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Cruwys T, Macleod E, Heffernan T, Walker I, Stanley SK, Kurz T, Greenwood LM, Evans O, Calear AL. Social group connections support mental health following wildfire. Soc Psychiatry Psychiatr Epidemiol 2024; 59:957-967. [PMID: 37428193 PMCID: PMC11116249 DOI: 10.1007/s00127-023-02519-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Accepted: 06/07/2023] [Indexed: 07/11/2023]
Abstract
PURPOSE As environmental disasters become more common and severe due to climate change, there is a growing need for strategies to bolster recovery that are proactive, cost-effective, and which mobilise community resources. AIMS We propose that building social group connections is a particularly promising strategy for supporting mental health in communities affected by environmental disasters. METHODS We tested the social identity model of identity change in a disaster context among 627 people substantially affected by the 2019-2020 Australian fires. RESULTS We found high levels of post-traumatic stress, strongly related to severity of disaster exposure, but also evidence of psychological resilience. Distress and resilience were weakly positively correlated. Having stronger social group connections pre-disaster was associated with less distress and more resilience 12-18 months after the disaster, via three pathways: greater social identification with the disaster-affected community, greater continuity of social group ties, and greater formation of new social group ties. New group ties were a mixed blessing, positively predicting both resilience and distress. CONCLUSIONS We conclude that investment in social resources is key to supporting mental health outcomes, not just reactively in the aftermath of disasters, but also proactively in communities most at risk.
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Affiliation(s)
- Tegan Cruwys
- School of Medicine and Psychology, The Australian National University, Canberra, Australia.
| | - Emily Macleod
- School of Medicine and Psychology, The Australian National University, Canberra, Australia
| | - Timothy Heffernan
- School of Medicine and Psychology, The Australian National University, Canberra, Australia
- UNSW School of Built Environment, Sydney, Australia
| | - Iain Walker
- School of Medicine and Psychology, The Australian National University, Canberra, Australia
- Melbourne Centre for Behaviour Change, University of Melbourne, Parkville, Australia
| | - Samantha K Stanley
- School of Medicine and Psychology, The Australian National University, Canberra, Australia
| | - Tim Kurz
- School of Psychological Science, University of Western Australia, Perth, Australia
| | - Lisa-Marie Greenwood
- School of Medicine and Psychology, The Australian National University, Canberra, Australia
| | - Olivia Evans
- School of Medicine and Psychology, The Australian National University, Canberra, Australia
| | - Alison L Calear
- Centre for Mental Health Research, The Australian National University, Canberra, Australia
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Ahmadi F, Goodarzi MA, Taghavi MR, Imani M. Modeling the structural relationships between trauma exposure with substance use tendency, depression symptoms, and suicidal thoughts in individuals with earthquake trauma experience: the mediatory role of peritraumatic dissociation and experiential avoidance. BMC Psychiatry 2024; 24:171. [PMID: 38429677 PMCID: PMC10905816 DOI: 10.1186/s12888-024-05595-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2023] [Accepted: 02/06/2024] [Indexed: 03/03/2024] Open
Abstract
BACKGROUND Despite the fact that studies indicate that earthquake trauma is associated with numerous psychological consequences, the mediating mechanisms leading to these outcomes have not been well-studied. Therefore, this study investigates the relationship between trauma exposure with substance use tendency, depression, and suicidal thoughts, with the mediating role of peritraumatic dissociation and experiential avoidance. METHODS The descriptive-correlational approach was employed in this study. The participants were people who had experienced the Kermanshah earthquake in 2017. A total of 324 people were selected by convenient sampling method. The Traumatic Exposure Severity Scale, the Peritraumatic Dissociative Experiences Questionnaire, the Acceptance and Action Questionnaire, the Iranian Addiction Potential Scale, Beck's Depression Inventory [BDI-II], and Beck's Suicidal Thoughts Scale were used to collect data. The gathered data was analyzed using structural equation modeling in SPSS Ver. 24 and LISREL Ver. 24. RESULTS The study findings indicated that the intensity of the trauma exposure is directly and significantly associated with depression symptoms, peritraumatic dissociation, and experiential avoidance. The severity of exposure to trauma had a significant indirect effect on the tendency to use substances through experiential avoidance. This is while the severity of the trauma experience did not directly correlate with substance use and suicidal thoughts. In addition, peritraumatic dissociation did not act as a mediator in the relationship between the severity of trauma exposure with substance use, depression, and suicidal thoughts. CONCLUSIONS The severity of exposure to the earthquake was associated with symptoms of depression and these findings indicate the importance of experiential avoidance in predicting the tendency to use drugs. Hence, it is essential to design and implement psychological interventions that target experiential avoidance to prevent drug use tendencies and to establish policies that lower depression symptoms following natural disasters.
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Affiliation(s)
- Farshad Ahmadi
- Department of Clinical Psychology, Faculty of Educational Sciences and Psychology, University of Shiraz, Shiraz, Iran.
| | - Mohammad Ali Goodarzi
- Department of Clinical Psychology, Faculty of Educational Sciences and Psychology, University of Shiraz, Shiraz, Iran
| | - Mohammad Reza Taghavi
- Department of Clinical Psychology, Faculty of Educational Sciences and Psychology, University of Shiraz, Shiraz, Iran
| | - Mahdi Imani
- Department of Clinical Psychology, Faculty of Educational Sciences and Psychology, University of Shiraz, Shiraz, Iran
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Macleod E, Heffernan T, Greenwood LM, Walker I, Lane J, Stanley SK, Evans O, Calear AL, Cruwys T, Christensen BK, Kurz T, Lancsar E, Reynolds J, Rodney Harris R, Sutherland S. Predictors of individual mental health and psychological resilience after Australia's 2019-2020 bushfires. Aust N Z J Psychiatry 2024; 58:58-69. [PMID: 37264605 PMCID: PMC10756019 DOI: 10.1177/00048674231175618] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
AIMS We assessed the mental health effects of Australia's 2019-2020 bushfires 12-18 months later, predicting psychological distress and positive psychological outcomes from bushfire exposure and a range of demographic variables, and seeking insights to enhance disaster preparedness and resilience planning for different profiles of people. METHODS We surveyed 3083 bushfire-affected and non-affected Australian residents about their experiences of bushfire, COVID-19, psychological distress (depression, anxiety, stress, post-traumatic stress disorder) and positive psychological outcomes (resilient coping, wellbeing). RESULTS We found high rates of distress across all participants, exacerbated by severity of bushfire exposure. For people who were bushfire-affected, being older, having less financial stress, and having no or fewer pre-existing mental disorders predicted both lower distress and higher positive outcomes. Being male or having less income loss also predicted positive outcomes. Severity of exposure, higher education and higher COVID-19-related stressors predicted both higher distress and higher positive outcomes. Pre-existing physical health diagnosis and previous bushfire experience did not significantly predict distress or positive outcomes. RECOMMENDATIONS To promote disaster resilience, we recommend investment in mental health, particularly for younger adults and for those in rural and remote areas. We also recommend investment in mechanisms to protect against financial distress and the development of a broader definition of bushfire-related impacts than is currently used to capture brushfires' far-reaching effects.
