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Lac A. Drinking to Cope With the COVID-19 Pandemic Mediates Pathways From COVID-19 Anxiety to Alcohol Use and Alcohol Myopia Consequences. J Dual Diagn 2024:1-13. [PMID: 38742669 DOI: 10.1080/15504263.2024.2343372] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/16/2024]
Abstract
OBJECTIVE People may consume alcohol to cope with the stressors and anxieties of the COVID-19 pandemic. The present study applied the self-medication hypothesis, tension reduction hypothesis, and alcohol myopia theory to understand COVID-19 alcohol coping as a mediator of the pathways from COVID-19 anxiety to alcohol use and alcohol consequences. METHODS Participants (N = 477) were undergraduate college students. The mean age was 22.14 (SD = 5.66) years. Gender distribution included 73% females, 26% males, and 1% transgender. Racial categories included 70% White, 11% Latino, 5% Black, 5% Asian, and 9% multiracial. They completed the Coronavirus Anxiety Scale, the COVID-19 Alcohol Coping Scale developed and validated in the present study, measures of drinking frequency and drinking quantity, and the Alcohol Myopia Scale to assess alcohol consequences. RESULTS First, confirmatory factor analysis supported the measurement structure of the COVID-19 Alcohol Coping Scale. Second, a general structural equation model containing only latent factors provided evidence for the following pathways: COVID-19 anxiety to COVID-19 alcohol coping to overall alcohol use to alcohol myopia consequences. Third, a specific structural equation model separated the overall alcohol use factor into two measures of drinking frequency and drinking quantity. Results found that COVID-19 alcohol coping uniquely explained drinking frequency (but not drinking quantity), indicating that the pursuit of alcohol to cope with the pandemic was related to more frequent days of alcohol use but not more concentrated use on drinking days. Tests of indirect effects corroborated the mediational pathways in the explanatory models. CONCLUSIONS The research offers insights into understanding that the risk connections from COVID-19 anxiety to alcohol behavioral outcomes are mediated by alcohol use to cope with the pandemic.
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Affiliation(s)
- Andrew Lac
- Department of Psychology, University of Colorado, Colorado Springs, Colorado, USA
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2
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Alpers SE, Pallesen S, Vold JH, Haug E, Lunde LH, Skogen JC, Mamen A, Mæland S, Fadnes LT. The association between psychological distress and alcohol consumption and physical activity: a population-based cohort study. Front Psychiatry 2023; 14:1181046. [PMID: 37426109 PMCID: PMC10323831 DOI: 10.3389/fpsyt.2023.1181046] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Accepted: 05/30/2023] [Indexed: 07/11/2023] Open
Abstract
Introduction The COVID-19 pandemic and infection control measures caused changes to daily life for most people. Heavy alcohol consumption and physical inactivity are two important behavioral risk factors for noncommunicable diseases worldwide. The COVID-19 pandemic, with its social distancing measures, home office policies, isolation, and quarantine requirements may have an impact on these factors. This three-wave longitudinal study aims to investigate if psychological distress and worries related to health and economy were associated with levels and changes in alcohol consumption and physical activity during the two first years of the COVID-19 pandemic in Norway. Methods We used data collected in April 2020, January 2021, and January 2022 from an online longitudinal population-based survey. Alcohol consumption and physical activity status were assessed at all three measuring points via the Alcohol Use Disorder Identification Test (AUDIT-C) and the International Physical Activity Questionnaire (IPAQ-SF). COVID-19-related worries, home office/study, occupational situation, age, gender, children below 18 years living at home, and psychological distress (measured with the Symptom Checklist (SCL-10)) were included as independent variables in the model. A mixed model regression was used and presented with coefficients with 95% confidence intervals (CI). Results Analysis of data from 25,708 participants demonstrates that participants with substantial symptoms of psychological distress more often reported higher alcohol consumption (1.86 units/week, CI 1.48-2.24) and lower levels of physical activity [-1,043 Metabolic Equivalents of Task (METs) per week, CI -1,257;-828] at baseline. Working/studying from home (0.37 units/week, CI 0.24-0.50) and being male (1.57 units/week, CI 1.45-1.69) were associated with higher alcohol consumption. Working/studying from home (-536 METs/week, CI -609;-463), and being older than 70 years (-503 METs/week, CI -650;-355) were related to lower levels of physical activity. The differences in activity levels between those with the highest and lowest levels of psychological distress reduced over time (239 METs/week, CI 67;412), and similarly the differences in alcohol intake reduced over time among those having and not having children < 18 years (0.10 units/week, CI 0.01-0.19). Conclusion These findings highlight the substantial increases in risks related to inactivity and alcohol consumption among those with high levels of psychological distress symptoms, and particularly during the COVID-19 pandemic, and increase the understanding of factors associated with worries and health behavior.
