title: Mental health in Sumatra after the tsunami.
abstract: OBJECTIVE
  We assessed the levels and correlates of posttraumatic stress reactivity (PTSR) of more than 20,000 adult tsunami survivors by analyzing survey data from coastal Aceh and North Sumatra, Indonesia.
  
  
  METHODS
  A population-representative sample of individuals interviewed before the tsunami was traced in 2005 to 2006. We constructed 2 scales measuring PTSR by using 7 symptom items from the Post Traumatic Stress Disorder (PTSD) Checklist-Civilian Version. One scale measured PTSR at the time of interview, and the other measured PTSR at the point of maximum intensity since the disaster.
  
  
  RESULTS
  PTSR scores were highest for respondents from heavily damaged areas. In all areas, scores declined over time. Gender and age were significant predictors of PTSR; markers of socioeconomic status before the tsunami were not. Exposure to traumatic events, loss of kin, and property damage were significantly associated with higher PTSR scores.
  
  
  CONCLUSIONS
  The tsunami produced posttraumatic stress reactions across a wide region of Aceh and North Sumatra. Public health will be enhanced by the provision of counseling services that reach not only people directly affected by the tsunami but also those living beyond the area of immediate impact.
authors.affiliation: Duke University, Sanford Institute of Public Policy, 286 Rubenstein Hall, 302 Towerview Dr, Durham, NC 27708-0239, USA. e.frankenberg@duke.edu
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Frankenberg
authors.forename: Jed
authors.initials: J
authors.lastname: Friedman
authors.forename: Thomas
authors.initials: T
authors.lastname: Gillespie
authors.forename: Nicholas
authors.initials: N
authors.lastname: Ingwersen
authors.forename: Robert
authors.initials: R
authors.lastname: Pynoos
authors.forename: Iip Umar
authors.initials: IU
authors.lastname: Rifai
authors.forename: Bondan
authors.initials: B
authors.lastname: Sikoki
authors.forename: Alan
authors.initials: A
authors.lastname: Steinberg
authors.forename: Cecep
authors.initials: C
authors.lastname: Sumantri
authors.forename: Wayan
authors.initials: W
authors.lastname: Suriastini
authors.forename: Duncan
authors.initials: D
authors.lastname: Thomas
mesh_terms: D000293:Adolescent; D000328:Adult; D016000:Cluster Analysis; D004190:Disasters; D005190:Family; D005260:Female; D006801:Humans; D007214:Indonesia / Q000453:epidemiology; D008016:Life Change Events; D008297:Male; D008603:Mental Health; D008875:Middle Aged; D009026:Mortality; D015999:Multivariate Analysis; D011159:Population Surveillance; D012111:Residence Characteristics; D012959:Socioeconomic Factors; D013313:Stress Disorders, Post-Traumatic / Q000453:epidemiology*; D017741:Survivors / Q000523:psychology* / Q000706:statistics & numerical data