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Affiliation(s)
- Emily Macleod
- School of Medicine and Psychology, The Australian National University, Canberra, ACT, Australia
- Centre for Mental Health Research, The Australian National University, Canberra, ACT, Australia
| | - Timothy Heffernan
- School of Medicine and Psychology, The Australian National University, Canberra, ACT, Australia
- School of Built Environment, University of New South Wales, Sydney, NSW, Australia
| | - Lisa-Marie Greenwood
- School of Medicine and Psychology, The Australian National University, Canberra, ACT, Australia
| | - Iain Walker
- School of Medicine and Psychology, The Australian National University, Canberra, ACT, Australia
- Melbourne Centre for Behaviour Change, The University of Melbourne, Parkville, VIC, Australia
| | - Jo Lane
- National Centre for Epidemiology and Population Health, The Australian National University, Canberra, ACT, Australia
| | - Samantha K Stanley
- School of Medicine and Psychology, The Australian National University, Canberra, ACT, Australia
| | - Olivia Evans
- School of Medicine and Psychology, The Australian National University, Canberra, ACT, Australia
| | - Alison L Calear
- Centre for Mental Health Research, The Australian National University, Canberra, ACT, Australia
| | - Tegan Cruwys
- School of Medicine and Psychology, The Australian National University, Canberra, ACT, Australia
| | - Bruce K Christensen
- School of Medicine and Psychology, The Australian National University, Canberra, ACT, Australia
| | - Tim Kurz
- School of Psychological Science, The University of Western Australia, Perth, WA, Australia
| | - Emily Lancsar
- Centre for Mental Health Research, The Australian National University, Canberra, ACT, Australia
| | - Julia Reynolds
- School of Medicine and Psychology, The Australian National University, Canberra, ACT, Australia
| | - Rachael Rodney Harris
- Centre for Entrepreneurial Agri-Technology, The Australian National University, Canberra, ACT, Australia
| | - Stewart Sutherland
- School of Medicine and Psychology, The Australian National University, Canberra, ACT, Australia
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Bell C, Moot W, Porter R, Frampton C, Mcintosh V, Purnell M, Smith R, Douglas K. Examining the long-term cognitive effects of exposure to the Canterbury earthquakes in a resilient cohort. BJPsych Open 2022; 8:e114. [PMID: 35703099 PMCID: PMC9230545 DOI: 10.1192/bjo.2022.512] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Although most people do not develop mental health disorders after exposure to traumatic events, they may experience subtle changes in cognitive functioning. We previously reported that 2-3 years after the Canterbury earthquake sequence, a group of trauma-exposed people, who identified as resilient, performed less well on tests of spatial memory, had increased accuracy identifying facial emotions and misclassified neutral facial expressions to threat-related emotions, compared with non-exposed controls. AIMS The current study aimed to examine the long-term cognitive effects of exposure to the earthquakes in this resilient group, compared with a matched non-exposed control group. METHOD At 8-9 years after the Canterbury earthquake sequence, 57 earthquake-exposed resilient (69% female, mean age 56.8 years) and 60 non-exposed individuals (63% female, mean age 55.7 years) completed a cognitive testing battery that assessed verbal and visuospatial learning and memory, executive functioning, psychomotor speed, sustained attention and social cognition. RESULTS With the exception of a measure of working memory (Digit Span Forward), no significant differences were found in performance between the earthquake-exposed resilient and non-exposed groups on the cognitive tasks. Examination of changes in cognitive functioning over time in a subset (55%) of the original earthquake-exposed resilient group found improvement in visuospatial performance and slowing of reaction times to negative emotions. CONCLUSIONS These findings offer preliminary evidence to suggest that changes in cognitive functioning and emotion processing in earthquake-exposed resilient people may be state-dependent and related to exposure to continued threat in the environment, which improves when the threat resolves.
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Affiliation(s)
- Caroline Bell
- Department of Psychological Medicine, University of Otago, New Zealand
| | - Will Moot
- Department of Psychological Medicine, University of Otago, New Zealand
| | - Richard Porter
- Department of Psychological Medicine, University of Otago, New Zealand
| | - Chris Frampton
- Department of Psychological Medicine, University of Otago, New Zealand
| | | | - Melissa Purnell
- Department of Psychological Medicine, University of Otago, New Zealand
| | | | - Katie Douglas
- Department of Psychological Medicine, University of Otago, New Zealand
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Post-Hurricane Distress Scale (PHDS): Determination of General and Disorder-Specific Cutoff Scores. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19095204. [PMID: 35564598 PMCID: PMC9100105 DOI: 10.3390/ijerph19095204] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Revised: 04/11/2022] [Accepted: 04/19/2022] [Indexed: 11/16/2022]
Abstract
The Post-Hurricane Distress Scale (PHDS) was developed to assess mental health risk in the aftermath of hurricanes. We derive both disorder-specific cutoff values and a single nonspecific cutoff for the PHDS for field use by disaster relief and mental health workers. Data from 672 adult residents of Puerto Rico, sampled 3 to 12 months after Hurricane Maria, were collected. Participants completed a five-tool questionnaire packet: PHDS, Kessler K6, Patient Health Questionnaire 9, Generalized Anxiety Disorder 7, and Post-Traumatic Stress Disorder Checklist for DSM V (PCL-5). ROC curves, AUC values, sensitivities, specificities, Youden’s index, and LR+ ratios are reported. The recommended single cutoff value for the PHDS is 41, whereby a respondent with a PHDS score of 41 or above is deemed high-risk for a mental health disorder. The single field use PHDS cutoff demonstrated high specificity (0.80), an LR + ratio (2.84), and a sensitivity of 0.56. The mean ROC values of PHDS for Kessler K6, Patient Health Questionnaire 9, Generalized Anxiety Disorder 7, and PCL-5 were all above 0.74. The derived cutoff for the PHDS allows efficient assessment of respondents’ and/or a community’s risk status for mental health disorders in the aftermath of hurricanes and natural disasters.
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Nobakht HN, Ojagh FS, Dale KY. Validity, Reliability and Internal Consistency of Persian Versions of the Childhood Trauma Questionnaire, the Traumatic Exposure Severity Scale and the Peritraumatic Dissociative Experiences Questionnaire. J Trauma Dissociation 2021; 22:332-348. [PMID: 33416029 DOI: 10.1080/15299732.2020.1869640] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
The Childhood Trauma Questionnaire (CTQ), the Traumatic Exposure Severity Scale (TESS) and the Peritraumatic Dissociative Experiences Questionnaire (PDEQ) are questionnaires widely used in studies of trauma and dissociation. This study aimed to examine the validity of the Persian versions of these questionnaires among a total of 230 individuals from the cities of Kermanshah and Sarpol-e Zahab that had experienced 2017 Iran earthquake. Results from a confirmatory factor analysis did not support the original five-factor solution for the TESS. Two principal component analyses resulted in a four-component solution for a revised version of the scale. PDEQ scores, TESS scores, and its sub-scales, were found to significantly correlate with a PTSD measure with their effect sizes ranging from medium to large according to Cohen's guidelines. Furthermore, significant correlations between two sub-scales of the CTQ and a dissociation measure were found with medium effect sizes. Consequently, reliability and validity measures obtained from the sample of this study were supportive of the use of the Persian versions of the TESS, the PDEQ, and the CTQ among Persian-speaking populations. Further research on psychological responses to earthquakes and other natural disasters can provide the opportunity for cross-cultural comparisons in terms of specific resilience factors and vulnerabilities following mass trauma.
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Affiliation(s)
- Habib Niyaraq Nobakht
- International Centre for Research in Human Development, Tomsk State University, Tomsk, Russia
| | - Faeze Sadat Ojagh
- School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Karl Yngvar Dale
- Department of Health and Social Sciences, Molde University College, Molde, Norway
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Watkins DJ, Torres Zayas HR, Vélez Vega CM, Rosario Z, Welton M, Agosto Arroyo LD, Cardona N, Díaz Reguero ZJ, Santos Rivera A, Huerta-Montañez G, Brown P, Alshawabkeh A, Cordero JF, Meeker JD. Investigating the impact of Hurricane Maria on an ongoing birth cohort in Puerto Rico. POPULATION AND ENVIRONMENT 2020; 42:95-111. [PMID: 33746324 PMCID: PMC7967016 DOI: 10.1007/s11111-020-00345-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/03/2023]
Abstract
Prior to Hurricane Maria, Puerto Rico already had 200+ hazardous waste sites, significant contamination of water resources, and among the highest rates of preterm birth in the US. To address these issues, the Puerto Rico Testsite for Exploring Contamination Threats (PROTECT) Center was formed in 2010 to investigate prenatal environmental exposures, particularly phthalates, and adverse birth outcomes. Recent work from the PROTECT study confirms that in utero exposure to certain phthalates is associated with shorter gestation and increased risk of preterm birth. However, previous research also suggests that pregnant women who experience a natural disaster such as Hurricane Maria are at higher risk of adverse birth outcomes, but it is unknown whether this is due to stress, hazardous exposures, or a combination of factors. Thus, the aim of this analysis was to characterize hurricane-related changes in phthalate exposures and experiences within the PROTECT cohort. Among 176 participants who were pregnant during or within 5 months after Maria, 122 completed a questionnaire on hurricane-related experiences. Questionnaire results and biomarkers of exposure suggest that participants did not have regular access to fresh foods and water during hurricane recovery, and almost half reported structural damage to their home. In addition, biomarker concentrations of phthalates commonly used in food packaging were higher among participants post-hurricane, while phthalates commonly used in personal care products were lower compared to pre-hurricane levels. Hurricane-related increases in phthalate exposure, as well as widespread structural damage, food and water shortages, and long-term absence of electricity and cell phone service, likely increased the risk of adverse birth outcomes among this already vulnerable population.