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Affiliation(s)
- Silvia Eiken Alpers
- Department of Addiction Medicine, Haukeland University Hospital, Bergen, Norway
- Department of Clinical Psychology, Faculty of Psychology, University of Bergen, Bergen, Norway
| | - Ståle Pallesen
- Department of Psychosocial Science, Faculty of Psychology, University of Bergen, Bergen, Norway
- Optentia Research Focus Area, North-West University, Vanderbijlpark, South Africa
| | - Jørn Henrik Vold
- Bergen Addiction Research, Department of Addiction Medicine, Haukeland University Hospital, Bergen, Norway
- Department of Global Public Health and Primary Care, Faculty of Medicine, University of Bergen, Bergen, Norway
- Division of Psychiatry, Haukeland University Hospital, Bergen, Norway
| | - Ellen Haug
- Department of Health Promotion and Development, Faculty of Psychology, University of Bergen, Bergen, Norway
- Department of Teacher Education, NLA University College, Bergen, Norway
| | - Linn-Heidi Lunde
- Department of Addiction Medicine, Haukeland University Hospital, Bergen, Norway
- Department of Clinical Psychology, Faculty of Psychology, University of Bergen, Bergen, Norway
| | - Jens Christoffer Skogen
- Department of Health Promotion, Norwegian Institute of Public Health, Bergen, Norway
- Alcohol and Drug Research Western Norway, Stavanger University Hospital, Stavanger, Norway
- Centre for Evaluation of Public Health Measures, Norwegian Institute of Public Health, Oslo, Norway
| | - Asgeir Mamen
- School of Health Sciences, Kristiania University College, Oslo, Norway
| | - Silje Mæland
- Department of Global Public Health and Primary Care, Faculty of Medicine, University of Bergen, Bergen, Norway
| | - Lars Thore Fadnes
- Bergen Addiction Research, Department of Addiction Medicine, Haukeland University Hospital, Bergen, Norway
- Department of Global Public Health and Primary Care, Faculty of Medicine, University of Bergen, Bergen, Norway
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Talwar S, Kaur P, Kumar S, Laroche M, Dhir A. Caged, helpless but not bored: consumption values derived from over-the-top platforms during pandemic. INFORMATION TECHNOLOGY & PEOPLE 2023. [DOI: 10.1108/itp-11-2021-0837] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/10/2023]
Abstract
PurposeThe use of over-the-top (OTT) platforms grew substantially after the declaration of the COVID-19 pandemic in 2020. With the pandemic receding, there is a concern that users may not continue with their subscriptions. To counter this, OTT service providers must strategize proactively to retain and acquire new users once the pandemic abates. Positing that understanding the consumption values that users ascribe to OTT platform usage can provide useful customer retention insights, the purpose of this paper is to use the theory of consumption value (TCV) to study the values that users derived from their use of OTT following the onset of the pandemic.Design/methodology/approachThe mixed-method approach is used to collect qualitative and quantitative data. Analysis of qualitative responses collected through interviews of 12 current OTT platform users helped identify two categories of OTT platform-specific values: attribute-level and benefit-based. Next, the study examined the association of values thus identified with one another, as well as with continued intentions to use OTT platforms, by analyzing data collected from 371 existing users.FindingsThe findings indicated that functional value quality and social value, representing the attribute-level values, were positively associated with two benefit-based values – functional value price and emotional value (EMV). Next, EMV was not only associated with intentions but also partially mediated the association of attribute-level values with intentions. Premium subscription purchased and increased viewing time were confirmed to have moderating effects on the association between attribute-level and benefit-based values.Originality/valueThe study is amongst the foremost research initiatives to examine consumption values derived from OTT platform usage after the onset of the pandemic. Its novelty also comes from its identifying OTT platform-specific consumption values for the first time and adding a new dimension to the TCV by examining the interplay of these values in the OTT platform context.
