Effects on Human Behavior

Author(s): E. I. Chazov and M. E. Vartanian

Source: Ambio , 1982, Vol. 11, No. 2/3, Nuclear War: The Aftermath (1982), pp. 158-160
Published by: Springer on behalf of Royal Swedish Academy of Sciences

Stable URL: https://www.jstor.org/stable/4312784

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 Effects on Human
Behavior BY E I CHAZOV AND M E VARTANIAN

At least one third of the survivors of a nuclear war will suffer from severe
mental and behavioral disturbances. For the vast majority of these psychiatric
casualties, no adequate medical treatment will be possible.

A group of stunned and badly injured survivors just hours after the bomb was dropped on Hiroshima, August 6, 1945. This photo was held by America
military censors until 1952. In an all out modern nuclear war, the "living" would no doubt envy the dead. Photo: Pressens Bild.

158 AMBIO VOL

!1 11 NO 2 3

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 catastrophes (13). First, the survivors suf-able to provide treatment following a nuc-
It is difficult to predict the possible effects
of a global nuclear war on mental health fer from severe demoralization, reflected lear attack; third, the amount of time re-
and human behavior, but a number of au- in a profound apathy, a feeling that the quired for treatment; fourth, the availabil-
thors have made attempts in recent dec- world has more-or-less come to an end and ity of treatment facilities following a nuc-
ades (1, 2, 3). Most use an analysis of data that there is no longer any sound reason lear attack; and fifth, the availability of
from the atomic attacks on Hiroshima and for doing anything. Second, the survivors psychotropic and other drugs for treat-
Nagasaki (2, 4, 5), or attempt to make suffer from a prolonged sense of diso- ment.
extrapolations by analyzing individual and rientation. They are likely to be unable to It is immediately obvious that no ade-
group behavior in other, non-nuclear, locate themselves meaningfully in space or quate treatment would be possible for the
mass disasters (6, 7, 8). It should be noted time. Places and objects seem transitory. vast bulk of the psychiatric casualties. Let
that such extrapolations are suspect, since Time seems to stop. They are frequently us assume, in accordance with a number of
non-nuclear disasters-earthquake, flood, unable to remember such everyday details studies, that approximately 20-25 percent
fire-can scarcely equal the impact of a as the names of close friends, their own of the urban population of European coun-
nuclear war on the human organism. telephone number, etc. Third, the survi- tries would survive a nuclear attack. About
It is usually acknowledged that the dis- vors frequently exhibit what might be de- one third of the survivors would be in a
turbances of behavior and mental activity scribed as a loss of connection-a sense of state of acute anxiety; about 20 percent of
which would follow a nuclear war can be separation from other people. the survivors would be so incapacitated by
divided into two classes: disorders arising The survivors of Hiroshima and Nagasa- psychological and pathopsychological con-
directly from the explosions, and more re- ki also displayed a form of "survivor ditions that they would be unable to care
mote effects. The direct disorders may in- guilt." In their flight from the cities, most
for themselves or others. In an urban area
clude acute brain syndromes, protracted survivors could not avoid ignoring appeals of one million population, with 200
anxiety states, and reactive psychoses, and for help from other victims, because of the psychiatrists and psychologists, it would
the behaviors which are manifested as a impossibility of helping the large numbers require 120 hours to examine each person
result of these disorders may range from of casualties and the need to escape the in need of treatment for 10 minutes. If the
massive panic reactions, psychomotor ex- fires. The feelings aroused by that situa- mental health professionals suffered the
citation and flight to reactive depressive tion become a long-term source of emo- same rate of casualties as the population at
states, adynamic conditions and conflict tional stress (14); the survivors associated large, it would require 25 days before each
behavior. However, it has frequently been the disaster with chaos, helplessness and patient could be seen for 10 minutes-
observed that mass catastrophes do not death, and the feelings of personal insig- assuming in both cases that the psychia-
cause a marked increase in cases of psy- nificance that arose from it remained trists and psychologists worked 24 hours
chosis (9, 10), and in a number of catas- troublesome for a long period of time. per day.
