Psychological Consequences of Indirect Exposure to Disaster Due to the Haiti Earthquake

Factors Associated with Complicated Grief Following a Railway Tragedy

On July 6, 2013, a train with 72 crude oil tank cars derailed in the heart of Lac-Mégantic, a small municipality of 6,000 inhabitants located in Québec (Canada). This tragedy killed 47 people. Technological disasters are rarely studied in bereavement research, and train derailments even less. The goal of this article is to increase our understanding of the bereavement consequences of technological disasters. Specifically, we aim to identify the factors that lead to the experience complicated grief and distinguish from the protective factors. A representative population-based survey was conducted among 268 bereaved people, three and a half years after the train accident. Of these, 71 people (26.5%) experienced complicated grief. People with complicated grief (CG) differ significantly from those without CG in terms of psychological health, perception of physical health, alcohol use and medication, as well as social and professional relationships. Hierarchical logistic regression analysis identified four predictive factors for CG: level of exposure to the disaster, having a negative perception of the event, as well as having a paid job and low-income increase the risk of CG. The importance of having health and social practitioners pay attention to these factors of CG are discussed along with future directions for research.

Effects of social support on mental health outcomes in disasters: A cross-sectional study

This study examined the mediating effects of social support on the association between disaster distress and mental health outcomes. We analyzed the data of 1006 participants with either direct or indirect exposure to one or more disasters. Disaster distress, social support, depression, and anxiety were significantly correlated. Multiple regression and mediation analyses with bootstrapping showed that social support was a partial mediator between disaster distress and depression, and between disaster distress and trait anxiety. It was a complete mediator between disaster distress and state anxiety. The results suggest that enhancing social support may reduce the negative effects of disaster distress on depression and anxiety. Therefore, comprehensive interventions incorporating disaster distress management and enhanced social support are essential in national disaster management policies and psychiatric and mental health nursing services for individuals who have experienced disasters.

Chronic Mental Health Sequelae of Climate Change Extremes: A Case Study of the Deadliest Californian Wildfire

Introduction. Weather-related disasters, such as wildfires exacerbated by a rise in global temperatures, need to be better studied in terms of their mental health impacts. This study focuses on the mental health sequelae of the deadliest wildfire in California to date, the Camp Fire of 2018. Methods. We investigated a sample of 725 California residents with different degrees of disaster exposure and measured mental health using clinically validated scales for post-traumatic stress disorder (PTSD), major depressive disorder (MDD) and generalized anxiety disorder (GAD). Data were collected at a chronic time-point, six months post-wildfire. We used multiple regression analyses to predict the mental health outcomes based on self-reported fire exposure. Additionally, we included vulnerability and resilience factors in hierarchical regression analyses. Results. Our primary finding is that direct exposure to large scale fires significantly increased the risk for mental health disorders, particularly for PTSD and depression. Additionally, the inclusion of vulnerability and resilience factors in the hierarchical regression analyses led to the significantly improved prediction of all mental health outcomes. Childhood trauma and sleep disturbances exacerbated mental health symptoms. Notably, self-reported resilience had a positive effect on mental health, and mindfulness was associated with significantly lower depression and anxiety symptoms. Conclusion. Overall, our study demonstrated that climate-related extreme events, such as wildfires, can have severe mental illness sequelae. Moreover, we found that pre-existing stressful life events, resilient personality traits and lifestyle factors can play an important role in the prevalence of psychopathology after such disasters. Unchecked climate change projected for the latter half of this century may severely impact the mental wellbeing of the global population, and we must find ways to foster individual resiliency.

Symptoms of posttraumatic stress disorder, depression, anxiety and other mental health problems following the 2010 earthquake in Haiti: A systematic review and meta-analysis

BACKGROUND

The 2010 earthquake in Haiti caused significant human and material damages, thousands of deaths and injuries, and 1.5 million homeless. This systematic review and meta-analysis aims to synthesize research on the prevalence and factors associated with PTSD, depression, anxiety symptoms, and other mental health problems among survivors.

METHODS

We searched six databases and retained 50 articles for the systematic review, 28 of which were included in three random effects meta-analyses on the prevalence of PTSD, depression, and anxiety symptoms in survivors.

