Social Support and the PTSD Symptoms of Japanese Earthquake Survivors

Haruka Kokaze

Each year, Japan experiences more than 1,500 earthquakes (World Vision, 2019). The 2011 Great East Japan Earthquake and the 1995 Great Hanshin Earthquake, with approximately 6,000 and 18,000 fatalities respectively, were amongst the most devastating, and have served as wake-up calls to the nation’s readiness and response to natural disasters (Goodwin et al., 2015; Uemoto et al., 2011). The majority of the research into the earthquakes tends to place emphasis on earthquake-resistant technological advancements in urban planning, rather than on mitigating psychological distress, such as Post Traumatic Stress Disorder (PTSD), after traumatic earthquake experiences (The Government of Japan, 2019). Yet, many survivors of the Great East Japan Earthquake and the Great Hanshin Earthquake continue to face psychological distress stemming from the traumatic experiences (Shigemura et al., 2021; The Japan Times, 2020, 2022). As a result, recent research in Japan has begun to explore how factors such as social support from different sources can help reduce the severity of PTSD symptoms of earthquake survivors (Honda et al., 2019; Kino et al., 2021). This paper, thus, explored the following research question: How does social support at the individual- and community-levels help mitigate the PTSD symptoms of Japanese earthquake survivors?

Effect of Social Support at the Individual-Level

Social support at the individual level includes assistance from family and friends related to managing psychological distress during challenging times, and can help mitigate PTSD symptoms (e.g., hyperarousal) after experiencing a disaster (American Psychological Association [APA], n.d.b; Goodwin et al., 2015; Matsuyama et al., 2016). Immediate family and other relatives are the first place Japanese people go to for emotional support during times of need (Goto & Wilson, 2003). In times of distress, receiving emotional social support from immediate family and other relatives helps Japanese individuals to feel more encouraged and reassured (Ikeda, 2015). It is, thus, not surprising that research conducted in Japan has found that survivors of earthquakes and other natural disasters caused by earthquakes (e.g., tsunamis) who received social support from immediate family and other relatives soon after a traumatic experience were less likely to develop PTSD symptoms (Hikichi et al., 2016; Kino et al., 2021; Kwon et al., 2001; Teramoto et al., 2015). In turn, survivors with social support from their immediate family and other relatives were more likely to overcome their newly arisen challenges, such as adapting to temporary housing (Matsuyama et al., 2016).

Like family members, friends also play a significant role in an individual’s social support network (Hamamura,

2012). While immediate family and other relatives are often the primary source of social support for Japanese people, they also turn to close friends during difficult times (Harada et al., 2018). The evaluative support that friends provide through encouraging words can inspire those in crisis to carry on with their healing process (Ikeda, 2015). In fact, studies have shown that survivors of Japanese earthquakes who received social support from friends were more likely to cope with their PTSD symptoms (e.g., feeling isolated), than those who did not have social support from their friends (Kino et al., 2021; Kwon et al., 2001).

Effect of Social Support at the Community-Level

Social support at the community-level can also aid in the management of PTSD symptoms during difficult times (American Psychological Association [APA], n.d.b; Hikichi et al., 2016; Matsuyama et al., 2016). Similar to social support at the individual-level, community-level social support, including support from residents who live nearby, as well as from government agencies and programs, can lessen PTSD symptoms after a disaster by providing a larger scale of assistance to survivors (Matsuyama et al., 2016; Pike et al., 2021). Since Japan is a collectivist culture, Japanese people place a great emphasis on community-level social support in order to uphold their close social ties and promote group solidarity (Hikichi et al., 2016). This level of social support, often categorized as informational support, encourages the community to use its available resources and recover together as a society, building community resilience (Goodwin et al., 2015; Ikeda, 2015). Community resilience can help alleviate feelings of isolation and loneliness, which are prevalent PTSD symptoms (Hikichi et al., 2016; Matsuyama et al., 2016).

Furthermore, providing mutual assistance and instrumental support, such as exchanging information on where to gain food and water post earthquakes, ultimately enhance community resilience, helping mitigate survivors’ PTSD symptoms after experiencing a disaster (Ikeda, 2015; Kawachi & Berkman, 2014; Kino et al., 2021; Pike et al., 2021). As a result, survivors of earthquakes in Japan who relocated temporarily to prefabricated dwellings in affected areas due to losing their housing to earthquakes or tsunamis were less likely to develop PTSD, as they gained a robust social support system from living in communal housing where a tight-knit network of survivors and a sense of belonging and purpose were fostered (Kino et al., 2021; Koyama et al., 2014).

Conclusion

Overall, research on the 1995 Great Hanshin Earthquake and the 2011 Great East Japan Earthquake suggests that both individual-level and community-level social support are beneficial for Japanese earthquake survivors. More specifically, these forms of social support help to mitigate or address PTSD symptoms resulting from the trauma (Honda et al., 2019; Koyama et al., 2014; Teramoto et al., 2015). As the Japanese government postulated that there is 70% chance of Tokyo being struck again by an earthquake similar in magnitude to the 2011 Great East Japan Earthquake (The World, 2012), there should be a greater focus on developing prevention and intervention systems that draw on individual-level and community-level social supports to address future earthquake survivors’ development of PTSD symptoms (Kino et al., 2021).

Future studies should concentrate on how populations that depend significantly on their immediate families, such as the elderly, whose numbers are rising quickly in Japan, can benefit most from individual-level social support (Oe et al., 2017). To further understand the power of community-level social support, future disaster-related mental health crisis prevention studies should also explore how social support from international organizations (e.g., American Red Cross) might alleviate PTSD symptom development among natural disaster survivors in Japan. Finally, more research should examine how salient Japanese values (e.g., thinking of others before themselves) influence people’s provision of social support and, in turn, affect the development of PTSD symptoms (Sasaki et al., 2019).

Japan showed extraordinary resilience after the 2011 Great East Japan Earthquake and the 1995 Great Hanshin Earthquake; with an increase in social support research, the nation can further improve its capacity to heal and recover as a whole.

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