A prospective study of religiousness and psychological distress among female survivors of Hurricanes Katrina and Rita

Religiosity and Social Support Predict Resilience in Older Adults After a Flood

In this study, we examined religiosity and social support as predictors of resilience after a devastating flood. Three flood exposure groups of primarily middle-aged and older adults were compared: (1) non-flooded adults as controls, (2) once-flooded adults with structural damage to homes and property in the 2016 flood, and (3) twice-flooded adults who had relocated inland because of prior catastrophic losses in the 2005 Hurricanes Katrina and Rita and then flooded again in 2016. Resilience was assessed using the Connor-Davidson Resilience Scale (CD-RISC). Correlation analyses confirmed that older age was correlated with higher religiosity, charitable work done for others, and resilience. Regression analyses indicated that religious beliefs and coping, social support, and charitable work done for others were associated with higher levels of resilience, whereas flood damage was unrelated to resilience. Implications for current views on post-disaster adversity and resilience in later life are discussed.

Turning toward or away from God: COVID-19 and changes in religious devotion

Major stressors can influence religiosity, making some people more religious, while making others less religious. In response to the COVID-19 pandemic, we conducted a mixed-method study with a nationally representative sample of religiously affiliated American adults (N = 685) to assess group differences between those who decreased, stayed the same, or increased in their religious devotion. In quantitative analyses we evaluated differences on sociodemographic variables, religious behaviors, individual differences, prosocial emotions, well-being, and COVID-19 attitudes and behaviors. Of most note, those who changed (i.e., increased or decreased) in religious devotion were more likely than those with no change in devotion to experience high levels of stress and threat related to COVID-19, but only those who increased in religious devotion had the highest dispositional prosocial emotions (i.e., gratitude and awe). Further, those who changed in religious devotion were more likely to report searching for meaning than those with no change, but only those who increased were more likely to report actual presence of meaning. Qualitative analyses revealed that those who increased in religious devotion reported increasing personal worship, the need for a higher power, and uncertainty in life as reasons for their increase in religious devotion; those who decreased reported being unable to communally worship, a lack of commitment or priority, and challenges making it hard to believe in God as reasons for their decrease in religious devotion. The findings help identify how COVID-19 has affected religious devotion, and how religion might be used as a coping mechanism during a major life stressor.

Violence against children and natural disasters: A systematic review and meta-analysis of quantitative evidence

OBJECTIVES

Reviews of violence against children in disaster settings focus on armed conflict. Little is understood about natural disasters which has implications in planning humanitarian response. We examined the magnitude and direction of the association between exposure to natural disasters and physical, emotional, and sexual violence against children, and assessed the quality of the evidence.

METHODS

We searched 15 health and social science databases from first record until May 16, 2018. Publications describing all types of quantitative study design were eligible for inclusion. We presented study characteristics and quality in a narrative form and generated pooled estimates using a three-level random effects model. We evaluated Cochrane's Q with p-values below 0.10 and radial plots to assess heterogeneity. Planned subgroup analyses explored differential results by violence form, study design, and analysis method.

RESULTS

11 publications met inclusion criteria. The majority were cross-sectional studies examining physical or sexual violence in the United States. We found no evidence of a consistent association or directional influence between natural disasters and violence against children. Combined categorical violence outcomes had substantial heterogeneity [Q (df = 66) = 252.83, p < 0.001]. Subgroups without evidence of heterogeneity had confidence intervals that included a possible null effect. Our findings were mainly limited by inconsistencies in operational definitions of violence, a lack of representative sampling, and unclear establishment of temporal order between natural disaster exposure and violence outcomes.

CONCLUSIONS

Based on the available evidence, we cannot confidently conclude that natural disasters increase the level or severity of violence against children above non-disaster settings, however heterogeneity and study quality hamper our ability to draw firm conclusions. More nuanced and rigorous research is needed to inform practice and policy as natural disasters increasingly affect human populations.

Health-related quality of life and psychological distress among cancer survivors in a middle-income country

OBJECTIVES

Quality of life and psychological well-being are important patient-centered outcomes, which are useful in evaluation of cancer care delivery. However, evidence from low-income and middle-income countries remains scarce. We assessed health-related quality of life (HRQoL) and prevalence of psychological distress (anxiety or depression), as well as their predictors, among cancer survivors in a middle-income setting.

