Changes In Self-perception Research Articles

C-69 * The Relationship between Self-Awareness and Functional Outcomes in Brain Injury Rehabilitation

Objective: Functional outcomes of transitional rehabilitation programs are often measured across multiple domains, including physical abilities, adjustment, and social participation. While research suggests clinician ratings on measures such as the Mayo-Portland Adaptability Index (MPAI-4) predict outcomes, the role of self-awareness in achieving rehabilitation outcomes is unclear. We explored how patients' self-awareness of deficits correspond to clinicians' ratings and whether level of self-awareness (as measured by the discrepancy between patient and staff MPAI-4 total score at discharge) predicts functional outcomes. Method: Clinicians completed the MPAI-4, a 29-item rating scale of functional impairment, at admission and discharge for 72 (mean age = 30.5) active duty service members and Veterans with acquired or traumatic brain injury who participated in a residential transitional rehabilitation program at the VA Palo Alto between 2008 and 2014. Patients also completed the MPAI-4 at the same time points. Results: Analyses revealed that following rehabilitation treatment, both patients and staff reported improved functional outcome on MPAI-4 total score from admission to discharge (t = 5.05, t = 11.16, p < .01, respectively). At admission, patients rated themselves as less impaired across all functional domains compared to the clinicians' ratings (p < .01). Poor self-awareness at admission was associated with poorer functional outcome at discharge (r = −.44, p < .01) and greater self-perceived functional changes at discharge (r = −.83, p < .00). Conclusion(s): Self-awareness of functional deficits may predict functional outcomes in a brain injury rehabilitation program. Moreover, impaired insight may serve to hinder functional gains and should be a focus for intervention in the rehabilitation setting.

Posttraumatic Growth Inventory at Living Kidney Donors.

Kidney transplantation from living donors is regarded as a contradictory case to the “first do no harm” principle as a major surgical intervention is performed on a normal and healthy person at the expense of recovery of the organ recipient. Nevertheless, the living donor's acknowledgement of the reason why the operation is performed and awareness of the importance of organ donation as a life gift, makes the kidney transplantaion ethically acceptable. The purpose of this study is to investigate whether there is a significant difference between the socio-demographic variables, which have an impact on psychiatric change of living kidney donors and post-traumatic development of living kidney donors. In the scope of the study, 184 living kidney donors aged 19 to 65 are selected. Comparison is made concerning the reserach results of those having survived a car accident, those diagnosed with cancer and those having no health problems. Assumptions of those having survived a car accident about the world can be negatively affected in the aftermath of the accident. The sample comprises 436 people aged 16 to 70, including 206 people having survived an accident and 230 people not having survived an accident. 66 percent of people having survived an accident were injured at different levels and almost all of them felt the fear of death. The sample consists of 78 patients aged 19 to 65, who receive diagnosis and treatment of several types of cancer at different stages within the last 6 to 60 months after the diagnosis. In comparison to the results of other 3 groups, the living kidney donors have a higher total score on the subscales of change in relationships and change in self-perception. Living donors have lower scores than those having survived a car accident and the control group on the subscale of the change in life philosophy only. Donors have higher scores than those diagnosed with cancer on the subscale of the change in life philosophy. The study puts that being a living kidney donor has no negative effect on people themselves.Table: No Caption available.

Building a team to fight diabetes: Pharmacy students’ perceptions about serving as patient navigators

To describe pharmacy students’ changes in self-perceptions during a program that introduces them to working as a “patient navigator” with patients who have diabetes. Pharmacy students were trained during their Advanced Pharmacy Practice Experience (APPE) as part of a continuing study of patients in an urban clinic. The interdisciplinary program combines hands-on experience in primary care with behavioral knowledge including cultural competency. Training by pharmacy and social science faculty included the use of lectures, video, and role-playing. These applied clinical education, motivational interviewing, and a well-tested behavioral model of health beliefs. The students then observed and held direct, supervised interactions with patients. To assess their experience, students completed surveys at the beginning and end of the five-week rotations. This article discusses responses from 34 students (2009–2012) and compares changes in students’ perceptions after the experience. Students’ self-perceptions of their knowledge or abilities in four areas of patient self-management were significantly more positive upon completion: providing diabetes education, setting self-management goals, identifying barriers to treatment, and understanding patients’ health beliefs and attitudes. Students felt that the experience was useful for their professional development and future practice. Exposing students to skills as patient navigators can have a positive effect on their confidence about assisting with diabetes management. Hands-on application of behavioral techniques and cultural competence within a primary care-based APPE can provide a promising learning experience. This is meaningful for today’s pharmacists, who will function in a multicultural environment, in which diabetes has a powerful effect on public health.

