Exposure to rapid succession disasters: a study of residents at the epicenter of the Chilean Bío Bío earthquake.

We examined cumulative and specific types of trauma exposure as predictors of distress and impairment following a multifaceted community disaster. Approximately 3 months after the 8.8 magnitude earthquake, tsunami, and subsequent looting in Bío Bío, Chile, face-to-face interviews were conducted in 5 provinces closest to the epicenter. Participants (N = 1,000) were randomly selected using military topographic records and census data. Demographics, exposure to discrete components of the disaster (earthquake, tsunami, looting), and exposure to secondary stressors (property loss, injury, death) were evaluated as predictors of posttraumatic stress (PTS) symptoms, global distress, and functional impairment. Prevalence of probable posttraumatic stress disorder was 18.95%. In adjusted models examining specificity of exposure to discrete disaster components and secondary stressors, PTS symptoms and global distress were associated with earthquake intensity, tsunami exposure, and injury to self/close other. Increased functional impairment correlated with earthquake intensity and injury to self/close other. In adjusted models, cumulative exposure to secondary stressors correlated with PTS symptoms, global distress, and functional impairment; cumulative count of exposure to discrete disaster components did not. Exploratory analyses indicated that, beyond direct exposure, appraising the tsunami and looting as the worst components of the disaster correlated with greater media exposure and higher socioeconomic status, respectively. Overall, threat to life indicators correlated with worse outcomes. As failure of government tsunami warnings resulted in many deaths, findings suggest disasters compounded by human errors may be particularly distressing. We advance theory regarding cumulative and specific trauma exposure as predictors of postdisaster distress and provide information for enhancing targeted postdisaster interventions.