RELATIONSHIP BETWEEN COPING STRATEGIES AND POST-TRAUMATIC STRESS DISORDERS (PTSD) AMONG FLOOD VICTIMS IN DELTA STATE

RELATIONSHIP BETWEEN COPING STRATEGIES AND POST-TRAUMATIC STRESS DISORDERS (PTSD) AMONG FLOOD VICTIMS IN DELTA STATE

RELATIONSHIP BETWEEN COPING STRATEGIES AND POST-TRAUMATIC

STRESS DISORDERS (PTSD) AMONG FLOOD VICTIMS IN DELTA STATE

 

 

By

Ohre Ighoyohwo Joseph

And

Prof. Odiase Jerry Edobor

 

Department of Educational Psychology, Guidance and Counselling

Faculty of Education

University of Port Harcourt

 

Abstract

This study investigated the relationship between coping strategies and post-traumatic stress disorders (PTSD) among flood victims in Delta state. Using a correlational research design, the study adopted Purposive and convenient sampling techniques to select 1240 victims affected by flood across the state. Two instruments Post-traumatic Stress Disorder Questionnaire and the Coping Strategies Scale were used for data collection. Pearson Product moment correlation and multiple regression were used to answer the research questions and test their corresponding null hypotheses at 0.05 level of significance. Validation was done by experts in University of Port Harcourt. The reliability of the instruments was tested using Cronbach alpha reliability method of internal consistency. Reliability of the items in the Post-traumatic Stress Disorder Questionnaire at 0.71, Coping Strategies Scale at 0.77 coefficient reliabilities. The results revealed among others that there is significant positive relationship between self-distraction coping strategy and post-traumatic stress disorders (PTSD) among flood victims in Delta state. Recommendations were made among others that flood victims should learn to use the coping strategies of active, passive and most especially the self-distraction coping strategy to overcome post-traumatic stress disorder.

 

 

Keywords: Flood, Post-Traumatic Stress Disorder, Victims.

 

Introduction

Globally, natural disasters in different forms is a hectic experience by many people, likewise, floods have regularly become a threat to the people of Delta State especially communities living in the riverine areas and those in the lower land. Every year most people in these communities are displaced from their homes. The flood occurs suddenly across a limited area associated with very heavy rainfall and worsened with the overflow of the River Niger. The 2019 flood disaster in some parts of Delta State resulted to human tragedy, displacement of people from their homes, disruption of communities and business processes. Some communities in the upland may be of an advantage than those who live on the lower land. Just as the rainy season may have short or long period, so also flood event can be short term or long term depending on the speed and duration. This was the case of 2019 flood incidence in Delta State because the rain was quite heavy and lasted longer than usual.

          According to some of the victims in some communities of Delta state, the problem of the flood is almost yearly. It usually starts with heavy rain and when the River Niger overflowed to the land, some of the communities are usually displaced. The flood usually affects their roads, farm, poultry, fish pond, houses and even wild life. These accounted for great number of loss. According to experts, the water level was about 4-8 feet above the ground level. The flood left negative impact on the lives of the victims such as disease outbreak, hunger, poverty, poor sanitation, and financial problem such that a good number of them are still struggling today to earn a living. The most frequently diagnosed psychological illness of people living in flood-affected areas is PTSD which manifests as difficulty in sleeping, emotional distress, avoidance and emotional arousal. Delta State is one that has recurrently suffered from flood crises. Studies identified rising sea levels in addition to low elevation as some of the factors causing flooding in the State.

         Post-traumatic stress disorder (PTSD) is a severe and complex disorder precipitated by exposure to psychologically distressing events. It is characterized by persistent intrusive memories about the traumatic event, persistent avoidance of stimuli associated with the trauma and persistent symptoms of increased arousal. Globally, serious flooding constitutes a major disaster in both rich and poor nations, like the United States of America, Europe, South East Asia, and Africa in the past decade (Ahern, Kovats, Wilkinson, Few and Matthies, 2005).

