.

Help seeking behaviors: This study examined if individuals saw at least one of the
following professionals or non-professional people for coping with any types of
stress associated with the Great East Japan Earthquake Disaster: psychiatrist,
physician, nurse, counselor, social worker, school counselor, family members and
friends residing in U.S. or Japan, and others.
4. Geographic distance: The DSM-V clarifies that proximity or having a close
family member or friend impacted by the trauma might cause PTSD. This study
tested if the distance from the epicenter of the earthquake was associated with
psychological and psychosomatic symptoms among people. The distance
measured by a the straight line, on a 2-dimenstional map, between the epicenter of
the Great East Japan Earthquake and each of locations identified by postal zip
codes of survey participants. The Japanese zip code were converted to latitude
and longitude with convert software offered by the Japan Geographic Data Canter
(Japan Geographic Data Center, 2015). The geographic location of the epicenter
used for this study is 381919N (38.10333)1422208E (142.86) reported by the
Japan Meteorological Agency (2011). Then the participants latitude and
longitude were inserted to a formula calculating the distance
=ACOS(COS(RADIANS(90-38.10333))*COS(RADIANS(90-Latitude of the
participant))+SIN(RADIANS(90-Lat38.10333))*SIN(RADIANS(90-latitude of
the participant))*COS(RADIANS(142.86-longitude of the participant)))*6371.

23

Anticipated Results
This study was anticipated to show that people experience psychological and/or

somatic stress following a natural disaster regardless of directness of the disaster;

that
people who have experienced psychological and/or somatic stress seek help or at
least
consider it; and that there are differences in help-seeking behaviors between
Japanese
residing in the U.S. as an ethnic minority and Japanese in Japan as a majority, for
example, depending on perceived accessibility to health professionals.
Limitations
There are several limitations that need to be acknowledged in this proposed
study. Secondary analysis is limited to the information collected by the original
study.
Adults assessed in this study cannot be considered representative of all Japanese
people
who experienced the Great East Japan Earthquake disaster, because the
convenience
sampling was adopted in this study. Because of it, generalizability of the results of
this
study calls attentions. The parent survey excluded adults if they were identified as
residents in Iwate, Miyagi, or Fukushima prefectures because they are assumed to
have
different stress responses to the disaster and coping strategies, requiring clinical
interventions more often, compared to those outside the three prefectures and
beyond the
scope of this proposed study. The surveillance was implemented online, thus this
can
cause selection bias and response bias (Granello & Wheaton, 2004). For example,
individuals without sufficient internet literacy might have had less opportunity and
willingness to participate to the survey and been less likely to complete the survey
despite
participation. Additionally, the original data used only Japanese language; therefore,

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