Different types of exposure to the 2004 tsunami are associated with different levels of psychological distress and posttraumatic stress

The impact of traumatic exposure on psychological distress and posttraumatic stress was investigated at 14 months through self report of 1505 Swedish tourists who survived the 2004 Indian Ocean Tsunami.

Results indicate that the degree of experiential and factual exposure is associated with impaired mental health measured by General Health Questionnaire (GHQ) and Impact of Event Scale-Revised (IES-R), in a dose-response pattern. Demographic factors (sex, age, parenthood, living arrangements, education) are associated with outcome on either GHQ or IES-R.

The authors propose that identification of the exposure of disaster survivors may be a way of distinguishing groups of individuals that at a later stage can be screened for psychological ill health.


  • Lars Wahlström, PhD, MD
  • Hans Michélsen, Ast prof, PsyD
  • Abbe Schulman, PhD, MD
  • Magnus Backheden, MS