          People who have experienced or have been affected by natural disasters are able to recover with the support of their families, friends or colleagues. However, a significant proportion of them may still suffer from long-term health problems and disabilities that deeply affect their well-being. Such events can cause grief, substance misuse, exacerbation of domestic violence and other aggressive behaviours. Climate change is increasing the risk of flooding worldwide. In Europe, 1.6 million people are at risk of experiencing a flood each year. Indeed, the World Health Organization (WHO) estimates that floods in Europe have affected 3.4 million people over the last 10 years. Floods are amongst the most severe, life-threatening natural disasters. They usually require long recovery periods, mainly due to significant material damages. In fact, works associated with cleaning, rebuilding and/or refurbishing properties may be costly; affected areas may also suffer from decline of both tourism and house prices (Kar and Bastia, 2006). Thus, people who have been affected by a severe flood may experience long-term stressors and strong fears of similar disasters happening again. Recovery following a flood involves adaptation to new social circumstances. This often carries common anxiety that may eventually evolve to more complex mental health problems. Hence, the incidence of severe mental disorders might increase significantly. Post-traumatic stress disorder (PTSD) is a condition that arises as a delayed reaction to extremely threatening or catastrophic, brief or long-lasting, situations. Estimates have shown that for the past 10years, flooding affected approximately 949 million people worldwide. The vast majority of these, 900 million, lived in countries of medium human development (IRFC, 2010). An examination of the psychological consequences of flooding is essential both in relation to present and future flooding disasters.

           Numerous studies have shown that long-term adverse psychological outcomes may lead to a decreased quality of life, as well as impaired cognitive and social functioning. Therefore, reducing the prevalence of long-term adverse psychological outcomes is necessary and could be achieved by providing effective psychological intervention services such as coping strategies to individuals with a higher risk of suffering from these consequences. Categories of coping styles are active coping and passive (or avoidant) coping (Nielsen & Knardahl, 2014). Other coping strategies are the social support system and self-distraction coping strategy.

         Active-coping is a stress-management strategy in which a person directly works to control a stressor through appropriately targeted behavior, embracing responsibility for resolving the situation using one’s available internal resources. This type of coping strategy may take various forms, such as changing established habits. According to Baglama and Uzunboylu (2017), active coping strategy helps to a moderate Post-traumatic stress disorder (PTSD) among flood victims of North Cyprus.

          Passive-coping is a stress-management strategy in which a person absolves himself or herself of responsibility for managing a stressor and instead relinquishes control over its resolution to external resources, such as other people and environmental factors. Individuals who cope passively often withdraw from interpersonal relationships and instead engage in such activities as hoping, praying, or avoiding the stressor. Nasir & Shiang (2013) agreed from their study that there is a significant positive relationship between passive coping strategy and post-traumatic stress disorders (PTSD) among victims of fire disaster in Lagos.

           Self-distraction involves using behaviours such as watching television, exercising, reading, or engaging in other pleasurable activities to distract oneself from the stressful event. Distraction is a passive coping strategy in that the person copes without directly confronting the situation or trying to solve the problem. According to Sokaje (2011), self-distraction coping skill has a high positive influence on victims of post-traumatic stress disorders (PTSD). Chukwudi (2012) also agreed with this finding in a similar finding where he said there is negative significant relationship between self-distraction coping and students’ post-traumatic stress disorders (PTSD). Coping styles dictate the response to threats or challenges to prevent or reduce associated distress. Thus this study investigated the relationship between coping strategies and post-traumatic stress disorders (PTSD) among flood victims in Delta state.

Statement of the Problem

There is virtually no year indigenes of the state are not affected by flood and this has almost become a life style with them as most of the indigenes of the state have taken it upon themselves to manage the remains of their properties destroyed by flood as no government assistant is forthcoming. While it could be observed by the researchers that some persons have moved on with live after the flood, others seem to be trapped in the trauma left behind by it. Flood has destroyed valuable properties of people residing in the affected areas ranging from agricultural products, buildings, loss of lives and numerous valuable properties. These loss have caused serious psychological trauma to victims of the state and some of their family members afar. The stress of starting from scratch, the thought of losing what they have laboured for, the pains of living in poverty, the challenges of living by the roadside filled with the fear of accident, robbers, rape etc has increased the trauma experienced by these victims hence it became necessary to investigate the relationship between coping strategies and post-traumatic stress disorders (PTSD) among flood victims in Delta state.

