Questionnaire of Flashbulb Memory on Reaction to Tsunami
Date___/____/_____ Time_________
This survey consists of some questions concerning the tragic event of Tsunami that occurred in 2004 in Indian Ocean. The study questions on the paper should be completed in around twenty minutes. Individuals are required to participate in this exercise voluntarily. However, one has the right to discontinue his or her participation at any given moment she feels that the exercise is distressing
So as to ensure that the response has been kept in a confidential and anonymous manner Identification codes will be assigned to the response book. Records that link these codes to names will not be kept unless one is contacted in the future for follow-up purposes.
ID code __ __ __ __ __
Demographic Data:
Date of Birth __ __ _____
2. Sex Male • or Female • (tick one)
Occupation__________________
religion___________________ (optional)
Race/ethnicity_______________ (optional)?
9. Do you need in assistance filling out this survey?
11. In response to the 2004 Indian Ocean earthquake, did you seek the following?
Psychological Counseling? yes • no •
Financial Assistance? yes • no •
KEEP IN MIND THAT WHEN RESPONDING TO QUESTIONS, ONE A PAGE HAS BEEN COMPLETED AND PROCEEDED TO THE NEXT, PLEASE TO GO BACK TO REVIEW THE PREVIOUS ANSWERS
Do you agree to participate in this study? Check: yes • no •
1) Please explain how you first became aware of the Tsunami
(Please do not turn to the next page until you have completed your response to this
Question).
2) Where were you?
How well do you think you will remember this in a year?
(Not at all) 1————-2————-3————-4————-5 (perfectly)
3) What were you doing straight away before you became informed of the earthquake?
How well do you think you will remember this in a year?
(Not at all) 1————-2————-3————-4————-5 (perfectly)
4) How did you feel when you first became aware of the tsunami (earthquake)?
How well do you think you will remember this in a year?
(Not at all) 1————-2————-3————-4————-5 (perfectly
5) Who was the first person you communicated to about the earthquake, and how did he/she
Feel about it?
How well do you think you will remember this in a year?
(Not at all) 1————-2————-3————-4————-5 (perfectly)
6) What did you do right away after you became aware of the attack?
How well do you think you will remember this in a year?
(Not at all) 1————-2————-3————-4————-5 (perfectly)
7) Did you suffer any personal losses in the tsunami (earthquake)? If so, please specify.
8) Did the attack inconvenience your daily activities in some way? If so, please specify.
FOR THE FOLLOWING QUESTIONS, PLEASE TELL US ABOUT CURRENT FEELINGSCONCERNING THE EARTHQUAKE PLEASE INDICATES YOUR RESPONSE BY MARKING THE APPROPRIATE POINT ON THE SCALES PROVIDED. NOTE THAT YOU MAY INDICATE PARTIAL NUMBERS (E.G. 3.5)
9) At this moment, how powerfully or extremely do you feel sad about the Tsunami (Earthquake)?
(Low) 1—————-2—————-3—————-4—————5 (high)
10) How powerfully or extremely did you feel shock about the Earthquake?
(Low) 1—————-2—————-3—————-4—————5 (high)
11) At this period, what other emotions might you be experiencing? Please indicate their intensity out of ten .__________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
12) How much did you have a discussion about the earthquake since the incidence?
(Very little) 1—————-2—————-3—————-4—————5 (very much)
FOR THE FOLLOWING QUESTIONS, PLEASE TELL US ABOUT HOW YOU THINK
YOU’LL FEEL ABOUT THE EVENT ONE YEAR FROM NOW. PLEASE
RESPOND BY MARKING THE APPROPRIATE POINT ON THE SCALES PROVIDED. NOTE THAT YOU MAY INDICATE PARTIAL NUMBERS (E.G. 3.5)
13) A year from now, how powerfully or extremely will you feel sad about the earthquake?
(Low) 1—————-2—————-3—————-4—————5 (high)
14) A year from now, how powerfully or extremely will you feel shock about the earthquake?
(Low) 1—————-2—————-3—————-4—————5 (high)
15) A year from now, what other emotions might you are encountering? List and rate their expected severity:
__________________________________________________________________________________________________________________________________________________________________________________________________________________
16) What is your biggest concern as a result of the tsunami (earthquake)?
17) How should the affected countries respond to the tsunami (earthquake)?
Reference
Paris, R et al (2007). Coastal sedimentation associated with the December 26, 2004 tsunami in Lhok Nga, west Banda Aceh (Sumatra, Indonesia)”. Marine Geology (Elsevier) 238 (1–4): 93–106.
Roehm Jr (2007). Can brand encounters inspire flashbulb memories?”. Psychology and Marketing 24 (1): 25–40
Talarico, et al (2007). “Flashbulb memories are special after all; in phenomenology, not accuracy”. Applied Cognitive Psychology 21 (5): 557–578
Martin C. (2013). Flashbulb Memories. Psychology Press: Cheltenham
Mike C & Cara F.(2005). Psychology AS. Nelson Thornes.New York
