中文摘要
我们以2004年印度洋地震和海啸这一大规模、高死亡率自然灾害为背景，考察意外死亡对社会心理健康的短期和长期影响。利用“海啸后果与恢复研究”中具有总体代表性的纵向调查数据，我们将社区层面海啸相关死亡率的影响与个人失去近亲的影响进行对比。短期来看，即海啸发生两年后，社区和个人层面的死亡暴露均可显著预测抑郁和创伤后应激症状的加重。长期来看，即海啸发生十年后，个人层面暴露的影响略有减弱，但仍可显著预测两项社会心理健康指标；相比之下，社区层面的死亡率能预测创伤后应激症状，但不能预测抑郁症状。死亡与短期和长期的较小家庭规模相关，也与长期的社会支持减少相关，不过后一影响在男性和女性之间存在显著差异。上述估计对其他海啸暴露指标进行了调整；在个人层面的分析中，我们比较了海啸发生时居住在同一社区、因而面临相同社区层面死亡率的人群。
Abstract
We investigate the short- and long-run impacts of unexpected mortality on psychosocial health in the context of a large-scale high-mortality natural disaster, the 2004 Indian Ocean earthquake and tsunami. The effects of the tsunami-related mortality measured at the community level are contrasted with the effects of individual-specific loss of close kin using population-representative longitudinal survey data from the Study of the Tsunami Aftermath and Recovery. In the short-run, two years post-tsunami, both community and individual-level mortality exposures are significant predictors of elevated depression and post-traumatic stress symtoms. In the longer-run, ten years post-tsunami, individual-level exposures are slightly attenuated but remain significant predictors of both psychosocial health measures; in contrast, community-level mortality predicts post-traumatic stress but not depression symptoms. Mortality is linked to smaller household sizes in the short- and long-run and to less social support in the long-run, although the latter effect differs substantially for males and females. The estimates adjust for other tsunami exposure measures and, in the individual-level analyses, we compare people living in the same community at the time of the tsunami who were exposed to the same community-level mortality rate.