METHODS

Through the Association of Southeast Asian Nations Costs in Oncology study, 1490 newly diagnosed cancer patients were followed-up in Malaysia for 1 year. Health-related quality of life was assessed by using the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core 30 (EORTC QLQ-C30) and EuroQol-5 (EQ-5D) dimension questionnaires at baseline, 3 and 12 months. Psychological distress was assessed by using Hospital Anxiety and Depression Scale. Data were modeled by using general linear and logistic regressions analyses.

RESULTS

One year after diagnosis, the mean EORTC QLQ-C30 Global Health score of the cancer survivors remained low at 53.0 over 100 (SD 21.4). Fifty-four percent of survivors reported at least moderate levels of anxiety, while 27% had at least moderate levels of depression. Late stage at diagnosis was the strongest predictor of low HRQoL. Increasing age, being married, high-income status, hospital type, presence of comorbidities, and chemotherapy administration were also associated with worse HRQoL. The significant predictors of psychological distress were cancer stage and hospital type.

CONCLUSION

Cancer survivors in this middle-income setting have persistently impaired HRQoL and high levels of psychological distress. Development of a holistic cancer survivorship program addressing wider aspects of well-being is urgently needed in our settings.

Spirit or Fleeting Apparition? Why Spirituality's Link with Social Support Might Be Incrementally Invalid

Previously published path models apparently confirm the belief-as-benefit perspective that spirituality boosts well-being via social support. The broad acceptance of such findings has motivated recommendations that clinical psychologists and psychiatrists routinely assess their patients' spiritual status. Skeptics retort that past findings are statistically confounded and that numinous beliefs and well-being are unrelated. A multivariate regression analysis testing whether spirituality explains variance in social support after personality traits are simultaneously included is reported. Although spirituality displays a significant positive correlation and partial correlation (after controlling for socio-demographics) with social support, regression analysis specifying agreeableness and conscientiousness-individual differences related to both spirituality and social support-as predictors renders spirituality nonsignificant. In summary, spirituality's correlation with social support appears spurious; demonstrating the hazards of relying on simple associations and highlighting the urgent need for researchers to utilize statistical methods capable of establishing cause and parsing effects across rival theoretical explanations.

Religious narratives and their implications for disaster risk reduction

The role of religious factors in the disaster experience has been under-investigated. This is despite evidence of their influence throughout the disaster cycle, including: the way in which the event is interpreted; how the community recovers; and the strategies implemented to reduce future risk. This qualitative study examined the role of faith in the disaster experience of four faith communities in the Hawaiian Islands of the United States. Twenty-six individuals from the Bahá'í, Buddhist, Church of Jesus Christ of Latter-day Saints (LDS), and United Methodist Church communities participated, including 10 faith leaders and 16 laypersons. The results suggest that religious narratives provide a framework for interpretation of, preparedness for, and responses to disasters. Preparedness varied widely across faith communities, with the LDS community reporting greater levels of preparedness than other communities. Recommendations include the development of collaborative efforts between disaster managers and faith leaders to increase preparedness within faith communities, which may facilitate community-wide disaster risk reduction.

Women's Mental Health and Intimate Partner Violence Following Natural Disaster: A Scoping Review

Introduction Survivors of natural disasters in the United States experience significant health ramifications. Women particularly are vulnerable to both post-disaster posttraumatic stress disorder (PTSD) and depression, and research has documented that these psychopathological sequelae often are correlated with increased incidence of intimate partner violence (IPV). Understanding the link between these health concerns is crucial to informing adequate disaster response and relief efforts for victims of natural disaster. Purpose The purpose of this review was to report the results of a scoping review on the specific mental health effects that commonly impact women following natural disasters, and to develop a conceptual framework with which to guide future research.

METHODS

A scoping review of mental and physical health effects experienced by women following natural disasters in the United States was conducted. Articles from 2000-2015 were included. Databases examined were PubMed, PsycInfo, Cochrane, JSTOR, Web of Science, and databases available through ProQuest, including ProQuest Research Library.

