A STUDY ON FACTORS CONTRIBUTING TO RECOVERY PROCESSES OF DISASTER VICTIMS' METAL HEALTH

本研究旨在探讨灾难对受害者心理健康的影响、创伤与创伤后应激障碍（PTSD）的关系以及受害者心理保健的指导。主要研究结果如下：1。对北海道南关地震受灾最严重的奥尻岛居民实施了28项一般健康问卷（GHQ28）。GHQ28的公认阈值是6分及以上，表明非精神病性精神疾病的风险。在地震发生74个月后，54.6%的受访者得分在6分以上。研究结果支持了这样一种假设，即“一场中心灾难摧毁了整个社区的物质和组织结构，给许多受害者带来了严重的损失，增加了受害者长期严重心理障碍的可能性”。创伤分为两类；单一创伤和重复创伤。前者意味着多次经历一次大地震，后者意味着多次经历身体暴力。这些创伤性质的差异在确定所经历的精神障碍类型（即简单PTSD和复杂PTSD）方面起着重要作用。指出创伤后应激障碍的诊断标准有许多需要克服的问题。例如，PTSD诊断标准的描述以及PTSD与其他疾病之间的关系都需要明确。经常有报道说，在灾难受害者和救援人员中，使用述职对预防创伤后应激障碍是有效的。然而，关于述职效果的研究显示出矛盾的结果。这项研究指出，这种分歧来自于诸如是否存在控制组以及这些研究中使用的工具类型等问题。研究提出，灾害干预计划可分为减灾阶段、对应阶段、恢复阶段和反馈阶段。缓解阶段是灾难发生前的一个阶段。换句话说，这是一个准备阶段。对应阶段是指根据灾难应急计划有效采取行动的阶段。恢复阶段是指帮助受害者重建生活的阶段。反馈阶段是指利用从灾难中吸取的教训，修改应急计划，使其更加有效和实用。少

This study examined the influence that a disaster has on victims' mental health, the relationship of trauma and Post Traumatic Stress Disorder (PTSD), and the guideline of mental health care for victims.The main results were followongs :1. The 28-item General Health Questionnaire (GHQ28) was administered to residents of Okushiri Island which was most heavily damaged by the Hokkaido Nanseioki Earthquake. The accepted threshold for GHQ28 that indicates a risk for nonpsychotic psychiatric disorders, is a score of six and above. At 74 months after the earthquake, 54.6% of respondents scored above 6. The result supported the hypothesis that states'a central disaster which destroys the whole physical and organizational structure of the community, and which brings experiences of serious loss to many victims, increases the probability of serious long term psychological dysfunction among the victims.2. Trauma is classified into two categories ; single trauma and repeated trauma. The former mean … More s experience of a great earthquake once, and the latter means repeated experiences of physical violence. It was considered that the difference of nature of these trauma plays significant role in determining the types of psychiatric disorders, i.e. simple PTSD and complex PTSD, experienced. It was pointed out that there are many issues need to be overcome in the diagnosis criteria of PTSD. For instance, both the description of the criteria and relationship between PTSD with other disorders need to be clarified.3. It is often reported that the use of debriefing was effective in prevention of PTSD among disaster victims and relief workers. However, researches on the effects of debriefing indicated contradictory results. This study pointed out that such disagreement comes from issues such as presence or lack of control groups and types of instruments used in those reseaches4. The study propsed that disaster intervention plan was consisted of four phases : mitigation phase, correspondence phase, recovery phase, feedback phase. Mitigation phase is a stage before a disaster occurs. In other words, it is a preparation stage. Correspondence phase means a stage to act effectively according to the contingency plan for a disaster. Recovery phase means a stage to help the rebuilding of victims' lives. And feedback phase means to make use of a lesson learned from a disaster, and to modify the contingency plan to make it more effective and practical. Less