RESULTS

Following the earthquake, more than one out of four individuals (28.44%,CI 95%,17.68%-42.37%; k = 24) reported severe symptoms of PTSD, one out of three reported severe symptoms of depression (32.16%,CI 95%,23.60%-42.11%; K=14), and one out of five reported severe symptoms of anxiety (20.49%,CI 95%,15.74%-26.24%;k=5). Studies revealed important rates of other mental health problems (including psychological distress and disturbance, suicidal ideations, and increased alcohol consumption) in survivors. Females were 41.38% more likely than males to experience severe symptoms of PTSD (OR = 1.41,CI 95%,1.22-1.64). Time was a moderator for depression and anxiety but not for PTSD, while the average age of participants only moderated depression.

LIMITATIONS

The studies included are observational and most used self-reported measures.

CONCLUSIONS

In a global context where natural disasters tripled since 1980, this first systematic review showed that human and material damages associated with the earthquake were sufficiently traumatic to induce severe symptoms of PTSD, depression, anxiety, and other mental health problems. Clinical and research implications are discussed.

PROSPERO REGISTRATION NUMBER

CRD42018115430.

“That day no one spoke”: Florida Puerto Ricans’ Reaction to Hurricane María

We conducted two focus groups and four individual interviews to examine the experiences of Florida Puerto Rican adults ( N = 26) with secondary exposure to the devastation caused by Hurricane María. Results from our thematic analysis yielded four major themes and eight subthemes depicting responses to Hurricane María. Four major themes emerged across participant responses: 1) Participants’ Experience with Hurricane María, 2) Participants’ Negative Reactions to Hurricane María, 3) Participants Providing Support, and 4) Resilience and Growth. We also found that Florida Puerto Ricans’ secondary stress reactions were influenced by Puerto Rico’s political status and economic crisis. Results also indicated that participants experienced vicarious posttraumatic growth not only at the individual but also at the community level.

Factors Associated with Food Insecurity Following Hurricane Harvey in Texas

Food insecurity prevalence among disaster-affected households has been found to be higher than state prevalence in non-disaster times. This study applies a socio-ecological model of post-disaster food insecurity to a nested quota sample (n = 1002) recruited for a web survey from 41 Texas counties affected by Hurricane Harvey 12-15 months post-event. This analysis identifies risk and protective factors for food insecurity. Chi-square analysis was used to examine independent associations between individual, household, and social factors with food insecurity. A multivariate logistic model was fitted and adjusted odds ratios are reported. Economic instability (adjusted odds ratio (OR) 2.43; 95% Confidence Interval (CI) 1.73, 3.41), relocation due to Hurricane Harvey (OR 1.89; CI 1.15, 3.09), major home damage (OR 2.11; CI 1.12, 3.98), non-white race - black (OR 1.79; CI 1.01, 3.18), Hispanic (OR 1.67; CI 1.09, 2.54), other race (OR 4.39; CI 1.96, 9.82) - and community-based organization assistance (1.99; 1.11, 3.58) were risk factors while older age (45-64 years: 0.49; 0.32, 0.73; 65+ years 0.40; 0.22, 0.75), better physical health (0.46; 0.29, 0.71), better mental health (0.46; 0.32, 0.67), and high social support (0.37; 0.25, 0.55) were protective against food insecurity. Disaster policies and programs should address the disproportionate burden on households that relocate or have health conditions. Fostering social support networks, especially among relocated populations, may improve disaster health outcomes.

Posttraumatic Stress Disorder Symptoms and Posttraumatic Growth Following Indirect Trauma from the Sewol Ferry Disaster, 2014

OBJECTIVE

The definition of psychological trauma, which was traditionally restricted to immediate and direct experience, is now expanding to include mediated or vicarious experience. So the present study aims to examine the relationship between the negative effects and the positive outcomes to a national disaster by assessing the posttraumatic stress disorder (PTSD) symptoms and posttraumatic growth of the general public.

METHODS

A nationwide survey of the Korean population (n=811) who were exposed to the Sewol ferry disaster through the media participated in this research, completing a self-report questionnaire consisting of demographic characteristics, Impact of Event Scale-Revised- Korean, and Korean-Stress-related Growth Scale-Revised. The participants were divided into three groups according to the severity of PTSD symptoms, then one-way ANOVA were conducted.