Objectives of the study

This study aimed at investigating the relationship between coping strategies and post-traumatic stress disorders (PTSD) among flood victims in Delta state. Specifically, the study investigated:

  1. The relationship between active coping strategy and post-traumatic stress disorders (PTSD) among flood victims in Delta state.
  2. The relationship between passive coping strategy and post-traumatic stress disorders (PTSD) among flood victims in Delta state.
  3. The relationship between self-distraction coping strategy and post-traumatic stress disorders (PTSD) among flood victims in Delta state.
  4. The relationship between active, passive, self-distraction coping strategies jointly and post-traumatic stress disorders (PTSD) among flood victims in Delta state.

1.4 Research Questions

The following research questions guided the study:

  1. What is the relationship between active coping strategy and post-traumatic stress disorders (PTSD) among flood victims in Delta state?
  2. What is the relationship between passive coping strategy and post-traumatic stress disorders (PTSD) among flood victims in Delta state?
  3. What is the relationship between self-distraction coping strategy and post-traumatic stress disorders (PTSD) among flood victims in Delta state?
  4. What is the relationship between active, passive, self-distraction coping strategies jointly and post-traumatic stress disorders (PTSD) among flood victims in Delta state?

1.5 Hypotheses

The following null hypotheses were tested at 0.05 level of significance to guide this study.

  1. There is no significant relationship between active coping strategy and post-traumatic stress disorders (PTSD) among flood victims in Delta state.
  2. There is no significant relationship between passive coping strategy and post-traumatic stress disorders (PTSD) among flood victims in Delta state.
  3. There is no significant relationship between self-distraction coping strategy and post-traumatic stress disorders (PTSD) among flood victims in Delta state.
  4. There is no significant relationship between active, passive, self-distraction coping strategies jointly and post-traumatic stress disorders (PTSD) among flood victims in Delta state.

Review of Literature

Flooding is arguably the weather-related hazard that is most widespread around the globe. It can occur virtually anywhere. A flood is defined as water overflowing onto land that usually is dry. Flooding is often thought of as a result of heavy rainfall, but floods can arise in a number of ways that are not directly related to ongoing weather events. Thus, a complete description of flooding must include processes that may have little or nothing to do with meteorological events. Nevertheless, it is clear that in some ultimate sense, the water that is involved in flooding has fallen as precipitation at some time, perhaps long ago. The origins of flooding, therefore, ultimately lie in atmospheric processes creating precipitation, no matter what specific event causes the flooding. Floods produce damage through the immense power of moving water and through the deposition of dirt and debris when floodwaters finally recede. People who have not experienced a flood may have little or no appreciation for the dangers of moving water. The energy of that moving water goes up as the square of its speed; when the speed doubles, the energy associated with it increases by a factor of four. Flooding is typically coupled to water moving faster than normal, in part because of the weight of an increased amount of water upstream, leading to an increase in the pressure gradient that drives the flow.

            Post-traumatic stress disorder (PTSD) is an intense physical and emotional response to thoughts and reminders of the event that last for many weeks or months after the traumatic event. Post-traumatic stress disorder (PTSD) is a psychiatric disorder in which an individual experience one or more traumatic events during their lifetime, which would lead to a person experiencing a countless number of symptoms (Heshmati, Hoseinifar, Rezaeinejad & Miri, 2010). According to Ahmadizadeh (2010), “PTSD is characterized by intrusive thoughts, nightmares, and flashbacks of past traumatic events, avoidance of reminders of the trauma, hypervigilance and sleep disturbance.

         Post-Traumatic Stress Disorder (PTSD) is a mental disorder characterized by disturbing symptoms that interfere with daily functioning (see below), following either witnessing or experiencing a traumatic life-threatening event. Trauma itself is experienced as terrifying. Common reactions to a traumatic event are to think that one’s life or others’ lives are in danger, to experience heightened fear or terror, or to feel out of control.

