Psychosocial Resources in the Aftermath of Natural and Human-Caused Disasters:
A Review of the Empirical Literature, with Implications for Intervention
A National Center for PTSD Fact Sheet
Prepared by: Fran H. Norris, Georgia State University, now at Dartmouth Medical
School and NCPTSD, with the assistance of Christopher M. Byrne and Eolia Diaz,
Georgia State University, and Krzysztof Kaniasty, Indiana University of Pennsylvania
Findings regarding psychosocial resources are organized by distinguishing
between resources that are threatened by stress (vulnerable resources) and
resources that emerge in response to stress (emergent resources). Emergent
resources must be mobilized to replace or replenish the vulnerable ones. We
first reviewed the evidence regarding the protection afforded by psychological
and social resources, then the evidence regarding the potential for resource
deterioration, then the evidence regarding resource mobilization in the
aftermath of disasters.
Protection Afforded by Psychological Resources
Psychological resources such as coping efforts, self-efficacy, mastery, perceived
control, self-esteem, hope, and optimism do protect disaster victims, as
indicated by the following empirical results:
*
Ways of coping
influenced symptom outcomes in several studies, but the findings were not
always consistent across them. Avoidance coping and blame assignment were
consistently problematic, but other ways of coping were sometimes helpful and
sometimes not.
*
Beliefs about
coping were far more important
than ways of coping. What matters, apparently, is not how individuals actually
cope but rather how they perceive their capabilities to cope.
*
Self-efficacy,
mastery, perceived control, self-esteem, hope, and optimism all are related
positively, strongly, and consistently to mental health in both the short-term
and long-term.
Protection Afforded by Social Resources
Social embeddedness, received social support, and perceived social support
are all critical for disaster victims, as indicated by the following findings
in the empirical research:
*
Social
embeddedness-the size, activeness, and closeness of the survivor's
network-is related strongly and consistently to mental health.
*
Received social
support is the actual helping behavior that emerges in response to stress.
Although it usually is related positively to mental health, the findings are
not entirely consistent, in part because levels of help received are confounded
with need. Received support is important primarily because it protects and
replenishes other resources, such as perceived social support.
*
Perceived social
support is the most thoroughly
researched social resource. With few exceptions, disaster survivors who
subsequently believe that they are cared for by others and that help will be
available if needed, fare better psychologically than disaster survivors who
believe they are unloved and alone.
Resource Deterioration
The extent to which resources were lost may be the single most important
thing to understand about a postdisaster environment, as indicated by the
following research:
*
Global indices
of resource loss show that the
greater the amount of resource loss, regardless of the specific resources, the
greater the psychological distress. Several studies have found such measures to
be the strongest predictors of symptom outcomes.
*
Psychological
resources, such as optimistic
biases and perceived control, occasionally have been found to decline after
disasters.
*
Social resources,
specifically social embeddedness and perceived social support, appear to be
especially vulnerable to the effects of disasters. The reasons are many, including
loss of network members through death and relocation and community-wide changes
in social activities. An important feature of disasters is the likelihood that
potential supporters are victims themselves. As a result, the need for support
for all affected may surpass its availability, leaving social networks unable
to provide necessary support.
*
The Social
Support Deterioration Model, which has been tested across several
disasters, indicates that declines in social support account for a large share
of victims' subsequent declines in mental health. Attending to the social needs
of disaster victims could go a long way toward protecting survivors from
long-term adverse psychological consequences.
*
Resource
mobilization can help counteract the forces that engender resource
deterioration. It is therefore critical to understand the processes that
influence the receipt or mobilization of postdiaster social support.
*
The Social
Support Deterioration Deterrence Model, an extension of the earlier
deterioration model, shows that resource deterioration is not inevitable. When disaster victims receive too little help
relative to their needs, their subsequent perceptions of social support
deteriorate. However, when disaster victims receive help that is adequate relative
to their needs, they maintain their expectations of support (and subsequent
mental health).
*
Families and
friends are relied upon more often, and with greater subsequent comfort,
than outsiders and professional sources of support.
*
Emotional,
informational, and tangible help are all important to disaster victims.
*
The rule of
relative needs, which means that the most help should go to those who need
it the most, is followed appropriately by most communities.
*
The rule of
relative advantage acknowledges that the distribution of postdisaster help
is not governed by need alone. Within communities, the amount of received
support increases as network size, help-seeking, comfort, and economic
well-being increases. These rules operate at the macro- as well as micro-level.
Postdisaster "altruistic communities" are less likely to develop in a
context of low resources than in a context of high resources. These communities are also less likely to
develop after technological disasters than after natural disasters. As far as
we know, support mobilization has not been studied in the aftermath of mass
violence.
*
Sustaining
helping activities may be more difficult than mobilizing them. In time, attentive media and other
outsiders leave. Families and social networks become saturated with stories and
shared feelings. Over time, fatigue, irritability, and scarcity of resources
increase the potential for interpersonal conflict and social withdrawal. When
support provisions are inadequate, inequitable, or too short-lived, the mobilization
of support gives way to the deterioration of support.