RESULTS

The results revealed 30.4% of the sampled participants reported stress symptoms equivalent to partial or full PTSD. Posttraumatic growth was significantly higher in the full and the partial PTSD symptom groups when compared to the normal group [F (2, 759)=20.534, p<0.001]. At a subscale level, mature thinking showed a more significant result [F (2,759)=23.146, p<0.001] than religious growth [F (2, 180.984)=4.811, p<0.01].

CONCLUSION

The results indicated a general linear trend between the severity of PTSD symptoms and posttraumatic growth level, suggesting that indirect trauma also induces both PTSD symptoms and posttraumatic growth like direct trauma does. The theoretical implications based on these findings were discussed.

Mental Health Impact of Hosting Disaster Refugees: Analyses from a Random Sample Survey Among Haitians Living in Miami

OBJECTIVES

Studies on the mental health of families hosting disaster refugees are lacking. This study compares participants in households that hosted 2010 Haitian earthquake disaster refugees with their nonhost counterparts.

METHODS

A random sample survey was conducted from October 2011 through December 2012 in Miami-Dade County, Florida. Haitian participants were assessed regarding their 2010 earthquake exposure and impact on family and friends and whether they hosted earthquake refugees. Using standardized scores and thresholds, they were evaluated for symptoms of three common mental disorders (CMDs): posttraumatic stress disorder, generalized anxiety disorder, and major depressive disorder (MDD).

RESULTS

Participants who hosted refugees (n = 51) had significantly higher percentages of scores beyond thresholds for MDD than those who did not host refugees (n = 365) and for at least one CMD, after adjusting for participants' earthquake exposures and effects on family and friends.

CONCLUSIONS

Hosting refugees from a natural disaster appears to elevate the risk for MDD and possibly other CMDs, independent of risks posed by exposure to the disaster itself. Families hosting refugees deserve special attention.

Priorities, concerns and unmet needs among Haitians in Boston after the 2010 earthquake

In January 2010, a massive earthquake struck Haiti. The devastation not only affected those living in Haiti at the time but also those Haitians living in the United States (U.S.). Few studies have assessed the degree of impact of the earthquake in U.S. Haitian communities. The purpose of this study was to elicit information about health priorities, concerns and resources needed to improve the delivery of health and social care for Haitians in Boston, MA. We conducted six focus groups among 78 individuals in the spring of 2011. Participants were recruited through community organisations, including churches, Haitian social service centres, restaurants and by word of mouth. Analysis of qualitative data revealed an enormous psychological, emotional, financial and physical toll experienced by Boston-area Haitians following the earthquake. Participants described increased distress, depressive episodes, headaches and financial hardship. They also noted insufficient resources to meet the increased needs of those living in the U.S., and those who had immigrated after the earthquake. Most participants cited an increased need for mental health services, as well as assistance with finding employment, navigating the immigration system, and balancing the health and financial needs of families in the U.S. and in Haiti. Despite this, many reported that the tragedy created a sense of unity and solidarity within the Haitian community. These findings corroborate the need for culturally and linguistically appropriate mental health services, as well as for employment, immigration and healthcare navigation services. Participants suggested that interventions be offered through Haitian radio and television stations, as well as group events held in churches. Further research should assess the need for and barriers to utilisation of mental health services among the Haitian community. A multi-faceted approach that includes a variety of outreach strategies implemented through multiple channels may offer a means of improving awareness of and access to health and social services.

Determinants of psychological resistance and recovery among women exposed to assaultive trauma

INTRODUCTION

Women exposed to potentially traumatic events (PTEs) are at high risk for developing psychiatric disorders, including posttraumatic stress disorder (PTSD), general anxiety disorder (GAD), major depressive disorder (MDD), and substance-related disorders. However, this risk is not universal. Most women are resistant (i.e., remain asymptomatic), or recover following a brief symptomatic period. This study examined the psychological factors associated with resistant and recovered outcomes in a sample of high-risk women exposed to assault-related PTEs.

