This study examined the impact of disaster-related stressors and peri-trauma emotional reactions on mental health 10 months after the 2004 Southeast Asian tsunami disaster in a sample of 660 Danish tourists evacuated from the disaster area. The estimated rates of posttraumatic stress disorder and depression were 10.2% and 6.4%, respectively. The strongest predictors of posttraumatic stress and depressive symptoms were peri-trauma fear and dissociation. Among exposure variables, only witnessing others suffering was associated with both these disorders, whereas loss of family members and history of psychiatric treatment emerged as independent risk factors for depression. These variables explained a smaller proportion of variance in posttraumatic stress symptoms. These findings contribute to a body of evidence showing the critical role that appraisal of trauma plays in posttraumatic stress disorder and depression.