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Chevance G, Fresán U, Hekler E, Edmondson D, Lloyd SJ, Ballester J, Litt J, Cvijanovic I, Araújo-Soares V, Bernard P. Thinking Health-related Behaviors in a Climate Change Context: A Narrative Review. Ann Behav Med 2022; 57:193-204. [PMID: 35861123 PMCID: PMC10074036 DOI: 10.1093/abm/kaac039] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023] Open
Abstract
BACKGROUND Human activities have changed the environment so profoundly over the past two centuries that human-induced climate change is now posing serious health-related threats to current and future generations. Rapid action from all scientific fields, including behavioral medicine, is needed to contribute to both mitigation of, and adaption to, climate change. PURPOSE This article aims to identify potential bi-directional associations between climate change impacts and health-related behaviors, as well as a set of key actions for the behavioral medicine community. METHODS We synthesized the existing literature about (i) the impacts of rising temperatures, extreme weather events, air pollution, and rising sea level on individual behaviors (e.g., eating behaviors, physical activity, sleep, substance use, and preventive care) as well as the structural factors related to these behaviors (e.g., the food system); and (ii) the concurrent positive and negative roles that health-related behaviors can play in mitigation and adaptation to climate change. RESULTS Based on this literature review, we propose a first conceptual model of climate change and health-related behavior feedback loops. Key actions are proposed, with particular consideration for health equity implications of future behavioral interventions. Actions to bridge the fields of behavioral medicine and climate sciences are also discussed. CONCLUSIONS We contend that climate change is among the most urgent issues facing all scientists and should become a central priority for the behavioral medicine community.
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Affiliation(s)
| | | | - Eric Hekler
- Herbert Wertheim School of Public Health and Human Longevity Science, UC San Diego, San Diego, CA, USA.,Center for Wireless and Population Health Systems, Qualcomm Institute, UC San Diego, San Diego, CA, USA
| | - Donald Edmondson
- Center for Behavioral Cardiovascular Health, Columbia University Irving Medical Center, New York, NY, USA
| | | | | | - Jill Litt
- ISGlobal, Barcelona, Spain.,Environmental Studies, University of Colorado Boulder, CO, USA
| | | | - Vera Araújo-Soares
- Health Technology & Services Research, University of Twente, The Netherlands
| | - Paquito Bernard
- Department of Physical Activity Sciences, Université du Québec à Montréal, Montréal, Québec, Canada.,Research Center, University Institute of Mental Health at Montreal, Montréal, Quebec, Canada
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5
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Aguilar L, Vicente-Hernández B, Remón-Gallo D, García-Ullán L, Valriberas-Herrero I, Maciá-Casas A, Pérez-Madruga A, Garzón MÁ, Álvarez-Navares A, Roncero C. A real-world ten-week follow-up of the COVID outbreak in an outpatient drug clinic in Salamanca (Spain). J Subst Abuse Treat 2021; 125:108303. [PMID: 34016295 PMCID: PMC8065063 DOI: 10.1016/j.jsat.2021.108303] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2020] [Revised: 11/06/2020] [Accepted: 01/19/2021] [Indexed: 01/13/2023]
Abstract
Objective To compare over ten weeks the number of relapses, hospital admissions, calls made, admissions to therapeutic communities, face-to-face visits, treatment adjustment, number of injectables administered, and number of emergencies attended due to emotional and behavioral alterations and/or substance use disorder, and to describe and quantify social emergencies in an outpatient drug clinic (ODC) in Salamanca (Spain) from March 16, 2020, to May 22, 2020. Methods This is an ecological study of the COVID pandemic over ten weeks. The study examines the set of alcohol or other drug-dependent or dual disorder patients in the population of Salamanca, Spain. The measurements were: professionals; calls made; percentage of successful calls; face-to-face visits; first visits made; reviews made; techniques; injectable treatments; other treatments; evolution; relapses. The ODC includes about 375 new patients each year and another 650 other patients annually. Results The study found the number of relapses to be greater in the last five weeks of the 10-week study period. Patients' psychopathological instability also increased, and face-to-face visits were necessary. The most frequent psychopathology that required face-to-face intervention was depressive disorder. The number of interventions with patients increased. In parallel, social workers' efforts were greater after the seventh week. There was a decrease in response to calls. Throughout this time, the ODC attended to patients who needed to be treated for the first time. Conclusions Confinement due to the coronavirus pandemic generated maladaptive emotional responses and other behaviors, such as excessive alcohol consumption. The number of face-to-face consultations, admissions, and referrals to therapeutic communities increased. Patients under stress and in social isolation resorted more often to substance use. The ODC had to adopt a flexible approach to evaluate patients with more serious problems, by using face-to-face assessments.