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Affiliation(s)
- Deborah J. Watkins
- University of Michigan, Department of Environmental Health Sciences - Ann Arbor, Michigan
| | | | - Carmen M. Vélez Vega
- University of Puerto Rico - Medical Sciences Campus, School of Public Health – San Juan, PR
| | - Zaira Rosario
- University of Puerto Rico - Medical Sciences Campus, School of Public Health – San Juan, PR
| | - Michael Welton
- University of Georgia, College of Public Health, University of Georgia, Department of Epidemiology and Biostatistics – Athens, GA
| | - Luis D. Agosto Arroyo
- University of Puerto Rico - Medical Sciences Campus, School of Public Health – San Juan, PR
| | - Nancy Cardona
- University of Puerto Rico - Medical Sciences Campus, School of Public Health – San Juan, PR
| | | | - Amailie Santos Rivera
- University of Puerto Rico - Medical Sciences Campus, School of Public Health – San Juan, PR
| | - Gredia Huerta-Montañez
- University of Puerto Rico - Medical Sciences Campus, School of Public Health – San Juan, PR
| | - Phil Brown
- Northeastern University, Social Science Environmental Health Research Institute – Boston, MA
| | - Akram Alshawabkeh
- Northeastern University, Department of Civil and Environmental Engineering – Boston, MA
| | - José F. Cordero
- University of Georgia, College of Public Health, University of Georgia, Department of Epidemiology and Biostatistics – Athens, GA
| | - John D. Meeker
- University of Michigan, Department of Environmental Health Sciences - Ann Arbor, Michigan
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Impact of a natural disaster on access to care and biopsychosocial outcomes among Hispanic/Latino cancer survivors. Sci Rep 2020; 10:10376. [PMID: 32587352 PMCID: PMC7316979 DOI: 10.1038/s41598-020-66628-z] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2019] [Accepted: 05/25/2020] [Indexed: 12/11/2022] Open
Abstract
Cancer is the leading cause of death in Puerto Rico (PR). Hurricane Maria (HM) and its aftermath lead to widespread devastation on the island, including the collapse of the healthcare system. Medically fragile populations, such as cancer survivors, were significantly affected. The goal of this study was to assess the impact of HM on barriers to care, emotional distress, and inflammatory biomarkers among cancer survivors in PR. This exploratory longitudinal study was conducted in health care facilities and community support groups from PR. Cancer survivors (n = 50) and non-cancer participants (n = 50) completed psychosocial questionnaires and provided blood samples that were used to assess inflammatory cytokines levels. Among this cohort, we identified 41 matched cancer survivors/non-cancer participants pairs. Data were analyzed through descriptive, frequencies, correlational, and regression analyses. Cancer survivors that were affected by HM reported increased barriers in accessing medical care, which were directly associated with anxiety, perceived stress, and post-traumatic symptomatology. Moreover, being a cancer survivor, predicted more barriers to receiving health care, especially in the first six weeks after the event, after which the effect was attenuated. Several inflammatory cytokines, such as CD31, BDNF, TFF3, Serpin E-1, VCAM-1, Vitamin D BP, and PDGF-AA, were significantly upregulated in cancer survivors while MMP9 and Osteopontin both had significant positive correlations with barriers to care. HM significantly impacted Puerto Ricans psychosocial well-being. Cancer survivors had significant barriers to care and showed increased serum inflammatory cytokines but did not show differences in anxiety, stress, and post-traumatic symptoms compared to non-cancer participants.
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Ni MY, Kim Y, McDowell I, Wong S, Qiu H, Wong IO, Galea S, Leung GM. Mental health during and after protests, riots and revolutions: A systematic review. Aust N Z J Psychiatry 2020; 54:232-243. [PMID: 31989834 DOI: 10.1177/0004867419899165] [Citation(s) in RCA: 67] [Impact Index Per Article: 16.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
OBJECTIVES Protests, riots and revolutions have long been a part of human history and are increasing globally, yet their impact on mental health remains largely unknown. We therefore systematically reviewed studies on collective actions and mental health. METHOD We searched PubMed, Web of Science, PsycINFO and CINAHL Plus for published studies from their inception until 1 January 2018. Study quality was rated using the Newcastle-Ottawa Scale. RESULTS We identified 52 studies (n = 57,487 participants) from 20 countries/regions. The prevalence of post-traumatic stress disorder ranged from 4% to 41% in riot-affected areas. Following a major protest, the prevalence of probable major depression increased by 7%, regardless of personal involvement in the protests, suggestive of community spillover effects. Risk factors for poorer mental health included female sex, lower socioeconomic status, exposure to violence, interpersonal conflicts, frequent social media use and lower resilience and social support. Nevertheless, two studies suggested that collective actions may reduce depression and suicide, possibly due to a collective cathartic experience and greater social cohesion within subpopulations. CONCLUSION We present the first systematic review of collective actions and mental health, showing compelling evidence that protests even when nonviolent can be associated with adverse mental health outcomes. Health care professionals therefore need to be vigilant to the mental and psychological sequelae of protests, riots and revolutions. Further research on this emerging sociopolitical determinant of mental health is warranted.
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Affiliation(s)
- Michael Y Ni
- School of Public Health, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, China
- Healthy High Density Cities Lab, HKUrbanLab, The University of Hong Kong, Hong Kong Special Administrative Region, China
- The State Key Laboratory of Brain and Cognitive Sciences, The University of Hong Kong, Hong Kong Special Administrative Region, China
| | - Yoona Kim
- Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
| | - Ian McDowell
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, ON, Canada
| | - Suki Wong
- School of Public Health, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, China
| | - Hong Qiu
- School of Public Health, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, China
| | - Irene Ol Wong
- School of Public Health, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, China
| | - Sandro Galea
- School of Public Health, Boston University, Boston, MA, USA
| | - Gabriel M Leung
- School of Public Health, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, China
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Qi J, Yang X, Tan R, Wu X, Zhou X. Prevalence and predictors of posttraumatic stress disorder and depression among adolescents over 1 year after the Jiuzhaigou earthquake. J Affect Disord 2020; 261:1-8. [PMID: 31590064 DOI: 10.1016/j.jad.2019.09.071] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2019] [Revised: 09/19/2019] [Accepted: 09/29/2019] [Indexed: 01/10/2023]
Abstract
BACKGROUND On August 8, 2017, a 7-magtitude earthquake struck Jiuzhaigou County in Sichuan, China. This was the third devastating earthquake in that province. The prevalence and predictors of posttraumatic stress disorder (PTSD), depression, and comorbid PTSD/depression among adolescents were unclear after the Jiuzhaigou earthquake. METHODS Participants were 1241 adolescent survivors in Jiuzhaigou. Data were collected using the PTSD Checklist for the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, and the Chinese version of the Center for Epidemiologic Studies Depression Scale for Children. RESULTS In total, 46.3% of participants reported PTSD, 64.5% reported depression, and 39.2% reported comorbid PTSD/depression symptoms. Risk factors for symptoms of these disorders were being female, having been injured or trapped, and intrusive rumination. High school students were less likely to report PTSD and comorbid PTSD/depression than middle school students. Participants with family members/friends that were injured or trapped reported more PTSD and comorbid symptoms than those without this experience. Loss of property also predicted PTSD. However, deliberate rumination was a protective factor for depression. LIMITATIONS This study did not cover all adolescents in Jiuzhaigou and all potential predictors. As we used a cross-sectional design, this study could not assess the trajectory of PTSD, depression, and comorbid symptoms after the earthquake. CONCLUSION The findings are meaningful for mental health care among adolescents after natural disasters such as an earthquake.
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Affiliation(s)
- Junjun Qi
- Department of Psychology and Behavioral Sciences, Zhejiang University, Hangzhou, 310028, China
| | - Xima Yang
- Department of Psychology and Behavioral Sciences, Zhejiang University, Hangzhou, 310028, China
| | - Ruyue Tan
- Department of Psychology and Behavioral Sciences, Zhejiang University, Hangzhou, 310028, China
| | - Xinchun Wu
- Beijing Key Laboratory of Applied Experimental Psychology, Faculty of Psychology, Beijing Normal University, Beijing, 100875, China
| | - Xiao Zhou
- Department of Psychology and Behavioral Sciences, Zhejiang University, Hangzhou, 310028, China.
