survivor) of such a disaster thus means becoming a 'cultural orphan,' violently separated from one culture now gone and silenced, who must attempt an existence and a reconstruction of identity on the sole basis of the 'host' culture. There is often no space in the latter to recapture the 'lost' roots. Social identity is intimately embedded with culture.
In summary, it appears that the most common symptoms displayed across the cultures sampled in the above studies of victims of various disasters were those associated with the diagnoses of depression, anxiety and PTSD. They manifest themselves in different ways within cultures, but the symptoms tend to fit the general diagnostic criteria for depression, anxiety disorders and PTSD. How to approach dealing with these in a culturally relevant counseling context is the task faced by the cross-cultural counselor providing disaster mental health services and psychological first aid.
Culture and PTSD
The diagnostic category of post traumatic stress disorder (PTSD) is relatively new and culture can play a very important role. There is only limited literature addressing the cultural aspects of this disorder unlike schizophrenia and depression, which have been extensively written about from this perspective. However, it is clear that cultural factors have an important role to play in the genesis and presentation of PTSD, and in how it is perceived, responded to and treated. The impact of culture on the incidence and characteristics of PTSD is related to reactions to natural disasters (e.g., floods, earthquakes) and man-made disasters (e.g., industrial accidents, imprisonment, torture). Culture is important in determining an individual's reactions to stressful situations and in influencing recovery from PTSD (de Silva, 1993). Reports of PTSD across different cultures and settings (e.g. war, natural disasters, other disasters, violence, accidents, concentration camp experience, torture, imprisonment during war) and PTSD and culture (e.g. perception of trauma and the reactions of society, social support, role of the military culture in war, cultural and national differences in responses to trauma, issues related to therapy) are not very plentiful. However, the literature that is available suggests that the use of the diagnosis of PTSD has not been very useful across cultures as it is based on the western cultural discourse that stress is an outcome of loss of control over nature (deVries, 1996). Trauma is an important dimension because the meaning of trauma is often culturally specific. The social and religious rituals surrounding loss and disaster have an important healing role in both individual and community trauma. Specific functions of social supports help in minimizing the impact of trauma, and the protective role of attachment. For example, Priya (2002) provides a glimpse of suffering and healing among the survivors of an earthquake that occurred in Bhuj in 2001. An ethnographic approach was used for this study. Priya found that the faith of the people that discharging their duties (karma) would lead them to peace and harmony with nature has resulted in better healing among the survivors in rural areas than among those in urban areas where life is guided mainly by materialistic goals. Priya proposes that suffering and healing help to understand earthquake survivors better than PTSD. Chemtob (1996) presents an ecologically centered definition of culture that highlights why it is important to consider the cultural context within which PTSD develops, focusing on cultural variation in the response to trauma. Unfortunately, impediments to the study of culture and trauma have resulted in a paucity of empirical research that bears directly on culture's impact on trauma.
Rabalais, Ruggiero & Scotti (2002) note the lack of attention to issues of cultural diversity in disaster-related research. They provide some interesting and important ideas for incorporating diversity-related concepts (e.g., acculturation stress, cultural beliefs and customs, kin networks) into future research efforts with diverse populations. Given the limitations of the current literature, Rabalais et al outline three goals for study. The first is to provide an overview of socioeconomic status and social support, two factors that may be relevant to ethnically diverse samples. They also propose that culture may serve as either a risk or a protective factor. A second goal they identify is to summarize studies of disasters among ethnically diverse, disaster-exposed, American children to provide a background for how ethnicity might interact with risk and protective factors to affect the development of PTSD in children. Finally, they use the example of American Indian youth to demonstrate the need for further empirical investigation of cultural variables as potential risk and protective factors for PTSD.
Some Cultural Approaches Or Models
Ridha & Orlin (1996) reviewed the effectiveness of seven Kuwaiti institutions created to help Kuwaiti citizens recover from the effects of the Iraqi occupation of 1990-1991. Three charities focused on helping men and four charities focused their efforts on women's problems. Problems suffered by Kuwaiti citizens included disturbed sleep patterns, anxiety, excessive fear of the dark or loud noises, feelings of hopelessness and lack of control, aggressive behavior against other persons, and destruction of property. Ridha & Orlin concluded that the Western model for disaster and catastrophe is incompatible with Kuwaiti culture. An intervention and service delivery model more suitable for an Arabian Islamic sociocultural context was recommended.
Shen (2002)investigated the effectiveness of short-term child-centered group play therapy in elementary school settings with Chinese children in Taiwan who experienced an earthquake in 1999. 65 children (aged 8-12 yrs) were screened. Children in the experimental group scored significantly lower on anxiety level and suicide risk after play therapy than did children in the control group. The effects of the treatment support previous studies of play therapy with American children. These findings suggest the possibility of using disaster intervention services which adopt Western helping techniques with school children of non-Western cultures.