OP0247-PARE Knowledgeable Patient Knows When It's Time to Seek Answers

Objectivesto know deeply how patients perceive, cope and live with SpA and assess the emotional, social and financial impact spondyloarthropathies (SpA) have on patients' QOLMethodssince Jan to March 2013 a...

The effect of variable light on the fidgetiness and social behavior of pupils in school

Studies on the effects of light in work environments show that specific lighting situations have different effects on human performance and social behavior. These findings suggest that beneficial lighting should also be applied in schools. The aim of the present study was to examine the effect of variable lighting on pupils' fidgetiness and their aggressive and prosocial behaviors. The variable lighting system employed was equipped with seven lighting programs featuring different varieties of illuminance and color temperature. In a controlled, quasi-experimental field study, a combination of cross-sectional and longitudinal observations was collected. The participants included n = 110 pupils of various age levels and school types and n = 11 teachers from Hamburg. Fidgetiness was measured by the changes in pixel scores in a digital recording of the students. To quantify aggressiveness and prosocial behaviors, structured behavioral observations were conducted. Self-perceived changes throughout the school year were captured using questionnaires. The findings showed a significantly stronger decline in fidgetiness and observed aggressive behaviors and a tendency toward increased prosocial behaviors within the intervention group. In the long term, the pupils did not rate themselves as being calmer or less aggressive. Overall, the findings indicated that variable light could directly reduce pupils' restlessness and improve their social behaviors. Variable lighting can thus play a part in optimizing general conditions for school learning.

A Mixed-Method Study to Explore Patients' Perspective of Self-Management Tasks in the Early Phase after Kidney Transplant

Patients' perspectives of posttransplant self-management tasks have not been explored.OBJECTIVE-To explore the concept and the presence of self-management tasks mastered by patients in the early phase after kidney transplant. Mixed-method study using semistructured interviews and a structured questionnaire.Setting-Outpatient Division of Nephrology at University Hospital Zurich, Switzerland. Twelve patients (median age, 52 years, interquartile range, 42.25-65.25 years; median time after kidney transplant, 6.5 months; interquartile range, 2.25-15.75 months) were included.Analysis-Qualitative data were analyzed according to Corbin and Strauss' 3 self-management tasks with content analysis procedures. In the quantitative analysis, the presence of each self-management task is expressed as a frequency. -The qualitative findings showed that patients were greatly challenged by the effort to manage the upcoming instability, which has a persistent broad impact on their lives. Managing emotions comprised dealing with uncertainty, disappointment, and frustration. Additionally, patients had to manage changes in self-perception. Managing life roles mainly involved an adaptation of relationships, occupational changes, and interactions with health care providers. Taking medications, managing symptoms, integrating new behaviors, and understanding one's course of disease were further tasks. Quantitatively, self-management tasks that were perceived as a challenge by at least half of the patients were primarily tasks from the questionnaire section "managing stressful emotions and self-perception." The synthesis of qualitative and quantitative findings indicates that self-management programs for kidney transplant recipients should focus on strengthening patients' self-management of emotional tasks and on regaining stability in daily life.

Children’s Perceived Competence Scale

To support children with chronic diseases, reference values to measure developmental changes in self-perception and self-esteem are considered a useful yardstick. To develop reference values to measure self-perceived competence and self-esteem in Japanese children, the Children's Perceived Competence Scale (CPCS) was administered to 768 children of elementary school grade 1 (6 years) to grade 6 (11 years) at four public schools in Japan, from November to December 2012. After excluding 74 with chronic diseases and/or incomplete responses, 694 children were included. CPCS measures children's self-perceived competence in cognitive, social, physical domains, and general self-worth, namely self-esteem. There was a tendency for scores of cognitive and general self-worth to decrease with increasing grade. Scores among grade 5 respondents were significantly lower than those among grade 4 respondents for both social and physical domains. Scores among boys and girls differed significantly, with boys scoring higher for physical domain in grades 3 and 6 and for general self-worth domain in grade 6. The CPCS reference values to measure self-perceived competence and self-esteem in Japanese children were developed in this study. These reference values are useful to inform practitioners supporting children with psychological or psychiatric problems or those with chronic diseases.