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Boskovic I, Hope L, Ost J, Orthey R, Merckelbach H. Detecting feigned high impact experiences: A symptom over-report questionnaire outperforms the emotional Stroop task. J Behav Ther Exp Psychiatry 2019; 65:101483. [PMID: 31125844 DOI: 10.1016/j.jbtep.2019.101483] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2018] [Revised: 05/10/2019] [Accepted: 05/12/2019] [Indexed: 11/29/2022]
Abstract
BACKGROUND AND OBJECTIVES The Modified Stroop Task (MST) effect refers to a prolonged reaction time (RT) in color-naming words related to an individual's disorder. Some authors argue that its absence in people who claim symptoms might be an indication of feigning. METHOD We tested whether the MST effect is robust against feigning attempts and compared its absence as an index of feigning with over-reporting tendencies on a symptom questionnaire (i.e., the Self-Reported Symptom Inventory (SRSI)). We included participants (n = 22) who i) reported current high impact of aversive experiences (High scorers), ii) reported current low impact (Low scorers) of aversive experiences (n = 24), and iii) actors (n = 18) with low impact, but instructed to feign current high psychological impact of aversive life events (Simulators). We administered the MST, including impact-related, neutral, and feigning-related words, and the SRSI. RESULTS We found no MST effect for impact-related words in the high scorers group, or for feigning-related words in the simulators. Relative to high scorers and low scorers, simulators exhibited significantly longer RTs on all types of words and they also endorsed significantly more bogus symptoms on the SRSI. Thus, the SRSI was a more sensitive measure of feigning than the absence of an MST effect. LIMITATION Some limitations are related to our reliance on a sub-clinical student sample, whereas others reflect the unresolved issues surrounding the MST. Thus, the generalizability of our results is uncertain. CONCLUSION Our findings add to the doubts on the idea that the MST can be used to differentiate between genuine and feigned complaints.
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Affiliation(s)
- Irena Boskovic
- (a)Maastricht University, the Netherlands; University of Portsmouth, UK.
| | | | | | - Robin Orthey
- (a)Maastricht University, the Netherlands; University of Portsmouth, UK
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Douglas KM, Groves S, Porter RJ, Jordan J, Wilson L, Melzer TR, Wise RG, Bisson JI, Bell CJ. Traumatic imagery following glucocorticoid administration in earthquake-related post-traumatic stress disorder: A preliminary functional magnetic resonance imaging study. Aust N Z J Psychiatry 2019; 53:1167-1178. [PMID: 31146540 DOI: 10.1177/0004867419851860] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
OBJECTIVE Post-traumatic stress disorder involves excessive retrieval of traumatic memories. Glucocorticoids impair declarative memory retrieval. This preliminary study examined the effect of acute hydrocortisone administration on brain activation in individuals with earthquake-related post-traumatic stress disorder compared with earthquake-exposed healthy individuals, during retrieval of traumatic memories. METHOD Participants exposed to earthquakes with (n = 11) and without post-traumatic stress disorder (n = 11) underwent two functional magnetic resonance imaging scans, 1-week apart, in a double-blind, placebo-controlled, counter-balanced design. On one occasion, they received oral hydrocortisone (20 mg), and on the other, placebo, 1 hour before scanning. Symptom provocation involved script-driven imagery (traumatic and neutral scripts) and measures of self-reported anxiety. RESULTS Arterial spin labelling showed that both post-traumatic stress disorder and trauma-exposed controls had significantly reduced cerebral blood flow in response to retrieval of traumatic versus neutral memories in the right hippocampus, parahippocampal gyrus, calcarine sulcus, middle and superior temporal gyrus, posterior cingulate, Heschl's gyrus, inferior parietal lobule, angular gyrus, middle occipital gyrus, supramarginal gyrus, lingual gyrus and cuneus, and the left prefrontal cortex. Hydrocortisone resulted in non-significant trends of increasing subjective distress and reduced regional cerebral blood flow in the left inferior frontal gyrus, left anterior cingulate gyrus, middle temporal gyrus, cerebellum, postcentral gyrus and right frontal pole, during the trauma script. CONCLUSION Findings do not fit with some aspects of the accepted neurocircuitry model of post-traumatic stress disorder, i.e., failure of the medial prefrontal cortex to quieten hyperresponsive amygdala activity, and the potential therapeutic benefits of hydrocortisone. They do, however, provide further evidence that exposure to earthquake trauma, regardless of whether post-traumatic stress disorder eventuates, impacts brain activity and highlights the importance of inclusion of trauma-exposed comparisons in studies of post-traumatic stress disorder.
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Affiliation(s)
- Katie M Douglas
- Department of Psychological Medicine, University of Otago, Christchurch, Christchurch, New Zealand
| | - Samantha Groves
- Department of Psychological Medicine, University of Otago, Christchurch, Christchurch, New Zealand.,New Zealand Brain Research Institute, Christchurch, New Zealand.,Department of Medicine, University of Otago, Christchurch, Christchurch, New Zealand
| | - Richard J Porter
- Department of Psychological Medicine, University of Otago, Christchurch, Christchurch, New Zealand
| | - Jenny Jordan
- Department of Psychological Medicine, University of Otago, Christchurch, Christchurch, New Zealand
| | - Lynere Wilson
- Department of Psychological Medicine, University of Otago, Christchurch, Christchurch, New Zealand
| | - Tracy R Melzer
- New Zealand Brain Research Institute, Christchurch, New Zealand.,Department of Medicine, University of Otago, Christchurch, Christchurch, New Zealand
| | - Richard G Wise
- Brain Research Imaging Centre, School of Psychology, Cardiff University, Cardiff
| | | | - Caroline J Bell
- Department of Psychological Medicine, University of Otago, Christchurch, Christchurch, New Zealand
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13
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Schwind JS, Norman SA, Brown R, Frances RH, Koss E, Karmacharya D, Santangelo SL. Association Between Earthquake Exposures and Mental Health Outcomes in Phulpingdanda Village After the 2015 Nepal Earthquakes. Community Ment Health J 2019; 55:1103-1113. [PMID: 31102165 DOI: 10.1007/s10597-019-00404-w] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2018] [Accepted: 05/06/2019] [Indexed: 12/24/2022]
Abstract
In 2015, two strong earthquakes, as well as continuous, high magnitude aftershocks, struck Nepal. Phulpingdanda village was greatly impacted due to its lack of infrastructure and environmental remoteness. Adults from sampled households were surveyed 1-year later to examine the association between earthquake exposures and indicators of depression, post-traumatic stress disorder (PTSD), and resilience. Results showed 33% of surveyed residents screened positive for depression, 9% screened positive for severe PTSD, and 46% displayed moderate to high resilience. Additionally, participants experienced resource loss (100%), damaged home and goods (99%), and exposure to the grotesque (82%). Traumatic earthquake experiences related to personal harm were associated with symptoms of depression and PTSD and resource loss was associated with depressive symptoms. Earthquake experiences associated with less damage to home and goods, but greater exposure to the grotesque were associated with increased resilience. This research adds to our knowledge of the relationship between traumatic exposures and indicators of psychological distress and resilience following a disaster.
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Affiliation(s)
- Jessica S Schwind
- Department of Biostatistics, Epidemiology and Environmental Health Sciences, Jiann-Ping Hsu College of Public Health, Georgia Southern University, P.O. Box 8015, Statesboro, GA, 30460, USA. .,Department of Biostatistics and Epidemiology, Medical College of Georgia, Augusta University, Augusta, GA, USA.
| | - Stephanie A Norman
- Department of Biostatistics and Epidemiology, Medical College of Georgia, Augusta University, Augusta, GA, USA
| | | | - Rebecca Hoffmann Frances
- Maine Behavioral Healthcare, Portland, ME, USA.,Tufts University School of Medicine, Department of Psychiatry, Boston, MA, USA
| | | | | | - Susan L Santangelo
- Tufts University School of Medicine, Department of Psychiatry, Boston, MA, USA.,Maine Medical Center Research Institute, Center for Psychiatric Research, Portland, ME, USA
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14
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Post-Hurricane Distress Scale (PHDS): A Novel Tool for First Responders and Disaster Researchers. Disaster Med Public Health Prep 2019; 13:82-89. [PMID: 30841955 DOI: 10.1017/dmp.2019.12] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVE The aim of this study was the construction and validation of a novel research instrument to quantify the degree of post-hurricane trauma and distress in an affected population. The Post-Hurricane Distress Scale (PHDS) has quantitative measures of both acute and prolonged distress, attributable to meteorological and hydrological disasters. METHODS A careful evaluation of existing questionnaires, as well as extensive canvasing of the post-Maria population of Puerto Rico, availed the construction of the PHDS. The PHDS consists of 20 items, organized into 4 subscales. The PHDS was pre-validated (n=79), revised, and then distributed to a broad sampling of the post-Hurricane Maria Puerto Rican population (n=597). Validation, including factor analysis, analyses of concurrent validity, discriminant validity, and internal reliability, was performed. RESULTS After comparing various scales, factor loading profiles, concurrent validities, and models of fit, we show that the PHDS is best scored as a single 0-6 distress scale. When compared with the Traumatic Exposure Severity Scale, the PHDS shows superior concurrent validity, more accurately predicting scores for the Peritraumatic Distress Inventory, Impact of Event Scale - Revised, and Generalized Anxiety Disorder 7 Scale. The PHDS shows good internal reliability and discriminant validity. CONCLUSIONS The PHDS represents a novel, useful instrument for disaster first-responders and researchers. The prompt identification of high-risk populations is possible using this instrument. (Disaster Med Public Health Preparedness. 2019;13:82-89).
