Table Of ContentThis is a volume in
PERSONALITY AND PSYCHOPATHOLOGY
A Series of Monographs, Texts, and Treatises
Under the Editorship of David T. Lykken
A complete list of titles in this series appears at the end of this volume.
Prolonged Psychosociol
Effects of Disoster
A STUDY OF DUFFALO CREEK
GOLDINE C. GLESER
DONNIE L GREEN
CAROLYN WINGET
Department of Psychiatry
University of Cincinnati
College of Medicine
Cincinnati, Ohio
ACADEMIC PRESS 1961
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Library of Congress Cataloging in Publication Data
Gleser, Goldine C.
Prolonged psycnosocial effects of disaster.
(Personality and psychopathology)
Bibliography: p.
1. Disasters—Psychological aspects. 2. Survival
(after airplane accidents, shipwrecks, etc.)—Psycho
logical aspects. 3. Dam failures—West 'Virginia—
Buffalo Creek. U. Buffalo Creek (W. Va.)~Flood, 1972.
I. Green, Bonnie L. II. Winget, Carolyn N. III. Title.
IV. Series. CDNLM: 1. Diasters. 2. Stress, Psychologi
cal. 3. Psychology, Social. Wl PE861 V. 25 / BF 789.D5
G558p:
BF789.D5G55 I1!5 5.9f35 81-7899
ISBN O-I2-28626O-O AACR2
PRINTED IN THE UNITED STATES OF AMERICA
81 82 83 84 987654321
TO FREDERIC Τ. KAPP, M.D.
(1914-1980)
By his early involvement in the investigation of psychic trauma at
Buffalo Creek, Dr. Kapp set a standard of excellence and commitment
for his colleagues in this endeavor.
Preface
The extent of human misery occasioned by disasters, both man-made
and natural, highlights our need to learn more about the long-range
psychological effects that disasters have on their survivors. Are there con
structive as well as destructive sequelae, and if so, what aspects of a disaster
make a difference in this regard? Only by utilizing a systematic approach
and by combining information from many disaster studies are we likely to
make progress in understanding the ways in which people are affected by
such experiences. In so doing, it will become possible not only to deal more
humanely and effectively with survivors, but also to increase our knowledge
about personality and change. This book was written to provide impetus for
such studies as well as to disseminate the findings of an investigation into
the psychological effects of a specific disaster.
The disaster dealt with in this book took place on February 26, 1972,
when a slag dam collapsed, inundating the valley of Buffalo Creek, West
Virginia. A lawsuit filed on behalf of more than 600 men, women, and
children for whom psychic impairment was claimed necessitated interviews
by mental health professionals retained by each side in the case. These data,
supplemented by information from self-report instruments concerning cur
rent symptoms, sleep problems, family disruption, and dream reports, form
the data base for the detailed investigation reported here. From this exten
sive information there emerges a well-rounded description of the be
havioral and emotional upheaval still evident in this population when the
interviews were conducted 2 years after the traumatic event. Follow-up
studies extend the data on some individuals to as long as 5 years postflood,
assessing the impact of the legal settlement.
More importantly, relationships between the individual disaster experi
ences of the survivors and their later psychological functioning are exam
ined to determine which aspects of a disaster and its aftermath are most
ix
Χ : PREFACE
likely to lead to long-term impairment. Results are integrated into the
growing body of literature on the psychological effects of disaster. In addi
tion, a model is suggested to incorporate both aggregate and individual data.
Chapters 1-3 provide the necessary background information, including
an account of the disaster itself and of the subsequent lawsuit against the
coal company, as well as a description of the subjects. Chapter 4 indicates
how we went about quantifying our data and gives some information regard
ing their reliability and validity. Chapters 5-7 present the findings on these
data, while the follow-up studies are detailed in Chapter 8. The final chapter
contains a summary of our findings and proposes specific suggestions as well
as a model for future disaster studies.
Although this study will be of most practical importance to mental
health scientists and clinicians working with the victims of stress and disas
ter, it should also be of considerable interest to social and behavioral scien
tists and, more generally, to administrators of government activities. Fur
thermore, the detailed discussion of problems encountered in obtaining and
processing these data, and the suggestions for future research should be
particularly helpful to those planning to do work in this or related areas,
whether it be from the standpoint of epidemiology or basic personality
research.
This investigation, like most large-scale studies, necessitated the coop
eration and support of a large number of people. We are particularly
grateful to the law firm of Arnold and Porter for making available to us the
interview reports on all the litigants. Furthermore, the study would not have
been possible without the financial support given to us through Grant No.
ROI MH 26321 from the National Institute of Mental Health, 1973-1977,
as well as the seed money made available to us by the University of Cincin
nati Department of Psychiatry. Space does not permit a listing of the many
people who conducted the interviews, but certainly our indebtedness to
James Titchener, who made arrangements for the University of Cincinnati
Department of Psychiatry to participate in the interviewing of the Buffalo
Creek litigants, should be acknowledged.
