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Onookome-Okome T, Hsu A, Kilpatrick DG, Moreland A, Reuben A. Association of Public Works Disasters with Substance Use Difficulties: Evidence from Flint, Michigan, Five Years after the Water Crisis Onset. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:7090. [PMID: 38063520 PMCID: PMC10706393 DOI: 10.3390/ijerph20237090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/09/2023] [Revised: 11/03/2023] [Accepted: 11/16/2023] [Indexed: 12/18/2023]
Abstract
Public works environmental disasters such as the Flint water crisis typically occur in disenfranchised communities with municipal disinvestment and co-occurring risks for poor mental health (poverty, social disconnection). We evaluated the long-term interplay of the crisis and these factors with substance use difficulties five years after the crisis onset. A household probability sample of 1970 adults living in Flint during the crisis was surveyed about their crisis experiences, use of substances since the crisis, and risk/resilience factors, including prior potentially traumatic event exposure and current social support. Analyses were weighted to produce population-representative estimates. Of the survey respondents, 17.0% reported that substance use since the crisis contributed to problems with their home, work, or social lives, including 11.2% who used despite a doctor's warnings that it would harm their health, 12.3% who used while working or going to school, and 10.7% who experienced blackouts after heavy use. A total of 61.6% of respondents reported using alcohol since the crisis, 32.4% using cannabis, and 5.2% using heroin, methamphetamine, or non-prescribed prescription opioids. Respondents who believed that exposure to contaminated water harmed their physical health were more likely to use substances to the detriment of their daily lives (RR = 1.32, 95%CI: 1.03-1.70), as were respondents with prior potentially traumatic exposure (RR = 2.99, 95%CI: 1.90-4.71), low social support (RR = 1.94, 95%CI: 1.41-2.66), and PTSD and depression (RR's of 1.78 and 1.49, respectively, p-values < 0.01). Public works disasters occurring in disenfranchised communities may have complex, long-term associations with substance use difficulties.
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Affiliation(s)
- Tuviere Onookome-Okome
- Institute for the Environment, University of North Carolina Chapel Hill, Chapel Hill, NC 27517, USA
- Samuel Centre for Social Connectedness, Montréal, QC H3A 0G4, Canada
| | - Angel Hsu
- Institute for the Environment, University of North Carolina Chapel Hill, Chapel Hill, NC 27517, USA
| | - Dean G. Kilpatrick
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC 29425, USA; (D.G.K.); (A.M.)
| | - Angela Moreland
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC 29425, USA; (D.G.K.); (A.M.)
| | - Aaron Reuben
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC 29425, USA; (D.G.K.); (A.M.)
- Department of Psychology & Neuroscience, Duke University, Durham, NC 27708, USA
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2
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Córdoba-Salgado O, Andrews AR, Davidson TM, Galea S, Ruggiero KJ. Longitudinal and bidirectional associations between posttraumatic stress disorder and emotional support among disaster-affected men and women. J Trauma Stress 2023; 36:727-737. [PMID: 37309234 DOI: 10.1002/jts.22949] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Revised: 03/10/2023] [Accepted: 03/10/2023] [Indexed: 06/14/2023]
Abstract
Research has demonstrated a negative association between social support and symptoms of posttraumatic stress disorder (PTSD). This has been interpreted as a protective influence of social support against the development of posttraumatic stress symptoms (PTSS). Research on the opposite association is more limited, but findings suggest that PTSS have a negative impact on social support. There is conflicting evidence that these effects are moderated by gender. Few studies have assessed both associations and gender moderation in a postdisaster context. We examined the longitudinal and bidirectional effects of emotional support and PTSS and whether gender moderates these effects among U.S. survivors of the 2017-2018 season. Participants (N = 1,347) were assessed at four time points over 1 year. Bidirectional effects were assessed using cross-lagged, autoregressive analyses with the combined sample (Model 1) and grouped by gender (Model 2) to assess gender moderation. The results supported small bidirectional negative effects of social support and PTSS on one another from one assessment point (e.g. Wave 1) to the subsequent point (e.g., Wave 2) for all waves, βs = -.07-.15, p < .001-p = .040. Multigroup analyses suggested the effects were not significantly different by gender. Overall, the results suggest that social support and PTSS may mutually diminish one another. Such effects may result in a positive or negative cascade wherein high PTSS may lead to lower social support and, therefore, even higher PTSS and vice versa. These findings support the importance of including social support in interventions to promote PTSS prevention and recovery.
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Affiliation(s)
| | - Arthur R Andrews
- Department of Psychology, University of Nebraska-Lincoln, Lincoln, Nebraska, USA
| | - Tatiana M Davidson
- College of Nursing, Medical University of South Carolina, Charleston, South Carolina, USA
| | - Sandro Galea
- School of Public Health, Boston University, Boston, MA, USA
| | - Kenneth J Ruggiero
- College of Nursing, Medical University of South Carolina, Charleston, South Carolina, USA
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3
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Srinagesh A, Forthal S, Madden SP, Stein LAR, Muench F. Impacts of COVID-19 on alcohol use among help-seeking adults. ADVANCES IN DRUG AND ALCOHOL RESEARCH 2023; 3:11159. [PMID: 38389810 PMCID: PMC10880767 DOI: 10.3389/adar.2023.11159] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/30/2022] [Accepted: 05/02/2023] [Indexed: 02/24/2024]
Abstract
The coronavirus (COVID-19) pandemic has been associated with both increased and decreased alcohol use. Authors explored reasons for increased and decreased alcohol use since the COVID-19 lockdown (March 2020) in a sample of help-seeking adults (HSA) participating in a remote-based alcohol reduction text-messaging intervention in the USA. At the time of recruitment, the HSA in this study were interested in reducing rather than stopping their alcohol consumption. An optional self-report questionnaire was completed by 324 participants (mean age 41.6 ± 10.2 years; 71.5% female; 83.9% White) in February 2021. Survey questions assessed sociodemographic factors, social stressors (quarantine conditions, employment status, changes to daily routine), and drinking patterns. Authors fit two ordinal logistic regression models: one for increased drinking and one for decreased drinking, as functions of the potential predictors and control variables. Most participants (n = 281; 87.0%) reported drinking more than usual since COVID-19 lockdown began. The most common self-reported reasons for drinking more were increased stress/anxiety (74.7%), boredom (69.4%), and spending more time at home (65.5%) whereas reasons for drinking less were less socializing (33.7%) and worrying about how alcohol would impact the immune system (31.5%). Identifying as female, severity of changes to daily routine, and increased access to alcohol were significantly associated with drinking more than usual. These data suggest that the general consequences of the pandemic in the general population (e.g., boredom) led to greater alcohol use among help-seeking adults attempting to reduce their drinking. Identifying these factors may help create more targeted interventions during public health crises.
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Affiliation(s)
- Aradhana Srinagesh
- Department of Psychology, University of Rhode Island, South Kingston, RI, United States
| | - Sarah Forthal
- Partnership to End Addiction, New York, NY, United States
| | - Sean P Madden
- Feinstein Institutes for Medical Research, Northwell Health, Manhasset, NY, United States
| | - L A R Stein
- Department of Psychology, University of Rhode Island, South Kingston, RI, United States
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Cannizzaro E, Cirrincione L, Malta G, Fruscione S, Mucci N, Martines F, Plescia F. The Influence of the COVID-19 Pandemic Emergency on Alcohol Use: A Focus on a Cohort of Sicilian Workers. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:4613. [PMID: 36901622 PMCID: PMC10001951 DOI: 10.3390/ijerph20054613] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/18/2023] [Revised: 03/02/2023] [Accepted: 03/03/2023] [Indexed: 06/18/2023]
Abstract
The period between the beginning and the end of the COVID-19 pandemic emergency generated a general state of stress, affecting both the mental state and physical well-being of the general population. Stress is the body's reaction to events or stimuli perceived as potentially harmful or distressing. Particularly when prolonged over time, it can promote the consumption of different psychotropic substances such as alcohol, and thus the genesis of various pathologies. Therefore, our research aimed to evaluate the differences in alcohol consumption in a cohort of 640 video workers who carried out activities in smart working, subjects particularly exposed to stressful situations due to the stringent rules of protection and prevention implemented during the pandemic. Furthermore, based on the results obtained from the administration of the AUDIT-C, we wanted to analyse the different modes of alcohol consumption (low, moderate, high, severe) to understand whether there is a difference in the amount of alcohol consumed that could predispose individuals to health problems. To this end, we administered the AUDIT-C questionnaire in two periods (T0 and T1), coinciding with annual occupational health specialist visits. The results of the present research showed an increase in the number of subjects consuming alcohol (p = 0.0005) and in their AUDIT-C scores (p < 0.0001) over the period considered. A significant decrease in subgroups who drink in a low-risk (p = 0.0049) mode and an increase in those with high (p = 0.00012) and severe risk (p = 0.0002) were also detected. In addition, comparing the male and female populations, it emerged that males have drinking patterns that lead to a higher (p = 0.0067) health risk of experiencing alcohol-related diseases than female drinking patterns. Although this study provides further evidence of the negative impact of the stress generated by the pandemic emergency on alcohol consumption, the influence of many other factors cannot be ruled out. Further research is needed to better understand the relationship between the pandemic and alcohol consumption, including the underlying factors and mechanisms driving changes in drinking behaviour, as well as potential interventions and support strategies to address alcohol-related harm during and after the pandemic.