PTSD symptoms may start very quickly following a traumatic event, or they might not appear for years after the event. PTSD is thus a heterogeneous disorder in terms of both the occurrence following a trauma and with respect to the symptoms experienced. The symptoms observed in PTSD include what are referred to as intrusive memories or reliving of the experience, avoidance of anything that reminds the person of the trauma, negative changes in thinking or mood that are a result of the trauma and which interfere with daily functioning, and changes in the person’s emotional reactions to everyday events.

          Other symptoms include hyperarousal in situations that may lead to being easily startled, experiencing problems with sleeping, and not being able to concentrate. Additional symptoms include nightmares or even experiencing what are called “flashbacks,” where the event is re-experienced as if it were happening all over again. There are also sometimes negative thoughts and feelings that interfere with everyday functioning, such as self-blame, depression, and thoughts of hurting oneself. Those suffering from PTSD also experience feeling unsafe or always in danger, feeling anxious or jittery, or even irritated. Also reported are feelings of panic that something terrible is about to happen. The social sharing theory proposed by Leon Festinger (1954) states sharing ones emotional experiences with others is a natural and advantageous way of recovering from emotional events (Rimé, Mesquita, Philippot & Boca, as cited in UKEssays, 2018). However, there has been mixed support for this theory. A common belief among lay people and indeed some researchers is that expressing ones emotions is beneficial in recovering from an emotional experience.

Methodology

The study adopted correlational research design to understudy the relationship between coping strategies and post-traumatic stress disorders (PTSD) among flood victims in Delta state Nigeria. Validation was done by the experts in University of Port Harcourt. The reliability coefficient using Pearson product moment technique was 0.71 coefficient value. The study was carried out in flood affected communities in Delta state. It is an oil and agricultural producing state of Nigeria, situated in the region known as the South-South geo-political zone with a population of 4,098,291 (Source: Population Census, 2006). The capital city is Asaba, located at the northern end of the state, with an estimated area of 762 square kilometres.

Table 1: Pearson Correlation of the relationship between active coping strategy and post-traumatic stress disorders (PTSD) among flood victims in Delta state.

Active coping strategy

Pearson Correlation

1

.610

Sig. (2-tailed)

                                            .001

N

1240

1240

Post-traumatic stress disorders (PTSD)

Pearson Correlation

.610

1

Sig. (2-tailed)

            .001

N

            1240                         1240

 

 

 

           

Table 1 shows that the correlation between active coping strategy and post-traumatic stress disorders (PTSD) is .610 which indicates a positive relationship. Therefore, there is positive relationship between active coping strategy and post-traumatic stress disorders (PTSD) among flood victims in Delta state. For two-tailed test, the observed correlation has probability level (p-value) of .001. The p-value of .001 is less than the chosen 0.05 alpha. Therefore, the null hypothesis which states that there is no significant relationship between active coping strategy and post-traumatic stress disorders (PTSD) among flood victims in Delta state is rejected. In other words, there is significant relationship between active coping strategy and post-traumatic stress disorders (PTSD) among flood victims in Delta state.

Table 2: Pearson Correlation of the relationship between passive coping strategy and post-traumatic stress disorders (PTSD) among flood victims in Delta state.

 

Passive coping strategy

Pearson Correlation

1

.501

Sig. (2-tailed)

                                            .001

N

1240

1240

Post-traumatic stress disorders (PTSD)

Pearson Correlation

.501

1

Sig. (2-tailed)

            .001

N

            1240                         1240

Table 2 shows that the correlation between passive coping strategy and post-traumatic stress disorders (PTSD) is .501 which indicates a positive relationship. Therefore, there is positive relationship between passive coping strategy and post-traumatic stress disorders (PTSD) among flood victims in Delta state. For two-tailed test, the observed correlation has probability level (p-value) of .001. The p-value of .001 is less than the chosen 0.05 alpha. Therefore, the null hypothesis which states that there is no significant relationship between passive coping strategy and post-traumatic stress disorders (PTSD) among flood victims in Delta state is rejected. In other words, there is significant relationship between passive coping strategy and post-traumatic stress disorders (PTSD) among flood victims in Delta state.

