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EpidemiologyDr. Galea emphasized that the majority of people in the proximity of the disaster are very resilient and do not develop psychopathology. To understand the impact of disasters, he said, "It's useful to conceptualize a hierarchy of persons affected."
The largest group in a pyramid of those affected is the general population. The next levels, in ascending order of proximity, are persons in the area of the disaster, rescuers, family members of those killed or injured, and people directly injured in the disaster (see Figure A).
According to this schema, the severity of the psychological consequences in the second pyramid corresponds to the level of proximity to the disaster in the first pyramid. Because of this, research results that might at times appear conflicting "are in fact different results for different groups," Dr. Galea said. He also noted that the bulk of clinical and research resources "focus on the smallest group of people at the top of the pyramid."
Dr. Galea used data from a study he conducted after the March 11, 2004, terrorist train bombing in Madrid and from another study he conducted after the September 11, 2001, attacks in New York City to discuss differences in psychological response following each event. He attributed the much higher level of post-traumatic stress disorder (PTSD) in the general population of New York City to the highly visible nature of the 9/11 attacks and the fact that the attacks took place in a busy downtown area. Dr. Galea also said that populations already stressed for any pre-existing reason—social, economic, or health-related—have a higher incidence of PTSD following a disaster. "The course of psychopathology is complicated after disasters," he said, indicating a need for more research. « See Part 1: Hurricane Recovery Guides Preparedness Planning « See Part 2: Hurricane Recovery Guides Preparedness Planning See Also—Hurricane Recovery Guides Preparedness Planning See AlsoPost-Disaster Response: Learning Schools Offer Stability for Children of Disasters » Documentary Features New Orleans High School » |
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