How Neuroscience is Impacting Disaster Management Strategy

When the massive 8.8-magnitude earthquake rocked Chile in 2010, Jose Miguel Fernandez was sound asleep in his fourth-floor apartment in Santiago. It was 3 a.m. when his wife woke him. Fernandez wanted to remain in bed, hoping it was just another uneventful tremor. “It wasn’t,” he recalls. “The ground jolted violently, rocking the bed back and forth. We knew we were in for the big one.”

Gripped with fear, the couple went into emergency mode — they had to take care of their kids. “I remained in the master bedroom and took our baby from the crib,” he relates. “My wife went to the next room to pick up our still-sleeping 3-year-old. We gathered in the hallway [the designated safe place].”

It seemed to last forever. Even though Santiago was hundreds of kilometers away from the epicenter, the earthquake’s impact was strongly felt. Fernandez recalls, “The noise was tremendous. The ground roared, and the windows rattled. We could hear the kitchenware falling from the cabinets, breaking into pieces. Outside, car alarms went berserk. The lights went out during the first seconds. The night sky lit up from exploding power transformers.” He notes that it was hard standing up. “Since we had the girls in our arms, we leaned against the walls for support. The walls literally slapped our backs as the whole building shook,” says Fernandez.

Life-threatening situations, like the ones created by natural calamities, can test even the bravest among us. How fear impacts the brain has emerged as an important area of study for neuroscientists and psychologists.

NATURAL DISASTERS AND THE BRAIN

When the brain detects imminent danger, it responds in a fairly standard manner. “Generally, the brain coordinates a complex behavioral and physiological response to threat,” says Ahmad Hariri, professor of psychology and neuroscience at Duke University. “Sometimes, this coordinated response is called ‘fight or flight’ in reference to two commonly observed responses when we are in physical danger.” The brain is basically gearing the body up to either flee the scene or face the situation head-on.

“It is an adaptive response,” says Jeffrey B. Rosen, professor of psychology at University of Delaware. “Most of the animals have a system that’s pretty much the same. You don’t want to take a lot of time you want to quickly stop, scan the surroundings and figure out what to do — either run or stay.”

A lot is going on in a body that is exposed to danger. For example, a threat response includes changes in physiology, including the release of chemicals such as adrenaline and cortisol, increases in heart rate, respiration, and blood flow to the skeletal muscles. These variations help us tackle what lies ahead. “There are equally profound changes in behavior, including increased alertness, awareness, and attention to the threat. These changes help us determine the exact nature of the threat and how best to overcome it,” says Hariri.

The amygdala, an almond-shaped structure located in the anterior temporal lobe of the brain, is at the heart of threat-detection circuitry and response. “Remarkably, the amygdala serves as the information-processing hub in the brain that triggers these changes, in both physiology and behavior, through its effects on downstream brain regions like the hypothalamus, brainstem, hippocampus, and prefrontal cortex,” says Hariri.

When confronted with a dangerous situation like an earthquake, the amygdala reaches out to the hypothalamus, a tiny but important structure located above the midbrain and below the thalamus. The hypothalamus triggers the sympathetic nervous system by sending signals to the adrenal glands, which unleash adrenaline that gears the body up for the threat. The heart beats faster so that it pumps out more blood to the muscles, heart, and other important organs.

The person will also breathe more rapidly, and their lungs will take in more oxygen. The brain needs the extra oxygen because it has to be on red alert. All this happens while adrenaline is also maneuvering to release glucose and fats into the bloodstream to provide that extra burst of energy needed for such situations.

Since people are different, so are their reactions. “This response is universal across all people, although the intensity and duration of the response may vary across individuals due to their unique genetic, biological, physiological, and psychological makeup,” explains Simon Rego, director of the cognitive-behavior therapy program at New York’s Montefiore Medical Center in the Bronx.

Hariri agrees. “There is considerable variability in the response of the amygdala to threat, as well as how this response is regulated by another brain region called the prefrontal cortex,” he says. Generally, a strong amygdala response is met with an equally strong response from the prefrontal cortex. Hariri notes that problems in responding to threats are seen in anxiety disorders, including post-traumatic stress disorder, often reflect an imbalance between the response of the amygdala and the prefrontal cortex. “Our work and that of others suggest that individual differences in the response of the amygdala and prefrontal cortex to threat predict some of the risk for psychopathology associated with exposure to stressors including natural disasters,” he says.