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Vardy T, Atkinson QD. Property Damage and Exposure to Other People in Distress Differentially Predict Prosocial Behavior After a Natural Disaster. Psychol Sci 2019; 30:563-575. [DOI: 10.1177/0956797619826972] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023] Open
Abstract
The persistent threat of natural disasters and their attendant resource shocks has likely shaped our prosocial drives throughout human evolution. However, it remains unclear how specific experiences during these events might impact cooperative decision making. We conducted two waves of four modified dictator-game experiments with the same individuals in Vanuatu ( N = 164), before and after Cyclone Pam in 2015. After the cyclone, participants were generally less likely to show prosocial motives toward both in-group and out-group members and more likely to show parochialism when sharing between groups. Experiencing greater property damage predicted a general decrease in prosocial allocations and preference for participants’ in-group. By contrast, exposure to other people in distress predicted increased prosocial allocations to both participants’ in-group and out-groups. Our results suggest that people adjust their prosocial behavior in response to natural disasters but that the nature and direction of the effect depend on the type and severity of their experiences.
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Affiliation(s)
- Tom Vardy
- School of Psychology, University of Auckland
| | - Quentin D. Atkinson
- School of Psychology, University of Auckland
- Max Planck Institute for the Science of Human History, Jena, Germany
- Institute of Cognitive and Evolutionary Anthropology, University of Oxford
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16
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Bell CJ, Frampton CM, Colhoun HC, Douglas KM, McIntosh VV, Carter FA, Jordan J, Carter JD, Smith RA, Marie LM, Loughlin A, Porter RJ. Earthquake brain: Impairment of spatial memory following long-term earthquake-related stress. Aust N Z J Psychiatry 2019; 53:37-47. [PMID: 30052053 DOI: 10.1177/0004867418789498] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVES The primary aim of this study was to investigate neuropsychological function in patients with earthquake-related posttraumatic stress disorder, compared with earthquake-exposed but resilient controls. We hypothesised that individuals with posttraumatic stress disorder would have poorer neuropsychological performance on tests of verbal and visuospatial learning and memory compared with the earthquake-exposed control group. The availability of groups of healthy patients from previous studies who had been tested on similar neuropsychological tasks prior to the earthquakes allowed a further non-exposed comparison. METHOD In all, 28 individuals with posttraumatic stress disorder and 89 earthquake-exposed controls completed tests of verbal and visuospatial learning and memory and psychomotor speed. Further comparisons were made with non-exposed controls who had been tested before the earthquakes. RESULTS No significant difference in performance on tests of verbal or visuospatial memory was found between the earthquake-exposed groups (with and without posttraumatic stress disorder), but the posttraumatic stress disorder group was significantly slowed on tests of psychomotor speed. Supplementary comparison with historical, non-exposed control groups showed that both earthquake-exposed groups had poorer performance on a test of visuospatial learning. CONCLUSION The key finding from this study is that there were no differences in verbal or visuospatial learning and memory in individuals with posttraumatic stress disorder compared with similarly earthquake-exposed controls. Compared with non-exposed controls, both earthquake-exposed groups had poorer performance on a test of visuospatial (but not verbal) learning and memory. This offers preliminary evidence suggesting that it is earthquake (trauma) exposure itself, rather than the presence of posttraumatic stress disorder that affects aspects of neuropsychological functioning. If replicated, this may have important implications for how information is communicated in a post-disaster context.
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Affiliation(s)
- Caroline J Bell
- 1 Department of Psychological Medicine, University of Otago, Christchurch, New Zealand.,2 Canterbury District Health Board, Christchurch, New Zealand
| | - Chris M Frampton
- 1 Department of Psychological Medicine, University of Otago, Christchurch, New Zealand
| | - Helen C Colhoun
- 2 Canterbury District Health Board, Christchurch, New Zealand
| | - Katie M Douglas
- 1 Department of Psychological Medicine, University of Otago, Christchurch, New Zealand
| | | | | | - Jennifer Jordan
- 1 Department of Psychological Medicine, University of Otago, Christchurch, New Zealand.,2 Canterbury District Health Board, Christchurch, New Zealand
| | - Janet D Carter
- 3 Department of Psychology, University of Canterbury, Christchurch, New Zealand
| | - Rebekah A Smith
- 2 Canterbury District Health Board, Christchurch, New Zealand.,3 Department of Psychology, University of Canterbury, Christchurch, New Zealand
| | - Leila Ma Marie
- 3 Department of Psychology, University of Canterbury, Christchurch, New Zealand
| | - Alex Loughlin
- 3 Department of Psychology, University of Canterbury, Christchurch, New Zealand
| | - Richard J Porter
- 1 Department of Psychological Medicine, University of Otago, Christchurch, New Zealand.,2 Canterbury District Health Board, Christchurch, New Zealand
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17
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Labarda CE, Chan CS. Sleep disturbances, posttraumatic stress, and psychological distress among survivors of the 2013 Super Typhoon Haiyan. Psychiatry Res 2018; 266:284-290. [PMID: 29609982 DOI: 10.1016/j.psychres.2018.03.019] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2017] [Revised: 01/03/2018] [Accepted: 03/07/2018] [Indexed: 01/08/2023]
Abstract
Sleep disturbances and their relation with posttraumatic stress and general psychological distress were examined after the 2013 Super Typhoon Haiyan. Sleep disturbances were hypothesized to be associated with posttraumatic stress and general psychological distress in two samples of survivors across two time points (N = 361) in the Philippines. Sample 1 (n = 223) and Sample 2 (n = 138) were collected 18 months and 30 months after the storm, respectively. Results from structural regression modeling indicated that insomnia was associated with both posttraumatic stress and general psychological distress. Poor sleep quality was associated with posttraumatic stress but not with general psychological distress. Findings underscore the longer-term relationship between sleep disturbances and overall sleep quality to posttraumatic stress in the context of a natural disaster. Implications for public mental health interventions in disaster settings are discussed.
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Affiliation(s)
- Charlie E Labarda
- Department of Psychology, The University of Hong Kong, Hong Kong Special Administrative Region, PRC
| | - Christian S Chan
- Department of Psychology, The University of Hong Kong, Hong Kong Special Administrative Region, PRC.
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18
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DeFraia GS. Workplace Disruption following Psychological Trauma: Influence of Incident Severity Level on Organizations' Post-Incident Response Planning and Execution. THE INTERNATIONAL JOURNAL OF OCCUPATIONAL AND ENVIRONMENTAL MEDICINE 2017; 7:75-86. [PMID: 27112716 PMCID: PMC6816515 DOI: 10.15171/ijoem.2016.746] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/03/2016] [Accepted: 03/08/2016] [Indexed: 11/09/2022]
Abstract
BACKGROUND Psychologically traumatic workplace events (known as critical incidents), which occur globally, are increasing in prevalence within the USA. Assisting employers in their response is a growing practice area for occupational medicine, occupational social work, industrial psychology and other occupational health professions. Traumatic workplace events vary greatly in their level of organizational disruption. OBJECTIVE To explore whether extent of workplace disruption influences organizations' decisions for post-incident response planning and plan execution. METHODS Administrative data mining was employed to examine practice data from a workplace trauma response unit in the USA. Bivariate analyses were conducted to test whether scores from an instrument measuring extent of workplace disruption associated with organizational decisions regarding post-incident response. RESULTS The more severe and disruptive the incident, the more likely organizations planned for and followed through to deliver on-site interventions. Following more severe incidents, organizations were also more likely to deliver group sessions and to complete follow-up consultations to ensure ongoing worker recovery. CONCLUSION Increasing occupational health practitioners' knowledge of varying levels of organizational disruption and familiarity with a range of organizational response strategies improves incident assessment, consultation and planning, and ensures interventions delivered are consistent with the level of assistance needed on both worker and organizational levels.