trophes the initial stages of the disaster The overwhelming majority of the survi- In addition, a patient load of such
result in more organized patterns of be- vors of the nuclear attacks on Japan still dimensions would exceed even the peace-
havior, as the survivors mobilize and con- exhibit signs of mental disturbances, in- time capacity of the mental hospitals in
centrate in places where first aid, food, cluding permanent fear, uncertainty, and both the USSR and the US. The US has
and assistance is available. various psychoneurological disorders. One about 1.6 beds per 1000 population in
Nevertheless, behavioral and mental source of those fears is exposure to radia- psychiatric hospitals, the USSR has about
disturbances will present one of the main tion. The health of the survivors is 1.5 per 1000 population, and those beds
after-effects of a nuclear war. In the first threatened by the emergence of remote are already well used: In peace-time, some
instance, such disturbances will be associ- radiation effects, and they fear diseases five to seven percent of the urban popula-
ated with the emergence of anxiety reac- and malformations in their children. They tion is in need of psychiatric treatment.
tions in large numbers of the survivors. It are also concerned about the cost of treat- Even if all of the psychiatric hospitals
is expected that one-third of the survivors ment, the decrease in their working capac- escaped damage in a nuclear attack-an
will be in a state of marked anxiety (11), ity, their unstable financial circumstances, unlikely prospect-the number of
characterized by fear, apprehensiveness, and by the discrimination shown by other psychiatric casualties would exceed the
irritability and confusion. Those emotional members of the community. number of beds for treatment by about 50
reactions will be heightened by the effect It seems clear that the psychological
times. It is also unlikely that the drugs
of encountering large numbers of casu- reactions of the survivors of a nuclear war necessary for effective treatment would be
alties. will continue for months or years after the available. There is no hope of adequate
Sensory deprivation, as a consequence disaster. These remote effects may include treatment for the wide range of behavioral
of isolation and the absence of customary chronic neurotic conditions, massive disorders, including profound neuro-
environmental stimuli, may play an essen- apathy, a drastic reduction in working psychic disturbances, which would be in-
tial role in prompting behavioral disturb- capacity and a thorough disorganization of curred in a nuclear war.
ances, and a form of sensory deprivation interpersonal relations. Any attempt to calculate the extent of
psychosis may be seen following the large- Long-term personality changes such as psychiatric casualties following a nuclear
scale destruction of a nuclear explosion. D increased aggressiveness, irritability, war is of necessity based to a large extent
K Kentsmith notes (12) that disorientation nightmares and irrational behavior are alsoon guesswork. Experience in military
results from the sensory deprivation typical of persons who have spent two catastrophes indicates that there are no in-
caused by the isolation and destruction of weeks in a locked, underground space dividual characteristics which predispose a
the immediate surrounding in a major dis- (15). There are obvious parallels with peo- person to a breakdown; the most critical
aster. Restlessness, boredom, irritability ple forced to spend long periods in an air- factor appears to be the duration of the
and increasing anxiety are common signs raid shelter under nuclear bombardment. stress (12), but it is impossible to predict
of this disorientation. The individual fre- The question of the help that can be who will become a casualty. It is equally
quently feels separated from his environ- afforded the survivors of a nuclear attackimpossible to predict the pattern of casual-
ment and depersonalized. There is often naturally arises, and the following factorsties, including psychiatric casualties, fol-
an impairment in the ability to solve simple must be considered in attempting to lowing a nuclear war; it follows that the
problems, difficulty in concentrating, and answer it: first, the number of individuals only rational alternative is to prevent such
in some cases abnormal visual sensations, with mental and behavioral disturbances a war from occuring. As the Pugwash
including hallucinations. and the duration and severity of these dis-Medical Working Group notes in its state-
K T Erikson singles out three common turbances; second, the number of psychiat-ment: "As doctors of medicine and scien-
behavioral changes in the survivors of rists and psychologists who might be avail-tists in health-related fields, we conclude