METHOD

One hundred and fifty-nine women completed the Life Events Checklist and were administered the Structured Clinical Interview for DSM-IV Axis I Disorders. This resulted in three groups: (1) no diagnosis (no past or current psychiatric disorder diagnosis; n = 56), (2) past diagnosis (a past psychiatric disorder diagnosis, but none currently; n = 31), and (3) current diagnosis (a current diagnosis of one or more psychiatric disorders; n = 72). Groups were compared on sociodemographics, PTE exposure, psychopathology, health-related quality of life (HRQOL), and psychological resilience-related factors.

RESULTS

The majority of respondents (79%) did not develop chronic PTSD following assault exposure, and the most common psychiatric outcome was MDD (30%). High endorsement of mastery and social support were associated with the no diagnosis group; and greater reports of mastery and posttraumatic growth were associated with recovery from a past psychiatric disorder. Furthermore, both resilient groups (i.e., no diagnosis and past diagnosis) scored higher on HRQOL measures compared with the current diagnosis group (P < 0.001).

CONCLUSION

Psychological resilience has ramifications to health and well-being, and identifying these factors has potential to inform preventive strategies and treatment interventions for assault exposed women.

Mental health impact of the 2010 Haiti earthquake on the Miami Haitian population: A random-sample survey

This study examined the mental health consequences of the January 2010 Haiti earthquake on Haitians living in Miami-Dade County, Florida, 2-3 years following the event. A random-sample household survey was conducted from October 2011 through December 2012 in Miami-Dade County, Florida. Haitian participants (N = 421) were assessed for their earthquake exposure and its impact on family, friends, and household finances; and for symptoms of posttraumatic stress disorder (PTSD), anxiety, and major depression; using standardized screening measures and thresholds. Exposure was considered as "direct" if the interviewee was in Haiti during the earthquake. Exposure was classified as "indirect" if the interviewee was not in Haiti during the earthquake but (1) family members or close friends were victims of the earthquake, and/or (2) family members were hosted in the respondent's household, and/or (3) assets or jobs were lost because of the earthquake. Interviewees who did not qualify for either direct or indirect exposure were designated as "lower" exposure. Eight percent of respondents qualified for direct exposure, and 63% qualified for indirect exposure. Among those with direct exposure, 19% exceeded threshold for PTSD, 36% for anxiety, and 45% for depression. Corresponding percentages were 9%, 22% and 24% for respondents with indirect exposure, and 6%, 14%, and 10% for those with lower exposure. A majority of Miami Haitians were directly or indirectly exposed to the earthquake. Mental health distress among them remains considerable two to three years post-earthquake.

Prevalence of psychiatric disorders and functional impairment after loss of a family member: a longitudinal study after the 2004 Tsunami

BACKGROUND

Bereavement following disasters is a devastating experience for family members. The aim of this study was to examine the long-term mental health effects of losing a loved one in a natural disaster.

METHODS

Ninety-four Norwegians aged 18-80 years who lost close family members in the 2004 Southeast Asian tsunami were evaluated 2 and 6 years after the disaster. The participants were either staying in an affected area at the time of the disaster (i.e., directly exposed) or not (i.e., not directly exposed). The prevalence of psychiatric disorders was assessed by the MINI International Neuropsychiatric Interview (M.I.N.I). Prolonged grief disorder (PGD) was self-reported using the Inventory of Complicated Grief (ICG), and functional impairment was self-reported using the Work and Social Adjustment Scale (WSAS).

RESULTS

We did not identify a significant decrease in the prevalence of PGD, posttraumatic stress disorder (PTSD), or major depressive disorder (MDD) from 2 to 6 years. Approximately, one-third of the bereaved (36%) had a psychiatric disorder 6 years after the tsunami. The most common disorder was PGD (12%) followed by general anxiety disorder (GAD, 11%), agoraphobia (11%), and MDD (10%). The prevalence of PTSD and MDD was higher among family members who were directly exposed to the disaster compared to those who were not (21 vs. 0%, and 25 vs. 3%). PGD was associated with functional impairment independent of other disorders.

CONCLUSIONS

Loss of a close family member in a natural disaster can have a substantial adverse long-term effect on mental health and everyday functioning.