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Affiliation(s)
- Emanuele Cannizzaro
- Department of Health Promotion Sciences, Maternal and Child Care, Internal Medicine and Medical Specialties ‘Giuseppe D’Alessandro’, University of Palermo, Via del Vespro 133, 90127 Palermo, Italy
| | - Luigi Cirrincione
- Department of Health Promotion Sciences, Maternal and Child Care, Internal Medicine and Medical Specialties ‘Giuseppe D’Alessandro’, University of Palermo, Via del Vespro 133, 90127 Palermo, Italy
| | - Ginevra Malta
- Department of Health Promotion Sciences, Maternal and Child Care, Internal Medicine and Medical Specialties ‘Giuseppe D’Alessandro’, University of Palermo, Via del Vespro 133, 90127 Palermo, Italy
| | - Santo Fruscione
- Department of Health Promotion Sciences, Maternal and Child Care, Internal Medicine and Medical Specialties ‘Giuseppe D’Alessandro’, University of Palermo, Via del Vespro 133, 90127 Palermo, Italy
| | - Nicola Mucci
- Department of Experimental and Clinical Medicine, University of Florence, Largo Brambilla, 3, 50134 Florence, Italy
| | - Francesco Martines
- Department of Biomedicine, Neuroscience and Advanced Diagnostics (BiND), Section of Audiology, University of Palermo, Via del Vespro 129, 90127 Palermo, Italy
| | - Fulvio Plescia
- Department of Health Promotion Sciences, Maternal and Child Care, Internal Medicine and Medical Specialties ‘Giuseppe D’Alessandro’, University of Palermo, Via del Vespro 133, 90127 Palermo, Italy
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Grossman ER, Sonnenschein S. The Impact of Helping Children with Distance Learning During COVID-19 on U.S. Parents' Alcohol Consumption. JOURNAL OF DRUG EDUCATION 2023; 52:3-15. [PMID: 37434400 PMCID: PMC10345395 DOI: 10.1177/00472379231185125] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/13/2023]
Abstract
We examined the impact of distance learning-related parental stress due to COVID-19 on parental alcohol consumption using an online survey in May 2020 with a convenience sample of U.S. adults. This article focuses on the 361 parents who had children under the age of 18 living with them. Seventy-eight percent had children who were engaged in distance learning; 59% reported being stressed because they were not sure how to help their children with distance learning. Stressed parents reported consuming significantly more alcohol and binge drinking more often than parents who were not stressed by distance learning. We hope that public health professionals can use our findings to better target alcohol prevention programs aimed at parents to reduce parental stress, and hopefully, parental alcohol consumption.
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Affiliation(s)
- Elyse R. Grossman
- National Institute on Drug Abuse, National Institutes of Health, Rockville, MD, USA
| | - Susan Sonnenschein
- Psychology Department, University of Maryland, Baltimore County, Baltimore, MD, USA
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6
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Comorbid posttraumatic stress disorder and alcohol use disorder in low- and middle-income countries: A narrative review. Glob Ment Health (Camb) 2023; 10:e5. [PMID: 36843880 PMCID: PMC9947613 DOI: 10.1017/gmh.2022.63] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/02/2022] [Revised: 11/22/2022] [Accepted: 12/05/2022] [Indexed: 12/14/2022] Open
Abstract
Much of the research on posttraumatic stress disorder (PTSD) and alcohol use disorder (AUD) has been conducted in high-income countries (HICs). However, PTSD and AUD commonly co-occur (PTSD + AUD) are both associated with high global burden of disease, and disproportionately impact those in low- and middle-income countries (LMICs). This narrative review attempts to synthesize the research on prevalence, impact, etiological models, and treatment of PTSD + AUD drawing from research conducted in HICs and discussing the research that has been conducted to date in LMICs. The review also discusses overall limitations in the field, including a lack of research on PTSD + AUD outside of HICs, issues with measurement of key constructs, and limitations in sampling strategies across comorbidity studies. Future directions are discussed, including a need for rigorous research studies conducted in LMICs that focus on both etiological mechanisms and on treatment approaches.
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7
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Ueda Y, Hayashi F, Ohira T, Maeda M, Yasumura S, Miura I, Itagaki S, Shimabukuro M, Nakano H, Kamiya K, Yabe H. A Six-Year Prospective Study on Problem Drinking among Evacuees of the Great East Japan Earthquake: The Fukushima Health Management Survey. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 20:319. [PMID: 36612640 PMCID: PMC9819237 DOI: 10.3390/ijerph20010319] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/29/2022] [Revised: 12/12/2022] [Accepted: 12/16/2022] [Indexed: 06/17/2023]
Abstract
Evacuees of the Great East Japan Earthquake have experienced adverse, long-term physical and psychological effects, including problem drinking. This study examined the risk and recovery factors for problem drinking among evacuees between fiscal years (FY) 2012 and 2017 using data on residents in the evacuation area from the Mental Health and Lifestyle Survey. With the FY 2012 survey as a baseline, a survey comprising 15,976 men and women was conducted in the evacuation area from FY 2013 to FY 2017, examining the risk and protective factors for problem drinking. Particularly, the Cutting down, Annoyed by criticism, Guilty feeling, and Eye-opener (CAGE) questionnaire was used to evaluate problem drinking. Univariate and multivariate Cox proportional hazard models were constructed to identify the risk and recovery factors of problem drinking. The findings indicated that the male gender, insufficient sleep, job change, trauma symptoms, mental illness, family financial issues, and heavy drinking (≥4 drinks per day) were significant risk factors for the incidence of problem drinking among the evacuees. Furthermore, a high blood pressure diagnosis could exacerbate problem drinking among men, while younger age and a diabetes mellitus diagnosis could increase problem drinking among women. Trauma symptoms and heavy drinking inhibited recovery from problem drinking after the disaster. Understanding these factors can shape effective long-term intervention strategies to physically and psychologically support evacuees.
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Affiliation(s)
- Yuka Ueda
- Department of Neuropsychiatry, Fukushima Medical University School of Medicine, Fukushima 960-1295, Japan
| | - Fumikazu Hayashi
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, Fukushima 960-1295, Japan
- Department of Epidemiology, Fukushima Medical University School of Medicine, Fukushima 960-1295, Japan
| | - Tetsuya Ohira
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, Fukushima 960-1295, Japan
- Department of Epidemiology, Fukushima Medical University School of Medicine, Fukushima 960-1295, Japan
| | - Masaharu Maeda
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, Fukushima 960-1295, Japan
- Department of Disaster Psychiatry, Fukushima Medical University School of Medicine, Fukushima 960-1295, Japan
| | - Seiji Yasumura
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, Fukushima 960-1295, Japan
- Department of Public Health, Fukushima Medical University School of Medicine, Fukushima 960-1295, Japan
| | - Itaru Miura
- Department of Neuropsychiatry, Fukushima Medical University School of Medicine, Fukushima 960-1295, Japan
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, Fukushima 960-1295, Japan
| | - Shuntaro Itagaki
- Department of Neuropsychiatry, Fukushima Medical University School of Medicine, Fukushima 960-1295, Japan
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, Fukushima 960-1295, Japan
| | - Michio Shimabukuro
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, Fukushima 960-1295, Japan
- Department of Diabetes, Endocrinology and Metabolism, Fukushima Medical University School of Medicine, Fukushima 960-1295, Japan
| | - Hironori Nakano
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, Fukushima 960-1295, Japan
- Department of Public Health, Fukushima Medical University School of Medicine, Fukushima 960-1295, Japan
| | - Kenji Kamiya
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, Fukushima 960-1295, Japan
| | - Hirooki Yabe
- Department of Neuropsychiatry, Fukushima Medical University School of Medicine, Fukushima 960-1295, Japan
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, Fukushima 960-1295, Japan
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Cedrone F, Buomprisco G, Nicola M, La Torre G, Nieto H, Perri R, Montagna V, Greco E, De Sio S. Alcohol Use during COVID-19 Pandemic: A Cross-Sectional Survey among Healthcare and Office Workers in Italy. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph191912587. [PMID: 36231887 PMCID: PMC9566002 DOI: 10.3390/ijerph191912587] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/21/2022] [Revised: 09/25/2022] [Accepted: 09/27/2022] [Indexed: 06/12/2023]
Abstract
BACKGROUND The aim of our study of a sample of Italian healthcare (HCWs) and office workers (OWs) carried out during the pandemic period was to understand alcohol consumption patterns during the COVID-19 pandemic. METHODS A web-based cross-sectional survey based on Google Forms was developed. Harmful alcohol use was assessed through a validated questionnaire (AUDIT-C). Three multivariate logistic regression models were implemented for the overall sample of HCWs and OWs. The presence of harmful alcohol consumption (AUDIT-C score) was considered as a dependent variable. RESULTS A total of 1745 workers answered the survey. A lower risk of harmful drinking behavior among men overall and in both working groups was found (aOR 0.42, CI 95% 0.33-0.53), but also for both HCWs (aOR 0.62, CI 95% 0.46-0.84) and OWs (aOR 0.17, CI 95% 0.11-0.27). Comparing OWs and HCWs, we found a higher risk of harmful drinking in the first group (aOR 1.62, CI 95% 1.20-2.18). CONCLUSIONS The results of the survey indicate that unhealthy behaviors were elevated during the pandemic. It is urgent to implement company policies managed by an occupational doctor to raise workers' awareness of alcohol-related dangers and provide educational tools that have the task of preventing the damage caused by alcohol.
