title: A Pilot Study of the Psychological Impact of the Great East Japan Earthquake and Tsunami.
abstract: BACKGROUND
  There is evidence that a large-scale disaster may have indirect psychological impact on the individuals who were not involved with the disaster first hand. The 2011 earthquake and tsunami disasters in Japan provide an opportunity to investigate the potential global effect of indirect exposure associated with intense media coverage.
  
  
  OBJECTIVE
  To compare the disaster's psychological impact between Japanese and non-Japanese students; to determine what factors are associated with higher psychological impact.
  
  
  METHODS
  A cross-sectional, anonymous online survey of university students in the Midwest.
  
  
  RESULTS
  Japanese students scored significantly higher on the Impact of Event Scale-Revised (IES-R) hyperarousal subscale compared with non-Japanese students. Those who were in Japan when the disaster occurred exhibited significantly higher psychological impact levels. There were significant correlations between media exposure and two IES-R subscales: avoidance and hyperarousal.
  
  
  CONCLUSIONS
  The results support the finding from 9/11 studies that indirect exposure is associated with stress-related psychological responses.
authors.affiliation: Kosuke Niitsu, BSN, RN, University of Nebraska Medical Center College of Nursing, Omaha, NE, USA kosuke.niitsu@unmc.edu.
authors.forename: Kosuke
authors.initials: K
authors.lastname: Niitsu
authors.affiliation: Shinobu Watanabe-Galloway, PhD, University of Nebraska Medical Center College of Public Health, Omaha, NE, USA.
authors.forename: Shinobu
authors.initials: S
authors.lastname: Watanabe-Galloway
authors.affiliation: Harlan Sayles, MS, University of Nebraska Medical Center College of Public Health, Omaha, NE, USA.
authors.forename: Harlan
authors.initials: H
authors.lastname: Sayles
authors.affiliation: Julia Houfek, PhD, APRN-CNS, University of Nebraska Medical Center College of Nursing, Omaha, NE, USA.
authors.forename: Julia
authors.initials: J
authors.lastname: Houfek
authors.affiliation: Michael Rice, PhD, APRN-NP, University of Colorado College of Nursing, Aurora, CO, USA.
authors.forename: Michael
authors.initials: M
authors.lastname: Rice
mesh_terms: D000328:Adult; D003430:Cross-Sectional Studies; D004190:Disasters; D055866:Earthquakes; D005260:Female; D006801:Humans; D007564:Japan / Q000208:ethnology; D008297:Male; D015146:Midwestern United States / Q000453:epidemiology; D010865:Pilot Projects; D013315:Stress, Psychological / Q000453:epidemiology* / Q000523:psychology*; D013334:Students / Q000523:psychology* / Q000706:statistics & numerical data; D011795:Surveys and Questionnaires; D057192:Tsunamis; D014495:Universities; D055815:Young Adult
keywords: indirect exposure; natural disaster; posttraumatic stress disorder