Distinguishing distress and psychopathology among survivors of the Oakland/Berkeley firestorm.

Disaster mental health research has historically focused on assessment of psychopathology, using measures of psychiatric symptoms and disorders. The Oakland/Berkeley firestorm provided an opportunity to explore resilience among highly exposed survivors through consideration of psychiatric variables in the context of personality. The Diagnostic Interview Schedule/Disaster Supplement was administered to 62 firestorm survivors at approximately 4, 16, and 39 months and the Temperament and Character Inventory administered at 16 months postdisaster. Few individuals had postdisaster psychopathology (16% with any diagnosis, 5%with PTSD). There was considerable evidence of distress, however, indicated by an abundance of reported posttraumatic symptoms, functional impairments, and endorsement of emotional upset, all of which decreased substantially over time. Group C (avoidance/numbing) posttraumatic symptoms were relatively uncommon and were specifically associated with elevated Self-Transcendence. Groups B (intrusion) and D (hyperarousal) symptoms were prevalent and were associated with high Harm Avoidance and low Self-Directedness. The generally healthy personality profiles of these firestorm survivors reflected their psychological resilience. Examination of symptoms and distress in the context of psychiatric disorders after this disaster demonstrated that symptomatic distress is not inconsistent with psychological resilience. The choice of research focus and methods can provide very different portraits of outcomes post-disaster.