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179 Pages·1981·4.803 MB·English
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This is a volume in PERSONALITY AND PSYCHOPATHOLOGY A Series of Monographs, Texts, and Treatises Under the Editorship of David T. Lykken A complete list of titles in this series appears at the end of this volume. Prolonged Psychosociol Effects of Disoster A STUDY OF DUFFALO CREEK GOLDINE C. GLESER DONNIE L GREEN CAROLYN WINGET Department of Psychiatry University of Cincinnati College of Medicine Cincinnati, Ohio ACADEMIC PRESS 1961 A Subsidiary of Harcourt Brace Jovanovich, Publishers New York London Toronto Sydney San Francisco COPYRIGHT © 1981, BY ACADEMIC PRESS, INC. ALL RIGHTS RESERVED. NO PART OF THIS PUBLICATION MAY BE REPRODUCED OR TRANSMITTED IN ANY FORM OR BY ANY MEANS, ELECTRONIC OR MECHANICAL, INCLUDING PHOTOCOPY, RECORDING, OR ANY INFORMATION STORAGE AND RETRIEVAL SYSTEM, WITHOUT PERMISSION IN WRITING FROM THE PUBLISHER. ACADEMIC PRESS, INC. 111 Fifth Avenue, New York, New York 10003 United Kingdom Edition published by ACADEMIC PRESS, INC. (LONDON) LTD. 24/28 Oval Road, London NW1 7DX Library of Congress Cataloging in Publication Data Gleser, Goldine C. Prolonged psycnosocial effects of disaster. (Personality and psychopathology) Bibliography: p. 1. Disasters—Psychological aspects. 2. Survival (after airplane accidents, shipwrecks, etc.)—Psycho­ logical aspects. 3. Dam failures—West 'Virginia— Buffalo Creek. U. Buffalo Creek (W. Va.)~Flood, 1972. I. Green, Bonnie L. II. Winget, Carolyn N. III. Title. IV. Series. CDNLM: 1. Diasters. 2. Stress, Psychologi­ cal. 3. Psychology, Social. Wl PE861 V. 25 / BF 789.D5 G558p: BF789.D5G55 I1!5 5.9f35 81-7899 ISBN O-I2-28626O-O AACR2 PRINTED IN THE UNITED STATES OF AMERICA 81 82 83 84 987654321 TO FREDERIC Τ. KAPP, M.D. (1914-1980) By his early involvement in the investigation of psychic trauma at Buffalo Creek, Dr. Kapp set a standard of excellence and commitment for his colleagues in this endeavor. Preface The extent of human misery occasioned by disasters, both man-made and natural, highlights our need to learn more about the long-range psychological effects that disasters have on their survivors. Are there con­ structive as well as destructive sequelae, and if so, what aspects of a disaster make a difference in this regard? Only by utilizing a systematic approach and by combining information from many disaster studies are we likely to make progress in understanding the ways in which people are affected by such experiences. In so doing, it will become possible not only to deal more humanely and effectively with survivors, but also to increase our knowledge about personality and change. This book was written to provide impetus for such studies as well as to disseminate the findings of an investigation into the psychological effects of a specific disaster. The disaster dealt with in this book took place on February 26, 1972, when a slag dam collapsed, inundating the valley of Buffalo Creek, West Virginia. A lawsuit filed on behalf of more than 600 men, women, and children for whom psychic impairment was claimed necessitated interviews by mental health professionals retained by each side in the case. These data, supplemented by information from self-report instruments concerning cur­ rent symptoms, sleep problems, family disruption, and dream reports, form the data base for the detailed investigation reported here. From this exten­ sive information there emerges a well-rounded description of the be­ havioral and emotional upheaval still evident in this population when the interviews were conducted 2 years after the traumatic event. Follow-up studies extend the data on some individuals to as long as 5 years postflood, assessing the impact of the legal settlement. More importantly, relationships between the individual disaster experi­ ences of the survivors and their later psychological functioning are exam­ ined to determine which aspects of a disaster and its aftermath are most ix Χ : PREFACE likely to lead to long-term impairment. Results are integrated into the growing body of literature on the psychological effects of disaster. In addi­ tion, a model is suggested to incorporate both aggregate and individual data. Chapters 1-3 provide the necessary background information, including an account of the disaster itself and of the subsequent lawsuit against the coal company, as well as a description of the subjects. Chapter 4 indicates how we went about quantifying our data and gives some information regard­ ing their reliability and validity. Chapters 5-7 present the findings on these data, while the follow-up studies are detailed in Chapter 8. The final chapter contains a summary of our findings and proposes specific suggestions as well as a model for future disaster studies. Although this study will be of most practical importance to mental health scientists and clinicians working with the victims of stress and disas­ ter, it should also be of considerable interest to social and behavioral scien­ tists and, more generally, to administrators of government activities. Fur­ thermore, the detailed discussion of problems encountered in obtaining and processing these data, and the suggestions for future research should be particularly helpful to those planning to do work in this or related areas, whether it be from the standpoint of epidemiology or basic personality research. This investigation, like most large-scale studies, necessitated the coop­ eration and support of a large number of people. We are particularly grateful to the law firm of Arnold and Porter for making available to us the interview reports on all the litigants. Furthermore, the study would not have been possible without the financial support given to us through Grant No. ROI MH 26321 from the National Institute of Mental Health, 1973-1977, as well as the seed money made available to us by the University of Cincin­ nati Department of Psychiatry. Space does not permit a listing of the many people who conducted the