Fifteen years after a ferry disaster: clinical interviews and survivors' self-assessment of their experience.

Background: Disasters yield increased rates of psychological disorders decades later. Other consequences, however, have received little attention in the past. Objective: We aimed to examine diagnostic status and survivors' views on disaster-related consequences and social support. Methods: A mixed-methods approach was used with 22 survivors (of 49 eligible) 15 years after a ferry disaster. Data collection included audiotaped interviews with open-ended questions and diagnostic assessment of Axis-I disorders. Results: The post-disaster incidence was 54% (12/22) for Axis-I disorders, and 45% (10/22) for full or subsyndromal posttraumatic stress disorder. Thematic analysis revealed that survivor perception of the long-term consequences included positive (character change) and negative aspects (being ascribed a survivor identity). Participants' sought social support for several years, yet many felt hindered by experiential dissimilarity and distress of significant others. Conclusions: Axis-I disorders were prevalent, but not salient to survivors' perceptions in the long-term. Post-disaster interventions need to attend to common barriers to support.