LETTER TO EDITOR
Year : 2020 | Volume
: 9 | Issue : 1 | Page : 448--449
Disaster-related media exposure and its impact on mental health
Department of Neuropsychiatry, Iqraa International Hospital and Research Centre, Calicut, Kerala, India
Dr. N A Uvais
Iqraa International Hospital and Research Centre, Calicut, Kerala
|How to cite this article:|
Uvais N A. Disaster-related media exposure and its impact on mental health.J Family Med Prim Care 2020;9:448-449
|How to cite this URL:|
Uvais N A. Disaster-related media exposure and its impact on mental health. J Family Med Prim Care [serial online] 2020 [cited 2020 Apr 3 ];9:448-449
Available from: http://www.jfmpc.com/text.asp?2020/9/1/448/276817
I have read the article titled “Disaster and its impact on mental health: A narrative review” with interest. The author did a commendable job in reviewing the qualitative researches regarding the linkage between disaster and its impact on mental health, which is a neglected subject especially in the developing world. As the author rightly pointed out, the aftermath of disasters has a significant impact on the mental state of the victims and a comprehensive and holistic approach is needed to address this challenging situation. However, community-based traumas (e.g., natural disasters) receive extensive media coverage that spreads rapidly across the multiple media outlets woven into our daily lives. Understanding how widespread media coverage of these events may play a role in our mental health and well-being is also an important public health issue related to disaster mental health that needs attention. Studies have shown that widespread media coverage of disasters extends the boundaries of local disasters, transmits their impact far beyond the directly exposed population, and turns them into collective traumas with potentially detrimental health effects.
During the month of August, 2018, an extraordinary southwest monsoon in Kerala has unleashed floods and landslides in the state, the magnitude of which has rarely been observed in recent memory. As reporters filmed the unprecedented disaster, the live telecast was shown in most of the regional TV channels, thereby potentially turning it into collective trauma. The following case vignette shows the clinical presentation of one of the patients we encountered following floods who presented with symptoms of posttraumatic stress disorder (PTSD) precipitated by exposure to live coverage of Kerala flood in various TV channels.
A 41-year-old married woman, a school teacher by profession, came to the psychiatric outpatient department of our hospital because of worries and reduced sleep. According to the patient, the symptoms started following exposure to live coverage of Kerala flood in various TV channels. The area she or any of her close family members lived was not affected by the floods. However, since then she started having nightmares related to floods. She also started experiencing intrusive memories of TV scenes whenever she was not engaged in any other works and she had to spend much energy and time to get rid of those intrusive memories. She purposefully avoided talking, watching, reading, or hearing about Kerala flood. She also became fearful whenever sky became cloudy or during rains. She also got intrusive memories of TV scenes whenever she saw water bodies. She started getting frightened easily, especially when electricity went off. Her mood gradually became sad and her interest and pleasures in activities got reduced. Her sleep and appetite significantly reduced. She had no past or family history of psychiatric illness. She reported no significant past medical or surgical history. She was diagnosed with PTSD according to ICD-10. After giving psychoeducation regarding the illness, she was started on oral sertraline 50 mg/day and oral clonazepam 0.25 mg/day.
Similar clinical presentations following TV exposure to disasters have been reported in the past. Pfefferbaum et al. explored the effects of media coverage of a terrorist incident in individuals remote from the location of a major attack and found that among the three investigated forms of media (TV, radio, and newspaper), only TV viewing was associated with 9/11-related PTS reactions. Pfefferbaum et al. also assessed the PTS reactions in children, who were exposed to broadcast and print media, distant from the 1995 Oklahoma City bombing explosion and found that children may have lingering reactions to highly publicized terrorist incidents. A recent study compared the mental health correlates of direct personal exposure versus widespread media exposure to a community-based trauma (the Boston Marathon bombings) and found that trauma-related media exposure is associated with acute psychological response in the aftermath of the bombings.
Our female patient had no direct exposure to floods, but followed flood-related live telecast on TV, which precipitated the PTSD symptoms. Accumulating evidences suggest that both live and video exposure of traumatizing or threatening content can influence fear conditioning by activating fear circuitry in the brain and can produce PTSD symptoms, especially flash backs. Unlike direct exposure to floods which could end with the resolution of the event, repeatedly engaging with flood-related live TV broadcast might have prolonged the acute experience by constantly reminding her of flood-related information, leading to ruminative thinking and perpetuate activation of fear circuitry in the brain, resulting in the abnormal consolidation of fear conditioning which is associated with the development of PTS responses.
Visual media has become a significant part of our daily lives. There are crucial roles for visual media during disasters. Kerala media outlets disseminated very crucial information related to floods and actively promoted messages of community solidarity and resilience. However, the ability of the visual media in blurring the line between fiction and reality can also have negative influences on susceptible individuals during disasters. Hence, healthcare providers and policy makers should advice vulnerable people with stress-related symptoms to avoid excessive watching of news coverage of disasters and visual media outlets also should recognize this potential negative role of their reports on the mental health of viewers. They should restrain from repetitive display of traumatic events and should warn viewers when these images are about to be shown.
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Conflicts of interest
There are no conflicts of interest.
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