A number of people were involved in the quantification, tabulation,
and processing of data. In particular, we thank David Brandt, Linda Crespo
da Silva, Laura Gantz, Mary Grace, Mary Kapp, Laurie Levi, and Lois
Winget for their dedicated help in this regard. We also wish to acknowledge
those who read earlier drafts of the chapters, making many helpful sugges
tions, especially Frederic Kapp before his untimely death, Sol Gleser, and
Mary Grace. And finally, we extend a most heartfelt thanks to Mary Dan-
zeisen, who patiently typed the manuscript of this book, cheerfully accept
ing version after version and often helping to spot errors and inconsisten
cies.
Chapter 1
Introduction
A major disaster is considered to be a rare event; and indeed it is for
any one area of the globe during a specified period of time. But taken
together, even natural calamities such as floods, typhoons, hurricanes, cy
clones, tornadoes, and earthquakes sum to a staggering number. Hewitt and
Sheehan (1969) and later Dworkin (1973) compiled a list of all reported
natural disasters (excluding droughts) occurring worldwide in the 27 years
from 1947 through 1973 in which 100 or more people were killed or
injured or in which at least $1 million worth of damage was incurred. There
were 836 such incidents reported, an average of 31 per year. These figures
do not include data from half the globe, since complete reports were not
available from northern Europe, the U.S.S.R., much of Africa, and, during
part of the period, China. Thus, the actual number of major natural disasters
could easily be double these figures. In the disasters listed, over a half-
million lives were reported lost, with the greatest number of deaths occur
ring in the less developed countries.
When it is realized that natural disasters comprise only about half of the
major disasters that occur, even in a world at peace, the total impact be
comes all the more staggering. Fires, plane crashes, railway accidents, min
ing catastrophes, chemical pollution, and dozens of other man-made mis
haps can affect entire communities as well as the lives of the victims and
their families. Furthermore, the head count of victims and the cost in terms
of property loss tell us little about the total impact of disasters on society.
For each person killed there are several more left bereaved. Each house
destroyed represents a major crisis for those who lived there, necessitating
that they rebuild and reorder their lives. A poignant picture of the im
mediate effect of a disaster on surviving victims is provided by Stretton
(1976) in a narrative of his experiences on taking over command in the
1
2 : LONG-TERM PSYCHOSOCIAL EFFECTS OF DISASTER
relief of Darwin, Australia, after the advent of Cyclone Tracy on Christmas
morning, 1974. He describes the scene at the police station upon his arrival
that evening: "Women and children were stretched out on the floor, on
tables, and in the corridors.... Children cried out in their sleep and
clutched mothers who were still in various stages of shock. Sleeping forms
would suddenly start to shudder and cry out as they relived their hours of
terror [p. 46]." How quickly do survivors recover from the impact of such
an experience? What are its immediate and long-term psychological effects?
These and other questions regarding disasters have only recently become
the subject of investigation by social and behavioral scientists.
It is fairly widely accepted that psychological consequences extend well
beyond the initial phase of a disaster and that they affect not only the
survivors but also many who are involved only by virtue of their participa
tion in rescue and relief activities, or through their kinship to the victims
(Raphael, 1977; Umbenhauer & Winget, 1980). There is much less agreement
regarding the persistence and pathological nature of psychological sequelae.
Some investigators (e.g., Quarantelli & Dynes, 1973) have pointed to posi
tive effects of a disaster: Participating in the effort to assist the injured and
needy, victims may discover within themselves previously unknown
strengths. Other investigators (e.g., Hocking, 1970a, 1970b; Lifton, 1967)
focus more on the potential for psychological impairment from such events.
Such diverse views may stem in part from the fact that disasters do not
form a homogeneous class of events. Some disasters occur without
warning—others have a slower onset. Some are due to the unpredictability
of nature, whereas others can be attributed to greed, malevolence, or negli
gence. Barton (1969) has suggested four dimensions along which disasters
may vary, resulting in differential effects on the victims. These dimensions
are {a) scope of the impact (i.e., how large an area and how many people are
involved); (b) speed of onset (sudden, gradual, or chronic); (c) duration of
impact; and (d) social preparedness of the community. Undoubtedly, signif
icant other worthwhile distinctions can also be made. For example, victims
may be members of a community or they may be a transient group (e.g.,
victims of a plane or train crash). The challenge for researchers is to pin
point those factors that lead to long-term psychopathology in survivors and
those factors that have the potential for strengthening the character of
individuals and for enhancing family and community bonds.
