Psychosocial Resources in the Aftermath of Natural and
Human-Caused Disasters: A Review of the Empirical Literature, with
Implications for Intervention
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:
Collective grieving expresses solidarity and facilitates unity
and collective action.
Keep people in their natural groups if they must be
relocated.
Provide social activities for new communities that form
because of displacement, especially if natural groups have not been
retained.
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.
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:
Encourage families to talk together about their experiences,
losses, and feelings.
Encourage families to resume normal activities to the extent
possible.
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.