RESULTS

A total of 58 articles were selected for inclusion, out of an original 149 that were selected for full-text review. Forty-eight articles, or 82.8%, focused on mental health outcomes. Ten articles, or 17.2%, focused on IPV. Discussion Certain mental health outcomes, including PTSD, depression, and other significant mental health concerns, were recurrent issues for women post-disaster. Despite the strong correlation between experience of mental health consequences after disaster and increased risk of domestic violence, studies on the risk and mediating factors are rare. The specific challenges faced by women and the interrelation between negative mental health outcomes and heightened exposure to IPV following disasters require a solid evidence base in order to facilitate the development of effective interventions. Additional research informed by theory on probable health impacts is necessary to improve development/implementation of emergency relief policy. Bell SA , Folkerth LA . Women's mental health and intimate partner violence following natural disaster: a scoping review. Prehosp Disaster Med. 2016;31(6):648-657.

Life after Hurricane Katrina: The Resilience in Survivors of Katrina (RISK) Project

This article presents an overview of the findings to date of the Resilience in Survivors of Katrina (RISK) Project, a longitudinal study of 1,019 young, predominantly female and African American community college students who were surveyed a year before Hurricane Katrina in New Orleans and then two to three times afterward. This study combines a multidisciplinary, multimethod approach to understanding the immediate and long-term effects of the Katrina disaster on physical and mental health, economic and social functioning, and neighborhood attainment. I discuss what we can learn from the rare inclusion of predisaster data and our unusual ability to follow participants for years after the disaster. I argue that it is important to follow the recovery of individuals and communities as well as the recovery of the city, as these are often not the same, especially in Katrina where a large proportion of the city never returned.

Meaning Making in the Context of Disasters

OBJECTIVE

Understanding the factors underlying adaptive psychological responses and recovery after disasters has important implications for intervention and prevention efforts. To date, little attention has been paid to successful coping processes in recovering from natural and technological disasters. This article takes a meaning making perspective to explicate how survivors successfully adapt after disasters.

METHOD

Relevant literature is reviewed to illustrate the process of adaptation and resilience after disasters.

RESULTS

Studies to date suggest both survivors' global meaning, particularly their religiousness and sense of meaning, and their appraisals and meaning making after the disaster are important influences on their postdisaster resilience. Meanings made in the form of changes in global beliefs and perceived growth have been reported and shown to have inconsistent relations with adjustment.

CONCLUSIONS

Although much more research is needed, current literature suggests that meaning making processes are central to recovery and resilience after a range of disasters.

Understanding Resilience and Other Trajectories of Psychological Distress: a Mixed-Methods Study of Low-Income Mothers Who Survived Hurricane Katrina

Recent longitudinal studies in the aftermath of natural disasters have shown that resilience, defined as a trajectory of consistently low symptoms, is the modal experience, although other trajectories representing adverse responses, including chronic or delayed symptom elevations, occur in a substantial minority of survivors. Although these studies have provided insight into the prototypical patterns of postdisaster mental health, the factors that account for these patterns remain unclear. In the current analysis, we aimed to fill this gap through a mixed-methods study of female participants in the Resilience in Survivors of Katrina (RISK) study. Latent class growth analysis identified six trajectories of psychological distress in the quantitative sample (n=386). Qualitative analysis of in-depth interviews with 54 participants identified predisaster, disaster-related and postdisaster experiences that could account for the trends in the quantitative data. In particular, preexisting and gains in psychosocial resources (e.g., emotion regulation, religiosity) and positive postdisaster impacts (e.g., greater neighborhood satisfaction, improved employment opportunities) were found to underlie resilience and other positive mental health outcomes. Conversely, experiences of childhood trauma, and pre and postdisaster stressors (e.g., difficulties in intimate partner relationships) were common among participants in trajectories representing adverse psychological responses. Illustrative case studies that exemplify each trajectory are presented. The results demonstrate the utility of mixed-methods analysis to provide a richer picture of processes underlying postdisaster mental health.

Long-term psychological outcomes in older adults after disaster: relationships to religiosity and social support

OBJECTIVES

Natural disasters are associated with catastrophic losses. Disaster survivors return to devastated communities and rebuild homes or relocate permanently, although the long-term psychological consequences are not well understood. The authors examined predictors of psychological outcomes in 219 residents of disaster-affected communities in south Louisiana.