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Affiliation(s)
- Fabrizio Cedrone
- Hospital Management, Local Health Authority of Pescara, 65122 Pescara, Italy
| | - Giuseppe Buomprisco
- R.U. of Occupational Medicine, “Sapienza” University of Rome, 00185 Rome, Italy
| | - Mucci Nicola
- Department of Experimental and Clinical Medicine, University of Florence, 50134 Florence, Italy
| | - Giuseppe La Torre
- Department of Public Health and Infectious Diseases, “Sapienza” University of Rome, 00185 Rome, Italy
| | - Hector Nieto
- Occupational Medicine School, University of Business and Social Sciences, Buenos Aires C1061 ABA, Argentina
| | - Roberto Perri
- R.U. of Occupational Medicine, “Sapienza” University of Rome, 00185 Rome, Italy
| | - Vincenzo Montagna
- Section of Hygiene, Department of Biomedical Science and Public Health, School of Medicine, Università Politecnica delle Marche, 60126 Ancona, Italy
| | - Emilio Greco
- Faculty of Innovative Technologies for Digital Communication, Link Campus University, Via del Casale di San Pio V 44, 00165 Roma, Italy
| | - Simone De Sio
- R.U. of Occupational Medicine, “Sapienza” University of Rome, 00185 Rome, Italy
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Rosen R, Shao Y, Zhang Q, Bao J, Zhang Y, Masurkar A, Wisniewski T, Urban N, Reibman J. Cognitive Function among World Trade Center-Exposed Community Members with Mental Health Symptoms. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:3440. [PMID: 35329128 PMCID: PMC8948727 DOI: 10.3390/ijerph19063440] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/18/2022] [Revised: 03/10/2022] [Accepted: 03/11/2022] [Indexed: 12/20/2022]
Abstract
The World Trade Center Environmental Health Center (WTC EHC), is a federally designated clinical center of excellence for surveillance and treatment of WTC disaster exposed community members (WTC Survivors). Cognitive impairment (CI) has been extensively described in WTC responders and a concern for progressive impairment in all WTC disaster exposed groups has been raised. Cognitive status, however, has not been systematically characterized in the WTC Survivor population. We describe cognitive status in a subgroup of the Survivor population referred for mental health evaluation (N = 480) in the WTC EHC as measured by scores on the Montreal Cognitive Assessment (MoCA) instrument, and examine their association with WTC exposures and individual-level covariates including PTSD and depression screening inventory scores. In regression analyses, probable cognitive impairment (MoCA score < 26) was found in 59% of the study subjects and was significantly associated with age, race/ethnicity, education, income, depression and PTSD scores. Being caught in the dust cloud on 11 September 2011 was significantly associated with cognitive impairment even after controlling for the above. These data suggest an association with cognitive dysfunction in WTC Survivors with exposure to the toxic dust/fumes and psychological stress from the 9/11 terrorist attack and warrant further systematic study.
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Affiliation(s)
- Rebecca Rosen
- Department of Psychiatry, NYU Grossman School of Medicine, New York, NY 10016, USA;
- World Trade Center Environmental Health Center, NYC Health+Hospitals, New York, NY 10016, USA; (Q.Z.); (J.B.); (Y.Z.); (J.R.)
| | - Yongzhao Shao
- World Trade Center Environmental Health Center, NYC Health+Hospitals, New York, NY 10016, USA; (Q.Z.); (J.B.); (Y.Z.); (J.R.)
- Department of Environmental Medicine, NYU Grossman School of Medicine, New York, NY 10016, USA
- Department of Population Health, NYU Grossman School of Medicine, New York, NY 10016, USA
- NYU Alzheimer’s Disease Research Center, New York, NY 10016, USA; (A.M.); (T.W.)
| | - Qiao Zhang
- World Trade Center Environmental Health Center, NYC Health+Hospitals, New York, NY 10016, USA; (Q.Z.); (J.B.); (Y.Z.); (J.R.)
- Department of Population Health, NYU Grossman School of Medicine, New York, NY 10016, USA
| | - Jia Bao
- World Trade Center Environmental Health Center, NYC Health+Hospitals, New York, NY 10016, USA; (Q.Z.); (J.B.); (Y.Z.); (J.R.)
- Department of Population Health, NYU Grossman School of Medicine, New York, NY 10016, USA
| | - Yian Zhang
- World Trade Center Environmental Health Center, NYC Health+Hospitals, New York, NY 10016, USA; (Q.Z.); (J.B.); (Y.Z.); (J.R.)
- Department of Population Health, NYU Grossman School of Medicine, New York, NY 10016, USA
| | - Arjun Masurkar
- NYU Alzheimer’s Disease Research Center, New York, NY 10016, USA; (A.M.); (T.W.)
- Department of Neurology, NYU Grossman School of Medicine, New York, NY 10016, USA
| | - Thomas Wisniewski
- NYU Alzheimer’s Disease Research Center, New York, NY 10016, USA; (A.M.); (T.W.)
- Department of Neurology, NYU Grossman School of Medicine, New York, NY 10016, USA
| | - Nina Urban
- Department of Psychiatry, NYU Grossman School of Medicine, New York, NY 10016, USA;
- World Trade Center Environmental Health Center, NYC Health+Hospitals, New York, NY 10016, USA; (Q.Z.); (J.B.); (Y.Z.); (J.R.)
| | - Joan Reibman
- World Trade Center Environmental Health Center, NYC Health+Hospitals, New York, NY 10016, USA; (Q.Z.); (J.B.); (Y.Z.); (J.R.)
- Department of Environmental Medicine, NYU Grossman School of Medicine, New York, NY 10016, USA
- Department of Medicine, NYU Grossman School of Medicine, New York, NY 10016, USA
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10
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Kapfhammer HP. [Comorbidity of posttraumatic stress disorder and addiction from a biopsychosocial perspective]. NEUROPSYCHIATRIE : KLINIK, DIAGNOSTIK, THERAPIE UND REHABILITATION : ORGAN DER GESELLSCHAFT OSTERREICHISCHER NERVENARZTE UND PSYCHIATER 2022; 36:1-18. [PMID: 33439473 PMCID: PMC8916999 DOI: 10.1007/s40211-020-00384-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/17/2020] [Accepted: 12/16/2020] [Indexed: 11/18/2022]
Abstract
Posttraumatic stress disorder and substance use disorder often co-occur within the health care system. Their comorbidity is associated with more serious acute clinical symptomatology, more frequent hospital admissions in state of emergency and significantly lower chances of improvement by psychological and pharmacological treatment. Their comorbidity contributes to dramatically unfavourable courses of illness as regards all biopsychosocial levels. The survey presented will discuss empirical findings from various perspectives: general epidemiology, substance use disorder as risk factor of trauma and PTSD, trauma and PTSD as risk factor of SUD, neurobiological effects of SUD converging towards neurobiology of PTSD, shared common factors of genetics/epigenetics, personality traits, and early developmental stress and trauma. The main focus of analysis will be put on processes that are intrinsically linked to the development and course of both disorders.
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Affiliation(s)
- Hans-Peter Kapfhammer
- Universitätsklinik für Psychiatrie und Psychotherapeutische Medizin, Medizinische Universität Graz, Auenbruggerplatz 31, 8036, Graz, Österreich.
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11
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Fedorova EV, Wong CF, Conn BM, Ataiants J, Iverson E, Lankenau SE. COVID-19’s Impact on Substance Use and Well-Being of Younger Adult Cannabis Users in California: A Mixed Methods Inquiry. JOURNAL OF DRUG ISSUES 2021; 52:207-224. [PMID: 35382397 PMCID: PMC8919106 DOI: 10.1177/00220426211052673] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2022]
Abstract
Few qualitative studies have examined the impact of COVID-19 on cannabis and alcohol use, and overall well-being among cannabis users. Cannabis users (aged 26-32) were surveyed quantitatively (n=158) and interviewed qualitatively (n=29) in April 2020–May 2021 in Los Angeles. 63.3% of the quantitative sample reported increasing use of either cannabis (29.1%) or alcohol (15.2%) or both (19.0%) following the COVID-19 outbreak. Qualitative data revealed that increases in cannabis and alcohol use were largely attributed to changes in employment and staying at home resulting in fewer impediments and boredom. Themes of loneliness and utilization of various coping strategies were more pronounced among those who increased cannabis and/or alcohol use. For some, increases in cannabis/alcohol use were temporary until participants adjusted to “a new normal” or embraced more adaptive coping strategies. Results suggest monitoring cannabis/alcohol use trends and identifying coping strategies to reduce the pandemic’s impact on substance use and mental health.
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Affiliation(s)
- Ekaterina V. Fedorova
- Department of Community Health and Prevention, Dornsife School of Public Health, Drexel University, Philadelphia, PA, United States
| | - Carolyn F. Wong
- Department of Pediatrics, Keck School of Medicine, University of Southern California, Los Angeles, CA, United States
- Division of Adolescent Medicine, Children’s Hospital Los Angeles, Los Angeles, CA, United States
- Division of Research on Children, Youth, & Families, Children’s Hospital Los Angeles, Los Angeles, CA, United States
| | - Bridgid M. Conn
- Department of Pediatrics, Keck School of Medicine, University of Southern California, Los Angeles, CA, United States
- Division of Adolescent Medicine, Children’s Hospital Los Angeles, Los Angeles, CA, United States
| | - Janna Ataiants
- Department of Community Health and Prevention, Dornsife School of Public Health, Drexel University, Philadelphia, PA, United States
| | - Ellen Iverson
- Department of Pediatrics, Keck School of Medicine, University of Southern California, Los Angeles, CA, United States
- Division of Adolescent Medicine, Children’s Hospital Los Angeles, Los Angeles, CA, United States
| | - Stephen E. Lankenau
- Department of Community Health and Prevention, Dornsife School of Public Health, Drexel University, Philadelphia, PA, United States
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12
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Adams RE, Boscarino JA, Hoffman SN, Urosevich TG, Kirchner HL, Boscarino JJ, Dugan RJ, Withey CA, Figley CR. Psychological well-being and alcohol misuse among community-based veterans: results from the Veterans' Health Study. J Addict Dis 2021; 40:217-226. [PMID: 34521314 DOI: 10.1080/10550887.2021.1972747] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
BACKGROUND Maladaptive drinking is an increasing concern among military policy makers and healthcare providers. The goal of this study was to assess how social and psychological factors relate to alcohol problems among post-deployed US veterans and how problematic drinking is associated with well-being. METHODS Data were collected via a telephone survey from a random sample of veterans receiving their healthcare from a large non-VA hospital system in central Pennsylvania (N = 1730). Interviewers inquired about participants' current alcohol consumption, using the CAGE and AUDIT-C scales, and health-related outcomes (general psychological distress, major depression, and self-reported health status). Analyses included demographic, military and nonmilitary stressful events, use of alcohol or drugs to cope post-deployment, use of psychiatric services, and personality characteristics as independent variables. Our sample was 95% male, 96% White, and had a mean age of 59 years old (SD = 12 years). RESULTS Analyses included demographic, military and nonmilitary stressful events, use of alcohol or drugs to cope post-deployment, use of psychiatric services, and personality characteristics as independent variables. Our sample was 95% male, 96% White, and had a mean age of 59 years old (SD = 12 years). Analyses for our drinking measures show that those who used drugs or alcohol to cope post-deployment were more likely to be problematic drinkers, while positive personality characteristics such as agreeableness and conscientiousness were related to fewer drinking problems. Multivariate logistic regressions for our well-being measures found that alcohol misuse was not related to distress or depression, but that a positive score on the AUDIT-C was associated with a lower likelihood of poor self-rated health. Using alcohol or drugs to cope was related to higher distress. DISCUSSION We conclude that service providers might consider using post-deployment AUDIT-C and the drugs and alcohol coping questions when screening for possible alcohol and mental health problems among veterans.