One disaster that has received considerable attention from a number of
social scientists as well as from the public at large took place in Buffalo
Creek, West Virginia in the early morning of February 26, 1972. On that
day, a slag dam constructed by a mining company gave way, unleashing 132
million gallons of churning black slag, debris-filled mud, and water into the
Buffalo Creek valley below, carrying with it bridges, houses, cars, trailers,
1. INTRODUCTION : 3
and human bodies. People who had scrambled up hillsides to safety watched
helplessly as relatives, friends, and neighbors were propelled past them by
the black swirling waters. Three hours later the last of the water emptied
into the Guyandotte River, leaving 125 dead, many hundreds injured, and
thousands homeless. Within hours, the local National Guard unit had sealed
off the area, and medical units from nearby hospitals had begun to evacuate
the badly injured. Volunteer rescue crews were formed and the Red Cross
and Salvation Army began bringing in needed supplies. But many weeks
went by before the worst of the debris could be cleared away and burned,
the black muck hauled away from those houses left standing, and some
order restored. In the meantime, families stayed with friends or camped in a
school gymnasium just outside the valley. Finally, they were housed in
trailers supplied by the Department of Housing and Urban Development
(HUD) in 13 sites in and near the valley. Trailers were assigned on a
first-come-first-served basis, so that friends, neighbors, and kinfolk were
often separated. A number of families packed up what few belongings they
still possessed and moved away. The situation was exacerbated by a decision
by the state of West Virginia to build a new highway up the middle of the
narrow Buffalo Creek Valley. This meant that many who owned their land
could not rebuild or move back until a final decision was made as to where
the new road would be placed. Two years later victims were still waiting to
return to their land.
Owing to the efforts of a group of survivors who did not see this as a
"natural" disaster, but rather as the result of a willfully illegal act by the
mine owners, a lawsuit ensued that has made legal history as well as making
possible the data for this book. Stern (1976) has written a fascinating ac
count of the legal maneuvers by which he and his partners in the firm of
Arnold and Porter forced into evidence the culpability of the Pittston Com
pany in maintaining an improperly constructed slag dam. The out-of-court
settlement in July, 1974 for $13.5 million, including an unprecedented $8
million for psychic impairment stemming from the disaster, marks the first
time it has been legally acknowledged that psychosocial as well as physical
injury can stem from a disaster.
Two other books as well as a number of journal accounts yield
additional perspectives of the Buffalo Creek disaster. Tom Nugent (1973),
a freelance reporter, has presented a poignant and dramatic account of the
event itself, following the movement of individuals and whole families
caught up in the black waters or fleeing to the hills as the flood approached
their homes. Erikson (1976), writing from a sociological viewpoint, gives
one a feel for the history and culture of the mountain people who inhabit
this area of West Virginia, the sense of community that knit them together,
and the devastating effect of their uprooting and dispersion as a result of the
4 : LONG-TERM PSYCHOSOCIAL EFFECTS OF DISASTER
disaster. From hundreds of legal documents, statements, and letters, as well
as from lengthy personal interviews, he concludes that the survivors were
not only individually traumatized by the disaster, but that there was a "loss
of communality" which left the victims isolated and lacking anchors or
community support. It is this loss that he feels accounts for much of the
chronicity of the depression that engulfed the survivors.
A symposium entitled "Disaster at Buffalo Creek" was held at the 1975
American Psychiatric Association meeting in Anaheim, California and its
proceedings published in the March 1976 issue of the American Journal of
Psychiatry. Material presented at this symposium describing the interviews
conducted with the litigants will be summarized in Chapter 2. In a journal
article elsewhere, Lifton and Olson (1976) related the emotional manifesta
tions of the survivors they interviewed at Buffalo Creek to the survivor
syndrome described previously by Lifton (1967) on the basis of his research
at Hiroshima. Church (1974) gave a brief description of four cases he
treated and suggested some procedures to alleviate emotional distress in
future disasters.
As has been mentioned, the data that are analyzed and presented in this
book became available as a result of the lawsuit filed on behalf of over 600
survivors. The University of Cincinnati Department of Psychiatry became
involved when one of its members was retained by the law firm of Arnold
and Porter to organize a group of experts to interview the litigants and
assess the psychological impairment they had suffered. Several of us, aware
of the unusual research possibilities of such data, hastily helped the team
leaders draw up a semistructured interview schedule in the hope of achiev
ing some comparability among data to be obtained by the numerous psychi
atrists, psychologists, and social workers who were to interview the
survivor-plaintiffs in the spring of 1974. In addition, we included a symp
tom checklist, a sleep survey, and a checklist of family disruption indicators
in the packets for each team, requesting that these be administered to the
adult survivors whenever possible.
The law firm also had copies of another set of reports on the physical
and mental health status of the litigants: those obtained for the defense.
Russell Meyers, a neuropsychiatrist, had been hired to examine each and
every plaintiff in his office at Williamson, West Virginia. These exam
inations, which included neurological and physical as well as psychological
tests, took place over a 6-month period during the fall and winter of 1973—
1974. The reports were made available to us by Arnold and Porter after we
had received a grant from the National Institute of Mental Health (NIMH)
to pursue our research. In them, Meyers presents his findings in a routine
manner, terminating with a diagnosis and recommendation. Although
Meyers often found psychopathoiogy at the time of his interview, he tended
