What is psychopathology after disasters? considerations about the nature of the psychological and behavioral consequences of disasters

INTRODUCTION Disasters are an unexpected but not uncommon aspect of our lives. In 2005, an estimated 162 million people worldwide were affected by disasters (i.e., natural disasters, industrial and other accidents, and epidemics). Over 105,000 people died, and damages totaled over $176 million (World Health Organization, 2006). Earthquakes illustrate the burden of natural disasters. Globally, there are over 20,000 earthquakes a year, and over half are magnitude five or greater. Earthquakes can result in significant loss of human life; an earthquake in Iran in 1990 killed 50,000 people. In the Armenian earthquake of 1988 over 25,000 died, and the 1976 earthquake in Tangshan, China, resulted in at least 255,000 deaths and perhaps as many as 655,000 (U.S. Geological Survey, 2007). Human-made disasters include war and terrorism. Over 29 armed conflicts are occurring now around the globe involving 25 countries (Project Plowshares, 2007). Over two million children have been killed in war in the last decade and six million permanently disabled or injured (Project Plowshares, 2005; Ursano & Shaw, 2007). One and a half million people are displaced because of war and conflict in Uganda alone (Bolton et al., 2007). Apart from causing death and dislocation, disasters exert a substantial psychological burden on affected populations (Neria, Nandi, & Galea, 2008). The nature of this burden varies from one disaster to another and, within a given disaster, from one individual to another. We begin this chapter by describing the interface of mental health and disaster generally.