Can repeated exposure to dangerous situations make people better at dealing with them or less fearful? No one knows for sure. “Some theories posit that people habituate to stress. Other theories posit that stress reactions get worse with repeated stressors. Both theories are probably true for different individuals. In general, there is not much evidence for either one of those theories,” says Michael S. Scheeringa, a psychiatrist at Tulane University School of Medicine. “The way a person responds to stress is probably a pretty hard-wired thing that doesn’t change that easily.”

David Ropeik, author of “How Risky Is It, Really? Why Our Fears Don’t Always Match the Facts,” says, in general, research on the psychology of risk perception has found that in many cases when we live with a risk for a while and it becomes familiar, we sort of get used to it and worry about it less. For example, people who have experienced many earthquakes are less scared than those who’ve had little to no experience. “However, severe personal cost from a risk heightens ongoing concern about it,” Ropeik notes. “So, people who lost loved ones in an earthquake take the risk more seriously, even if they live in an area that is familiar with them. People in Florida know what serious hurricanes can do and prepare more and evacuate more than [those] in areas hit by hurricanes less frequently.”

However, the amygdala does log important events for future reference. “The amygdala functions to learn what specific cues in our general environment are associated with the threat so that we are better able to avoid the threat when we encounter these cues in the future,” says Hariri. So, even though Fernandez has experience encountering earthquakes, he will likely go through the same drill — elevated heartbeat, rapid breathing, sweating — every time he encounters an earthquake. In fact, Fernandez was in Chile during another big earthquake in 1985.

NEUROBIOLOGY AND DISASTER MANAGEMENT

Disaster-management teams that deal with survivors can learn a lot from the research on the brain’s fear response. Ropeik feels that most disaster-management programs aren’t doing enough to integrate the research into their efforts. “Emergency managers take what I call the ‘inside the yellow police tape’ mindset, since these managers are largely emergency-response-agency people, and that’s their culture,” Ropeik says. “But how regular folks react to things and behave has a great deal to do with how much they are at risk, and the psychology of risk perception is not commonly applied to disaster preparedness, response, or long-term recovery.”

However, emergency managers disagree. “Emergency managers are becoming more aware of the psychological impact of disasters and the need to be prepared to respond as quickly as possible,” says Mike Haney, clinical director of the Florida Crisis Consortium, a division of the Florida Department of Health. It is a conglomeration of state agencies, nonprofit organizations and volunteers who work together to provide education, training, and response exercises for the psychological impact of a disaster to better prepare first responders and communities to deal with the physical impact and the emotional toll when a disaster strikes.

Curt H. Drennen, manager at Disaster Behavioral Health Services, Office of Emergency Preparedness and Response at the Colorado Department of Public Health and Environment in Denver, explains, “With natural disasters, fear and psychological stress are the two big responses. It deeply suppresses the ability of individuals to focus and adapt to these situations. We go into a limbic system response in order to deal with the stress. As emergency managers, we work on trying to get them out of the fear response.”

Drennen points out that disaster management has increasingly employed psychological insight into its handling of disasters. “It’s true that earlier disaster-management efforts were too focused on the initial response — life-saving process, infrastructure failure, preventing death and destruction in the immediate aftermath — but they have increasingly turned to mental health.”

Drennen’s team utilizes something called psychological first aid — a kind of a psychology toolbox — while dealing with disaster victims. “It’s based on a few core principles: safety, connection, efficacy, calming and hope. For example, we try to address hope, both at the community and individual levels,” Drennen says. “At the community level, mayors and governors try to communicate that we can collectively get through this challenge. At the individual level, we get people to start thinking about what their needs are. We try to remind them of their resilience to overcome the challenge.”

Drennen says his team draws heavily on the latest research in the field. “We’re constantly trying to update ourselves on the research in psychology and even neuroscience and integrate that into our program,” he says.

This article was originally published in the Summer 2014 issue of Brain World Magazine.

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