interviews, but certainly our indebtedness to James Titchener, who made arrangements for the University of Cincinnati Department of Psychiatry to participate in the interviewing of the Buffalo Creek litigants, should be acknowledged. A number of people were involved in the quantification, tabulation, and processing of data. In particular, we thank David Brandt, Linda Crespo da Silva, Laura Gantz, Mary Grace, Mary Kapp, Laurie Levi, and Lois Winget for their dedicated help in this regard. We also wish to acknowledge those who read earlier drafts of the chapters, making many helpful sugges­ tions, especially Frederic Kapp before his untimely death, Sol Gleser, and Mary Grace. And finally, we extend a most heartfelt thanks to Mary Dan- zeisen, who patiently typed the manuscript of this book, cheerfully accept­ ing version after version and often helping to spot errors and inconsisten­ cies. Chapter 1 Introduction A major disaster is considered to be a rare event; and indeed it is for any one area of the globe during a specified period of time. But taken together, even natural calamities such as floods, typhoons, hurricanes, cy­ clones, tornadoes, and earthquakes sum to a staggering number. Hewitt and Sheehan (1969) and later Dworkin (1973) compiled a list of all reported natural disasters (excluding droughts) occurring worldwide in the 27 years from 1947 through 1973 in which 100 or more people were killed or injured or in which at least $1 million worth of damage was incurred. There were 836 such incidents reported, an average of 31 per year. These figures do not include data from half the globe, since complete reports were not available from northern Europe, the U.S.S.R., much of Africa, and, during part of the period, China. Thus, the actual number of major natural disasters could easily be double these figures. In the disasters listed, over a half- million lives were reported lost, with the greatest number of deaths occur­ ring in the less developed countries. When it is realized that natural disasters comprise only about half of the major disasters that occur, even in a world at peace, the total impact be­ comes all the more staggering. Fires, plane crashes, railway accidents, min­ ing catastrophes, chemical pollution, and dozens of other man-made mis­ haps can affect entire communities as well as the lives of the victims and their families. Furthermore, the head count of victims and the cost in terms of property loss tell us little about the total impact of disasters on society. For each person killed there are several more left bereaved. Each house destroyed represents a major crisis for those who lived there, necessitating that they rebuild and reorder their lives. A poignant picture of the im­ mediate effect of a disaster on surviving victims is provided by Stretton (1976) in a narrative of his experiences on taking over command in the 1 2 : LONG-TERM PSYCHOSOCIAL EFFECTS OF DISASTER relief of Darwin, Australia, after the advent of Cyclone Tracy on Christmas morning, 1974. He describes the scene at the police station upon his arrival that evening: "Women and children were stretched out on the floor, on tables, and in the corridors.... Children cried out in their sleep and clutched mothers who were still in various stages of shock. Sleeping forms would suddenly start to shudder and cry out as they relived their hours of terror [p. 46]." How quickly do survivors recover from the impact of such an experience? What are its immediate and long-term psychological effects? These and other questions regarding disasters have only recently become the subject of investigation by social and behavioral scientists. It is fairly widely accepted that psychological consequences extend well beyond the initial phase of a disaster and that they affect not only the survivors but also many who are involved only by virtue of their participa­ tion in rescue and relief activities, or through their kinship to the victims (Raphael, 1977; Umbenhauer & Winget, 1980). There is much less agreement regarding the persistence and pathological nature of psychological sequelae. Some investigators (e.g., Quarantelli & Dynes, 1973) have pointed to posi­ tive effects of a disaster: Participating in the effort to assist the injured and needy, victims may discover within themselves previously unknown strengths. Other investigators (e.g., Hocking, 1970a, 1970b; Lifton, 1967) focus more on the potential for psychological impairment from such events. Such diverse views may stem in part from the fact that disasters do not form a homogeneous class of events. Some disasters occur without warning—others have a slower onset. Some are due to the unpredictability of nature, whereas others can be attributed to greed, malevolence, or negli­ gence. Barton (1969) has suggested four dimensions along which disasters may vary, resulting in differential effects on the victims. These dimensions are {a) scope of the impact (i.e., how large an area and how many people are involved); (b) speed of onset (sudden, gradual, or chronic); (c) duration of impact; and (d) social preparedness of the community. Undoubtedly, signif­ icant other worthwhile distinctions can also be made. For example, victims may be members of a community or they may be a transient group (e.g., victims of a plane or train crash). The challenge for researchers is to pin­ point those factors that lead to long-term psychopathology in survivors and those factors that have the potential for strengthening the character of individuals and for enhancing family and community bonds. One disaster that has received considerable attention from a number of social scientists as well as from the public at large took place in Buffalo Creek, West Virginia in the early morning of February 26, 1972. On that day, a slag dam constructed by a mining company gave way, unleashing 132 million gallons of churning black slag, debris-filled mud, and water into the Buffalo Creek valley below, carrying with it bridges, houses, cars, trailers, 1. INTRODUCTION : 3 and human bodies. People