Thesis advisor: Ann W. Burgess / Background: On March 11, 2011, a 9.0-magnitude earthquake hit the islands of Japan. Subsequent tsunami waves occurred as high as 40 meters above sea level and severely destroyed the nuclear plant in Fukushima. While it is known that both natural and manmade disasters impose physical and psychological distress on affected people, the impact on people's health of indirect exposure to a traumatic event has remained to be determined. This study investigates somatic and psychological stress reactions among residents in the United States and Japan to the Great East Japan Earthquake Disaster from comparative perspectives. Study design: A secondary analysis of data obtained from the mother study which examined media use and health impact among those living in the United States and Japan at the time of the disaster. Results: Two groups of participants, Japanese Americans (n=297) and Japanese (n=1142), were analyzed. Japanese Americans reported higher psychological and somatic symptoms than their counterpart in Japan. Among Japanese Americans, income, the severity of somatic symptoms, and help seeking behavior predicted 38.2% of the variance in psychological symptoms. Among Japanese, age, income, help seeking behavior, and severity of somatic symptoms predicted 31.9% of the variance in psychological symptoms related to the 311 disaster. Conclusions: It is evident that indirect exposure to a traumatic event occurring in a distant place has significant adverse effects on people's physical and mental health. Therefore, clinical nurses and health care providers, especially in primary care settings, need to acknowledge the importance of screening for psychological distress among ethnic groups when a natural or man-made disaster occurs in their country of origin. Nurses can promote mental health by responding to stress related responses associated with disasters for those both directly and indirectly impacted. / Thesis (PhD) — Boston College, 2015. / Submitted to: Boston College. Connell School of Nursing. / Discipline: Nursing.