A mega-earthquake and tsunami struck the northeastern coast of Japan on 11 March 2011. The most devastating property damages occurred in Fukushima, Miyagi, Iwate, and Ibaraki prefectures. The vast majority of the fatalities and damage came not from the earthquake itself, but from the resulting tsunami. Tsunami waves in excess of 10 m (33 feet) swept away almost every home, structure, vehicle, and area of vegetation in their path. This earthquake, with a magnitude of 9.0 on the Richter scale, was the worst and the most devastating disaster in Japan since the end of World War II. Furthermore, the event led to a Level 7 nuclear power plant disaster at the Fukushima Daiichi complex, the largest nuclear accident since the 1986 Chernobyl disaster. As a result, a country battling national crisis endured the additional threat of nuclear contamination. These simultaneous natural and manmade disasters inevitably had negative effects not only on the survivors, but also on Japanese society as a whole.
Natural disasters or disasters due to natural hazards, such as earthquakes and tsunamis, can have substantial detrimental effects on the physical and mental health of victims. Previous studies indicated the presence of emotional distress and psychiatric disorders among adult disaster victims. For instance, psychiatric disorders, such as post-traumatic stress disorder (PTSD) or major depressive disorder, increased in the aftermath of earthquakes in Italy, China, Turkey, and Southeast Asia. Survivors of natural disasters also experience enormous stress, due to relocations and the loss of families, communities, and properties. It is well documented that such stress is strongly associated with not only one's psychological well-being, but also one's physical health.[9, 10] Examination of the survivors' mental and physical health after these massive natural and manmade disasters is indispensable in order to provide needed and effective assistance to them.
Individuals respond to disasters differently, and numerous studies have documented that a number of factors influence how people react following disasters. For instance, Phifer found that some sociodemographic factors, such as sex, occupational status, and age, were all associated with amplified psychological symptoms. In particular, he concluded that within this older adult sample, men, those with lower occupational status, and persons aged 55–64 years were at significantly greater risk than their counterparts. Other researchers have found that unmarried persons and those with low levels of education and income have been found to be more susceptible to adverse mental health effects after stressful events than others.[12, 13] Recently, however, a growing number of studies have presented evidence that individuals' efforts to cope with extreme stress also significantly positively affect the psychological outcomes of those involved.[14, 15] One aspect of individual effort is psychological resilience. Resilience has been defined as a protective factor against mental problems and as a dynamic process of adaptation to changes in life circumstances. Previously, some researchers described resilience as a characteristic trait that buffers against the negative outcomes from stressors. However, the recent literature supports the conceptualization that resilience is most commonly understood as a process, not a trait of an individual. Thus, the current view of resilience has been theorized as a dynamic process that can be acquired at any point throughout the lifespan.
Vast numbers of studies concluded that resilience is a protective factor against the development of psychiatric disorders, such as PTSD, and depression. However, those studies have been conducted primarily outside of Japan. Given that resilience may be influenced by cultural components, investigating the role of resilience for survivors of natural disasters in Japan is worthy of study. Therefore, the focus of this study is to explore the prevalence of symptoms of PTSD, depression, and general health among the residents of Hirono who have been affected by the Great East Japan Earthquake and the nuclear power plant accident. This study also examined the factors that influence increased psychological resilience in those survivors.