Oxytocin and enhancement of the positive valence of social affiliation memories: An autobiographical memory study

Intranasal oxytocin has been shown to alter self-perceptions of personality (e.g., more trusting, increased extraversion). To follow up these findings, we examined the acute effects of two doses of intranasal oxytocin (24 IU and 48 IU) on another form of self-referential cognition: autobiographical memory. Changes in autobiographical memory (personal memories for the past) could conceivably effect change in self-perception and consequently alter social behaviors. We predicted that oxytocin would increase the number of specific personal memories recalled, and promote the recall of positive social affiliation memories. Seventeen male participants self-administered a placebo or oxytocin (24 IU, 48 IU) using a nasal spray on three separate occasions in a placebo-controlled, double-blind, and within-subject experiment. Participants completed the Autobiographical Memory Test (AMT) 110 minutes later. Analyses revealed a quadratic dose–response curve for the effects of intranasal oxytocin on autobiographical memory recall. The 24 IU dose, relative to the 48 IU dose and placebo, increased the number of specific personal memories recalled and promoted the recall of social affiliation memories that were rated more positively. The lack of effect with the 48 IU dose could be due to saturation of the oxytocin receptors at higher doses. Changes in autobiographical memory may be one mechanism by which oxytocin alters prosocial worldviews.

Perspective : A Nurse's Take on the Role of Healthcare Technology Management

As the presence and purpose of technology in the hospital becomes larger and more critical to healthcare delivery, so does the interaction between healthcare technology management (HTM) and nursing. The silos containing information technology (IT) and nursing are dissolving into a more collaborative community where HTM professionals can view themselves more accurately as “co-caregivers” alongside nurses and other clinicians. As this self-perception changes, HTM decisions more naturally will reflect an awareness of how technology can enhance patient care. There is a direct correlation between an efficient flow of patient care and the improvement of patient outcomes, patient/ family satisfaction, and working conditions. Technology is a key to enabling a seamless workflow, but it must become a team effort. The nursing function depends on the skills and knowledge of HTM professionals to deploy technologies that offer improvement in workflow, diagnostics, treatment, and recovery, but the feedback from nursing to HTM is fundamental to the success of any technology. HTM leadership must be aware of the impact that new deployments have on clinical work flow, and this awareness is transferred through a much closer working relationship with nurses and other clinicians. A partnership mentality between HTM professionals, such as clinical engineers and biomedical equipment technicians (BMETS), and nurses is the way of the future. HTM professionals are more likely at present to see themselves in a technical role, making sure that medical devices and technology are functioning properly. They aren’t as likely to see themselves as “co-caregivers,” on the frontline with nurses, physicians, and other caregivers, directly interacting with patients and thinking, “How can I tap my specific skills to improve the outcome for this patient?” Typically, HTM professionals focus on the technology and allow clinicians to focus on patient care. To achieve a truly optimized care environment, this mentality must shift so that HTM professionals sees themselves alongside other caregivers, recognizing that the tools they deploy are just as critical to success as the care delivered by nurses. As this paradigm shift takes place, hospitals may see changes in the ways that HTM and nursing interact. Two examples of a changed interaction follow. 1. Hospitals may establish a process by which new technology is introduced, either by HTM professionals or nurses, in a collaborative PERSPECTIVE A Nurse’s Take on the Role of Healthcare Technology Management

The Impact of Powerful Oral Language Lab on Chilean EFL Preservice Teachers

This exploratory qualitative case study reports the impact of using a public-speaking structure (Powerful Oral Language Lab [POLL]) in teaching preservice Chilean English pedagogy students. It describes how this task-based method of English as a Foreign Language (EFL) teacher training is related to language strategic competence. Twenty students from Year 4 of an EFL teacher training program in Chile participated in structured oral language training. Facilitated by the instructor, they engaged in weekly POLL meetings to use their English in an intense, but fun-filled, socially situated, learning environment. Six months after their POLL experiences, 15 completed their practicum, and 14 completed their practicum and were interviewed about how POLL might relate to their strategic competence as an English teacher and learner. Findings suggested positive effects of POLL and, more important, self-perceived positive changes in their strategic competence during their teaching. Univocally, participants maintained that POLL built their self-confidence and self-esteem as learners and pre-teachers of English in a Spanish-speaking country.

