Studies probe post-tsunami mental health

Are depression, anxiety and Post-Traumatic Stress Disorder useful concepts when applied to non-Western cultures? Or are they--as some critics have contended--simply Western cultural constructs?

Two studies recently published in the Journal of the American Medical Association offer the beginnings of an answer to these questions.

One study focused on post-tsunami mental health reactions among adults, the other study looked at children.

In an accompanying commentary, Derrick Silove and Richard Bryant note that "The ongoing controversy risks confusing funding agencies and other donors, as well as those responsible for planning mental health programs as part of humanitarian relief efforts following disasters." The two studies, Silove and Bryant write:

... add to a growing body of research indicating that PTSD symptoms can be identified both in adults and in children across cultures. The key question, however, is whether the prevalence of PTSD symptoms in the immediate aftermath of disasters offers valid information and reliable direction to guide local mental health planning.

Both studies identify cultural factors may help people cope with trauma. In the study of adults, the authors write:

The Buddhist component of the Thai belief system, for instance, contemplates that life is to a certain extent predetermined and the result of one's own actions or karma. This belief may help Buddhists accept and overcome negative events occurring during the course of their lives, which would be consistent with findings from other studies showing a protective effect of the Buddhist religion on anxiety and depression.

Another aspect of the Thai belief system is the notion that every space, be it air or water, has a ruler or spirit, a supernatural power that governs the space. For individuals to share the space, the ruler needs to be informed and pleased and its territory must be respected. Anecdotal conversations with tsunami survivors indicate that many individuals believe that overfishing and exploitation of the sea were causes of the tsunami, a revenge of the spirits of the sea. The notion of carrying a certain responsibility for the occurrence of the tsunami may make it easier to accept and cope with its consequences.

In the survey of adults, about 10 percent reported seeing a ghost after the tsunami. The authors explain:

Reports of seeing or hearing ghosts are common among rural Thais and are not confined to periods of disaster or specific events but are a normal part of Thai culture and beliefs. Hence, in most cases this phenomenon should be interpreted in the context of the local belief system and as a culturally specific way of coping with death and reincarnation rather than a symptom of mental illness.