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Affiliation(s)
- Lourdes Aguilar
- Psychiatry Service, University of Salamanca Health Care Complex, Paseo de San Vicente 58-182, 37007 Salamanca, Spain; Psychiatric Unit, School of Medicine, University of Salamanca (Spain), Alfonso X El Sabio Street, 37007 Salamanca, Spain; Institute of Biomedicine, University of Salamanca, Paseo de San Vicente, 58-182, 37007 Salamanca, Spain
| | - Begoña Vicente-Hernández
- Psychiatry Service, University of Salamanca Health Care Complex, Paseo de San Vicente 58-182, 37007 Salamanca, Spain; Institute of Biomedicine, University of Salamanca, Paseo de San Vicente, 58-182, 37007 Salamanca, Spain
| | - Diego Remón-Gallo
- Psychiatric Unit, School of Medicine, University of Salamanca (Spain), Alfonso X El Sabio Street, 37007 Salamanca, Spain; Institute of Biomedicine, University of Salamanca, Paseo de San Vicente, 58-182, 37007 Salamanca, Spain
| | - Llanyra García-Ullán
- Psychiatry Service, University of Salamanca Health Care Complex, Paseo de San Vicente 58-182, 37007 Salamanca, Spain; Psychiatric Unit, School of Medicine, University of Salamanca (Spain), Alfonso X El Sabio Street, 37007 Salamanca, Spain; Institute of Biomedicine, University of Salamanca, Paseo de San Vicente, 58-182, 37007 Salamanca, Spain
| | - Isabel Valriberas-Herrero
- Psychiatry Service, University of Salamanca Health Care Complex, Paseo de San Vicente 58-182, 37007 Salamanca, Spain; Institute of Biomedicine, University of Salamanca, Paseo de San Vicente, 58-182, 37007 Salamanca, Spain
| | - Ana Maciá-Casas
- Psychiatry Service, University of Salamanca Health Care Complex, Paseo de San Vicente 58-182, 37007 Salamanca, Spain; Institute of Biomedicine, University of Salamanca, Paseo de San Vicente, 58-182, 37007 Salamanca, Spain
| | - Ana Pérez-Madruga
- Psychiatry Service, University of Salamanca Health Care Complex, Paseo de San Vicente 58-182, 37007 Salamanca, Spain; Institute of Biomedicine, University of Salamanca, Paseo de San Vicente, 58-182, 37007 Salamanca, Spain
| | - Maria Ángeles Garzón
- Psychiatry Service, University of Salamanca Health Care Complex, Paseo de San Vicente 58-182, 37007 Salamanca, Spain; Institute of Biomedicine, University of Salamanca, Paseo de San Vicente, 58-182, 37007 Salamanca, Spain
| | - Ana Álvarez-Navares
- Psychiatry Service, University of Salamanca Health Care Complex, Paseo de San Vicente 58-182, 37007 Salamanca, Spain; Institute of Biomedicine, University of Salamanca, Paseo de San Vicente, 58-182, 37007 Salamanca, Spain
| | - Carlos Roncero
- Psychiatry Service, University of Salamanca Health Care Complex, Paseo de San Vicente 58-182, 37007 Salamanca, Spain; Psychiatric Unit, School of Medicine, University of Salamanca (Spain), Alfonso X El Sabio Street, 37007 Salamanca, Spain; Institute of Biomedicine, University of Salamanca, Paseo de San Vicente, 58-182, 37007 Salamanca, Spain.
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6
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Panagiotidis P, Rantis K, Holeva V, Parlapani E, Diakogiannis I. Changes in Alcohol Use Habits in the General Population, during the COVID-19 Lockdown in Greece. Alcohol Alcohol 2020; 55:702-704. [PMID: 32959877 PMCID: PMC7543262 DOI: 10.1093/alcalc/agaa092] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2020] [Revised: 08/07/2020] [Accepted: 09/01/2020] [Indexed: 02/02/2023] Open
Affiliation(s)
- Panagiotis Panagiotidis
- Department of Psychiatry, 424 General Military Hospital of Thessaloniki, Thessaloniki, Greece.,1st Department of Psychiatry, Papageorgiou General Hospital, Aristotle University of Thessaloniki, Ring Road, Efkarpia, 56403 Thessaloniki, Greece
| | - Konstantinos Rantis
- Department of Psychiatry, 424 General Military Hospital of Thessaloniki, Thessaloniki, Greece.,1st Department of Psychiatry, Papageorgiou General Hospital, Aristotle University of Thessaloniki, Ring Road, Efkarpia, 56403 Thessaloniki, Greece
| | - Vasiliki Holeva
- 1st Department of Psychiatry, Papageorgiou General Hospital, Aristotle University of Thessaloniki, Ring Road, Efkarpia, 56403 Thessaloniki, Greece
| | - Eleni Parlapani
- 1st Department of Psychiatry, Papageorgiou General Hospital, Aristotle University of Thessaloniki, Ring Road, Efkarpia, 56403 Thessaloniki, Greece
| | - Ioannis Diakogiannis
- 1st Department of Psychiatry, Papageorgiou General Hospital, Aristotle University of Thessaloniki, Ring Road, Efkarpia, 56403 Thessaloniki, Greece
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7
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Molyneaux R, Gibbs L, Bryant RA, Humphreys C, Hegarty K, Kellett C, Gallagher HC, Block K, Harms L, Richardson JF, Alkemade N, Forbes D. Interpersonal violence and mental health outcomes following disaster. BJPsych Open 2019; 6:e1. [PMID: 31796146 PMCID: PMC7001465 DOI: 10.1192/bjo.2019.82] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Disasters pose a documented risk to mental health, with a range of peri- and post-disaster factors (both pre-existing and disaster-precipitated) linked to adverse outcomes. Among these, increasing empirical attention is being paid to the relation between disasters and violence. AIMS This study examined self-reported experiences of assault or violence victimisation among communities affected by high, medium, and low disaster severity following the 2009 bushfires in Victoria, Australia. The association between violence, mental health outcomes and alcohol misuse was also investigated. METHOD Participants were 1016 adults