who had scrambled up hillsides to safety watched helplessly as relatives, friends, and neighbors were propelled past them by the black swirling waters. Three hours later the last of the water emptied into the Guyandotte River, leaving 125 dead, many hundreds injured, and thousands homeless. Within hours, the local National Guard unit had sealed off the area, and medical units from nearby hospitals had begun to evacuate the badly injured. Volunteer rescue crews were formed and the Red Cross and Salvation Army began bringing in needed supplies. But many weeks went by before the worst of the debris could be cleared away and burned, the black muck hauled away from those houses left standing, and some order restored. In the meantime, families stayed with friends or camped in a school gymnasium just outside the valley. Finally, they were housed in trailers supplied by the Department of Housing and Urban Development (HUD) in 13 sites in and near the valley. Trailers were assigned on a first-come-first-served basis, so that friends, neighbors, and kinfolk were often separated. A number of families packed up what few belongings they still possessed and moved away. The situation was exacerbated by a decision by the state of West Virginia to build a new highway up the middle of the narrow Buffalo Creek Valley. This meant that many who owned their land could not rebuild or move back until a final decision was made as to where the new road would be placed. Two years later victims were still waiting to return to their land. Owing to the efforts of a group of survivors who did not see this as a "natural" disaster, but rather as the result of a willfully illegal act by the mine owners, a lawsuit ensued that has made legal history as well as making possible the data for this book. Stern (1976) has written a fascinating ac­ count of the legal maneuvers by which he and his partners in the firm of Arnold and Porter forced into evidence the culpability of the Pittston Com­ pany in maintaining an improperly constructed slag dam. The out-of-court settlement in July, 1974 for $13.5 million, including an unprecedented $8 million for psychic impairment stemming from the disaster, marks the first time it has been legally acknowledged that psychosocial as well as physical injury can stem from a disaster. Two other books as well as a number of journal accounts yield additional perspectives of the Buffalo Creek disaster. Tom Nugent (1973), a freelance reporter, has presented a poignant and dramatic account of the event itself, following the movement of individuals and whole families caught up in the black waters or fleeing to the hills as the flood approached their homes. Erikson (1976), writing from a sociological viewpoint, gives one a feel for the history and culture of the mountain people who inhabit this area of West Virginia, the sense of community that knit them together, and the devastating effect of their uprooting and dispersion as a result of the 4 : LONG-TERM PSYCHOSOCIAL EFFECTS OF DISASTER disaster. From hundreds of legal documents, statements, and letters, as well as from lengthy personal interviews, he concludes that the survivors were not only individually traumatized by the disaster, but that there was a "loss of communality" which left the victims isolated and lacking anchors or community support. It is this loss that he feels accounts for much of the chronicity of the depression that engulfed the survivors. A symposium entitled "Disaster at Buffalo Creek" was held at the 1975 American Psychiatric Association meeting in Anaheim, California and its proceedings published in the March 1976 issue of the American Journal of Psychiatry. Material presented at this symposium describing the interviews conducted with the litigants will be summarized in Chapter 2. In a journal article elsewhere, Lifton and Olson (1976) related the emotional manifesta­ tions of the survivors they interviewed at Buffalo Creek to the survivor syndrome described previously by Lifton (1967) on the basis of his research at Hiroshima. Church (1974) gave a brief description of four cases he treated and suggested some procedures to alleviate emotional distress in future disasters. As has been mentioned, the data that are analyzed and presented in this book became available as a result of the lawsuit filed on behalf of over 600 survivors. The University of Cincinnati Department of Psychiatry became involved when one of its members was retained by the law firm of Arnold and Porter to organize a group of experts to interview the litigants and assess the psychological impairment they had suffered. Several of us, aware of the unusual research possibilities of such data, hastily helped the team leaders draw up a semistructured interview schedule in the hope of achiev­ ing some comparability among data to be obtained by the numerous psychi­ atrists, psychologists, and social workers who were to interview the survivor-plaintiffs in the spring of 1974. In addition, we included a symp­ tom checklist, a sleep survey, and a checklist of family disruption indicators in the packets for each team, requesting that these be administered to the adult survivors whenever possible. The law firm also had copies of another set of reports on the physical and mental health status of the litigants: those obtained for the defense. Russell Meyers, a neuropsychiatrist, had been hired to examine each and every plaintiff in his office at Williamson, West Virginia. These exam­ inations, which included neurological and physical as well as psychological tests, took place over a 6-month period during the fall and winter of 1973— 1974. The reports were made available to us by Arnold and Porter after we had received a grant from the National Institute of Mental Health (NIMH) to pursue our research. In them, Meyers presents his findings in a routine manner, terminating with a diagnosis and recommendation. Although Meyers often found psychopathoiogy at the time of his interview, he tended

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