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Affiliation(s)
| | - Joseph A Boscarino
- Department of Population Health Sciences, Geisinger Clinic, Danville, PA
| | - Stuart N Hoffman
- Department of Population Health Sciences, Geisinger Clinic, Danville, PA
| | - Thomas G Urosevich
- Department of Population Health Sciences, Geisinger Clinic, Danville, PA
| | - H Lester Kirchner
- Department of Population Health Sciences, Geisinger Clinic, Danville, PA
| | | | - Ryan J Dugan
- Department of Population Health Sciences, Geisinger Clinic, Danville, PA
| | - Carrie A Withey
- Department of Population Health Sciences, Geisinger Clinic, Danville, PA
| | - Charles R Figley
- Tulane Traumatology Institute, Tulane University, New Orleans, LA
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13
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Psychological outcomes for young adults after disastrous events: A mixed-methods scoping review. Soc Sci Med 2021; 276:113851. [PMID: 33812159 DOI: 10.1016/j.socscimed.2021.113851] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Revised: 02/03/2021] [Accepted: 03/13/2021] [Indexed: 12/13/2022]
Abstract
RATIONALE Young adulthood (18 to 34) is a time of transitional change where individuals can be highly susceptible to mental health concerns. Despite similar vulnerabilities to their adolescent counterparts, the psychological outcomes for young adults following disasters are not well understood. OBJECTIVE This scoping review aimed to explore the literature on the psychological outcomes for young adults after disaster events. METHODS A systematic search of the literature was conducted in seven electronic databases, including PsycINFO, Medline, CINAHL, PILOTS, EMBASE, Scopus, and ProQuest dissertations and theses global. In total, 91 reports from 15 countries were included. RESULTS Findings suggested that young adults experience a range of psychological consequences after disasters, including posttraumatic stress symptoms, depression, anxiety, and other psychological outcomes, such as general/non-specific psychological distress. Pre-disaster, peri-disaster, and post-disaster factors were also found to influence the degree of psychological outcomes experienced by young adults, including prior psychological functioning and disaster exposure, among a host of other factors. CONCLUSION Future research is recommended to better understand young adults' psychological outcomes, experiences, and service needs following disasters.
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Grossman ER, Benjamin-Neelon SE, Sonnenschein S. Alcohol Consumption during the COVID-19 Pandemic: A Cross-Sectional Survey of US Adults. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17249189. [PMID: 33316978 PMCID: PMC7763183 DOI: 10.3390/ijerph17249189] [Citation(s) in RCA: 203] [Impact Index Per Article: 50.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/22/2020] [Revised: 11/30/2020] [Accepted: 12/08/2020] [Indexed: 01/24/2023]
Abstract
Emerging but limited evidence suggests that alcohol consumption has increased during the COVID-19 pandemic. This study assessed: (1) whether drinking behaviors changed during the pandemic; and, (2) how those changes were impacted by COVID-19-related stress. We conducted a cross-sectional online survey with a convenience sample of U.S. adults over 21 years in May 2020. We conducted adjusted linear regressions to assess COVID-19 stress and alcohol consumption, adjusting for gender, race, ethnicity, age, and household income. A total of 832 responded: 84% female, 85% White, and 72% ages 26-49. Participants reported consuming 26.8 alcohol drinks on 12.2 of the past 30 days. One-third of participants (34.1%) reported binge drinking and 7.0% reported extreme binge drinking. Participants who experienced COVID-19-related stress (versus not) reported consuming more drinks (β = 4.7; CI (0.2, 9.1); p = 0.040) and a greater number of days drinking (β = 2.4; CI (0.6, 4.1); p = 0.007). Additionally, 60% reported increased drinking but 13% reported decreased drinking, compared to pre-COVID-19. Reasons for increased drinking included increased stress (45.7%), increased alcohol availability (34.4%), and boredom (30.1%). Participants who reported being stressed by the pandemic consumed more drinks over a greater number of days, which raises concerns from both an individual and public health perspective.
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Affiliation(s)
- Elyse R. Grossman
- Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA;
- Advancement Strategy Consulting, LLC, Columbia, MD 21046, USA
- Correspondence: ; Tel.: +1-301-758-0409
| | - Sara E. Benjamin-Neelon
- Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA;
| | - Susan Sonnenschein
- Psychology Department, University of Maryland, Baltimore County, Baltimore, MD 21250, USA;
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15
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Rodriguez LM, Litt DM, Stewart SH. Drinking to cope with the pandemic: The unique associations of COVID-19-related perceived threat and psychological distress to drinking behaviors in American men and women. Addict Behav 2020; 110:106532. [PMID: 32652385 PMCID: PMC7320671 DOI: 10.1016/j.addbeh.2020.106532] [Citation(s) in RCA: 235] [Impact Index Per Article: 58.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2020] [Revised: 06/23/2020] [Accepted: 06/25/2020] [Indexed: 01/02/2023]
Abstract
The 2019 Coronavirus pandemic has brought about significant and unprecedented changes to the modern world, including stay-at-home orders, high rates of unemployment, and more than a hundred thousand deaths across the United States. Derived from the self-medication hypothesis, this research explored how perceived threat and psychological distress related to the COVID-19 pandemic are associated with drinking behavior among an American sample of adults. We also evaluated whether links between COVID-19-related perceived threat and psychological distress with drinking behavior are different for men and women. Participants (N = 754; 50% women) completed an online Qualtrics Panels study between April 17th and 23rd, 2020. Results suggested that psychological distress related to the COVID-19 pandemic was consistently related to alcohol use indices, and moderation results indicated this pattern was significant only among women for number of drinks consumed during the recent heaviest drinking occasion and number of drinks consumed on a typical evening. COVID-related distress' link to frequency of drinking and heavy drinking episodes was not different for men and women. Our results suggest that continued monitoring, particularly among women, should be conducted as this pandemic continues to evolve to identify the long-term public health impacts of drinking to cope with COVID-19 distress.
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Affiliation(s)
| | - Dana M Litt
- University of North Texas Health Science Center, School of Public Health, USA
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16
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Avery AR, Tsang S, Seto EYW, Duncan GE. Stress, Anxiety, and Change in Alcohol Use During the COVID-19 Pandemic: Findings Among Adult Twin Pairs. Front Psychiatry 2020; 11:571084. [PMID: 33088277 PMCID: PMC7544945 DOI: 10.3389/fpsyt.2020.571084] [Citation(s) in RCA: 46] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2020] [Accepted: 09/07/2020] [Indexed: 12/30/2022] Open
Abstract
The novel coronavirus (COVID-19) has impacted the lives of people worldwide since being declared a pandemic on March 11, 2020. Social restrictions aimed at flattening the curve may be associated with an increase in stress and anxiety, which may increase the use of alcohol as a coping mechanism. The objective of this study was to examine if stress and anxiety were associated with changes in alcohol use in a sample of adult twins. Twins allowed us to control for genetic and shared environmental factors that would confound the alcohol - mental health relationship. Twins (N = 3,971; 909 same-sex pairs) from the Washington State Twin Registry (WSTR) completed an online survey examining several health-related behaviors and outcomes and their self-reported changes due to COVID-19. About 14% of the respondents reported an increase in alcohol use. We found an association between both stress and anxiety and increased alcohol use, where twins with higher levels of stress and anxiety were more likely to report an increase in alcohol consumption. The associations were small and confounded by between-family factors and demographic characteristics. However, there was no significant difference in stress or anxiety levels between non-drinkers and those who reported no change in alcohol use. Our findings suggest that individuals' mental health may be associated with changes in alcohol use during the COVID-19 pandemic.
