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Current Psychiatry Reports

, 18:104 | Cite as

The Role of Fear-Related Behaviors in the 2013–2016 West Africa Ebola Virus Disease Outbreak

  • James M. ShultzEmail author
  • Janice L. Cooper
  • Florence Baingana
  • Maria A. Oquendo
  • Zelde Espinel
  • Benjamin M. Althouse
  • Louis Herns Marcelin
  • Sherry Towers
  • Maria Espinola
  • Clyde B. McCoy
  • Laurie Mazurik
  • Milton L. Wainberg
  • Yuval Neria
  • Andreas Rechkemmer
Disaster Psychiatry: Trauma, PTSD, and Related Disorders (E Foa and A Asnaani, Section Editors)
Part of the following topical collections:
  1. Topical Collection on Disaster Psychiatry: Trauma, PTSD, and Related Disorders

Abstract

The 2013–2016 West Africa Ebola virus disease pandemic was the largest, longest, deadliest, and most geographically expansive outbreak in the 40-year interval since Ebola was first identified. Fear-related behaviors played an important role in shaping the outbreak. Fear-related behaviors are defined as “individual or collective behaviors and actions initiated in response to fear reactions that are triggered by a perceived threat or actual exposure to a potentially traumatizing event. FRBs modify the future risk of harm.” This review examines how fear-related behaviors were implicated in (1) accelerating the spread of Ebola, (2) impeding the utilization of life-saving Ebola treatment, (3) curtailing the availability of medical services for treatable conditions, (4) increasing the risks for new-onset psychological distress and psychiatric disorders, and (5) amplifying the downstream cascades of social problems. Fear-related behaviors are identified for each of these outcomes. Particularly notable are behaviors such as treating Ebola patients in home or private clinic settings, the “laying of hands” on Ebola-infected individuals to perform faith-based healing, observing hands-on funeral and burial customs, foregoing available life-saving treatment, and stigmatizing Ebola survivors and health professionals. Future directions include modeling the onset, operation, and perpetuation of fear-related behaviors and devising strategies to redirect behavioral responses to mass threats in a manner that reduces risks and promotes resilience.

Keywords

Ebola Ebola virus disease (EVD) Fear Fear-related behaviors Pandemic Outbreak 

Notes

Acknowledgments

A special thank you is extended by the authors to Dr. Michelle Riba for taking the time to review the manuscript.

Compliance with Ethical Standards

Conflict of Interest

James M. Shultz, Janice L. Cooper, Florence Baingana, Zelde Espinel, Benjamin M. Althouse, Louis Herns Marcelin, Sherry Towers, Maria Espinola, Clyde B. McCoy, Laurie Mazurik, Milton L. Wainberg, Yuval Neria, and Andreas Rechkemmer declare that they have no conflict of interest.

Maria A. Oquendo receives royalties for the use of the Columbia Suicide Severity Rating Scale. Her family owns stock in Bristol Myers Squibb. Dr. Oquendo receives a stipend from the APA for her service as president.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

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Copyright information

© Springer Science+Business Media New York 2016

Authors and Affiliations

  • James M. Shultz
    • 1
    Email author
  • Janice L. Cooper
    • 2
  • Florence Baingana
    • 3
  • Maria A. Oquendo
    • 4
  • Zelde Espinel
    • 5
  • Benjamin M. Althouse
    • 6
    • 7
    • 8
    • 9
  • Louis Herns Marcelin
    • 10
    • 11
  • Sherry Towers
    • 12
  • Maria Espinola
    • 13
  • Clyde B. McCoy
    • 14
  • Laurie Mazurik
    • 15
  • Milton L. Wainberg
    • 16
  • Yuval Neria
    • 4
  • Andreas Rechkemmer
    • 17
  1. 1.Center for Disaster and Extreme Event Preparedness (DEEP Center)University of Miami Miller School of MedicineMiamiUSA
  2. 2.The Carter Center, Mental Health Program LiberiaMonroviaLiberia
  3. 3.Makerere University School of Public HealthKampalaUganda
  4. 4.Department of PsychiatryColumbia University and New York State Psychiatric InstituteNew YorkUSA
  5. 5.Department of Psychiatry and Behavioral HealthUniversity of Miami Miller School of Medicine and Jackson Memorial HospitalMiamiUSA
  6. 6.Institute for Disease ModelingBellevueUSA
  7. 7.University of WashingtonSeattleUSA
  8. 8.New Mexico State UniversityLas CrucesUSA
  9. 9.Santa Fe InstituteSanta FeUSA
  10. 10.Interuniversity Institute for Research and Development (INURED)Port-au-PrinceHaiti
  11. 11.Department of AnthropologyUniversity of MiamiCoral GablesUSA
  12. 12.Simon A. Levin Mathematical, Computational and Modeling Sciences CenterArizona State UniversityTempeUSA
  13. 13.Department of Psychiatry and Behavioral NeuroscienceUniversity of Cincinnati College of MedicineCincinnatiUSA
  14. 14.Department of Public Health Sciences and Comprehensive Drug Research CenterUniversity of Miami Miller School of MedicineMiamiUSA
  15. 15.Department of Emergency MedicineSunnybrook Health Sciences CentreTorontoCanada
  16. 16.Department of PsychiatryColumbia University and the New York State Psychiatric InstituteNew YorkUSA
  17. 17.Graduate School of Social Work (GSSW)University of DenverDenverUSA

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