Summary and Conclusions
Although the empirical data on resources is less extensive than the research
on the overall impact of disasters or risk factors for adverse outcomes, it has
grown tremendously in recent years. These data yield the following conclusions
and recommendations:
*
Naturally
occurring psychosocial resources provide important protection against
adverse symptom outcomes. Unfortunately, these same protective resources are
themselves vulnerable to the impact of disasters and sometimes decline or
deteriorate in strength. Fortunately, such deterioration is unlikely when
postdisaster support provisions are adequate, equitably distributed, and
sufficiently lasting to meet survivors' needs.
One limitation is that the data
supporting this perspective emerged primarily from studies of natural
disasters. Although some of the natural disasters studied have been quite
serious, it has not been established
that naturally occurring resources are powerful enough to overcome the effects
of the profound trauma that accompanies mass violence. It also has not been
established that such resources and processes effectively protect survivors
from PTSD, as most of the studies predicted levels of nonspecific distress.
This is not to say that resources are not important in the context of mass
violence, only that they have not been studied very much.
*
We should educate survivors, and those who come into
contact with them, that avoidance and blame assignment are rarely
effective coping strategies. Otherwise, however, the specific ways of
coping matter much less than do people's
perceptions of themselves as able to cope and control outcomes. It may be more
important for disaster workers to reassure survivors that they do, in fact,
have what it takes to meet the demands faced.
*
A focus on
self-efficacy does not mean that mental-health services are not needed but
rather that such services should be delivered in a way that provides resources
without threatening them. Some people are more likely to accept help for
"problems in living" than to accept help for "mental-health
problems." In exercising our good intentions to help victims, we must not
inadvertently rob them of the very psychological resources they need to
persevere over the long term.
*
Naturally
occurring social resources are particularly vital for disaster victims.
Professionals and outsiders are important sources of assistance when the level
of need is high, but they must not and cannot supplant natural helping
networks. People should not abandon
their routine social activities because these keep people informed about the
relative needs of network members, provide natural forums for sharing
experiences, and preserve a sense of social embeddedness. It also might be
helpful to educate individuals about the reasons why significant others may not
always be able to provide them with the quality or quantity of interpersonal
support they expect.
Implications for
Intervention
A number of implications for intervention can be drawn from the above
results. Whether directed toward the community, family, or individual, the
emphasis for interventions should be on empowerment, meaning they should draw
upon and build strengths, capabilities, and self-sufficiency.
Community-focused interventions
for enhancing social resources will vary depending upon the disaster, the
setting, and the culture. General recommendations are as follows:
o
Collective grieving expresses solidarity and
facilitates unity and collective action.
o
Keep people in their natural groups if they must be
relocated.
o
Provide social activities for new communities that form
because of displacement, especially if natural groups have not been retained.
o
Group meetings in which participants brainstorm about
various themes for rebuilding the community help survivors to recognize the
reality of loss, to identify and discuss local problems, and to work together
toward an achievable, specific goal.
o
In order to emphasize inclusiveness, the above
activities must reach out to people who might feel isolated or marginalized.
Community members also might canvas the community to learn of others' needs.
Family-focused interventions are
very important. Most people are most comfortable seeking and receiving help
from family members, yet family members also are a significant source of strain
and conflict. Disaster workers should search for effective ways to build and
sustain support at the family level. The following are only a few general
suggestions:
o
Encourage families to talk together about their
experiences, losses, and feelings.
o
Encourage families to resume normal activities to the
extent possible.
o
Help families handle conflict appropriately so as to
minimize negative encounters caused by the strain, fatigue, and irritability
that often follow trauma.
Individual-focused interventions
are costly and often unnecessary. They should be reserved for those persons who
are most distressed, who had weak psychological and social resources to begin
with, or who suffered particularly dire resource losses. If it is recalled that
resources must be invested in order to acquire new ones, it will be understood
that the people who need such services the most may be least likely to seek
them. Outreach to such persons, and to the communities in which they are most
likely to live, is essential.
Clearly, resources matter in times of stress. The concepts of emergent and
vulnerable resources may be helpful not only for organizing the research but
for organizing information about a specific community's resources. A clear goal
of intervention should be to help disaster-stricken communities plot strategies
that increase the emergence of resources and decrease the vulnerability of resources.
Providing the people within indigenous networks with the resources they need
to help one another is (or should be) the primary objective of disaster mental-health
policy. The ultimate task is to foster a mobilization of community support that
will be powerful, inclusive, and that will last long enough to conquer the spiral
of losses.
Related Fact Sheets
Coping with
PTSD
Provides information for PTSD survivors on positive techniques for dealing
with PTSD
Risk factors
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disasters
Treatment and
assessment
Description of the phases of coping with traumatic stress and the typical symptoms
expressed following trauma
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