from high-, medium- and low-affected communities, 3-4 years after an Australian bushfire disaster. Rates of reported violence were compared by areas of bushfire-affectedness. Logistic regression models were applied separately to men and women to assess the experience of violence in predicting general and fire-related post-traumatic stress disorder, depression and alcohol misuse. RESULTS Reports of experiencing violence were significantly higher among high bushfire-affected compared with low bushfire-affected regions. Analyses indicated the significant relationship between disaster-affectedness and violence was observed for women only, with rates of 1.0, 0 and 7.4% in low, medium and high bushfire-affected areas, respectively. Among women living in high bushfire-affected areas, negative change to income was associated with an increased likelihood of experiencing violence (odds ratio, 4.68). For women, post-disaster violence was associated with more severe post-traumatic stress disorder and depression symptoms. CONCLUSIONS Women residing within high bushfire-affected communities experienced the highest levels of violence. These post-disaster experiences of violence are associated with post-disaster changes to income and with post-traumatic stress disorder and depression symptoms among women. These findings have critical implications for the assessment of, and interventions for, women experiencing or at risk of violence post-disaster.
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Affiliation(s)
- Robyn Molyneaux
- Research Fellow, Child and Community Wellbeing Unit, Centre for Health Equity, University of Melbourne, Australia
| | - Lisa Gibbs
- Director, Child and Community Wellbeing Unit, Centre for Health Equity, University of Melbourne; and Academic Lead, Community Resilience & Public Health, Centre for Disaster Management and Public Safety, University of Melbourne, Australia
| | - Richard A Bryant
- Scientia Professor and NHMRC Senior Principal Research Fellow, School of Psychology, University of New South Wales, Australia
| | - Cathy Humphreys
- Professor of Social Work, Department of Social Work, University of Melbourne, Australia
| | - Kelsey Hegarty
- Professor, Centre for Family Violence Prevention, Department of General Practice, The University of Melbourne and The Royal Women's Hospital, Australia
| | - Connie Kellett
- Family Violence Principal Practitioner, Department of Social Work, University of Melbourne; and Victorian Department of Justice and Community Safety, Australia
| | - H Colin Gallagher
- Postdoctoral Researcher, Centre for Transformative Innovation, Faculty of Business and Law, Swinburne University of Technology, Australia
| | - Karen Block
- Associate Director, Child and Community Wellbeing Unit, Centre for Health Equity, University of Melbourne, Australia
| | - Louise Harms
- Chair and Head, Department of Social Work, University of Melbourne, Australia
| | - John F Richardson
- National Resilience Adviser, Emergency Services, Australian Red Cross, Melbourne, Australia
| | - Nathan Alkemade
- Phoenix Australia: Centre for Posttraumatic Mental Health, Department of Psychiatry, University of Melbourne; and Senior Clinical Psychologist, Monash Health, Australia
| | - David Forbes
- Director, Phoenix Australia: Centre for Posttraumatic Mental Health, Department of Psychiatry, University of Melbourne, Australia
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Takahashi A, Ohira T, Hosoya M, Yasumura S, Nagai M, Ohira H, Hashimoto S, Satoh H, Sakai A, Ohtsuru A, Kawasaki Y, Suzuki H, Kobashi G, Ozasa K, Yamashita S, Kamiya K, Abe M. Effect of evacuation on liver function after the Fukushima Daiichi Nuclear Power Plant accident: The Fukushima Health Management Survey. J Epidemiol 2017; 27:180-185. [PMID: 28142046 PMCID: PMC5376311 DOI: 10.1016/j.je.2016.05.006] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2015] [Accepted: 05/17/2016] [Indexed: 02/05/2023] Open
Abstract
Background The Great East Japan Earthquake and subsequent Fukushima Daiichi Nuclear Power Plant accident caused residents to switch from their normal lives to lives focused on evacuation. We evaluated liver function before and after this disaster to elucidate the effects of evacuation on liver function. Methods This study was a longitudinal survey of 26,006 Japanese men and women living near the Fukushima Daiichi Nuclear Power Plant. This study was undertaken using data from annual health checkups conducted for persons aged 40–90 years between 2008 and 2010. Follow-up examinations were conducted from June 2011 to the end of March 2013, with a mean follow up of 1.6 years. Changes in liver function before and after the disaster were compared among evacuees and non-evacuees. We also assessed groups according to alcohol drinking status. Results The prevalence of liver dysfunction significantly increased in all participants from 16.4% before to 19.2% after the disaster. The incidence of liver dysfunction was significantly higher in evacuees than in non-evacuees. Multivariate logistic regression analysis showed that evacuation was significantly associated with liver dysfunction among residents. Conclusions This is the first study to show that evacuation due to the Fukushima Daiichi nuclear power plant disaster was associated with an increase in liver dysfunction. Prevalence of liver dysfunction increased after the Great East Japan Earthquake. The change in prevalence of liver dysfunction was greatest in evacuees. Evacuation is one risk factor associated with liver dysfunction.
