title: Trauma signature analysis of the great East Japan disaster: guidance for psychological consequences.
abstract: OBJECTIVE
  On March 11, 2011, Japan experienced the largest earthquake in its history. The undersea earthquake launched a tsunami that inundated much of Japan's eastern coastline and damaged nuclear power plants, precipitating multiple reactor meltdowns. We examined open-source disaster situation reports, news accounts, and disaster-monitoring websites to gather event-specific data to conduct a trauma signature analysis of the event.
  
  
  METHODS
  The trauma signature analysis included a review of disaster situation reports; the construction of a hazard profile for the earthquake, tsunami, and radiation threats; enumeration of disaster stressors by disaster phase; identification of salient evidence-based psychological risk factors; summation of the trauma signature based on exposure to hazards, loss, and change; and review of the mental health and psychosocial support responses in relation to the analysis.
  
  
  RESULTS
  Exposure to this triple-hazard event resulted in extensive damage, significant loss of life, and massive population displacement. Many citizens were exposed to multiple hazards. The extremity of these exposures was partially mitigated by Japan's timely, expert-coordinated, and unified activation of an evidence-based mental health response.
  
  
  CONCLUSIONS
  The eastern Japan disaster was notable for its unique constellation of compounding exposures. Examination of the trauma signature of this event provided insights and guidance regarding optimal mental health and psychosocial responses. Japan orchestrated a model response that reinforced community resilience.
authors.affiliation: Center for Disaster and Extreme Event Preparedness (DEEP Center), University of Miami Miller School of Medicine, Miami, FL.
authors.forename: James M
authors.initials: JM
authors.lastname: Shultz
authors.affiliation: Australian Centre for Posttraumatic Mental Health, Department of Psychiatry, The University of Melbourne, East Melbourne, Australia.
authors.forename: David
authors.initials: D
authors.lastname: Forbes
authors.affiliation: US Geological Survey and Colorado School of Mines, Golden, Colorado, USA.
authors.forename: David
authors.initials: D
authors.lastname: Wald
authors.affiliation: Clinical and Health Psychology, University of Edinburgh, Scotland.
authors.forename: Fiona
authors.initials: F
authors.lastname: Kelly
authors.affiliation: Department of Civil, Architectural, and Environmental Engineering, University of Miami, College of Engineering, Coral Gables, Florida, USA.
authors.forename: Helena M
authors.initials: HM
authors.lastname: Solo-Gabriele
authors.affiliation: Center for Disaster and Extreme Event Preparedness (DEEP Center), University of Miami Miller School of Medicine, Miami, FL.
authors.forename: Alexa
authors.initials: A
authors.lastname: Rosen
authors.affiliation: Center for Disaster and Extreme Event Preparedness (DEEP Center), University of Miami Miller School of Medicine, Miami, FL.
authors.forename: Zelde
authors.initials: Z
authors.lastname: Espinel
authors.affiliation: Department of Neuroscience, University of North Dakota School of Medicine and Health Sciences, Fargo, North Dakota, USA.
authors.forename: Andrew
authors.initials: A
authors.lastname: McLean
authors.affiliation: Public Health Programs, University of the Andes, Bogota, Colombia, USA.
authors.forename: Oscar
authors.initials: O
authors.lastname: Bernal
authors.affiliation: Trauma and PTSD Program, Columbia University, and Department of Psychiatry, The New York State Psychiatric Institute, New York, New York, USA.
authors.forename: Yuval
authors.initials: Y
authors.lastname: Neria
mesh_terms: D004189:Disaster Planning / Q000458:organization & administration*; D055866:Earthquakes; D062406:Fukushima Nuclear Accident; D006304:Health Status; D006801:Humans; D007564:Japan; D001523:Mental Disorders / Q000453:epidemiology; D008603:Mental Health; D057192:Tsunamis; D014947:Wounds and Injuries / Q000453:epidemiology