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Affiliation(s)
- G S DeFraia
- Adjunct Professor, Adelphi University, New York, USA.
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19
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Bell CJ, Colhoun HC, Frampton CM, Douglas KM, McIntosh VVW, Carter FA, Jordan J, Carter JD, Smith RA, Marie LMA, Loughlin A, Porter RJ. Earthquake Brain: Altered Recognition and Misclassification of Facial Expressions Are Related to Trauma Exposure but Not Posttraumatic Stress Disorder. Front Psychiatry 2017; 8:278. [PMID: 29312012 PMCID: PMC5732911 DOI: 10.3389/fpsyt.2017.00278] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/26/2017] [Accepted: 11/28/2017] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVES The study investigated facial expression recognition (FER) in posttraumatic stress disorder (PTSD) caused by exposure to earthquakes, and in particular whether people with this condition showed a bias toward interpreting facial expressions as threat-related emotions (i.e., as anger, fear, or disgust). The study included a trauma-exposed control group who had been similarly exposed to the earthquakes but had not developed PTSD. We hypothesized that individuals with PTSD would have increased sensitivity to threat-related facial emotions compared with the trauma-exposed control group. This would be shown by increased accuracy in recognition of threat-related emotions and the misinterpretation of neutral expressions to these emotions (i.e., misidentifying them as anger, fear, or disgust). The availability of a group of healthy controls from a previous study who had been tested on a similar task before the earthquakes allowed a further non-exposed comparison. METHOD Twenty-eight individuals with PTSD (71% female, mean age 42.8 years) and 89 earthquake-exposed controls (66% female, mean age 50.1 years) completed an FER task, which featured six basic emotions. Further comparisons were made with 50 non-exposed controls (64% female, mean age 38.5 years) who had been tested before the earthquakes. RESULTS There was no difference in sensitivity to threat-related facial expressions (as measured by accuracy in recognition of threat-related facial expressions and the misinterpretation of neutral expressions as threatening) in individuals with PTSD compared with similarly earthquake-exposed controls. Supplementary comparison with an historical, non-exposed control group showed that both earthquake-exposed groups had increased accuracy for the identification of all facial emotions and showed a bias in the misclassification of neutral facial expressions to the threat-related emotions of anger and disgust. CONCLUSION These findings suggest that it is exposure to earthquakes and repeated aftershocks, rather than the presence of PTSD that affects FER accuracy and misinterpretation. The importance of these biases in both PTSD and trauma-exposed controls needs further exploration and is an area for future research.
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Affiliation(s)
- Caroline J Bell
- Department of Psychological Medicine, University of Otago, Christchurch, New Zealand.,Canterbury District Health Board, Christchurch, New Zealand
| | - Helen C Colhoun
- Department of Psychological Medicine, University of Otago, Christchurch, New Zealand.,Canterbury District Health Board, Christchurch, New Zealand
| | - Chris M Frampton
- Department of Psychological Medicine, University of Otago, Christchurch, New Zealand
| | - Katie M Douglas
- Department of Psychological Medicine, University of Otago, Christchurch, New Zealand
| | | | - Frances A Carter
- Department of Psychological Medicine, University of Otago, Christchurch, New Zealand.,Canterbury District Health Board, Christchurch, New Zealand
| | - Jennifer Jordan
- Department of Psychological Medicine, University of Otago, Christchurch, New Zealand.,Canterbury District Health Board, Christchurch, New Zealand
| | - Janet D Carter
- Department of Psychology, University of Canterbury, Christchurch, New Zealand
| | - Rebekah A Smith
- Department of Psychology, University of Canterbury, Christchurch, New Zealand
| | - Leila M A Marie
- Department of Psychology, University of Canterbury, Christchurch, New Zealand
| | - Alex Loughlin
- Department of Psychology, University of Canterbury, Christchurch, New Zealand
| | - Richard J Porter
- Department of Psychological Medicine, University of Otago, Christchurch, New Zealand.,Canterbury District Health Board, Christchurch, New Zealand
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20
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Kaplan BJ, Rucklidge JJ, Romijn AR, Dolph M. A randomised trial of nutrient supplements to minimise psychological stress after a natural disaster. Psychiatry Res 2015; 228:373-9. [PMID: 26154816 DOI: 10.1016/j.psychres.2015.05.080] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/14/2014] [Revised: 04/29/2015] [Accepted: 05/24/2015] [Indexed: 10/23/2022]
Abstract
After devastating flooding in southern Alberta in June 2013, we attempted to replicate a New Zealand randomised trial that showed that micronutrient (minerals, vitamins) consumption after the earthquakes of 2010-11 resulted in improved mental health. Residents of southern Alberta were invited to participate in a study on the potential benefit of nutrient supplements following a natural disaster. Fifty-six adults aged 23-66 were randomised to receive a single nutrient (vitamin D, n=17), a few-nutrients formula (B-Complex, n=21), or a broad-spectrum mineral/vitamin formula (BSMV, n=18). Self-reported changes in depression, anxiety and stress were monitored for six weeks. Although all groups showed substantial decreases on all measures, those consuming the B-Complex and the BSMV formulas showed significantly greater improvement in stress and anxiety compared with those consuming the single nutrient, with large effect sizes (Cohen's d range 0.76-1.08). There were no group differences between those consuming the B-Complex and BSMV. The use of nutrient formulas with multiple minerals and/or vitamins to minimise stress associated with natural disasters is now supported by three studies. Further research should be carried out to evaluate the potential population benefit that might accrue if such formulas were distributed as a post-disaster public health measure.
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Affiliation(s)
- Bonnie J Kaplan
- Department of Paediatrics, Alberta Children's Hospital Research Institute, University of Calgary, Calgary, Canada.
| | - Julia J Rucklidge
- Department of Psychology, University of Canterbury, Christchurch, New Zealand
| | - Amy R Romijn
- Department of Psychology, University of Canterbury, Christchurch, New Zealand
| | - Michael Dolph
- Department of Paediatrics, Alberta Children's Hospital Research Institute, University of Calgary, Calgary, Canada
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21
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DeFraia GS. Psychological Trauma in the Workplace: Variation of Incident Severity among Industry Settings and between Recurring vs Isolated Incidents. THE INTERNATIONAL JOURNAL OF OCCUPATIONAL AND ENVIRONMENTAL MEDICINE 2015; 6:155-68. [PMID: 26174992 PMCID: PMC6977051 DOI: 10.15171/ijoem.2015.545] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/29/2014] [Accepted: 05/03/2015] [Indexed: 11/09/2022]
Abstract
BACKGROUND Psychologically traumatic workplace events (known as critical incidents) occur within various work environments, with workgroups in certain industries vulnerable to multiple incidents. With the increasing prevalence of incidents in the USA, incident response is a growing practice area within occupational medicine, industrial psychology, occupational social work and other occupational health professions. OBJECTIVE To analyze a measure of incident severity based on level of disruption to the workplace and explore whether incident severity varied among different industry settings or between workgroups experiencing multiple vs single traumatic incidents. METHODS Administrative data mining was employed to examine practice data from a workplace trauma response unit in the USA. Bivariate analyses were conducted to test whether scores from an instrument measuring incident severity level varied among industry settings or between workgroups impacted by multiple vs isolated events. RESULTS Incident severity level differed among various industry settings. Banks, retail stores and fast food restaurants accounted for the most severe incidents, while industrial and manufacturing sites reported less severe incidents. Workgroups experiencing multiple incidents reported more severe incidents than workgroups experiencing a single incident. CONCLUSION Occupational health practitioners should be alert to industry differences in several areas: pre-incident resiliency training, the content of business recovery plans, assessing worker characteristics, strategies to assist continuous operations and assisting workgroups impacted by multiple or severe incidents.
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22
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Surgenor LJ, Snell DL, Dorahy MJ. Posttraumatic stress symptoms in police staff 12-18 months after the Canterbury earthquakes. J Trauma Stress 2015; 28:162-6. [PMID: 25847416 DOI: 10.1002/jts.21991] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Understanding posttraumatic stress disorder (PTSD) symptoms in police first-responders is an underdeveloped field. Using a cross-sectional survey, this study investigated demographic and occupational characteristics, coping resources and processes, along with first-responder roles and consequences 18 months following a disaster. Hierarchical linear regression (N = 576) showed that greater symptom levels were significantly positively associated with negative emotional coping (β = .31), a communications role (β = .08) and distress following exposure to resource losses (β = .14), grotesque scenes (β = .21), personal harm (β = .14), and concern for significant others (β = .17). Optimism alone was negatively associated (β = -.15), with the overall model being a modest fit (adjusted R(2) = .39). The findings highlight variables for further study in police.