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Affiliation(s)
- Ally R. Avery
- Department of Nutrition and Exercise Physiology, Washington State University, Spokane, WA, United States
| | - Siny Tsang
- Department of Nutrition and Exercise Physiology, Washington State University, Spokane, WA, United States
| | - Edmund Y. W. Seto
- Department of Environmental and Occupational Health Sciences, University of Washington, Seattle, WA, United States
| | - Glen E. Duncan
- Department of Nutrition and Exercise Physiology, Washington State University, Spokane, WA, United States
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17
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Lee JY, Kim SW, Kim JM. The Impact of Community Disaster Trauma: A Focus on Emerging Research of PTSD and Other Mental Health Outcomes. Chonnam Med J 2020; 56:99-107. [PMID: 32509556 PMCID: PMC7250671 DOI: 10.4068/cmj.2020.56.2.99] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2020] [Revised: 03/04/2020] [Accepted: 03/05/2020] [Indexed: 12/12/2022] Open
Abstract
This paper reviews community residents' mental health following exposure to a community disaster trauma, with a focus on post-traumatic stress disorder (PTSD) and other mental health outcomes, such as emotional disorders, behavioral problems including addictive disorders, and personality as a maladaptive trait. This review concludes with recommendations to advance the field of community disaster research by exploring how natural and man-made disasters impact community residents across multiple domains. Moreover, this study suggests that residents impacted by community disaster trauma are frequently appropriate targets for mental health assessments or services in a community setting.
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Affiliation(s)
- Ju-Yeon Lee
- Department of Psychiatry, Chonnam National University Medical School, Gwangju, Korea
| | - Sung-Wan Kim
- Department of Psychiatry, Chonnam National University Medical School, Gwangju, Korea
| | - Jae-Min Kim
- Department of Psychiatry, Chonnam National University Medical School, Gwangju, Korea
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18
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Yun JY, Shim G, Jeong B. Verbal Abuse Related to Self-Esteem Damage and Unjust Blame Harms Mental Health and Social Interaction in College Population. Sci Rep 2019; 9:5655. [PMID: 30948757 PMCID: PMC6449380 DOI: 10.1038/s41598-019-42199-6] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2018] [Accepted: 03/27/2019] [Indexed: 12/14/2022] Open
Abstract
Verbal abuse is an emotional abuse intended to inflict intense humiliation-denigration-fear as perceived by exposed person. Network-based approaches have been applied to explore the integrative-segregated patterns of associations among the psychological features and external stimuli for diverse populations; few studies reported for verbal abuse effects in college population. Self-reporting measurements acquired form 5,616 college students were used for network analyses. Escalating cascades of verbal abuse from differential sources (parents, peers, or supervisors; network 1) and directed associations among verbal abuse severity-psychopathology-social interaction (network 2) were estimated using the directed acyclic graphs. Principal connectors of verbal abuse–psychopathology–social interaction were shown using the graph theory metrics calculated from the intra-individual covariance networks (network 3). Directed propagating patterns of verbal abuse phenomena differed by source (network 1). Severe peer-related verbal abuse affected psychomotor changes and influenced irritability (network 2). Verbal abuse of self-esteem damage and unjust blame served as connectors in the verbal abuse-psychopathology-social interaction; influence of smartphone overuse-related distress was stronger in cases with more severe verbal abuse (network 3). Verbal abuse that damages self-esteem and conveys unjust blame harms mental health and social interaction for college population.
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Affiliation(s)
- Je-Yeon Yun
- Seoul National University Hospital, Seoul, Republic of Korea.,Yeongeon Student Support Center, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Geumsook Shim
- KAIST Clinic Pappalardo Center, Korea Advanced Institute of Science and Technology (KAIST), Daejeon, Korea
| | - Bumseok Jeong
- KAIST Clinic Pappalardo Center, Korea Advanced Institute of Science and Technology (KAIST), Daejeon, Korea. .,Graduate School of Medical Science and Engineering, Korea Advanced Institute of Science and Technology (KAIST), Daejeon, Korea. .,KAIST Institute for Health Science and Technology, KAIST, Daejeon, Korea.
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19
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Adams RE, Urosevich TG, Hoffman SN, Kirchner HL, Figley CR, Withey CA, Boscarino JJ, Dugan RJ, Boscarino JA. Social and Psychological Risk and Protective Factors for Veteran Well-Being: The Role of Veteran Identity and Its Implications for Intervention. ACTA ACUST UNITED AC 2019; 7:304-314. [PMID: 31363423 PMCID: PMC6666406 DOI: 10.1080/21635781.2019.1580642] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Social psychological theory hypothesizes that one’s identity, self-definitions, and meanings used for a particular social role fosters individual purpose in life and affects behavior in specific social situations. As such, it can be protective against the onset of psychological disorders. We examined this hypothesis with data collected from 1,730 military veterans recruited to study the health effects of warzone deployments. The sample was primarily male, older, and White. Our key independent variable was a Likert scale rating the prominence of a respondent’s veteran identity: how important it is to the person. Outcome variables included posttraumatic stress disorder (PTSD), suicide ideation, depression, alcohol misuse, and use of VA services. Bivariate analysis suggested that veterans with a prominent veteran identity are older, noncollege graduates, have less income, and had their first deployment to Vietnam. In multivariate analyses, study participants with a prominent veteran identity were less likely to exhibit suicide ideation, but more likely to misuse alcohol and use VA services. We found no differences for PTSD, self-rated health, or depression by veteran identity. Veterans who scored higher on the veteran identity scale appeared to be protected from suicidal thoughts, although they had an elevated risk for alcohol misuse.
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Affiliation(s)
| | | | | | - H Lester Kirchner
- Department of Biomedical and Translational Informatics, Geisinger Clinic, Danville, Pennsylvania
| | - Charles R Figley
- Traumatology Institute and School of Social Work, Tulane University, New Orleans, Louisiana
| | - Carrie A Withey
- Department of Epidemiology & Health Services Research, Geisinger Clinic, Danville, Pennsylvania
| | - Joseph J Boscarino
- Department of Clinical Psychology, William James College, Newton, Massachusetts
| | - Ryan J Dugan
- Department of Epidemiology & Health Services Research, Geisinger Clinic, Danville, Pennsylvania
| | - Joseph A Boscarino
- Department of Epidemiology & Health Services Research, Geisinger Clinic, Danville, Pennsylvania
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20
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Cusack SE, Hicks TA, Bourdon J, Sheerin CM, Overstreet CM, Kendler KS, Dick DM, Amstadter AB. Prevalence and predictors of PTSD among a college sample. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2019; 67:123-131. [PMID: 29652647 PMCID: PMC6186195 DOI: 10.1080/07448481.2018.1462824] [Citation(s) in RCA: 41] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/11/2018] [Revised: 03/16/2018] [Accepted: 04/05/2018] [Indexed: 05/21/2023]
Abstract
OBJECTIVE This study examined the prevalence and correlates of probable posttraumatic stress disorder (PTSD) in freshman entering college and prospective associations of probable PTSD with additional outcomes. PARTICIPANTS 2,310 students with data collected from Fall 2014 through Spring 2015. METHODS Incoming freshman completed a survey assessing for relevant variables at the beginning of fall semester and during the spring semester. RESULTS Seventy percent of the sample endorsed experiencing at least one potentially traumatic event (PTE). 34.4% of PTE exposed individuals met criteria for probable PTSD. Female sex, higher depressive and anxiety symptoms, and interpersonal PTE count were positively associated with PTSD symptoms. Higher PTSD symptoms were associated with higher anxiety and depressive symptoms, and new-onset interpersonal PTE. CONCLUSIONS Identification of factors contributing to risk for PTSD is essential to inform prevention and intervention efforts. Intervention efforts should be targeted to students experiencing PTSD symptoms as they enter college.
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Affiliation(s)
- Shannon E Cusack
- a Virginia Institute for Psychiatric and Behavioral Genetics , Richmond , Virginia , USA
- b Department of Psychology , Virginia Commonwealth University , Richmond , Virginia , USA
| | - Terrell A Hicks
- a Virginia Institute for Psychiatric and Behavioral Genetics , Richmond , Virginia , USA
- b Department of Psychology , Virginia Commonwealth University , Richmond , Virginia , USA
| | - Jessica Bourdon
- a Virginia Institute for Psychiatric and Behavioral Genetics , Richmond , Virginia , USA
| | - Christina M Sheerin
- a Virginia Institute for Psychiatric and Behavioral Genetics , Richmond , Virginia , USA
| | - Cassie M Overstreet
- a Virginia Institute for Psychiatric and Behavioral Genetics , Richmond , Virginia , USA
- b Department of Psychology , Virginia Commonwealth University , Richmond , Virginia , USA
| | - Kenneth S Kendler
- a Virginia Institute for Psychiatric and Behavioral Genetics , Richmond , Virginia , USA
- c Department of Human and Molecular Genetics , Virginia Commonwealth University , Richmond , Virginia , USA
| | - Danielle M Dick
- b Department of Psychology , Virginia Commonwealth University , Richmond , Virginia , USA
- c Department of Human and Molecular Genetics , Virginia Commonwealth University , Richmond , Virginia , USA
| | - Ananda B Amstadter
- a Virginia Institute for Psychiatric and Behavioral Genetics , Richmond , Virginia , USA
- b Department of Psychology , Virginia Commonwealth University , Richmond , Virginia , USA
- c Department of Human and Molecular Genetics , Virginia Commonwealth University , Richmond , Virginia , USA
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21
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Alexander AC, Ward KD, Forde DR, Stockton M. Are posttraumatic stress and depressive symptoms pathways to smoking relapse after a natural disaster? Drug Alcohol Depend 2019; 195:178-185. [PMID: 30455073 PMCID: PMC8581624 DOI: 10.1016/j.drugalcdep.2018.09.025] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/26/2018] [Revised: 09/11/2018] [Accepted: 09/14/2018] [Indexed: 10/27/2022]
Abstract
BACKGROUND Smoking relapse is rarely examined in disaster research. Thus, this study investigated smoking relapse nine and eighteen months after Hurricane Katrina and identified pathways and conditions for this outcome. METHODS The data came from a prospective study of adult ever smokers who were living in New Orleans at the time Hurricane Katrina struck (n = 1003), and a comparison sample of Memphis residents (n = 1001) who were not directly impacted by the hurricane. Participants from both cities were recruited using random digit dialing and were surveyed nine and eighteen months after Hurricane Katrina. We assessed whether smoking relapse rates differed by city and evaluated potential mediators and moderators of this association using conditional process analysis. RESULTS Though the probabilities of smoking relapse, posttraumatic stress, and depressive symptoms were higher among New Orleans than Memphis participants, hurricane exposure did not indirectly affect smoking relapse through increases in posttraumatic stress and depressive symptoms. Instead, as the number of hurricane-related events increased so to did the probability of smoking relapse through increases in depressive (β = 0.08, SE = 0.03, p = .02) and posttraumatic stress symptoms (β=0.08, SE=0.04, p = .04). Social support lowered the probability of smoking relapse by protecting against increases in depressive and posttraumatic stress symptoms. CONCLUSIONS Posttraumatic stress and depressive symptoms mediated the effects of disaster exposure on smoking relapse, and this effect was most pronounced among survivors who reported disaster-related stressors. Former smokers heavily exposed to disasters may benefit from postdisaster interventions that reduce depressive and posttraumatic stress symptoms, which may prevent smoking relapse.
