Tsunami-affected Scandinavian tourists: disaster exposure and post-traumatic stress symptoms.
BACKGROUND
Studies of short- and long-term mental effects of natural disasters have reported a high prevalence of post-traumatic stress. Less is known about disaster-exposed tourists repatriated to stable societies.


OBJECTIVE
To examine the association between exposure to the 2004 Southeast Asian tsunami and symptoms of post-traumatic stress in three Scandinavian tourist populations.


METHODS
Postal survey of Norwegian, Danish and Swedish Southeast Asia tourists registered by the police when arriving at national airports. Follow-up time was 6 (Norway), 10 (Denmark) and 14 months (Sweden) post-disaster; 6772 individuals were included and categorized according to disaster exposure: danger exposed (caught or chased by the waves), non-danger exposed (other disaster-related stressors) and non-exposed. Outcome measures were the Impact of Event Scale-Revised (IES-R) and Post Traumatic Stress Disorder Check List (PCL).


RESULTS
Danger exposed reported more post-traumatic stress than non-danger exposed, and the latter reported more symptoms than non-exposed (each P<0.001). Comparison of the Norwegian and Swedish data suggested that symptoms were attenuated at 14 months follow-up (P<0.001). Female gender and low education, but not age, predicted higher levels of symptoms.


CONCLUSIONS
Disaster-exposed tourists repatriated to unaffected home environments show long-term post-traumatic stress disorder symptoms related to the severity of exposure.
Heir
Trond
T
Norwegian Centre for Violence and Traumatic Stress Studies, University of Oslo, Oslo, Norway. trond.heir@medisin.uio.no
Rosendal
Susanne
S
Bergh-Johannesson
Kerstin
K
Michel
Per-Olof
PO
Mortensen
Erik L
EL
Weisaeth
Lars
L
Andersen
Henrik S
HS
Hultman
Christina M
CM
D000328:Adult; D001210:Asia, Southeastern; D004190:Disasters; D004522:Educational Status; D004781:Environmental Exposure / Q000009:adverse effects*; D005260:Female; D006801:Humans; D008016:Life Change Events; D008297:Male; D008875:Middle Aged; D012537:Scandinavian and Nordic Countries; D012720:Severity of Illness Index; D012737:Sex Factors; D013313:Stress Disorders, Post-Traumatic / Q000209:etiology / Q000523:psychology; D011795:Surveys and Questionnaires; D013997:Time Factors; D014187:Transportation of Patients; D014195:Travel / Q000523:psychology; D057192:Tsunamis