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Affiliation(s)
- Atsushi Takahashi
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima, Japan; Department of Gastroenterology, Fukushima Medical University School of Medicine, Fukushima, Japan.
| | - Tetsuya Ohira
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima, Japan; Department of Epidemiology, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Mitsuaki Hosoya
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima, Japan; Department of Pediatrics, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Seiji Yasumura
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima, Japan; Department of Public Health, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Masato Nagai
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima, Japan; Department of Epidemiology, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Hiromasa Ohira
- Department of Gastroenterology and Rheumatology, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Shigeatsu Hashimoto
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima, Japan; Department of Nephrology, Hypertension, Diabetology, and Endocrinology, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Hiroaki Satoh
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima, Japan; Department of Nephrology, Hypertension, Diabetology, and Endocrinology, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Akira Sakai
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima, Japan; Department of Radiation Life Sciences, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Akira Ohtsuru
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima, Japan; Department of Radiation Health Management, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Yukihiko Kawasaki
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima, Japan; Department of Pediatrics, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Hitoshi Suzuki
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima, Japan; Department of Cardiology and Hematology, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Gen Kobashi
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima, Japan; Department of Public Health, Dokkyo Medical University School of Medicine, Tochigi, Japan
| | - Kotaro Ozasa
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima, Japan; Department of Epidemiology, Radiation Effects Research Foundation, Hiroshima, Japan
| | - Shunichi Yamashita
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima, Japan; Japan and Atomic Bomb Disease Institute, Nagasaki University, Nagasaki, Japan
| | - Kenji Kamiya
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima, Japan; Research Institute for Radiation Biology and Medicine, Hiroshima University, Hiroshima, Japan
| | - Masafumi Abe
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima, Japan; Department of Gastroenterology, Fukushima Medical University School of Medicine, Fukushima, Japan
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9
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Nollet KE, Komazawa T, Ohto H. Transfusion under triple threat: Lessons from Japan's 2011 earthquake, tsunami, and nuclear crisis. Transfus Apher Sci 2016; 55:177-183. [PMID: 27646984 DOI: 10.1016/j.transci.2016.09.009] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
The Great East Japan Earthquake of March 11, 2011 provoked tsunami waves with inland penetration up to 5 km and run-up heights to 40 m. More than 400 km2 were flooded, mainly along the northeast coast of Japan's largest island, Honshu. Nearly 20,000 human lives were abruptly taken by this natural disaster. Four coastal nuclear facilities went into automatic shutdown; at one, Fukushima Daiichi, cooling system failures resulted in the meltdown of three reactor cores, accompanied by explosive release of radioisotopes. Essentials of modern blood banking and transfusion medicine were lost: roads, vehicles, blood collection venues, and facilities for blood testing and processing. Normal channels of communication were interrupted, not only by physical damage but also due to circuit overload as mobile phone users sought information and tried to exchange messages about their own and others' health, welfare, and whereabouts. The Japanese Red Cross, as a monopoly supplier of allogeneic blood, responded with a nationally coordinated effort that met the transfusion demands of a disaster characterized by immediate mass fatality rather than mass injury. Japan's routine transfusion demands are also met by hospital-based autologous blood programs, which could be pressed into service for emergency allogeneic collections. Herein we report institutional and personal experience in anticipation of future disasters, in which transfusion needs might differ from routine demand.
