Long-term risks of complicated grief and insomnia in student survivors of the Sewol ferry disaster in South Korea: A four-year observational follow-up study


Background: The Sewol ferry disaster in April 2014 resulted in the drowning of 304 people. Of the 325 students on board, 250 died and 75 were rescued. The measure of stress caused by bereavement and sleep problems is common and can be a chronic health concern of disaster survivors. The aim of this study was to determine longitudinal predictive factors of complicated grief and insomnia among student survivors of the disaster. Methods: This study centered on 67 student survivors who were enrolled in the disaster registry after graduating from their high school. The self-report data as presented by the participants were collected at baseline (27 months after the disaster, T1) and again at two years later (51 months after the disaster, T2). Thirty-one participants completed both T1 and T2 surveys. The noted predictive variables in this case were event-related rumination, coping strategy, social support, attachment, meaning in life, and adverse childhood experiences. The outcome variables were complicated grief and insomnia. Results: Dysfunctional coping (T1) was positively associated with complicated grief (T2) (coefficient = 0.070; p<0.001). Intrusive rumination (T1) (coefficient = -0.114; p<0.001), social support (T1) (coefficient = -0.031; p<0.001), and meaning in life – search (T1) (coefficient = -0.082; p<0.001) were negatively associated with insomnia (T2). In contrast, dysfunctional coping (T1) (coefficient = 0.041; p = 0.012), adverse childhood experiences (T1) (coefficient = 0.280; p = 0.007), and insomnia (T1) (coefficient = 0.166; p<0.001) were positively associated with insomnia (T2). Conclusions: Dysfunctional coping influenced how student survivors of the Sewol ferry disaster suffered from complicated grief and insomnia over time. In this case, the findings from the current study indicate that interventions that target coping strategies should be provided to improve the resolution of grief and sleep among survivors. [Ethiop.J. Health Dev. 2020;34(Special issue-3):97-106] Keywords: Sewol ferry disaster, student survivors, coping strategy, complicated grief, insomnia