This project will study the factors that affect whether people seek help for mental health problems following a disaster. A major focus will be to determine who victims seek help from, with an emphasis on why they are likely to under-utilize professional mental health services. A four-stage plan is proposed. First, a theoretical model of post-disaster decision making is developed. It identifies antecedents that are likely to influence the mode of coping as well as factors that determine changes in mode of coping over time. The interrelationship between variables has been specified so that causal modeling statistical procedures can provide information on the model's validity. Second, measures will be developed that allow the theoretical model to be tested in a post-disaster field setting. Where reliable and valid measures already exist, they will be employed. For other variables new measures will be developed. The reliability and validity of these measures will be ensured by work done prior to entering the field. The third stage--a longitudinal field study conducted in the months following a disaster--is the core of the project. Structured interviews and questionnaires will be administered to households in the affected area within a month following the occurence of a catastrophe, and again 9 and 18 months later. A sub-sample of intact two-parent families will complete an additional behavioral measure that will provide exploratory evidence on how family decision-making style influences the coping process. A reactivity sub-study is proposed that examines the possible effects of the initial six-hour interview on later waves of data collection. Finally, various microprocesses that the field data suggest are important will be examined more closely in controlled laboratory studies. This will allow variables to be manipulated and causal relationships to be identified so that, in combination with the field study, a more complete picture of the coping process will emerge. The project will provide converging evidence about what modes people use to cope with the aftermath of a disaster and, more importantly, why these modes are chosen. Findings should provide important policy guidelines for disaster relief as well as contribute to the research literature in this area.
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