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Affiliation(s)
- Kenneth E Nollet
- Department of Blood Transfusion and Transplantation Immunology, Fukushima Medical University, Hikarigaoka 1, Fukushima City, Fukushima 960-1295, Japan.
| | - Tomoko Komazawa
- Department of Blood Transfusion and Transplantation Immunology, Fukushima Medical University, Hikarigaoka 1, Fukushima City, Fukushima 960-1295, Japan
| | - Hitoshi Ohto
- Department of Blood Transfusion and Transplantation Immunology, Fukushima Medical University, Hikarigaoka 1, Fukushima City, Fukushima 960-1295, Japan
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Impact of the 2011 Great East Japan Earthquake on the resumption of alcohol consumption after living-donor liver transplantation for alcoholic cirrhosis: a report of two cases. Transplant Proc 2014; 46:992-4. [PMID: 24767400 DOI: 10.1016/j.transproceed.2013.09.048] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2013] [Accepted: 09/26/2013] [Indexed: 11/21/2022]
Abstract
Alcoholic liver disease (ALD) is a leading indication for liver transplantation (LT) in Western countries. The rate of resumption of alcohol abuse is 7% to 95% after LT for ALD. A high prevalence of alcohol abuse has been observed in disaster-exposed populations; however, little is known about the association between resumption of alcohol abuse after LT and disasters. Between June 2007 and March 2011, 3 patients with alcoholic cirrhosis (2 men and 1 woman) underwent living-donor LT (LDLT) at Tohoku University Hospital, Sendai, Japan. The female patient died of graft failure 6 months after LDLT. The other patients (ages 55 and 56 years), who survived to discharge, resumed alcohol abuse after the 2011 Great East Japan Earthquake. Before transplantation, both patients had been abusing alcohol for >35 years, with a daily ethanol intake of 110 g and 140 g, respectively. The period of abstinence from alcohol consumption ranged from 4 to 6 months. After transplantation, patients showed good compliance with treatment and seemed at low risk of relapse until the earthquake. One patient was living in the nuclear evacuation zone at Fukushima, and resumed alcohol consumption after the evacuation. Another patient resumed alcohol consumption while temporarily living apart from his family during restoration work after the disaster. Extreme stress and changes in living arrangements after the Great East Japan Earthquake seemed to trigger the desire to drink. This is the first report on patients who underwent LT for ALD and who resumed alcohol consumption after a disaster.
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Leg extension power is a pre-disaster modifiable risk factor for post-traumatic stress disorder among survivors of the Great East Japan Earthquake: a retrospective cohort study. PLoS One 2014; 9:e96131. [PMID: 24760054 PMCID: PMC3997555 DOI: 10.1371/journal.pone.0096131] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2014] [Accepted: 04/02/2014] [Indexed: 11/19/2022] Open
Abstract
Background Post-traumatic stress disorder (PTSD) is a common psychological problem following natural disasters. Although pre-disaster risk factors are important for early detection and proactive support, the examination of such has been limited to sociodemographic factors, which were largely unaffected by the disasters. We examined the association between pre-disaster physical functioning and lifestyle and PTSD symptoms five months after the earthquake in the Great East Japan Earthquake survivors who were participating in a pre-existing cohort study. Methods We designed a retrospective cohort study of a cooperative association in Sendai from August 2010 to August 2011. In 2010, lifestyle, physical condition, and sociodemographic factors were examined by self-reported questionnaires completed by 522 employees of this organization. We also measured the leg extension power of all the participants. PTSD symptoms were evaluated by the Japanese version of the Impact of Event Scale-Revised (IES-R-J) following the earthquake of 2011. Results In multivariate linear regression analysis, leg extension power (β = –0.128, P = 0.025), daily drinking (β = 0.203, P = 0.006), and depressive symptoms (β = 0.139, P = 0.008) were associated with total score of the IES-R-J among men. Moreover, for the IES-R-J subscale, leg extension power was also negatively associated with Intrusion (β = –0.114, P = 0.045) and Hyperarousal (β = –0.163, P = 0.004) after adjusting for all other significant variables. For women, hypertension (β = 0.226, P = 0.032) and depressive symptoms (β = 0.205, P = 0.046) were associated with the total score of the IES-R-J. Conclusions Leg extension power is a potentially modifiable pre-disaster risk factor among men for attenuating the severity of PTSD symptoms associated with great disasters such as the Great East Japan Earthquake among men.
