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

本研究探讨了灾害对受灾者心理健康的影响、创伤与创伤后应激障碍(PTSD)的关系以及受灾者的心理健康护理指南。主要研究结果如下：1.采用28个项目的一般健康问卷(GHQ28)对北海道南海道地震受灾最严重的大石岛居民进行问卷调查。GHQ28的可接受阈值是6分及以上，这表明非精神病性精神障碍的风险。在地震后74个月，54.6%的受访者得分在6分以上。这一结果支持了以下假设：一场中心灾难破坏了社区的整个身体和组织结构，给许多受害者带来了严重损失的经历，增加了受害者发生严重长期心理功能障碍的可能性。创伤分为两类：单发创伤和反复创伤。前者意味着…S更多的是经历过一次大地震，而后者意味着重复经历过身体暴力。据认为，这些创伤性质的不同对确定所经历的精神障碍的类型，即单纯性创伤后应激障碍和复杂的创伤后应激障碍具有重要作用。有与会者指出，创伤后应激障碍的诊断标准有许多问题需要克服。例如，对创伤后应激障碍的标准的描述以及与其他疾病的关系都需要澄清。经常有报道说，利用情况通报在灾害受害者和救济人员中预防创伤后应激障碍是有效的。然而，对汇报效果的研究表明，结果是相互矛盾的。这项研究指出，这种分歧源于控制小组的存在或缺乏以及在这些研究中使用的工具类型4。研究认为，灾害干预计划由四个阶段组成：减灾阶段、对应阶段、恢复阶段、反馈阶段。减灾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预案采取有效行动的阶段。恢复阶段是帮助灾民重建生活的阶段。而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。较少

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