In assessing children's reactions to the extreme stress of war and disasters, Aptekar & Stoecklin (1997) suggest focusing on three ways in which culture interacts with childrens' reactions to extreme stress. These include how culture mediates the possible range of child responses from PTSD to a relatively benign reaction, and finally to actually improved mental health.
Ecevit & Kasapoglu (2002) conducted a survey of 500 male and female survivors (aged 19-80 yrs) of the 1999 earthquake in Turkey to investigate their levels of alienation and forms of preparedness for future disasters. It was found that the level of alienation in general was not very significant and that level of education was the most important influential independent variable. The only alienation component found to have a negative impact on the responsible behavior related to preparedness for earthquakes was the social isolation variable. As level of education increases and social isolation decreases, responsible behavior increases. The existence of little such research in developing societies like Turkey increases the importance of this work and it should have a positive impact on similar future studies.
Debriefing and Other Approaches
The concept of debriefing has been popularized as a mental health intervention in the early phases of response to disaster. Raphael (2003) addresses several issues about psychological debriefing techniques and their place as mental health interventions in the immediate postdisaster or posttrauma phase. She clarifies the meaning of "debriefing" and reviews research that addresses the question of whether debriefing works. Special issues in early intervention and debriefing include such areas as physical needs; separation; loss of loved ones; dislocation, loss of home, and destruction of community; human malevolence; making meaning; personality and individual coping styles; timing; and culture. (2) concludes that any intervention must encompass principles such as psychological first aid, ensuring safety, security, survival, shelter, and other basics. Debriefing is not effective as a one-to-one early intervention, and group debriefing is mostly questions. For those at high risk following trauma and loss, specialized counseling may be beneficial.
Family health counseling, counseling in disasters, health interventions, transcultural/multicultural family counseling, and reimbursement with families of diverse cultures are all areas that have relevance for mental health professionals responding to disasters and similar crisis situations. The development of a therapeutic relationship with multicultural families, supervision and training for clinical practice with multicultural families, family assessment, legal and ethical issues, treatment plans for problem families and troubled families, and initiating family interventions are some approaches that can be implemented. It may also be relevant to explore the politics of gender in clinical practice, skills needed for ranscultural/multicultural family counseling, the need for evidence-based treatments, issues related to reimbursement services, and family counseling in disasters such as the 9-11 crisis.
Emergency Management of Disasters
Figley, Giel & Borgo (1995) provide a concise summary of the key elements to consider when planning a course of action to implement within a disaster-stricken community. They categorize disasters according to two dimensions: (1) sudden vs long-term and (2) natural vs man-made. These distinctions provide initial insights into the character of the disaster impact and the types of interventions that are likely to be helpful. They emphasize that it is necessary to outline key types of information that need to be gathered.
Emergency management (EM), the decision making involved in directing the relief operation after a disaster or otherwise catastrophic accident is an issue of public and private concern because of the high stakes involved. Due to the nature of emergencies, and especially mass emergencies, EM teams are faced with decision making in stressful situations, information ambiguity and overload, and a significant level of uncertainty, whereby non-routine problem solving of a knowledge-based nature is required. An important characteristic of EM is that it is a team of teams; multiple teams that come from different organizations, with different organizational goals and different organizational cultures, that work together to minimize the negative effects of the emergency. As a consequence, EM requires good coordination and communication not just within, but also among the various teams involved. Coordination among teams should, therefore, be a key focus for training.
An application of program planning and evaluation was described within the larger domain of natural disaster planning and in relation to evacuation and relocation of residents of Montserrat, a British Dependent territory, to England (Kydd, 1999). It was anticipated that utilization of the program planning and evaluation process by an external consultant would involve clients and stakeholders in a series of sequential, interrelated activities, resulting in useful information for the eventual benefit of clearly defined groups of evacuees in relocation settings. Through this process, key clients and stakeholders were identified and involved, both in Montserrat and in England, subsequent to the eruption of the Soufriere Hills volcano, and the initiation of evacuation and relocation activities in that setting. Then, these individuals collaborated with the consultant in targeting evacuees, and in conducting an assessment of the psychological and psychosocial needs of this group, using multiple quantitative and qualitative methods, with resulting data analyzed and synthesized within the evacuation and relocation context according to program planning and evaluation protocols. This information was then used by clients and the consultant as the basis for the development and documentation of guidelines for evacuation and relocation for use by the British Government in further assisting the evacuees as well as for adaptation of the guidelines to other natural disaster planning situations. Data collected in response to a set of case study questions indicated that the program planning and evaluation process has potential to be a practical, useful, proper, and efficient means of contributing to sound natural disaster planning, within and across cultures.
