Prehospital and Disaster Medicine

Original Research

The “Trauma Signature:” Understanding the Psychological Consequences of the 2010 Haiti Earthquake

James M. Shultza1 c1, Louis Herns Marcelina2, Sharon B. Madanesa3, Zelde Espinela4 and Yuval Neriaa5

a1 Director, Center for Disaster & Extreme Event Preparedness (DEEP Center), University of Miami Miller School of Medicine, Miami, Florida USA

a2 University of Miami, Department of Anthropology & Department of Epidemiology and Public Health, Interuniversity Institute for Research and Development, Coral Gables, Florida USA

a3 Department of Psychiatry, Columbia University, New York, New York USA

a4 Co-Director, DEEP Center, University of Miami Miller School of Medicine, Miami, Florida USA

a5 Professor of Clinical Psychology and Director, Trauma and PTSD Program, Columbia University, Department of Psychiatry & The New York State Psychiatric Institute, New York, New York USA

Abstract

The 2010 Haiti earthquake was one of the most catastrophic episodes in history, leaving 5% of the nation’s population killed or injured, and 19% internally displaced. The distinctive combination of earthquake hazards and vulnerabilities, extreme loss of life, and paralyzing damage to infrastructure, predicts population-wide psychological distress, debilitating psychopathology, and pervasive traumatic grief. However, mental health was not referenced in the national recovery plan. The limited MHPSS services provided in the first eight months generally lacked coordination and empirical basis.

There is a need to customize and coordinate disaster mental health assessments, interventions, and prevention efforts around the novel stressors and consequences of each traumatic event. An analysis of the key features of the 2010 Haiti earthquake was conducted, defining its “Trauma Signature” based on a synthesis of early disaster situation reports to identify the unique assortment of risk factors for post-disaster mental health consequences. This assessment suggests that multiple psychological risk factors were prominent features of the earthquake in Haiti. For rapid-onset disasters, Trauma Signature (TSIG) analysis can be performed during the post-impact/pre-deployment phase to target the MHPSS response in a manner that is evidence-based and tailored to the event-specific exposures and experiences of disaster survivors. Formalization of tools to perform TSIG analysis is needed to enhance the timeliness and accuracy of these assessments and to extend this approach to human-generated disasters and humanitarian crises.

(Received September 17 2010)

(Accepted September 23 2010)

(Revised October 04 2010)

(Online publication November 18 2011)

Correspondence:

c1 Correspondence: James M. Shultz, PhD 251 174th Street #2319 Sunny Isles Beach, FL, USA Email: jamesmichaelshultz@gmail.com

Footnotes

Shultz JM, Marcelin LH, Madanes SB, Espinel Z, Neria Y: The “Trauma Signature”: Understanding the psychological consequences of the 2010 Haiti earthquake. Prehosp Disast Med 2011;26(4):mm–nn.