ASSESSING SELF-ESTEEM AND PERCEIVED PHYSICAL COMPETENCE IN ELDERLY USING THE PHYSICAL SELF-PERCEPTION PROFILE

The paper examined the psychometric properties of the Physical Self-Perception Profile (PSPP) when used with elderly groups and described gender differences in physical self and global self-esteem. A sample of 207 elderly participants (age 65-93 years, M=76.54 and SD=6.56) completed the PSPP and the Rosenberg Self-esteem Scale as a self-reported measure of physical self and global self-esteem during different social and cultural activities in senior daily care centres. Reliability, factor structure, hierarchical structure and criterion-related validity were assessed. Findings revealed limited gender differences for the total sample, with males expressing more positive feelings than females for physical strength (p<.05), however when analysed by age group, statistical differences were found for physical confidence (p<.05), body (p<.05) and physical self-worth (p<.05) with females reporting more positive values than males. Factor analysis results showed limited goodness-of-fit indexes for the model revealing structural problems for the use of PSPP with elderly groups. Elderly participants may perceive themselves in the physical domain using different feelings than those extensively assessed with the PSPP in younger groups highlighting the hypothetical change in self-perceptions over the lifespan.

Responsiveness of FDG PET/CT to Treatment of Patients With Active Chronic Sarcoidosis

This study aimed to compare baseline to follow-up 18F-FDG PET/CT findings after treatment for active chronic sarcoidosis and to correlate changes on 18F-FDG PET/CT with changes in clinical status. The sample included 66 patients with chronic sarcoidosis and evidence of active inflammation on baseline F-FDG PET/CT for which they received therapy. Of these 66 patients, 30 returned for the follow-up 18F-FDG PET/CT after 12 (5) months to evaluate response to treatment. They were also asked to indicate changes in clinical status. Baseline characteristics of patients who did and did not return for the follow-up were compared to assess selection bias. SUVmax was significantly decreased at the follow-up compared with baseline 18F-FDG PET/CT (8.46 [3.52] vs 4.90 [0.96]; P = 0.006), primarily in the mediastinum. Inflammatory activity appeared absent in 9 patients, decreased in 12 patients, and increased in 9 patients, with the corresponding changes in SUVmax of -80%, -41%, and +54%, respectively. The changes on 18F-FDG PET/CT were in agreement with self-perceived changes in clinical symptoms (P = 0.019). The angiotensin-converting enzyme at the follow-up was not significantly different from baseline (49.80 [19.25] vs 46.35 [25.58], P = 0.522). There was no difference in baseline characteristics of patients who did and did not return for the follow-up. 18F-FDG PET/CT is able to detect clinically meaningful changes in magnitude and extent of inflammatory activity in patients receiving treatment for active chronic sarcoidosis. Thus, 18F-FDG PET/CT is a valuable adjunct to clinical evaluation for monitoring the response to treatment in these patients.

“There's a deeper level of meaning as to what suffering's all about”: experiences of religious and spiritual growth following trauma

Some survivors of trauma report experiencing beneficial changes in self-perception, relationships, and philosophy of life, and positive changes in the realm of existential, spiritual, or religious matters. The purpose of the present study was to examine participants’ phenomenological experiences of spiritual and religious posttraumatic growth (PTG). Transcribed data from semi-structured interviews with 10 women, self-identified as Christian, who had experienced spiritual or religious growth following various trauma were analysed using Interpretative Phenomenological Analysis. Results indicated how religion provided a framework that assisted participants to incorporate life changes, and to find meaning in their suffering. The most salient themes identified in relation to religious and spiritual PTG included: process of spiritual and religious growth, strengthening of religious and spiritual beliefs, and personal and spiritual growth and healing. Participants’ trauma and associated distress prompted a process of questioning and meaning-making that facilitated deeply experienced personal and spiritual growth, and was related to intrinsic religiosity.

Therapeutic photography

Recent reviews of therapeutic photography have identi¢ed the technique’s unique ability to transcend culture and language, both essential characteristics of international trauma therapy. This article describes a process, through which youth identi¢ed changes in self-perception after a photojournalism workshop, using an interpretive phenomenological analysis (IPA) approach and conducted in a Shan migrant community centre in northern Thailand. The authors (a) provide a broad overview of a form of therapeutic photography utilised within a humanitarian aid context, (b) examine the concept of posttraumatic growth (PTG) within a traumatised adolescent population on the Thai/Burma border and, (c) suggest the potential for a new domain of growth as it relates to the application of Tedeshi & Calhoun’s conceptual foundation of PTG (1995), within a Southeast Asian context. Results suggest that perceptions of self, and one’s role in the community, did improve within the context of this project. A discussion of the limits and merits of this approach is also presented.