DeVries (1995) reviewed the multiple, interacting processes that are relevant to individual and community stress in response to catastrophe. He outlines three stages of the community response to stress: (1) inducing and legitimizing the communication of distress, and beginning to mobilize resources; (2) facilitating resource mobilization, including cultural coping mechanisms; and (3) maintaining support processes after the crisis has ended, including such resources as self-help healing strategies. Culture plays a role in coping with stress in that: (1) it organizes and provides meaning in stressful circumstances; (2) maintains itself through rules, roles, and rituals; and, (3) especially within traditional cultures, utilizes symbols to conceptualize the relationships between individuals, religious beliefs, body, and mind. These illustrate the three processes of inducing, facilitating, and maintaining community-level support systems within traditional and developed cultures and the ritualization of social communication and coping responses.
Conclusions
The studies which have been reviewed in the limited space available indicate that if behavior during and after disasters is to be adequately understood, more research is needed concerning the social and cultural attributes of the social systems involved. In addition to the social and cultural dimensions in disaster research, there are the typical differences related to their duration and focus. Studies of personality adjustment under stress, although important, must be analyzed within the broader social and cultural contexts of life.
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REFERENCES Apfelbaum, Erika (2000). The impact of culture in the face of genocide: Struggling between a silenced home culture and a foreign host culture. In: Squire, Corinne (Ed). Culture in psychology. New York, NY, US: Routledge. pp. 163-174.
Aptekar, Lewis & Stoecklin, Daniel (1997). Children in particularly difficult circumstances. In: Berry, John W. (Ed); Dasen, Pierre R. (Ed). Handbook of cross-cultural psychology, Vol. 2: Basic processes and human development (2nd ed.). pp. 377-412.
Canino, G.J.; Bravo, M.; Rubio-Stipec, M,; & Woodbury, M. (1990). The impact of disaster on mental health: Prospective and retrospective analyses. International Journal of Mental Health, 19: 51-69.
Chemtob, Claude M. (1996). Posttraumatic stress disorder, trauma, and culture. In: Mak, Felice Lieh (Ed); Nadelson, Carol C. (Ed. International review of psychiatry, Vol. 2. Washington, DC, US: American Psychiatric Association. pp. 257-292.
Cox, Ruth P.; Farr, Ken; Parrish, Eddie (2003). Family health counseling, counseling in disasters, health interventions, and reimbursement with families of diverse cultures. ; In: Cox, Ruth P. (Ed). Health related counseling with families of diverse cultures: Family, health, and cultural competencies. Westport, CT, US: Greenwood Press/Greenwood Publishing Group, Inc. pp. 169-191.
de Silva, Padmal (1999). Cultural aspects of post-traumatic stress disorder. In: Yule, William (Ed). Post-traumatic stress disorders: Concepts and therapy. New York, NY, US: John Wiley & Sons Ltd. pp. 116-138.
de Silva, Padmal (1993). Post-traumatic stress disorder: Cross-cultural aspects. International Review of Psychiatry, Vol 5(2-3), pp. 217-229.
deVries, Marten W. (1996). Trauma in cultural perspective. In: van der Kolk, Bessel A. (Ed); McFarlane, Alexander C. (Ed). Traumatic stress: The effects of overwhelming experience on mind, body, and society. New York, NY, US: Guilford Press. pp. 398-413.
deVries, Marten W. (1995). Culture, community and catastrophe: Issues in understanding communities under difficult conditions. In: Hobfoll, Stevan E. (Ed); deVries, Marten W. (Ed). Extreme stress and communities: Impact and intervention. New York, NY, US: Kluwer Academic/Plenum Publishers. pp. 375-393.
Ecevit, Mehmet & Kasapoglu, Aytuel (2002). Demographic and psychosocial features and their effects on the survivors of the 1999 earthquake in Turkey. Social Behavior & Personality, Vol 30(2), pp. 195-202.
Escobar, J.I.; Canino, G.; Rubio-Stipec, M.; & Bravo, M. (1992). Somatic symptoms after a natural disaster: A prospective study. American Journal of Psychiatry, 149: 965-967.
Figley, Charles R.; Giel, Robert & Borgo, Stefania (1995). Prevention and treatment of community stress: How to be a mental health expert at the time of disaster. In: Hobfoll, Stevan E. (Ed); deVries, Marten W. (Ed); Extreme stress and communities: Impact and intervention. New York, NY, US: Kluwer Academic/Plenum Publishers. pp. 489-497.
Form, William H.; Loomis, Charles P.; Clifford, Roy A. (1956). The persistence and emergence of social and cultural systems in disasters. American Sociological Review, 21, pp. 180-185.
Guarnaccia, P.J. (1993). Ataques de nervios in Puerto Rico: Culture-bound syndrome or popular illness? Medical Anthropology, Apr, 15: 157-170.