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Affiliation(s)
- Adam C. Alexander
- School of Public Health, University of Memphis, 201 Robison Hall, Memphis, Tennessee, United States, 38152-3450
| | - Kenneth D. Ward
- School of Public Health, University of Memphis, 201 Robison Hall, Memphis, Tennessee, United States, 38152-3450
| | - David R. Forde
- Department of Criminology & Criminal Justice, University of North Florida, 1 UNF Drive, Jacksonville, Florida, United States, 32224
| | - Michelle Stockton
- School of Health Studies, University of Memphis, 106 Fieldhouse, Memphis, Tennessee, United States, 38152-3450
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Hirst A, Miller-Archie SA, Welch AE, Li J, Brackbill RM. Post-9/11 drug- and alcohol- related hospitalizations among World Trade Center Health Registry enrollees, 2003-2010. Drug Alcohol Depend 2018; 187:55-60. [PMID: 29627406 DOI: 10.1016/j.drugalcdep.2018.01.028] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2017] [Revised: 01/25/2018] [Accepted: 01/30/2018] [Indexed: 10/17/2022]
Abstract
OBJECTIVE To describe patterns of drug- and alcohol-related hospitalizations among persons exposed to the 2001 World Trade Center (WTC) terrorist attacks and to assess whether 9/11-related exposures or post-9/11 post-traumatic stress disorder (PTSD) were associated with increased odds of hospitalization. METHODS Data for adult enrollees in the WTC Health Registry, a prospective cohort study, were linked to New York State (NYS) administrative hospitalization data to identify alcohol- and drug-related hospitalizations from enrollment to December 31, 2010. Logistic regression was used to analyze the associations between substance use-related hospitalization, 9/11-related exposure and PTSD. RESULTS Of 41,176 NYS resident enrollees, we identified 626 (1.5%) who had at least one alcohol- or drug-related hospitalization; 53.4% (n = 591) of these hospitalizations were for alcohol only diagnoses and 46.6% (n = 515) were drug-related. Witnessing ≥3 traumatic events on 9/11 was significantly associated with having a drug-related hospitalization (AOR 1.4, 95% CI = [1.1, 1.9]). PTSD was significantly associated with both having a drug-related hospitalization as well as an alcohol only-related hospitalization. (AOR 2.6, 95% CI = [2.0, 3.3], AOR 1.8, 95% CI = [1.4, 2.3], respectively). CONCLUSIONS Witnessing traumatic events and having PTSD were independently associated with substance use-related hospitalizations. Targeting people who witnessed traumatic events on 9/11 and/or who have PTSD for substance use- treatment could reduce alcohol and drug-related hospitalizations connected to 9/11.
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Affiliation(s)
- Andrew Hirst
- World Trade Center Health Registry, New York City Department of Health and Mental Hygiene, 125 Worth St. CN-6W, New York, NY 10013, United States
| | - Sara A Miller-Archie
- World Trade Center Health Registry, New York City Department of Health and Mental Hygiene, 125 Worth St. CN-6W, New York, NY 10013, United States.
| | - Alice E Welch
- World Trade Center Health Registry, New York City Department of Health and Mental Hygiene, 125 Worth St. CN-6W, New York, NY 10013, United States
| | - Jiehui Li
- World Trade Center Health Registry, New York City Department of Health and Mental Hygiene, 125 Worth St. CN-6W, New York, NY 10013, United States
| | - Robert M Brackbill
- World Trade Center Health Registry, New York City Department of Health and Mental Hygiene, 125 Worth St. CN-6W, New York, NY 10013, United States
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Alexander AC, Ward KD. Understanding Postdisaster Substance Use and Psychological Distress Using Concepts from the Self-Medication Hypothesis and Social Cognitive Theory. J Psychoactive Drugs 2017; 50:177-186. [PMID: 29125424 DOI: 10.1080/02791072.2017.1397304] [Citation(s) in RCA: 42] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
This article applies constructs from the Self-Medication Hypothesis and Social Cognitive Theory to explain the development of substance use and psychological distress after a disaster. A conceptual model is proposed, which employs a sequential mediation model, identifying perceived coping self-efficacy, psychological distress, and self-medication as pathways to substance use after a disaster. Disaster exposure decreases perceived coping self-efficacy, which, in turn, increases psychological distress and subsequently increases perceptions of self-medication in vulnerable individuals. These mechanisms lead to an increase in postdisaster substance use. Last, recommendations are offered to encourage disaster researchers to test more complex models in studies on postdisaster psychological distress and substance use.
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Affiliation(s)
- Adam C Alexander
- a Graduate Assistant, Division of Social and Behavioral Sciences, School of Public Health , University of Memphis , Memphis , TN , USA
| | - Kenneth D Ward
- b Professor, Division of Social and Behavioral Sciences, School of Public Health , University of Memphis , Memphis , TN , USA
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Gargano LM, Nguyen A, DiGrande L, Brackbill RM. Mental health status of World Trade Center tower survivors compared to other survivors a decade after the September 11, 2001 terrorist attacks. Am J Ind Med 2016; 59:742-51. [PMID: 27582476 DOI: 10.1002/ajim.22636] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/11/2016] [Indexed: 11/10/2022]
Abstract
BACKGROUND Studies of individuals directly exposed to the World Trade Center (WTC) terrorist attacks of September 11, 2001 have found increased risk for post-traumatic stress disorder (PTSD) and binge drinking (BD). No long-term studies have been conducted on one highly exposed group, WTC tower evacuees. METHODS The study sample included 7,695 adult civilians in the WTC Health Registry. Logistic regression was used to examine the odds of PTSD and BD in 1,946 towers evacuees compared to 5,749 others in nearby buildings or on the street. RESULTS WTC tower survivors were at increased risk for PTSD and BD compared to the others. Infrastructure and behavioral barriers experienced during evacuation were significantly associated with PTSD. CONCLUSIONS WTC tower evacuees are at increased risk for PTSD and BD. Understanding the effects of disaster-related evacuation barriers on the long-term mental health status of survivors can help in the planning of continuing post-disaster treatment. Am. J. Ind. Med. 59:742-751, 2016. © 2016 Wiley Periodicals, Inc.
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Affiliation(s)
- Lisa M. Gargano
- Division of Epidemiology; New York City Department of Health and Mental Hygiene; World Trade Center Health Registry; Queens New York
| | - Angela Nguyen
- Division of Epidemiology; New York City Department of Health and Mental Hygiene; World Trade Center Health Registry; Queens New York
| | - Laura DiGrande
- Department of Sociology and Anthropology; Farmingdale State College; State University of New York; Farmingdale New York
| | - Robert M. Brackbill
- Division of Epidemiology; New York City Department of Health and Mental Hygiene; World Trade Center Health Registry; Queens New York
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Lee YC, Agnew-Blais J, Malspeis S, Keyes K, Costenbader K, Kubzansky LD, Roberts AL, Koenen KC, Karlson EW. Post-Traumatic Stress Disorder and Risk for Incident Rheumatoid Arthritis. Arthritis Care Res (Hoboken) 2016; 68:292-8. [PMID: 26239524 PMCID: PMC4740283 DOI: 10.1002/acr.22683] [Citation(s) in RCA: 67] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2014] [Revised: 06/24/2015] [Accepted: 07/28/2015] [Indexed: 12/12/2022]
Abstract
OBJECTIVE To examine the association between symptoms of post-traumatic stress disorder (PTSD) and rheumatoid arthritis (RA) risk in a prospective cohort and to characterize the role of smoking in this relationship. METHODS A subset (n = 54,224) of the Nurses' Health Study II, a prospective cohort of female nurses, completed the Brief Trauma Questionnaire and a screen for PTSD symptoms. Participants were categorized based on trauma exposure and number of PTSD symptoms. Incident RA cases (n = 239) from 1989 to 2011 were identified. Cox proportional hazards models were used to calculate hazard ratios (HRs) and 95% confidence intervals (95% CIs) between PTSD symptoms and incident RA. To identify the impact of smoking, secondary and subgroup analyses were performed. In all analyses, PTSD and smoking were lagged 2 years before the development of RA. RESULTS Compared to no history of trauma/PTSD symptoms, the HR for ≥4 PTSD symptoms and incident RA was 1.76 (95% CI 1.16-2.67) in models adjusted for age, race, and socioeconomic status. The risk for RA increased with an increasing number of PTSD symptoms (P = 0.01). When smoking was added to the model, the HR for RA remained elevated (HR 1.60 [95% CI 1.05-2.43]). In a subgroup analysis, excluding women who smoked before PTSD onset, results were unchanged (HR 1.68 [95% CI 1.04-2.70]). CONCLUSION This study suggests that women with high PTSD symptomatology have an elevated risk for RA, independent of smoking, adding to emerging evidence that stress is an important determinant of physical health.
