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accident American Psychiatric Association anxiety disorder assess associated Beach behavior Bromet Cambodian clinical clonidine criteria depression diagnostic differences dioxin 96 direct exposure group directly exposed disaster experience disaster exposure disaster stress disaster victims Dohrenwend DSM-III eruption experienced exposed subjects exposure to disaster ﬂood ﬂood threat ﬂoodplain follow-up health status Helens households I-Ielens imipramine included increased Institute of Mental major mediating variables Mental Disorders mental health Mount St Mount St Helens MSH disorders nonexposed nuclear occurred onset rates patients pattem perceived danger perceived trauma percent versus perception of threat persons Phobia Pol Pot postdisaster interview posteruption onsets posttraumatic stress disorder predisaster prior symptoms problems psychiatric disorders psychiatric symptoms PTSD recurrent reported residents result sample significantly higher social support somatization disorder startle reaction statistically significant stress response syndromes symp symptomatology Table Three Mile Island tion tomado types of disaster variables volcanic activity