This study assesses the long-term psychological consequences after the 2004 Asian tsunami in Kerala, India. Participants are the inhabitants of Kerala s coastal regions. The results indicated that the participants who were affected by the tsunami showed significantly greater psychological distress and symptoms of post-traumatic stress disorder (PTSD) than a control group. In addition, it could be shown that protective factors, such as perceived social support, certain coping strategies, and a sense of coherence, could decrease the level of symptoms. Perceived social support, in particular,...