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Affiliation(s)
- Yvonne C. Lee
- Division of Rheumatology, Immunology and Allergy, Harvard Medical School, Brigham and Women’s Hospital, 75 Francis Street, PBB-B3, Boston, MA 02115, USA
| | | | - Susan Malspeis
- Division of Rheumatology, Immunology and Allergy, Harvard Medical School, Brigham and Women’s Hospital, 75 Francis Street, PBB-B3, Boston, MA 02115, USA
| | - Katherine Keyes
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY
| | - Karen Costenbader
- Division of Rheumatology, Immunology and Allergy, Harvard Medical School, Brigham and Women’s Hospital, 75 Francis Street, PBB-B3, Boston, MA 02115, USA
| | - Laura D. Kubzansky
- Department of Social and Behavioral Sciences, Harvard School of Public Health, Boston, MA
| | - Andrea L. Roberts
- Department of Social and Behavioral Sciences, Harvard School of Public Health, Boston, MA
| | - Karestan C. Koenen
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY
| | - Elizabeth W. Karlson
- Division of Rheumatology, Immunology and Allergy, Harvard Medical School, Brigham and Women’s Hospital, 75 Francis Street, PBB-B3, Boston, MA 02115, USA
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Boscarino JA, Hoffman SN, Pitcavage JM, Urosevich TG. Mental Health Disorders and Treatment Seeking Among Veterans in Non-VA Facilities: Results and Implications from the Veterans' Health Study. ACTA ACUST UNITED AC 2015; 3:244-254. [PMID: 26640743 DOI: 10.1080/21635781.2015.1077179] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/09/2022]
Abstract
We surveyed 700 veterans who were outpatients in a non-Veterans Affairs (VA) multihospital system. Our objective was to assess the prevalence of mental disorders and service use among these veterans. The majority were Vietnam veterans (72.0%), and male (95.9%), and 40.4% reported recently using the VA for care. The prevalence of lifetime post-traumatic stress disorder (PTSD) was 9.6%, lifetime depression 18.4%, and lifetime mental health service use 50.1%. In multivariate analyses, significant factors associated with PTSD, depression, and mental health service use were low self-esteem, use of alcohol/drugs to cope, history of childhood adversity, high combat exposure, and low psychological resilience. VA service use was associated with greater mental health service use and combat exposure. With the exception of alcohol misuse, the mental health status of veterans seen in non-VA facilities appeared to be better than reported in past studies. Because most veterans have access to both VA and non-VA services, these findings have implications for veterans and outcomes research.
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A. Crane M, Levy-Carrick NC, Crowley L, Barnhart S, Dudas M, Onuoha U, Globina Y, Haile W, Shukla G, Ozbay F. The Response to September 11: A Disaster Case Study. Ann Glob Health 2014; 80:320-31. [DOI: 10.1016/j.aogh.2014.08.215] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
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Abstract
A large existing academic disaster mental health literature provides a foundation to help guide disaster mental health response. Recent studies, however, have indicated that reconceptualization of certain mental health aspects of disasters may be indicated to guide further research to inform the planning and implementation of disaster mental health interventions. In particular, there is need to more carefully measure specific postdisaster disorders and syndromes using full diagnostic assessments, differentiate pre-existing from incident (new) postdisaster psychopathology, appropriately consider disaster trauma exposure groups in assessing psychopathology, and conduct prospective follow-up assessments over time from the acute postdisaster period to the long term. Further descriptive and longitudinal research is needed to better characterize the occurrence and course of fully-assessed psychiatric disorders after different disasters, clarify the role of disaster trauma exposures in the development of postdisaster psychopathology, and deconstruct confounding effects in determination of causalities in mental health consequences of disasters.
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Abler LA, Sikkema KJ, Watt MH, Eaton LA, Choi KW, Kalichman SC, Skinner D, Pieterse D. Longitudinal cohort study of depression, post-traumatic stress, and alcohol use in South African women who attend alcohol serving venues. BMC Psychiatry 2014; 14:224. [PMID: 25095874 PMCID: PMC4149269 DOI: 10.1186/s12888-014-0224-9] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/21/2014] [Accepted: 07/23/2014] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND In South Africa, alcohol use poses a public health burden. Hazardous alcohol use often co-occurs with psychological distress (e.g., depression and post-traumatic stress). However, the majority of the research establishing the relationship between alcohol use and psychological distress has been cross-sectional, so the nature of co-occurring changes in psychological distress and alcohol use over time is not well characterized. The objective of this study is to examine the longitudinal relationship between psychological distress and alcohol use among South African women who attend alcohol serving venues. METHODS Four waves of data were collected over the course of a year from 560 women in a Cape Town township who attended drinking venues. At each assessment wave, participants reported depressive symptoms, post-traumatic stress symptoms, and alcohol use. Multilevel growth models were used to: 1) assess the patterns of alcohol use; 2) examine how depressive symptoms uniquely, post-traumatic stress symptoms uniquely, and depressive and post-traumatic stress symptoms together were associated with alcohol use; and 3) characterize the within person and between person associations of depressive symptoms and post-traumatic stress symptoms with alcohol use. RESULTS Women reported high levels of alcohol use throughout the study period, which declined slightly over time. Post-traumatic stress symptoms were highly correlated with depressive symptoms. Modeled separately, both within person and between person depressive and post-traumatic stress symptoms were uniquely associated with alcohol use. When modeled together, significant between person effects indicated that women who typically have more post-traumatic stress symptoms, when controlling for depressive symptoms, are at risk for increased alcohol use; however, women with more depressive symptoms, controlling for post-traumatic stress symptoms, do not have differential risk for alcohol use. Significant within person effects indicated an interaction between depressive and post-traumatic stress symptoms; women reported more alcohol use than usual at times when they had higher post-traumatic stress symptoms, and this increase in alcohol use was further exacerbated for women who also had higher depressive symptoms than usual. CONCLUSIONS These findings suggest that interventions targeting post-traumatic stress, especially when post-traumatic stress is comorbid with depression, may reduce alcohol use among South African women who drink.
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Affiliation(s)
- Laurie A Abler
- Duke Global Health Institute, Duke University, Duke Box 90519, 27708 Durham, NC USA
| | - Kathleen J Sikkema
- Duke Global Health Institute, Duke University, Duke Box 90519, 27708 Durham, NC USA ,Department of Psychology and Neuroscience, Duke University, Durham, NC USA
| | - Melissa H Watt
- Duke Global Health Institute, Duke University, Duke Box 90519, 27708 Durham, NC USA
| | - Lisa A Eaton
- Department of Human Development and Family Studies, University of Connecticut, Storrs, CT USA
| | - Karmel W Choi
- Department of Psychology and Neuroscience, Duke University, Durham, NC USA
| | - Seth C Kalichman
- Department of Psychology, University of Connecticut, Storrs, CT USA
| | - Donald Skinner
- Unit for Research on Health and Society, Stellenbosch University, Tygerberg, South Africa
| | - Desiree Pieterse
- Unit for Research on Health and Society, Stellenbosch University, Tygerberg, South Africa
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Welch AE, Caramanica K, Maslow CB, Cone JE, Farfel MR, Keyes KM, Stellman SD, Hasin DS. Frequent binge drinking five to six years after exposure to 9/11: findings from the World Trade Center Health Registry. Drug Alcohol Depend 2014; 140:1-7. [PMID: 24831753 PMCID: PMC4154498 DOI: 10.1016/j.drugalcdep.2014.04.013] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/08/2014] [Revised: 04/16/2014] [Accepted: 04/17/2014] [Indexed: 02/04/2023]
Abstract
BACKGROUND Exposure to 9/11 may have considerable long-term impact on health behaviors, including increased alcohol consumption. We examined the association between frequent binge drinking, posttraumatic stress disorder (PTSD), and number of 9/11-specific experiences among World Trade Center Health Registry (Registry) enrollees five-to-six years after 9/11. METHODS Participants included 41,284 lower Manhattan residents, workers, passers-by, and rescue/recovery workers aged 18 or older without a pre-9/11 PTSD diagnosis who completed Wave 1 (2003-2004) and Wave 2 (2006-2007) interviews. Frequent binge drinking was defined as consuming five or more drinks on five or more occasions in the prior 30 days at Wave 2. Probable PTSD was defined as scoring 44 or greater on the PTSD Checklist. 9/11 exposure was measured as the sum of 12 experiences and grouped as none/low (0-1), medium (2-3), high (4-5) and very high (6+). RESULTS Frequent binge drinking was significantly associated with increasing 9/11 exposure and PTSD. Those with very high and high exposures had a higher prevalence of frequent binge drinking (13.7% and 9.8%, respectively) than those with medium and low exposures (7.5% and 4.4%, respectively). Upon stratification, very high and high exposures were associated with frequent binge drinking in both the PTSD and no PTSD subgroups. CONCLUSIONS Our findings suggest that 9/11 exposure had an impact on frequent binge drinking five-to-six years later among Registry enrollees. Understanding the effects of traumatic exposure on alcohol use is important to identify risk factors for post-disaster alcohol misuse, inform policy, and improve post-disaster psychological and alcohol screening and counseling.