Guarnaccia, Peter J.; Canino, Glorisa & Rubio-Stipec, Maritza (Mar 1993). The prevalence of ataques de nervios in the Puerto Rico Disaster Study: The role of culture in psychiatric epidemiology. Journal of Nervous & Mental Disease, Vol 181(3), pp. 157-165.
Kydd, Sally Anna (Oct 1999). A case study of program planning and evaluation in assisting Montserratian evacuees and British government officials in natural disaster planning. Dissertation Abstracts International Section A: Humanities & Social Sciences, Vol 60(4-A), pp. 1351.
Marshall, Randall D. & Suh, Eun Jung (Win 2003). Contextualizing Trauma: Using Evidence-Based Treatments in a Multicultural Community After 9/11. Psychiatric Quarterly, Vol 74(4). Special Issue: The Fifteenth Annual New York State Office of Mental Health Research Conference. pp. 401-420.
Mileti, Dennis S. & Darlington, Joanne Derouen (Feb 1997). The role of searching in shaping reactions to earthquake risk information. Social Problems, Vol 44(1), pp. 89-103.
Perilla,JuliaL.; Norris, Fran H. Lavizzo Evelyn A. (Spr 2002). Ethnicity, culture, and disaster response: Identifying and explainingethnic differences in PTSD six months after Hurricane Andrew. Journal of Social & Clinical Psychology Vol 21(1), pp. 20-45.
Priya, Kumar Ravi (Jan,Jul,& Nov 2002). Suffering and healing among the survivors of Bhuj earthquake. Psychological Studies, Vol 47(1-3), pp. 106-112.
Rabalais, Aline E.; Ruggiero, Kenneth J.; Scotti, Joseph R. (2002). Multicultural issues in the response of children to disasters. In: La Greca, Annette M. (Ed); Silverman, Wendy K. (Ed). Helping children cope with disasters and terrorism. Washington, DC, US: American Psychological Association. pp. 73-99.
Raphael, Beverley (2003). Early intervention and the debriefing debate. In: Ursano, Robert J. (Ed); Uniformed Services U of the Health Sciences; Dept of Psychiatry; Ctr for the Study of Traumatic Stress. Terrorism and disaster: Individual and community mental health interventions. New York, NY, US: Cambridge University Press. pp. 146-161.
Ridha, Hadi; Orlin, Malinda (Dec 1996). Dealing with disaster victims: A Kuwaiti model. Journal of the Social Sciences, Vol 24(4), pp. 229-238.
Schaafstal, Alma M.; Johnston, Joan H. & Oser, Randall L. (Sep-Nov 2001). Training teams for emergency management. Computers in Human Behavior, Vol 17(5-6), Special Issue: Computer supported collaborative learning pp. 615-626.
Shen, Yih-Jiun (2002). Short-term group play therapy with Chinese earthquake victims: Effects on anxiety, depression and adjustment. International Journal of Play Therapy Vol 11(1), pp. 43-64.
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by Susan D. Moeller
From Publishers Weekly
"Compassion fatigue"?the dulled public sensitivity toward crisis?isn't inevitable, asserts Moeller, director of the journalism program at Brandeis. But formulaic and sensationalistic news coverage promotes it, she claims. In four worthy but somewhat belabored case studies, Moeller analyzes major American media coverage of recent crises, such as the Ebola virus, Ethiopian famine, the assassinations of Sadat and Rabin, and "death camps" in Bosnia. In these stories she found certain things were emphasized, others ignored: coverage of sensational disease, she notes, obscures more ordinary killers; images of starving children overshadow political causes for famine (and famines without photo opportunities are often ignored); the "Americanization" of assassination emphasizes that killers are crazy, rather than politically motivated; and lack of a simple heroes-and-villains story line obscured the Kurdish tragedy. The solution, she argues in an earnest but pollyannaish conclusion, is for the media to invest in international coverage, aiming for nuance and quality over sensationalism. More valuable for its analysis of what's wrong than on how to make it right, Moeller's book could have been made more helpful still through a brief comparison with media in other countries. Copyright 1998 Reed Business Information, Inc.
The Australian
"[Moeller] provides challenging detail and analysis [and] raises uncomfortable truths in a readable, provocative manner."
Book Description
In her impassioned new book, Compassion Fatigue, Moeller warns that the American media threatens our ability to understand the world around us. Why do the media cover the world in the way that they do? Are they simply following the marketplace demand for tabloid-style international news? Or are they creating an audience that has seen too much--or too little--to care? Through a series of case studies of the "Four Horsemen of the Apocalypse"--disease, famine, death and war--Moeller investigates how newspapers, newsmagazines and television have covered international crises over the last two decades, identifying the ruts into which the media have fallen and revealing why.
Additional Readings at:
Also try looking here for September 11, 2001: A Simple Account for Children.
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