title: Cognitive and psychological reactions of the general population three months after the 2011 Tohoku earthquake and tsunami.
abstract: BACKGROUND
  The largest earthquake on record in Japan (magnitude 9.0) occurred on March 11, 2011, and the subsequent tsunami devastated the Pacific coast of Northern Japan. These further triggered the Fukushima I nuclear power plant accidents. Such a hugely complex disaster inevitably has negative psychological effects on general populations as well as on the direct victims. While previous disaster studies enrolled descriptive approaches focusing on direct victims, the structure of the psychological adjustment process of people from the general population has remained uncertain. The current study attempted to establish a path model that sufficiently reflects the early psychological adaptation process of the general population to large-scale natural disasters.
  
  
  RESULTS
  Participants from the primary disaster area (n = 1083) and other areas (n = 2372) voluntarily participated in an online questionnaire study. By constructing path models using a structural equation model procedure (SEM), we examined the structural relationship among psychological constructs known related to disasters. As post-traumatic stress symptoms (PTS) were significantly more present in people in the primarily affected area than in those in secondary- or non-affected areas, the path models were constructed for the primary victims. The parsimoniously depicted model with the best fit was achieved for the psychological-adjustment centered model with quality of life (QoL) as a final outcome.
  
  
  CONCLUSIONS
  The paths to QoL via negative routes (from negative cognitive appraisal, PTS, and general stress) were dominant, suggesting the importance of clinical intervention for reducing negative cognitive appraisal, and for caring for general stress and PTS to maintain QoL at an early stage of psychological adaptation to a disaster. The model also depicted the presence of a positive route where positive cognitive appraisal facilitates post-traumatic growth (PTG) to achieve a higher QoL, suggesting the potential importance of positive psychological preventive care for unexpected natural disasters.
authors.affiliation: Functional Brain Science Laboratory, Center for Development of Advanced Medical Technology, Jichi Medical University, Tochigi, Japan. qworkdog@jichi.ac.jp
authors.forename: Yasushi
authors.initials: Y
authors.lastname: Kyutoku
authors.forename: Ryoko
authors.initials: R
authors.lastname: Tada
authors.forename: Takahiko
authors.initials: T
authors.lastname: Umeyama
authors.forename: Kenji
authors.initials: K
authors.lastname: Harada
authors.forename: Senichiro
authors.initials: S
authors.lastname: Kikuchi
authors.forename: Eiju
authors.initials: E
authors.lastname: Watanabe
authors.forename: Angela
authors.initials: A
authors.lastname: Liegey-Dougall
authors.forename: Ippeita
authors.initials: I
authors.lastname: Dan
mesh_terms: D000223:Adaptation, Psychological; D004190:Disasters; D055866:Earthquakes; D006801:Humans; D007564:Japan / Q000453:epidemiology; D011788:Quality of Life; D013313:Stress Disorders, Post-Traumatic / Q000453:epidemiology* / Q000209:etiology; D013315:Stress, Psychological / Q000453:epidemiology / Q000209:etiology; D011795:Surveys and Questionnaires; D057192:Tsunamis