Table 3: Pearson Correlation of the relationship between self-distraction coping strategy and post-traumatic stress disorders (PTSD) among flood victims in Delta state.

Self-distraction coping strategy

Pearson Correlation

1

.663

Sig. (2-tailed)

                                            .000

N

1240

1240

Post-traumatic stress disorders (PTSD)

Pearson Correlation

.663

1

Sig. (2-tailed)

            .000

N

            1240                         1240

 

Table 3 shows that the correlation between self-distraction coping strategy and post-traumatic stress disorders (PTSD) is .663 which indicates a positive relationship. Therefore, there is positive relationship between self-distraction coping strategy and post-traumatic stress disorders (PTSD) among flood victims in Delta state. For two-tailed test, the observed correlation has probability level (p-value) of .000. The p-value of .000 is less than the chosen 0.05 alpha. Therefore, the null hypothesis which states that there is no significant relationship between passive self-distraction strategy and post-traumatic stress disorders (PTSD) among flood victims in Delta state is rejected. In other words, there is significant relationship between self-distraction coping strategy and post-traumatic stress disorders (PTSD) among flood victims in Delta state.

Table 4: Multiple regression of the relationship between active, passive, self-distraction coping strategies jointly and post-traumatic stress disorders (PTSD) among flood victims in Delta state.

 

R

R2

Adj R2

Std Error

.782

.612

.609

.38997

 

 

Sum of Sq

Df

Mean Sq

F

µ

Sig.

Result

Regression

Residual

Total

4728.08

68131.69

73459.78

6

443

449

788.01

155.15

 

5.09

 

0.005

 

0.0001

 

Significant

Reject Ho

 

Table 4 shows that active, passive, self-distraction coping strategies jointly and post-traumatic stress disorders (PTSD) obtained a correlation coefficient of r = 0.78 indicating a high positive relationship. In answer to the research question, an R Square of 0.612 was obtained and an adjusted R2 value of 0.609. Based on the adjusted R2 value of 0.609, it shows that 60.9% (0.609 x 100) variations in the post-traumatic stress disorders (PTSD) of the respondents is determined by their joint active, passive, self-distraction coping strategies. The associated ANOVA shows calculated F to be 5.09 while the sig-value is 0.0001. Therefore, since sig (p= 0.00001<0.05) is less than the alpha level of 0.05, the null hypothesis which states there is no significant relationship between active, passive, self-distraction coping strategies jointly and post-traumatic stress disorders (PTSD) among flood victims in Delta state is rejected. Therefore, there is significant relationship between active, passive, self-distraction coping strategies jointly and post-traumatic stress disorders (PTSD) among flood victims in Delta state.

Discussion of findings

The results obtained from research question 1 revealed that there is significant positive relationship between active coping strategy and post-traumatic stress disorders (PTSD) among flood victims in Delta state. This indicates that flood victims who practice the active coping strategy will be able to overcome the post-traumatic stress disorder (PTSD). This finding agreed with that of Baglama and Uzunboylu (2017) where they revealed that active coping strategy helps to moderate Post-traumatic stress disorder (PTSD) among flood victims of North Cyprus.

Results from research question 2 revealed that there is significant positive relationship between passive coping strategy and post-traumatic stress disorders (PTSD) among flood victims in Delta state. This indicates that flood victims who practice the active coping strategy will be able to overcome the post-traumatic stress disorder (PTSD). This finding agreed with that of Nasir & Shiang (2013) where they agreed from their study that there is a significant positive relationship between passive coping strategy and post-traumatic stress disorders (PTSD) among victims of fire disaster in Lagos.

