Disaster Medicine and Public Health Preparedness

Special Focus

Trauma Signature Analysis of the Great East Japan Disaster: Guidance for Psychological Consequences

James M. Shultza1 c1, David Forbesa2, David Walda3, Fiona Kellya4, Helena M. Solo-Gabrielea5, Alexa Rosena1, Zelde Espinela1, Andrew McLeana6, Oscar Bernala7 and Yuval Neriaa8

a1 Center for Disaster and Extreme Event Preparedness (DEEP Center), University of Miami Miller School of Medicine, Miami, FL

a2 Australian Centre for Posttraumatic Mental Health, Department of Psychiatry, The University of Melbourne, East Melbourne, Australia

a3 US Geological Survey and Colorado School of Mines, Golden, Colorado, USA

a4 Clinical and Health Psychology, University of Edinburgh, Scotland

a5 Department of Civil, Architectural, and Environmental Engineering, University of Miami, College of Engineering, Coral Gables, Florida, USA

a6 Department of Neuroscience, University of North Dakota School of Medicine and Health Sciences, Fargo, North Dakota, USA

a7 Public Health Programs, University of the Andes, Bogota, Colombia, USA

a8 Trauma and PTSD Program, Columbia University, and Department of Psychiatry, The New York State Psychiatric Institute, New York, New York, USA


Objectives 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. (Disaster Med Public Health Preparedness. 2013;0:1-14)

(Online publication March 26 2013)

Key Words

  • trauma;
  • disaster;
  • trauma signature analysis;
  • TSIG;
  • disaster mental health;
  • psychosocial;
  • resilience;
  • evidence-based intervention


c1 Address correspondence and reprint requests to James M. Shultz, MS, PhD, Center for Disaster and Extreme Event Preparedness (DEEP Center), University of Miami Miller School of Medicine, 251 174 St, #2319, Sunny Isles Beach FL 33160 (e-mail: jshultz1@med.miami.edu).