Psychological reactions of disaster victims.

A general review of psychological reactions to a disaster situation in four groups of people is presented. Adult reactions (and management thereof) vary according to the phase of the disaster, viz (i) the pre-impact phase characterized by underactivity, development of anxiety symptoms or involvement in adaptive activities; (ii) the warning phase typically manifested by overactivity; (iii) the impact phase characterized by bewilderment, confusion or hysteria; (iv) the turmoil-recoil phase manifesting in emotional expression relating to the immediate past; and (v) the emotionally wounded or post-traumatic phase featuring reconstructive activity with some elements of anger and resentment. Reactions in children are usually transitory but may be influenced by parental psychopathology, separation anxiety or previous emotional disturbances. Typical adult reactions seen in the elderly may be compounded by what has been termed a high sense of deprivation. Relief workers are exposed to psychic stress in the form of greater responsibilities and role identification and many also show delayed reactions to the death and destruction observed.