Psychological Distress, Essay Example

Psychological Distress and its Correlates Related to Environmental Concerns and Social Functioning among College Students from Tokyo after the Great East Japan Disaster

Abstract

Mental health is constantly affected by some environmental stressors (e.g., natural and technological disasters, pollution, food contamination), with the effects potentially evolving gradually as the stressors are elevated unpredictably. Therefore, it is necessary to study these events in the aim of assessing prevalence of negative health symptoms, and identify factors, and mechanisms which counteract devastating effects of stressors. The aim of the study was to assess prevalence of mental health problems and examine its correlation with environmental concerns and social functioning among college students from Tokyo. While existing studies are useful for showing directions, they do not represent strong tests of the possible processes underlying the relation between mental health and its correlates.  Data was collected from 103 respondents 10 months after the Great East Japan Disaster.  It was assumed that psychological distress experienced by the survivors will be high and negatively correlated to environmental concerns and good social functioning of the survivors. The study results revealed severe psychological distress, measured by the Kessler Psychological Distress Scale (K10), in 43% of the students. Structural equation modeling analyses supported our expectations and showed that the higher concerns on environmental pollution, and the  greater levels of sense of community, social support, coping by social joining, and positive relations with others were negatively related to the outcome. These findings emphasizes the need for mental health assessment and demonstrate directions of effective intervention. 

The Great East Japan Earthquake of March 11, 2011 off the coast of Honshu was classified as an apocalyptic disaster (Level 9 on the Richter Scale). The National Police Agency (2013) reports that because of the scale of the catastrophe with 15,883 deaths and thousands injured, missing, and rendered homeless. The earthquake caused a tsunami which damaged the Fukushima Daiichi nuclear power plant (Level 7 on the International Nuclear and Radiological Event Scale) and resulted in radiation leaks (2011, Japanese Nuclear and Industrial Safety Agency, NISA).

Mental health

Natural and/or man-made disasters are highly distressing events that affect whole communities as well as individuals. Therefore, most of the people living in active disaster action zones are susceptible to a wide range of mental health problems.  Short and long term mental health effects of natural and technological disasters can  occur in the form of general psychological distress and psychiatric disorders, including post-traumatic stress, depression, and anxiety (Nandi, & Galea, 2008; Vogel & Vera-Villarroel, 2010; Leiva, 2010).

Several studies have suggested a number of psychological responses to The Great East Japan Earthquake; includingpotentially traumatic effects on mental health of people (Yamashita, & Shigemura, 2013). The impact of the disaster on mental health among undergraduate students was studied recently by Harada and colleagues (2015). They evaluated mental health responses among undergraduate students in the immediate aftermath and 2.5 years after the event. The symptoms of traumatic stress, anxiety, depression, and anger were measured in the three different areas within the disaster trauma regions: Fukushima, Tokyo, and Kyoto. The results showed that students from Tokyo had the highest level of traumatic response, as well as anxiety, and depression immediately after the earthquake. Thus, conducting research on the mental health of Tokyo’s residents appear to be justified high risk of occurrence of mental disorders. A large study by Yokoyama and colleagues (2014) has been carried out 6-11 months after the disaster with the participation of more than ten thousand respondents. The aim of the study was to test the prevalence and correlates of mood and anxiety disorders among survivors of the Great East Japan Disaster measured by K6 Kessler’s scale. The findings suggest high prevalence of mental health problems in survivors. The results showed that 42.6% of the respondents had moderate or serious mental health problems. More mental health problems were related to certain characteristics; younger male, existing health issues, severe economic status, relocations, and lack of a social network (Yokyama et. al, 2014). 

Environmental concerns

The three disasters had significant impact on Japanese daily functioning, especially in Tokyo, 240 km from the Fukushima. Immediately after the disaster living conditions in the city were very difficult. Power outages, lack of proper drinking water, a paralyzed transport network, a aura of anxiety and widespread fear of buying radioactively contaminated products plagues Tokyo (Kato, Uchida, & Mimura, 2012).  Goodwin and colleagues (2012) in data collected 11-13 weeks following these events, found the majority of survivors were greatly concerned about a subsequent earthquake and the potential nuclear risks, especially in Tokyo. The perceived earthquake and nuclear risks were positively correlated with preventive actions (e.g., keeping an earthquake kit) and avoidance behaviors (e.g., avoiding certain foods or going outside). This study results suggest that people who were concerned about the environmental outcomes of the disaster made behavioral efforts to prevent any negative health outcomes. It is in line with Schultz (2001) study showing that concerns about specific environmental issues are related to people’s awareness of its negative consequences. To the authors’ knowledge, no study has examined the relationships between environmental concerns and mental health of disaster survivors. However, there are reasons to believe that people more concerned on environment use more appropriate coping strategies, i.e., behave more carefully and cautiously. Such behaviors should have positive impact on their mental health.

