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Survey: Katrina survivors find inner strength

/ Source: The Associated Press

A new survey reveals that the traumatized survivors of Hurricane Katrina forged a surprisingly powerful inner strength that steeled them against suicidal despair.

The study is the most elaborate post-storm survey yet. It shows that while the survivors suffered twice as much mental illness as the pre-storm population, they contemplated suicide far less often than mentally ill people surveyed before Katrina.

“The people who have these terrible experiences — they’re often the ones who have these epiphanies,” said Ronald Kessler, a Harvard University researcher who led the survey.

This capacity to grow from catastrophe may be an ancient survival mechanism that evolved to help humans live through frequent disasters, researchers suspect. It is sometimes called post-traumatic growth: External disasters may shake us, but also make us unwilling to give up — as in the resolve people feel in wartime.

This study takes the first major stride in quantifying such an effect. Its results were reported Monday in the online Bulletin of the World Health Organization and in a separate paper to the National Institute of Mental Health, which funded the study.

In its key findings:

  • It detected a 30 percent rate of suspected mental illness — double the usual — after the storm. People were predictably troubled by what they lived through and lost in the disaster.
  • Yet only 1 percent of these troubled survivors either thought about or planned for suicide. Before Katrina, 8 percent of mentally ill people from the same region had such thoughts and 4 percent made plans to carry out suicide.

This striking decrease in suicidal risk appears to flow from a newfound self-confidence in the vast majority of Katrina survivors, the researchers found. More than 95 percent of all survivors professed more faith in their ability to rebuild their lives when necessary, and 70 percent felt more inner strength. These beliefs seemed to fend off suicide, because only the mentally ill people holding them showed the lower suicide risk.

The study makes a strong case for this protective effect, says psychiatrist Dr. Matthew Friedman, who directs the National Center for Post-Traumatic Stress Syndrome at the Department of Veterans Affairs.

“A lot of things happen in a traumatic event,” said Friedman, who read an advance report of the findings. “You can have a ramping up of your psychological stress or symptoms — but at the same time it can be a positive event in a life-changing way.”

As the country’s costliest natural disaster, Katrina flooded much of New Orleans one year ago, forced hundreds of thousands to flee, killed about 2,000, and left hundreds more missing. Earlier studies, though less comprehensive, also found high rates of psychological distress among survivors. This survey’s national research team sought to also look at the potential for emotional growth from disaster, a phenomenon hinted at by research on earlier catastrophes.

Beginning in January, the researchers surveyed a representative cross-section totaling 1,043 adults who lived in the path of destruction across Louisiana, Mississippi and Alabama.

Participants were asked about their lives before and afterward. These telephone interviews, to be repeated every three months for seven years, cover everything from housing and income to physical and mental health. The researchers then compared these results with surveys of 826 people from the same areas in a national health study from 2001-03.

“The battle for us is just a continual battle against negativity,” said Juan Lizarraga, a New Orleans lawyer who lives in his yard inside a trailer supplied by federal emergency officials.

Lizarraga was one of those surveyed and he accompanied researchers to a news conference. “I think what your results are showing is the incredible resilience of the people,” he told the researchers.

There were earlier reports that suggested that suicide rates may have climbed in New Orleans after the storm. However, this study considered a much broader region where even a pocket of suicides in one place might wash out in broader statistics, because suicides are so rare.

The Harvard researchers were unable to calculate actual suicide rates — only suicidal tendencies of survivors — partly because evacuees scattered so widely. The survey showed no spike in suicidal tendencies in New Orleans but did find that half the city’s survivors were having nightmares about their experiences, compared with a quarter of all survivors.

As for practical concerns, a third of all participants said their living situation was worse now, but 11 percent said it was better. Similarly, a fourth said their life was worse as a whole, but 14 percent said it was better.

Of those who had left New Orleans, 16 percent intended to return, 19 percent planned to live elsewhere, and others were uncertain.

One possible weakness of the survey is that it has roughly a 4 percent margin of error for disease rates, and it relies on people’s own, possibly faulty, accounts of their experiences. Finally, only 42 percent of those contacted agreed to participate — a low rate that can theoretically skew results.

It’s also unclear if the apparent protective effect against suicide will be permanent. If survivors eventually lose hope in the recovery, they might become more susceptible to giving up, researchers suspect.

“There may be a crash-and-burn experience ... months down the road,” cautioned Alan Green, a Johns Hopkins University counselor who treated survivors and knew of the survey findings.