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Affiliation(s)
- Lois J Surgenor
- Department of Psychological Medicine, University of Otago, Christchurch, New Zealand
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23
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Thormar SB, Gersons BPR, Juen B, Djakababa MN, Karlsson T, Olff M. The impact of disaster work on community volunteers: The role of peri-traumatic distress, level of personal affectedness, sleep quality and resource loss, on post-traumatic stress disorder symptoms and subjective health. J Anxiety Disord 2014; 28:971-7. [PMID: 25445088 DOI: 10.1016/j.janxdis.2014.10.006] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/18/2014] [Revised: 08/21/2014] [Accepted: 10/25/2014] [Indexed: 10/24/2022]
Abstract
Disaster work has shown to cause PTSD symptoms and subjective health complaints in professional emergency personnel. However, very little is known about how disaster work affects community volunteers. This first time longitudinal study examined factors contributing to post-traumatic stress disorder symptoms (PTSD) and subjective health complaints in volunteers working in an earthquake setting. At six and eighteen months post disaster, a sample of 506 Indonesian Red Cross volunteers were assessed using the Impact of Event Scale-Revised and the Subjective Health Complaints Inventory. Factors analyzed in relation to the outcomes included: peri-traumatic distress, level of personal affectedness by the disaster, sleep quality and loss of resources as a consequence of the disaster. At 18 months post-disaster the findings showed high levels of PTSD symptoms and subjective health complaints. Quality of sleep was related to both outcomes but resource loss only to PTSD symptoms. Neither peri-traumatic distress nor level of affectedness by the disaster (external versus directly affected volunteers), were predictive of symptoms. This study indicates that characteristics of disaster work e.g. low quality of sleep, may be an important contributor to PTSD symptoms and subjective health complaints in volunteers.
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Affiliation(s)
- Sigridur B Thormar
- Center for Anxiety Disorders, Department of Psychiatry, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.
| | | | - Barbara Juen
- Department of Psychology, University of Innsbruck, Innsbruck, Austria
| | - Maria Nelden Djakababa
- Department of Psychiatry, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | | | - Miranda Olff
- Arq Psychotrauma Expert Group - Centrum 45, Amsterdam, The Netherlands; Department of Psychiatry, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
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Rucklidge JJ, Blampied N, Gorman B, Gordon HA, Sole E. Psychological functioning 1 year after a brief intervention using micronutrients to treat stress and anxiety related to the 2011 Christchurch earthquakes: a naturalistic follow-up. Hum Psychopharmacol 2014; 29:230-43. [PMID: 24554519 DOI: 10.1002/hup.2392] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/10/2013] [Revised: 12/09/2013] [Accepted: 01/02/2014] [Indexed: 11/05/2022]
Abstract
OBJECTIVE We investigated whether micronutrients given acutely following the Christchurch earthquakes continued to confer benefit 1 year following the treatment. METHODS Sixty-four adults from the original 91 participants experiencing heightened anxiety or stress 2-3 months following the 22nd February 2011 earthquake and who had been randomized to receive three different doses of micronutrients completed on-line questionnaires assessing mood, anxiety, stress, and symptoms associated with post-traumatic stress disorder 1 year after completing the initial study. Twenty-one out of 29 nonrandomized controls who did not receive the treatment also completed the questionnaires. RESULTS Both the treated and control groups experienced significant improvement in psychological functioning compared with end-of-trial. However, treated participants had better long-term outcomes on most measures compared with controls (ES=0.69-1.31). Those who stayed on micronutrients through to follow-up or stopped all treatment reported better psychological functioning than those who switched to other treatments including medications. About 10% of the sample continued to have post-traumatic stress disorder symptoms. CONCLUSIONS Disaster survivors improve psychologically over time regardless of receiving intervention; however, those taking micronutrients during the acute phase following a disaster show better outcomes, identifying micronutrients as a viable treatment for acute stress following a natural disaster with maintenance of benefits 1 year later. ACTRN 12611000460909
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Affiliation(s)
- Julia J Rucklidge
- Department of Psychology, University of Canterbury, Christchurch, New Zealand
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25
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Chan CS, Rhodes JE. Measuring exposure in Hurricane Katrina: a meta-analysis and an integrative data analysis. PLoS One 2014; 9:e92899. [PMID: 24713851 PMCID: PMC3979656 DOI: 10.1371/journal.pone.0092899] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2013] [Accepted: 02/26/2014] [Indexed: 12/21/2022] Open
Abstract
To date there is no consensus on the operationalization of exposure severity in the study of the impact of natural disasters. This is problematic because incomplete and inconsistent measurement of exposure limits the internal and external validity of disaster studies. The current paper examined the predictive validity of severity measures in two interrelated studies of Hurricane Katrina survivors. First, in a meta-analysis of eight studies that measured both exposure severity and posttraumatic stress, the effect size was estimated to be r = .266. The moderating effects of sample and study characteristics were examined and we found that minority status and number of stressors assessed were significant moderators. Second, in an integrative data analysis of five independent samples of Hurricane Katrina survivors, the impact of specific disaster-related stressors on mental health was compared. Threat to physical integrity of self and others were found to have the strongest association with posttraumatic stress (PTS) and general psychological distress (GPD). The lack of basic necessities, such as food, water, and medical care, and loss of pet were also found to be strongly associated with both PTS and GPD. The results from the two studies are integrated and their implication for disaster research and relief are discussed.
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Affiliation(s)
- Christian S Chan
- Department of Psychology, The University of Hong Kong, Hong Kong SAR, China
| | - Jean E Rhodes
- Department of Psychology, University of Massachusetts Boston, Boston, Massachusetts, United States of America
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Thormar SB, Gersons BP, Juen B, Djakababa MN, Karlsson T, Olff M. Organizational factors and mental health in community volunteers. The role of exposure, preparation, training, tasks assigned, and support. ANXIETY STRESS AND COPING 2013. [DOI: 10.1080/10615806.2012.743021] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Hussain A, Weisæth L, Heir T. Posttraumatic stress and symptom improvement in Norwegian tourists exposed to the 2004 tsunami--a longitudinal study. BMC Psychiatry 2013; 13:232. [PMID: 24063414 PMCID: PMC3851444 DOI: 10.1186/1471-244x-13-232] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/27/2012] [Accepted: 09/17/2013] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Mental health consequences of disasters are frequently studied. However, few studies have investigated symptom improvement in victims after natural disasters. This study aimed to identify predictors of 6 months post-disaster stress symptoms and to study 6 months and 24 months course of symptoms among Norwegian tourists who experienced the 2004 tsunami. METHODS Norwegian tourists (≥ 18 years) who experienced the 2004 tsunami (n = 2468) were invited to return a postal questionnaire at two points of time. The first data set was collected at 6 months (T1, n = 899) and the second data set at 24 months post-disaster (T2, n = 1180). The population studied consisted of those who responded at both assessments (n = 674). Impact of Event Scale Revised (IES-R) was used to measure posttraumatic stress symptoms. IES-R score ≥ 33 (caseness) was used to identify various symptom trajectories from T1 to T2. Multiple linear regression was used to determine predictors of posttraumatic stress at T1 and to identify variables associated with symptom improvement from T1 to T2. RESULTS The majority was identified as non-case at both assessments (57.7%), while 20.8% of the respondents were identified as case at both assessments. Symptoms at T1 were positively related to female gender, older age, unemployment, being chased or caught by the waves, witnessing death or suffering, loss of loved ones, experiencing intense fear during the disaster, low conscientiousness, neuroticism and low levels of social support. The IES-R sum score declined from 24.6 (SD = 18.5) at T1 to 22.9 (SD = 18.3) at T2, p < 0.001. Emotional stability and high IES-R scores at T1 were positively related to symptom improvement, while received social support was not. Being referred to a mental health specialist was negatively related to symptom improvement. CONCLUSIONS A significant minority (20-30%) among Norwegian tourists developed enduring posttraumatic stress symptoms in the aftermath of the 2004 tsunami. Tsunami exposure, peritraumatic fear, neuroticism and low levels of social support were the strongest predictors of posttraumatic stress at 6 months post-disaster. Decrease in posttraumatic stress was related to emotional stability and higher symptom levels at T1. Being referred to a mental health specialist did not facilitate symptom improvement.