AMBIO, 1982 159

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therefore that nuclear weapons are so des- 7. G C Gleser, B L Green and C N Winget, Quantify-
ing Interviewed Data on Psychic Impairment of
tructive to human health and life that they Disaster Survivors, Journal of Nervous and Mental
must never be used. Prevention of nuclear Disease 166, 209 (1966).
8. K J Tierney and B Baisden, Crisis Intervention
war offers the only possibility for protect- Evgeni I Chazov is a medical doctor
Programs for Disaster Victims. DHEW Publication
ing people from its medical consequences. (USA); 79-675, 1979 and the deputy Minister of Health of
There is no alternative." 9. R R Dynes, Organized Behavior in Disaster, the USSR. He is also Director-Gener-
Monograph Series 3 (The Disaster Research Cen- al of the National Cardiology Re-
ter, Ohio State University, Columbus, Ohio,
1974).
search Centre and a member of the
10. J G Edwards, Psychiatric Aspects of Civilian Dis- Presidium of the Soviet Academy of
aster, British Medical Journal 1, 944 (1976). Sciences. His co-author, M E Varta-
11. G W Baker and D W Chatman, Man and Society in
nian, is Deputy-Director of the Insti-
Disaster (Basic Book Inc, New York, 1967).
References and notes tute of Psychiatry of the Soviet
12. D K Kentsmith, Minimizing the Psychological
1. F Hocking, Extreme Environmental Stress and its Effects of a Wartime Disaster on an Individual, Academy of Medical Sciences. His
Significance for Psychopathology, Medical Journal Aviation, Space and Environment Medicine, pp. address: c/o Institute of Psychiatry,
of Australia 2, 477 (1965). 409-413, 1980.
2. W Kinston and R Rosser. Disaster: Effects on 13. K T Erikson, Loss of Communality at Buffalo USSR Academy of Medical Sciences,
Mental and Physical State. Journal of Psycho- Creek, American Journal of Psychiatry 133 (3), Zagorodnoe shosse 2, Moscow,
somatic Research 18, 437 (1974). 302 (1976). USSR
3. J G Edwards, Psychiatric Aspects of Civilian Dis- 14. A Hedge, Surviving a Nuclear War (Proceedings of
asters, British Medical Journal 1, 944 (1976). the Medical Association for Prevention of War v.
4. R J Lifton, Death in Life: Survivors of Hiroshima 3, P. 5 1981) p. 185-199.
(Random House, New York, 1967). 15. A Ploeger, A 10-year follow up of miners trapped
5. J L Janis, Air War and Emotional Stress (McGraw- for two weeks under threatening circumstances, in:
Hill, New York, 1951). Stress and Anxiety vol 4, pp. 23-28, (1977).
6. G J Newman, Children of Disaster: Clinical 16. R R Rogers, On Emotional Responses to Nuclear
Observation at Buffalo Creek, American Journal Issues and Terrorism, Psychiatric Journal of the
of Psychiatry 133 (3), 306 (1976). University of Ottawa, 5 (3), 1980.

The Paradox of the Arms Race:

hncreased Threat, but Decreased Response
The potential for psychological damage in a nuclear attack is
obviously catastrophic. But the continuing arms race between
the two superpowers also contributes-together with other
factors-to psychological distress and the intensification of
mental and emotional tension in large numbers of people. The
damage is less obvious, but all the more insidious for that.
A number of investigators have tried to clarify the concrete
mechanisms by which the threat of nuclear war has its psycho-
logical impact (16). It should be noted that no convincing
proof of the part played by such a threat in psychological
disturbances was obtained, perhaps in part because the inves-
tigations were limited and did not include examinations of
large numbers of people, and did not attempt to identify the
remote effects of such a threat.
After the bombing of Hiroshima and Nagasaki, popular
movements against the use of nuclear weapons developed in
many countries. But this public response to the horrors of
nuclear war gradually fell off during subsequent decades, de-
spite the increasing numbers of weapons in the nuclear arsen-
als and therefore the increasing threat of nuclear war.
In an attempt to explain this apparent paradox-an in-
creased threat, but a decreased public response to that threat
- concepts of denial, suppression and adaptation were bor-
rowed from theories of individual psychology. Explaining the
failure of public response to the nuclear threat as a denial
phenomenon arising from an adaptive response of individuals
to an unpleasant situation can seem tempting, but these extra-
polations are essentially speculative, without any basis in
direct studies of large groups. And they fail to explain whyall
public response to the threat of nuclear war suddenly became
more active at the beginning of the 1980s.
Suppression has also been suggested as an adaptive response
to a continuing threat, a phenomenon which implies a loss of
ability to respond to constant stimuli which are lost in the flood
of other stimuli that make up our daily lives. Little by little, the
horrors of Hiroshima and Nagasaki are forgotten in the joys
and sorrows of everyday life.
And because of the length of time that has passed since the
nuclear attacks on Japan, many people-and especially the
young-view the nuclear threat as an abstraction, divorced of
any real force. One result is that many people fail to perceive
the qualitative difference between nuclear weapons and
others. Some authors view this process of abstraction, arising
from a lack of experience, as one possible mechanism leading
to an underestimation of the realities and consequences of a
nuclear war.
But the explanations for the absence of public response to
the nuclear threat in the 1960s and 1970s are perhaps less
interesting than the reasons behind the sudden explosion of
public concern at the beginning of the 1980s. It is well known
that behavioral reactions become stronger as a given threat
becomes more real, and it seems clear that events in the
armaments race developed in such a way-particularly in
Europe-that they created a more serious threat to the bal-
ance of forces in this region. The public has reached a level of
comprehension that recognizes changes in the nuclear bal-
ance-both because of increased quantities of weapons and
because of more effective weapons-as a concrete threat to
their security. This in turn has prompted a marked increase in
the protests against nuclear weapons. Widespread discussion
of the possibility of a "limited" nuclear war, of the deployment
of neutron bombs, and the acceleration of the arms race have
the
created and increased the psychological pressure felt by the
public at large. There is considerable fear for the continued
existence of man on earth; in the end that fear, as it gathers
force, may well lead to more effective measures for the pre-
vention of a nuclear catastrophe.

160 AMBIO VOL. 11 NO. 2-3

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