Reflections on the process of translation and cultural adaptation of an instrument to investigate taste and smell changes in adults with cancer

Taste and smell changes are common and distressing symptoms in patients with cancer, which may contribute to decreased nutritional intake leading to malnutrition and reduced quality of life. Evidence-based knowledge available to healthcare staff regarding dietary counselling of patients with taste and smell changes is lacking. To be able to develop advice to patients, these symptoms need to be characterised and assessed. The Taste and Smell Survey (TSS) is a 16-item questionnaire in English, which has been used in Canada to investigate self-perceived changes in taste and smell reported by patients with cancer. As no equivalent instrument exists in Swedish, we therefore translated the TSS. This article describes and discusses experiences of using a 5-step process for translation and cultural adaptation of the TSS. Each of the five steps was found to elicit different, essential information contributing to the enhancement of the translation and building further upon refinements of the previous steps. Using a structured, multistep approach to translation and cultural adaptation, we have produced a robust instrument to investigate taste and smell changes specifically adapted for use in the Swedish language and culture.

Relationship Between Camp Attendance and Self-Perceptions in Children With Chronic Health Conditions: A Meta-Analysis

A meta-analysis examined the association between camp attendance and changes in self-perceptions in children with chronic health conditions. Studies using quantitative methods to assess changes in self-perceptions while attending camps designed for children with chronic health conditions were included in analyses. A random-effects model was used, and Cohen's d was used to calculate effect sizes at both post-camp and follow-up. Some potential moderators of effects were examined (i.e., type of measure of self-perceptions, children's chronic health condition, camp components). 31 studies were included in the analyses. Children experienced small, but statistically significant, improvements in self-perceptions at both post-camp (d = .25, 95% CI [.16-.34]) and extended follow-up (d = .15, 95% CI [.05-.26]). This relationship was moderated by type of measure of self-perceptions and child health condition. Camp attendance is associated with small improvements in self-perceptions for children with some chronic health conditions.

Capsule Commentary on Waldura et al., Teleconsultation Improves Primary Care Clinicians’ Confidence about Caring for HIV

The study by Waldura et al. used an electronic survey to examine primary care clinicians’ self-perceived confidence and self-reported clinical practice patterns after using the University of San Francisco-based National Human Immunodeficiency Virus (HIV) Telephone Consultative Service (HIV Warmline).1 The HIV Warmline provides clinicians with no-cost, real-time telephone consultations with experts in HIV medicine. Over the two-year study period, the authors found that among the primary care clinicians (physicians and mid-level practitioners), most reported the HIV Warmline to be quicker, more applicable to their clinical management issues, and more trustworthy as compared with other HIV information sources. The majority reported that using the teleconsultation service increased their confidence in managing HIV patients, changed their HIV management, and decreased the likelihood of referral to an HIV specialist. This study provides an initial assessment of the potential clinical impact of the HIV Warmline, an innovative adjunct to clinical care. However, the study is ultimately limited in its scope, as its outcomes are subjective provider-reported measures. Patient-level data was not collected, so we do not know the range of complexity of the cases discussed on the Warmline. Although clinicians who used the Warmline reported more confidence and that they were less likely to refer their patients, it is unknown whether these self-perceived changes actually translated to lower rates of referral to specialists and, more importantly, whether they positively affected patient quality of care and clinical outcomes. Waldura et al.’s study is timely, as teleconsultation is becoming increasingly utilized to address disparities in access to specialty care.2–4 With regards to HIV care, the emergence of teleconsultation is occurring in the context of expanded HIV testing, an HIV care provider shortage and a paradigm shift in HIV care—from specialty care-based to primary care-based.5 Other existing teleconsultation models have had success in providing clinical support to primary care clinicians in settings with limited access to specialists,2–4 and have positively impacted clinical outcomes.4 While the HIV Warmline offers a promising approach to strengthening clinical support for HIV primary care clinicians in resource-constrained settings, data on its actual impact on patient quality of care and clinical outcomes is needed.

A Psychology of Economic Migration

This article introduces a psychology of economic immigration as a field complementary to but separate from research on acculturation. A theoretical model of psychological disharmony is outlined, where hard work and thrift become the crucial elements of immigrant condition. Three studies are reported. Studies 1 and 2 were conducted among Polish immigrants in Ireland. These studies addressed personality comparisons between immigrants and nonimmigrant samples (Study 1: peer observations) and immigrant self-perceived changes (Study 2). Adaptive personality changes did occur as hypothesized, particularly in the domain of conscientiousness, which regulates work-related activities. This finding was restricted in Study 2 to a prospective time frame (change measured with time flow). Study 2 introduced four lifestyles: eudaimonia, hedonism, self-sacrifice, and alienation. Prospective change in conscientiousness favored eudaimonic lifestyle, but retrospective change predicted self-sacrifice. Participants in Study 3 were Eastern Slav and Vietnamese immigrants in Poland. Based on previous work on Confucian work dynamism, it was expected that Vietnamese would demonstrate greater work involvement, eudaimonic lifestyle, and thrift, compared to Slav immigrants. These hypotheses were confirmed, showing that within the general model of immigrant adaptation, there is room for cultural differences.