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Affiliation(s)
- Alice E Welch
- New York City Department of Health and Mental Hygiene, 42-09 28th Street, 07-24, Queens, NY 11101, USA.
| | - Kimberly Caramanica
- New York City Department of Health and Mental Hygiene, 42-09 28th Street, 07-24, Queens, NY 11101, USA
| | - Carey B Maslow
- New York City Department of Health and Mental Hygiene, 42-09 28th Street, 07-24, Queens, NY 11101, USA
| | - James E Cone
- New York City Department of Health and Mental Hygiene, 42-09 28th Street, 07-24, Queens, NY 11101, USA
| | - Mark R Farfel
- New York City Department of Health and Mental Hygiene, 42-09 28th Street, 07-24, Queens, NY 11101, USA
| | - Katherine M Keyes
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY 10032, USA; Department of Psychiatry, College of Physicians and Surgeons, Columbia University, New York, NY, 10032, USA
| | - Steven D Stellman
- New York City Department of Health and Mental Hygiene, 42-09 28th Street, 07-24, Queens, NY 11101, USA; Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY 10032, USA
| | - Deborah S Hasin
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY 10032, USA
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North CS, Adinoff B, Pollio DE, Kinge S, Downs DL, Pfefferbaum B. Alcohol use disorders and drinking among survivors of the 9/11 attacks on the World Trade Center in New York City. Compr Psychiatry 2013; 54:962-9. [PMID: 23642636 DOI: 10.1016/j.comppsych.2013.03.027] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2012] [Revised: 03/16/2013] [Accepted: 03/19/2013] [Indexed: 10/26/2022] Open
Abstract
Research on the relationship of alcohol and disasters has yielded mixed conclusions. Some studies investigate alcohol consumption but others examine alcohol use disorders in relation to disaster. Alcohol consumption and alcohol use disorders have not be studied concurrently in relation to specific disaster trauma exposures. A volunteer sample of 379 individuals from New York City agencies affected by the September 11, 2001 (9/11) attacks on World Trade Center were assessed approximately 3years postdisaster for alcohol consumption and alcohol use disorders relative to specific disaster exposures. Increases in alcohol consumption were relatively small, eventually returning to pre-9/11 levels, with few cases of new alcohol use disorders or alcohol relapse. The findings suggest that postdisaster alcohol use has negligible clinical relevance for most of the population. Scarce disaster resources should be focused on those at identified risk of excessive alcohol use, that is, those with pre-existing alcohol or other psychiatric disorders.
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Affiliation(s)
- Carol S North
- The VA North Texas Health Care System, Dallas, TX, USA; The University of Texas Southwestern Medical Center, Departments of Psychiatry and Surgery/Division of Emergency Medicine, Dallas, TX, USA.
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Abstract
BACKGROUND Short sleep and weight gain are inversely related. Sleep deprivation acutely increases food intake but little is known about eating behavior in chronically sleep-deprived, obese individuals. OBJECTIVE To characterize the relationship between sleep, food intake and alcohol consumption under free-living conditions in obese, chronically sleep-deprived individuals. DESIGN Cross-sectional study of a cohort of obese men and premenopausal women. SUBJECTS A total of 118 obese subjects (age: 40.3±6.7 years; 91 females/27 males; body mass index 38.7±6.4 kg m(-2)). MEASUREMENTS Energy, macronutrient, alcohol and caffeine intake assessed by 3-day food records. Sleep duration estimated by actigraphy. Respiratory disturbance index assessed by a portable device. RESULTS SUBJECTS slept 360.7±50.2 min per night and had a total energy intake of 2279.1±689 kcal per day. Sleep duration and energy intake were inversely related (r=-0.230, P=0.015). By extrapolation, each 30-min deficit per day in sleep duration would translate to an ∼83 kcal per day increase in energy intake. In addition, sleep apnea was associated with a shift from carbohydrate to fat intake. Alcohol intake in subjects consuming >3.5 g of alcohol per day (N=41) was inversely related to sleep duration (r=-0.472, P=0.002). CONCLUSIONS Shorter sleep duration and obstructive sleep apnea are associated with higher energy, fat and alcohol intakes in obese individuals. The importance of this study relies on the population studied, obese subjects with chronic sleep deprivation. These novel findings apply to the large segment of the US population who are obese and sleep-deprived.
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Adams RE, Boscarino JA. Differences in mental health outcomes by acculturation status following a major urban disaster. INTERNATIONAL JOURNAL OF EMERGENCY MENTAL HEALTH 2013; 15:85-96. [PMID: 24558696 PMCID: PMC4007276] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
A number of studies have assessed the association between acculturation and psychological outcomes following a traumatic event. Some suggest that low acculturation is associated with poorer health outcomes, while others show no differences or that low acculturation is associated with better outcomes. One year after the terrorist attacks on the World Trade Center, we surveyed a multi-ethnic population of New York City adults (N= 2,368). We assessed posttraumatic stress disorder (PTSD), major depression, panic attack, anxiety symptoms, and general physical and mental health status. We classified study respondents into "low," "moderate," or "high" acculturation, based on survey responses. Bivariate results indicated that low acculturation individuals were more likely to experience negative life events, have low social support, and less likely to have pre-disaster mental health disorders. Those in the low acculturation group were also more likely to experience post-disaster perievent panic attacks, have higher anxiety, and have poorer mental health status. However, using logistic regression to control for confounding, and adjusting for multiple comparisons, we found that none of these outcomes were associated with acculturation status. Thus, our study suggests that acculturation was not associated with mental health outcomes following a major traumatic event.
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Affiliation(s)
- Charles R Figley
- Traumatology Institute, Tulane University School of Social Work, New Orleans, LA 70124, USA.
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Boscarino JA. PTSD is a risk factor for cardiovascular disease: time for increased screening and clinical intervention. Prev Med 2012; 54:363-4; author reply 365. [PMID: 22285944 DOI: 10.1016/j.ypmed.2012.01.001] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/30/2011] [Revised: 12/31/2011] [Accepted: 01/02/2012] [Indexed: 11/17/2022]
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Boscarino JA, Kirchner HL, Hoffman SN, Sartorius J. Use of the New York PTSD risk score to predict PTSD: current and future research efforts. Gen Hosp Psychiatry 2012; 34:317-9. [PMID: 22325632 PMCID: PMC3418878 DOI: 10.1016/j.genhosppsych.2012.01.005] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2012] [Accepted: 01/06/2012] [Indexed: 10/14/2022]
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Boscarino JA, Erlich PM, Hoffman SN, Zhang X. Higher FKBP5, COMT, CHRNA5, and CRHR1 allele burdens are associated with PTSD and interact with trauma exposure: implications for neuropsychiatric research and treatment. Neuropsychiatr Dis Treat 2012; 8:131-9. [PMID: 22536069 PMCID: PMC3333786 DOI: 10.2147/ndt.s29508] [Citation(s) in RCA: 82] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
OBJECTIVE The study aim was to assess the cumulative burden of polymorphisms located within four genetic loci previously associated with posttraumatic stress disorder (PTSD) among outpatients at risk for PTSD. METHODS Diagnostic interviews were completed and DNA samples collected among 412 pain patients to determine if FKBP5 (rs9470080), COMT (rs4680), CHRNA5 (rs16969968), and CRHR1 (rs110402) single nucleotide polymorphisms were cumulatively associated with increased risk for PTSD. RESULTS In bivariate analyses, it was found that a count of specific PTSD risk alleles located within FKBP5, COMT, CHRNA5, and CRHR1 genetic loci (allele range = 0-6, mean count = 2.92, standard deviation = 1.36) was associated with lifetime (t [409] = 3.430, P = 0.001) and early onset PTSD (t [409] = 4.239, P = 0.000028). In logistic regression, controlling for demographic factors, personality traits, and trauma exposures, this risk allele count remained associated with both lifetime (odds ratio = 1.49, P = 0.00158) and early onset PTSD (odds ratio = 2.36, P = 0.000093). Interaction effects were also detected, whereby individuals with higher risk allele counts and higher trauma exposures had an increased risk of lifetime PTSD (allele count × high trauma, P = 0.026) and early onset PTSD (allele count × high trauma, P = 0.016) in these logistic regressions. Those with no or few risk alleles appeared resilient to PTSD, regardless of exposure history. CONCLUSION A cumulative risk allele count involving four single nucleotide polymorphisms located within the FKBP5, COMT, CHRNA5, and CRHR1 genes are associated with PTSD. Level of trauma exposure interacts with risk allele count, such that PTSD is increased in those with higher risk allele counts and higher trauma exposures. Since the single nucleotide polymorphisms studied encompass stress circuitry and addiction biology, these findings may have implications for neuropsychiatric research and treatment.
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Abstract
OBJECTIVE Posttraumatic stress disorder (PTSD) is associated with altered neuropsychological function, possibly including complex visual information processing. Grapheme-color synesthesia refers to the phenomenon that a particular letter or number elicits the visual perception of a specific color. The study objective was to assess if grapheme-color synesthesia was associated with PTSD among US veterans. METHOD We surveyed 700 veterans who were outpatients in a multihospital system in Pennsylvania. All veterans had served at least one warzone deployment. PTSD and grapheme-color synesthesia were assessed using validated research instruments. RESULTS The mean age of veterans was 59 years, and 96% were men. The prevalence of current PTSD was 7% (95% confidence interval [CI] = 5.1-8.8), and current partial PTSD was 11% (95% CI = 9.3-14.0). The prevalence of current depression was 6% (95% CI = 4.7-8.3). Altogether, 6% (95% CI = 4.8-8.5) of veterans screened positive for grapheme-color synesthesia. Bivariate analyses suggested that grapheme-color synesthesia was associated with current PTSD (odds ratio [OR] = 3.4, p = .004) and current partial PTSD (OR = 2.4, p = .013), but not current depression (OR = 1.1, p = .91). Multivariate logistic regression results, adjusting for age, sex, marital status, level of education, current psychotropic medication use, and concussion history, confirmed these results. CONCLUSIONS Grapheme-color synesthesia seems to be associated with PTSD among veterans who had been deployed. This finding may have implications for PTSD diagnostic screening and treatment. Research is recommended to confirm this finding and to determine if synesthesia is a risk indicator for PTSD among nonveterans.
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