Results from research question 3 revealed that there is significant positive relationship between self-distraction coping strategy and post-traumatic stress disorders (PTSD) among flood victims in Delta state. This indicates that flood victims who practice the active coping strategy will be able to overcome the post-traumatic stress disorder (PTSD). This finding agreed with that of Sokaje (2011) where he revealed that self-distraction coping skill has a high positive influence on victims of post-traumatic stress disorders (PTSD).

Finally, results from research question 4 revealed that there is significant positive relationship between active, passive, self-distraction coping strategies jointly and post-traumatic stress disorders (PTSD) among flood victims in Delta state. This indicates that flood victims who practice the active coping strategy will be able to overcome the post-traumatic stress disorder (PTSD).

Conclusion & Recommendation

It was concluded that flood victims in Delta state overcome post-traumatic stress disorder (PTSD) using active coping strategy. It was also concluded that flood victims in Delta state do overcome post-traumatic stress disorder (PTSD) using passive coping strategy. It was further concluded that flood victims in Delta state do overcome post-traumatic stress disorder (PTSD) using self-distraction coping strategy. Finally it was also concluded that flood victims in Delta state who practice the joint coping strategies of active, passive and self-distraction do overcome post-traumatic stress disorder (PTSD). It is therefore recommended that flood victims should learn to use the coping strategies of active, passive and most especially the self-distraction coping strategy to overcome post-traumatic stress disorder. Government, while giving relief materials to victims of flood should organize seminars and workshop for victims of flood to enlighten then on relevant coping strategies like the active, passive and post-traumatic and this will go a long way reducing post-traumatic stress disorder (PTSD).

 

 

References

Ahern, M., Kovats, R. S., Wilkinson, P., Few, R. and Matthies, F. (2005). Global health impacts of floods: epidemiologic evidence. Epidemiol Rev. 27: 36-46.

Ahmadizadeh, M. J., Ahmadi, K., Eskandari, H., Falsafinejad, M. R., Borjali, A., Anisi, J., & Teimoori, M. (2010). Improvement in quality of life after exposure therapy, problem solving and combined therapy in chronic war-related post-traumatic stress disorder. Procedia - Social and Behavioral Sciences, 5(2), 262–266.

Baglama, B., & Uzunboylu, H. (2017) investigated psychological factors influencing Post-traumatic stress disorder (PTSD) among flood victims of North Cyprus. Procedia-Social and Behavioral Sciences, 190, 448-454

Chukwudi, N. B. (2012). Coping strategies as a panacea for post-traumatic stress disorders (PTSD) among flood victims of Riverine areas in Rivers state. Journal of Social Sciences. 4 (2) 173-190

Heshmati, R., Hoseinifar, J., Rezaeinejad, S., & Miri, M. (2010). Sensation seeking and marital adjustment in handicapped veterans suffering from PTSD. Procedia-Social and Behavioral Sciences, 5, 1783-1787

IRFC (International Federation of Red Cross Red Crescent Societies) (2010) World Disasters Report: Focus on Urban Risk. http://www.ifrc.org/Global/Publications/disasters/ WDR/WDR2010-full.pdf Accessed 15-05-2021

Kar, N., and Bastia, B. K. (2016). Post-traumatic stress disorder, depression and generalised anxiety disorder in adolescents after a natural disaster: a study of comorbidity. Clin Pract Epidemiol Ment Health. 2:17

Nasir, D. & Shiang, L. C. (2013). Psychological remedies to post-traumatic stress disorders (PTSD) among victims of fire disaster in Lagos. Faculty of Education Journal. 26 (12) 201-215

Nielsen, M.B., & Knardahl, S. (2014). Coping strategies: A prospective study of patterns, stability, and relationships with psychological distress. Scandinavian Journal of Psychology, 55, 142-150

UKEssays. (November 2018). The social sharing of emotion theory. Retrieved from https://www.ukessays.com/essays/psychology/the-social-sharing-of-emotion-theory-psychology-essay.php?vref=1. Accessed 19-06-2021

Sokaje, W. P. (2011). Psychological factors influencing post-traumatic stress disorders (PTSD) among indigenes of Ekeremor Local Government Area of Rivers state. Unpublished Msc Dissertation. University of Calabar.

 

 

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