Self-perceived changes in oral health-related quality of life after receiving different types of conventional prosthetic treatments: A cohort follow-up study

ObjectivesTo evaluate the changes in oral health-related quality of life (OHRQoL) reported by subjects treated with conventional prostheses. MethodsA consecutive sample of 153 patients seeking prosthodontic rehabilitation was recruited. Socio-demographic and prosthetic-related factors (Eichner Index; number of occlusal, aesthetic, and lost units) were registered. Baseline impacts on OHRQoL were collected using the OHIP-14 questionnaire. One month after treatment, the participants answered whether the prostheses had generated better, equal, or poorer effects within the 14 items of a retrospective scale (Post-OHIP). The study patients were compared with the reference population (P-population; n=123) in terms of OHRQoL. Such P-population consisted of Spanish adults wearing conventional dental prostheses who were not seeking any dental treatment. The reliability and validity of the tests applied and the factor structure of the Post-OHIP were investigated. A Poisson regression model was calculated to predict what items would change favourably after treatment. ResultsFour prosthetic cohorts were established according to the types of rehabilitations performed: 1-FDPs: metal–ceramic fixed dental prostheses; 2-M-RPDs: metal-based removable partial dentures; 3-ADs: acrylic partial dentures and 4-CDs: complete dentures. Both tests confirmed adequate psychometric properties. Most items of the Post-OHIP consistently loaded on a single factor. Patients requiring ADs or CDs reported significantly lower baseline OHRQoL than those needing M-RPDs or FDPs. Pain/discomfort was the only hampering issue subsequent to removable rehabilitation. M-RPDs are expected to provide the significantly highest therapeutic improvements. ConclusionsPatients perceived benefits in chewing ability, aesthetics and satisfaction with their mouth after receiving conventional dental prostheses. Clinical significanceConventional prosthetic therapy enhances patients’ overall well-being although it can cause discomfort and chewing dysfunction in more than 20% of subjects. Metal-based removable partial dentures are the most predictable in terms of patient satisfaction. The higher the clinical impairment felt by patients, the higher the increase in OHRQoL after rehabilitation.

Changes in alcohol consumption after a natural disaster: a study of Norwegian survivors after the 2004 Southeast Asia tsunami

BackgroundMany studies suggest that disaster exposure is related to a subsequent increase in alcohol consumption. Most of these studies have relied on retrospective self-reports to measure changes in alcohol use. The aim of the present study was to examine the association between disaster exposure and drinking behaviors more closely, analyzing data on both self-perceived changes in alcohol consumption and current drinking habits in groups with different extents of disaster exposure.MethodsA sample of Norwegian adults (≥ 18 years) who resided in areas affected by the 2004 Southeast Asia tsunami (N = 899) were assessed by a postal questionnaire 6 months after the disaster. Based on detailed questions about experiences with the tsunami, participants were grouped according to their extent of disaster exposure. The Impact of Event Scale-Revised was applied to measure the level of post-traumatic stress. Participants were asked whether they had increased or decreased their alcohol consumption after the disaster. Moreover, weekly alcohol consumption and frequency of intoxication during the past month were used as indicators of current drinking behaviors.ResultsSeverely exposed individuals more often reported changing their alcohol consumption compared with those who were less exposed. Severe exposure to the tsunami was associated with both a self-perceived increase (OR 21.38, 95% CI 2.91–157.28) and decrease in alcohol consumption (OR 7.41, 95% CI 1.74–31.51). The odds ratios decreased and were not significant when adjusting for post-traumatic stress symptoms. Weekly consumption and frequency of intoxication during the past month did not vary with extent of disaster exposure.ConclusionsOur findings indicate a polarization effect of severe disaster exposure on self-perceived changes in alcohol consumption; that is, disaster exposure was associated with self-perceived increases and decreases in drinking. However, the absence of associations between disaster exposure and indicators of current drinking behaviors suggests that the observed polarization effect may be overestimated because of attribution and recall bias.