Social functioning

Studies conducted after natural disasters in various countries around the world prove that the interpersonal and community context catastrophic events of coping with trauma intertwine (Kaniasty & Norris, 2009). The review of literature research-based by Hobfoll and colleagues (2007) shows that one of the primary factors for successful coping with disaster stress are good interpersonal relationships and connectedness. The increased post crisis community cohesion has therapeutic effect and may mitigate adverse psychological effects of disasters (Kaniasty, 2012). Specifically, collective life is related to one’s evaluation of social well-being (Keyes, 1998). Social well-being is defined as the extent to which a person perceives themselves as a functioning member of his or her group or community (Keyes & Lopez, 2002). Specifically, collective life is related to one’s evaluation of social well-being (Keyes, 1998).

One of the better known disaster-related stress buffering agents is perceived social support (Bokszczanin, 2008, Koyama, 2014). The study by Koyama and colleagues (2014) run one year after the Great East Japan disaster among people who have been forced to live in temporary housing. The study showed 35.9% of refugees aged 40 years or older reported serious psychological distress, and documented that participants without social support had a higher risk of psychological distress. Social support in the time of disaster works also through the using of active coping strategies assistance (Prinstaine, La Greca, Vernberg, Silverman, 1996). These kind of coping buffers stress by the advice, feedback, and encouragement offered by members of the person’s primary social network (Thoits, 2011).

The next important factor associated with good social functioning after a disaster is a sense of community defined by belonging and trust to the group members (Goodman et al. 1998). High sense of community is a key factor of resilient communities. However the role of this factor is debatable because in some cases disasters can disrupt sense of community, while on the other hand amplify interdependence of the survivor’s, their feeling of belongingness, and pursue common goals (Norris et. al, 2008).

To sum up, (1) the first aim of the study was to assess the prevalence of psychological distress among college students in Tokyo aftermath the Great East Japan Disaster. We hypothesized that rate of the distress would be high based on data from other studies after this event (Harada et. al, 2015). We also hypothesized (2) that observed psychological distress extent will be diminished by environmental concerns because of using effective coping strategies (Goodwin et al. 2012; Sugimoto, Shinozaki, Naruse, & Miyamoto, 2014). Based on the literature showing that community-level factors influence postdisaster resilience we expected that (3) psychological distress will be also diminished by better social functioning of the survivors. While these existing studies are useful for showing directions, they do not represent strong tests of the possible processes underlying the relation between mental health and its correlates related to social functioning.

Discussion

Prevalence of the distress

The first purpose of the study was to estimate the prevalence of mental health problems. According with our hypothesis we found high prevalence of psychological distress among our respondents, college students from Tokyo, 10 months after Great East Japan Disaster.  Psychological distress is mental disorder specifically related to negative mood, feeling anxiety and depression (Kessler, RC, Andrews, G., Colpa, .et al 2002). Altogether about 67% of our respondents suffered moderate to severe psychological distress.

For comparison, study conducted among a community sample of young Japanese (aged 25-59) revealed that 31% of them showed high levels of psychological distress measured by the same scale (Kuriyama S, Nakaya N, Ohmori-Matsuda M, Shimazu T Kikuchi N, et al. 2009). In turn, Yokoyama et. al, (2014) using the same tool 6-11 months after the same disaster and  has also observed sever distress prevalence lower than in our study (in 43% of respondents). However, in their study included more than 10 thousand adults from the whole country (mean age 61.0), the highest proportion of disorders were found in the youngest group of respondents, age 18-44 old. Similarly, the other study by Ishikawa and colleagues (2015) run among undergraduates showed the highest levels of traumatic response measured  immediately after the disaster  in the group from Tokyo, to compare people from the other regions of Japan. The cited above examples of research demonstrate that the results of our study corresponding to the other studies results collected near the disasters activity epicenters and in the capital of Japan. Harada and colleagues (2015) in a review of 49 studies on mental health believed that mental responses after this disaster were diverse and complex, especially high prevalence is observed in the near Fukushima nuclear plant because of imperceptible nature of radioactive fear.