METHOD

Current coastal residents with severe property damage from the 2005 Hurricanes Katrina and Rita, and exposure to the 2010 British Petroleum Deepwater Horizon oil spill were compared and contrasted with former coastal residents and an indirectly affected control group. Participants completed measures of storm exposure and stressors, religiosity, perceived social support, and mental health.

RESULTS

Non-organizational religiosity was a significant predictor of post-traumatic stress disorder (PTSD) in bivariate and multivariate logistic regressions. Follow-up analyses revealed that more frequent participation in non-organizational religious behaviors was associated with a heightened risk of PTSD. Low income and being a coastal fisher were significant predictors of depression symptoms in bivariate and multivariate models. Perceived social support had a protective effect for all mental health outcomes, which also held for symptoms of depression and GAD in multivariate models.

CONCLUSION

People who experienced recent and severe trauma related to natural and technological disasters are at risk for adverse psychological outcomes in the years after these events. Individuals with low income, low social support, and high levels of non-organizational religiosity are also at greater risk. Implications of these data for current views on the post-disaster psychological reactions and the development of age-sensitive interventions to promote long-term recovery are discussed.

Happily Ever After? Pre-and-Post Disaster Determinants of Happiness Among Survivors of Hurricane Katrina

This study investigated pre- to post-disaster changes in happiness of 491 women affected by Hurricane Katrina, and identified factors that were associated with the survivors' happiness after the storm. Participants completed surveys approximately 1 year before and 1 and 4 years after the storm. The surveys collected information on the women's happiness, social support, household characteristics, and hurricane exposure. We found that happiness significantly decreased from pre-disaster to 1 year post-disaster but there were no significant differences in happiness between the pre-disaster and 4 years post-disaster assessments. An exception were 38 women who continued to have lower levels of happiness 4 years post-disaster than at pre-disaster. These women were more likely to be living on their own after the storm and reported consistently lower levels of perceived social support from the community both before and after the storm than the other women of the sample. Factors associated with the survivor's happiness after the storm included exposure to hurricane stressors and losing a loved one to the hurricane. These were predictive of lower happiness 1 year post-disaster. Four years after the hurricane only exposure to hurricane stressors was predictive of lower levels of happiness. In contrast, pre-disaster happiness and post-disaster social support were protective against the negative effect of the hurricane on survivors' happiness.

Disaster impact across cultural groups: comparison of Whites, African Americans, and Latinos

The current study extends knowledge regarding the differential impact of natural disasters among White, African American, and Latino survivors of Hurricane Ike through its use of a large, regional sample recruited via representative sampling procedures to examine the associations between cultural identification and disaster impact, including loss, damage, and negative mental health outcomes. Consistent with previous research, results indicated disparities between cultural groups with regard to disaster exposure. Additionally, type of disaster impact was differentially associated with PTSD and depression status dependent on cultural group. Specifically, the extent of personal disaster exposure, property damage, and loss of services made significant contributions to PTSD status among White survivors. African-Americans were more likely than White and Latino Ike survivors to endorse post-disaster PTSD and depression and endorsement of depression was predicted by severity of property damage. With respect to Latino respondents, only the extent of personal disaster exposure significantly contributed to both PTSD and depression status. Implications of the current findings are discussed with regard to future disaster preparedness and response efforts and the implementation and evaluation of community-based disaster resources.

Religious coping, posttraumatic stress, psychological distress, and posttraumatic growth among female survivors four years after Hurricane Katrina

Positive and negative religious coping strategies and their relation with posttraumatic stress (PTS), psychological distress, and posttraumatic growth (PTG) were examined in the context of Hurricane Katrina. Positive religious coping was hypothesized to be associated with PTG, whereas negative religious coping was hypothesized to be associated with PTS and psychological distress. Low-income mothers (N = 386, mean age = 25.4 years, SD = 4.43) were surveyed before, and 1 and 4 years after the storm. Results from structural regression modeling indicated that negative religious coping was associated with psychological distress, but not PTS. Positive religious coping was associated with PTG. Further analysis indicated significant indirect effects of pre- and postdisaster religiousness on postdisaster PTG through positive religious coping. Findings underscore the positive and negative effect of religious variables in the context of a natural disaster.