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Affiliation(s)
- Ajmal Hussain
- Norwegian Centre for Violence and Traumatic Stress Studies, University of Oslo, Postboks 181, Nydalen, Oslo 0409, Norway.
| | - Lars Weisæth
- Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Trond Heir
- Norwegian Centre for Violence and Traumatic Stress Studies, University of Oslo, Postboks 181, Nydalen, Oslo 0409, Norway,Faculty of Medicine, University of Oslo, Oslo, Norway
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Rucklidge JJ, Andridge R, Gorman B, Blampied N, Gordon H, Boggis A. Shaken but unstirred? Effects of micronutrients on stress and trauma after an earthquake: RCT evidence comparing formulas and doses. Hum Psychopharmacol 2012; 27:440-54. [PMID: 22782571 DOI: 10.1002/hup.2246] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2012] [Revised: 05/27/2012] [Accepted: 06/08/2012] [Indexed: 01/30/2023]
Abstract
OBJECTIVE To compare two micronutrient (vitamins and minerals) formulas (Berocca™ and CNE™) and assess their impact on emotions and stress related to the 6.3 earthquake on February 22(nd) 2011 in Christchurch, New Zealand. METHODS 91 adults experiencing heightened anxiety or stress 2-3 months following the earthquake were randomized to Berocca™, CNE™ low dose (CNE4), or CNE™ high dose (CNE8), for 28 days and monitored weekly via on-line questionnaires and followed 1 month post-trial. A nonrandomized control group (n = 25) completed questionnaires at baseline and 4 weeks. RESULTS All treatment groups experienced significant declines in psychological symptoms (p < .001). CNE™ groups experienced greater reduction in intrusive thoughts as compared with Berocca™ (p = .05), with no group differences on other measures of psychological symptoms. However, CNE8 group reported greater improvement in mood, anxiety, and energy (p < .05) with twice as many reporting being "much" to "very much" improved and five times more likely to continue taking CNE™ post-trial than Berocca™ group. Treated participants had better outcomes on most measures over 4 weeks as compared to controls. CONCLUSIONS This study supports micronutrients as an inexpensive and practical treatment for acute stress following a natural disaster with a slight advantage to higher doses ACTRN 12611000460909.
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Affiliation(s)
- Julia J Rucklidge
- Department of Psychology, University of Canterbury, Christchurch, New Zealand.
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Agustini EN, Asniar I, Matsuo H. The prevalence of long-term post-traumatic stress symptoms among adolescents after the tsunami in Aceh. J Psychiatr Ment Health Nurs 2011; 18:543-9. [PMID: 21749561 DOI: 10.1111/j.1365-2850.2011.01702.x] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
The aim of this study was to identify long-term post-traumatic stress disorder (PTSD) symptoms in Aceh 4.5 years after the tsunami and to examine whether certain factors affected the severity of PTSD symptoms among adolescents. The PTSD symptoms of 482 adolescents aged 11 to 19 years were assessed according to the Child Post-Traumatic Stress Reaction Index (CPTSD-RI). The severity of the disaster was identified by the Traumatic Exposure Severity Scale (TESS). Of the adolescents who completed the questionnaire, 54 (11.2%), 124 (25.7%), 196 (40.7%), 103 (21.4%) and 5 (1%), respectively, reported none, mild, moderate, severe and very severe symptoms on CPTSD-RI. Gender, loss of parents, somatic response and support level were significantly associated with the total score on CPTSD-RI (P < 0.05). The TESS-Occurrence Scale and CPTSD-RI were significantly correlated (r= 0.33, P < 0.05). The TESS-Distress Scale was significantly correlated with CPTSD-RI (r= 0.48, P < 0.05). The study indicated that the symptoms of PTSD, ranging from very severe to moderate, could persist for a long time after the tsunami and be affected by gender, loss of parents, somatic response, support level and severity of the disaster.
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Affiliation(s)
- E N Agustini
- Department of Psychiatric Nursing, School of Nursing, Faculty of Medicine and Health Sciences, Syarif Hidayatullah State Islamic University, Ciputat, Indonesia
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Ehring T, Razik S, Emmelkamp PMG. Prevalence and predictors of posttraumatic stress disorder, anxiety, depression, and burnout in Pakistani earthquake recovery workers. Psychiatry Res 2011; 185:161-6. [PMID: 20537401 DOI: 10.1016/j.psychres.2009.10.018] [Citation(s) in RCA: 81] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2009] [Revised: 10/26/2009] [Accepted: 10/27/2009] [Indexed: 11/19/2022]
Abstract
Past research has shown a substantial prevalence of emotional disorders in professionals involved in rescue and/or relief operations following natural disasters, including earthquakes. However, no published study to date has investigated whether disaster rehabilitation and reconstruction workers involved in later phases of the earthquake response are also affected by emotional problems. A nearly complete sample of earthquake rehabilitation and reconstruction workers (N=267) involved in the response to the 2005 earthquake in Northern Pakistan filled in a set of self-report questionnaires assessing emotional problems and predictor variables approximately 24 months after the earthquake. Most participants had experienced the disaster themselves and suffered from a number of stressors during and shortly after the acute earthquake phase. A substantial subgroup of participants reported clinically relevant levels of emotional disorders, especially earthquake-related posttraumatic stress disorder (42.6%), as well as depression and anxiety (approx. 20%). Levels of burnout were low. Symptom levels of posttraumatic stress disorder were associated with the severity of the earthquake experience, past traumas, work-related stressors, low social support, and female gender. The results document a high prevalence of emotional problems in earthquake rehabilitation and recovery workers.
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Affiliation(s)
- Thomas Ehring
- Department of Clinical Psychology, University of Amsterdam, Roetersstraat 15, Amsterdam, The Netherlands.
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Munson MS, Davis TE, Grills-Taquechel AE, Zlomke KR. The Effects of Hurricane Katrina on Females with a Pre-Existing Fear of Storms. CURRENT PSYCHOLOGY 2010. [DOI: 10.1007/s12144-010-9093-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Davis TE, Grills-Taquechel AE, Ollendick TH. The psychological impact from hurricane Katrina: effects of displacement and trauma exposure on university students. Behav Ther 2010; 41:340-9. [PMID: 20569783 PMCID: PMC3374339 DOI: 10.1016/j.beth.2009.09.004] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2009] [Revised: 09/21/2009] [Accepted: 09/23/2009] [Indexed: 11/28/2022]
Abstract
The following study examined the reactions of university students to Hurricane Katrina. A group of 68 New Orleans area students who were displaced from their home universities as a result of the hurricane were matched on race, gender, and age to a sample of 68 students who had been enrolled at Louisiana State University (LSU) prior to the hurricane. All students were enrolled at LSU at the time they participated in an online survey, conducted 3 months following the hurricane. The survey included symptom measures of depression, anxiety, stress, posttraumatic stress disorder (PTSD), and other variables. Results indicated displaced students experienced more trauma exposure and greater subsequent distress, more symptoms of PTSD, and more symptoms of depression. Moreover, traumatic exposure and distress from the traumatic exposure were found to fully mediate depressive symptoms and posttraumatic symptoms in the displaced students.
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Reuther ET, Davis TE, Matthews RA, Munson MS, Grills-Taquechel AE. Fear of anxiety as a partial mediator of the relation between trauma severity and PTSD symptoms. J Trauma Stress 2010; 23:519-22. [PMID: 20684018 DOI: 10.1002/jts.20549] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Fear of anxiety has previously been found to be a predictor of overall symptoms of posttraumatic stress disorder (PTSD). The current exploratory study examines the relationship between fear of anxiety and symptoms of PTSD in a sample of adults exposed to Hurricane Katrina. Fear of anxiety was found to partially mediate the relationship between the severity of trauma and the severity of PTSD. Further, this mediation was found to operate differently by gender, with the mediation holding true for men but not for women. For both men and women, fear of anxiety was positively correlated with PTSD symptoms.
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Affiliation(s)
- Erin T Reuther
- Laboratoryfor Anxiety, Phobia, and Internalizing Disorder Studies, Department of Psychology, Louisiana State University, Baton Rouge, LA 70803, USA.
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Thomson P, Keehn EB, Gumpel TP. Generators and Interpretors in a Performing Arts Population: Dissociation, Trauma, Fantasy Proneness, and Affective States. CREATIVITY RESEARCH JOURNAL 2009. [DOI: 10.1080/10400410802633533] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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