More support in the explanation of the result of high prevalence of psychological distress among college students comes from our study. We have also controlled a risk factors related to negative mental health outcomes – distance from the disasters epicenters they usually live, and experienced direct traumatic stressors and loses.  However, no significant proportion of the respondents experienced direct trauma and losses associated with the operation of the disasters our study revealed that most of our study participants live permanently at a considerable small distance from the disaster epicenters, a region where the Tsunami struck and the Fukushima nuclear power plant leak. The less distance from epicenter the higher level of mental health problems are observed in many previous studies run by disasters (Ahmad et al. 2010).  We can suggest than that in the time of our research the other stressors, uncontrolled here, could also exacerbate mental health problems of college students like exams or students economic problems (Greenglass,  & Mara, 2012).

Environmental concerns and disaster-related distress

Unexpectedly, our data showed no statistically significant correlation between environmental concerns measures and psychological distress. Therefore, structural equation modeling technique was used in the aim of assessing interdependence between psychological distress and examined correlates. The analysis results supported our second prediction considered that observed distress will be diminished by environmental concerns. All variables captured in the model explained statistically significant variance of psychological distress. However only one variable measuring perceived environmental concerns, worries on environmental pollution, occurred statistically significance. It suggests that 10 month after the Great Japan Disaster the mental health of people in Tokyo was related to concerns on power plant damage more than worries on natural disasters like hurricanes or earthquakes. We can speculate that Tokyo citizens at the time of study had sense of threaten by Fukushima damage. Moreover, we observed the direct impact of environmental concerns on social coping strategies. It is in line with theoretical assumption that more environmental concerns lead to active behaviors (Fransson, & Gärling, 1999). Coping efforts by working together with other people, cooperation and common help prevent occurrence of negative health outcomes (Goodwin et. al, 2012; Osofsky, Cross-Hansel, Osofsky, & Speier, 2015).

Good social functioning and disaster-related distress

We have also hypothesized that less psychological distress observed among disaster survivors will be related to their good social functioning. This expectation was supported by the results of the model we proposed.  The direct effect on psychological distress was observed only in the path from positive relations with others. It means that the better social-well being the less psychological distress. The other variables included in the model were not directly associated with the outcome. The result shows, overall, that better relations with other people, more friendly associations, stronger ties, and more coping with stress by working in

conjunction with other  people had protective effect on  mental health of the disaster survivors. In a crisis situation caused by disaster good social functioning paying off in the form of better mental health. Our research has also shown that even in an emergency situation linked to influence of technological disasters people who are well established in their communities have less mental health problems. We have learn from the other disaster studies, also after the same tragedy in Japan,  that good social functioning are crucial in disaster recovery (Dumont, Wigboldus, Gordijn, 2003; Nakagawa & Shaw 2004; Koyama et al. 2014).

We should noted that our considerations about the direction of the relationships between the variables are limited due to the cross-sectional design. We also did not inquire about the other potentially seriously distressing for college students problems, related to their everyday life, such as examinations or financial problems.  Furthermore, the small number of respondents seems to be  the factor decreasing the strength of  the observed correlates and the stability of the  model.

Conclusions

The greatest severity of psychological distress and the other psychiatric disorders is shown in the first months after the disaster among young people. It is generally observed that after a year, the majority of mental health problems slowly disappear. It remains only in persons susceptible to the psychiatric disorders and if not treated can be seen even by many years. Thus, it is extremely important to detect mood and anxiety disorders among population attracted by disaster–related trauma in the aim to abate the mental health consequences, including suicide. Therefore, our study findings emphasize the need for mental health assessment, interventions, and service availability for the most severe affected individuals.

We have also shown that those who is more concerned on environment is also  more willing to cooperate with others, cope better with stress, and then diminishes risk of mental problems after disaster. Further studies should focus on intervention programs to increase awareness of the environmental factors influences behaviors in the process of dealing with disaster trauma. Once again, we also showed that cooperation and strong social bonds improve the well-being of disaster survivors and can counteract anxiety and depression. The findings provide evidence that factors related to social functioning had positive and significant impact on the recovery process after the disaster (Ursano et al. 2014).