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Williams AR, Tofighi B, Rotrosen J, Lee JD, Grossman E. Psychiatric comorbidity, red flag behaviors, and associated outcomes among office-based buprenorphine patients following Hurricane Sandy. J Urban Health 2014; 91:366-75. [PMID: 24619775 PMCID: PMC3978155 DOI: 10.1007/s11524-014-9866-7] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
In October 2012, Bellevue Hospital Center (Bellevue) in New York City was temporarily closed as a result of Hurricane Sandy, the largest hurricane in US history. Bellevue's primary care office-based buprenorphine program was temporarily closed and later relocated to an affiliate public hospital. Previous research indicates that the relationships between disaster exposure, substance use patterns, psychiatric symptoms, and mental health services utilization is complex, with often conflicting findings regarding post-event outcomes (on the individual and community level) and antecedent risk factors. In general, increased use of tobacco, alcohol, and illicit drugs is associated with both greater disaster exposure and the development or exacerbation of other psychiatric symptoms and need for treatment. To date, there is limited published information regarding post-disaster outcomes among patients enrolled in office-based buprenorphine treatment, as the treatment modality has only been relatively approved recently. Patients enrolled in the buprenorphine program at the time of the storm were surveyed for self-reported buprenorphine adherence and illicit substance and alcohol use, as well as disaster-related personal consequences and psychiatric sequelae post-storm. Baseline demographic characteristics and insurance status were available from the medical record. Analysis was descriptive (counts and proportions) and qualitative, coding open-ended responses for emergent themes. There were 132 patients enrolled in the program at the time of the storm; of those, 91 were contacted and 89 completed the survey. Almost half of respondents reported disruption of their buprenorphine supply. Unexpectedly, patients with psychiatric comorbidity were no more likely to report increased use/relapse as a result. Rather, major risk factors associated with increased use or relapse post-storm were: (1) shorter length of time in treatment, (2) exposure to storm losses such as buprenorphine supply disruption, (3) a pre-storm history of red flag behaviors (in particular, repeat opioid-positive urines), and (4) new-onset post-storm psychiatric symptoms. Our findings highlight the relative resilience of buprenorphine as an office-based treatment modality for patients encountering a disaster with associated unanticipated service disruption. In responding to future disasters, triaging patient contact and priority based on a history of red-flag behaviors, rather than a history of psychiatric comorbidity, will likely optimize resource allocation, especially among recently enrolled patients. Additionally, patients endorsing new-onset psychiatric manifestations following disasters may be an especially high-risk group for poor outcomes, warranting further study.
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Tofighi B, Grossman E, Williams AR, Biary R, Rotrosen J, Lee JD. Outcomes among buprenorphine-naloxone primary care patients after Hurricane Sandy. Addict Sci Clin Pract 2014; 9:3. [PMID: 24467734 PMCID: PMC3940298 DOI: 10.1186/1940-0640-9-3] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2013] [Accepted: 12/23/2013] [Indexed: 11/19/2022] Open
Abstract
Background The extent of damage in New York City following Hurricane Sandy in October 2012 was unprecedented. Bellevue Hospital Center (BHC), a tertiary public hospital, was evacuated and temporarily closed as a result of hurricane-related damages. BHC’s large primary care office-based buprenorphine clinic was relocated to an affiliate public hospital for three weeks. The extent of environmental damage and ensuing service disruption effects on rates of illicit drug, tobacco, and alcohol misuse, buprenorphine medication supply disruptions, or direct resource losses among office-based buprenorphine patients is to date unknown. Methods A quantitative and qualitative semi-structured survey was administered to patients in BHC’s primary care buprenorphine program starting one month after the hurricane. Survey domains included: housing and employment disruptions; social and economic support; treatment outcomes (buprenorphine adherence and ability to get care), and tobacco, alcohol, and drug use. Open-ended questions probed general patient experiences related to the storm, coping strategies, and associated disruptions. Results There were 132 patients enrolled in the clinic at the time of the storm; of those, 91 patients were recruited to the survey, and 89 completed (98% of those invited). Illicit opioid misuse was rare, with 7 respondents reporting increased heroin or illicit prescription opioid use following Sandy. Roughly half of respondents reported disruption of their buprenorphine-naloxone medication supply post-event, and self-lowering of daily doses to prolong supply was common. Additional buprenorphine was obtained through unscheduled telephone or written refills from relocated Bellevue providers, informally from friends and family, and, more rarely, from drug dealers. Conclusions The findings highlight the relative adaptability of public sector office-based buprenorphine treatment during and after a significant natural disaster. Only minimal increases in self-reported substance use were reported despite many disruptions to regular buprenorphine supplies and previous daily doses. Informal supplies of substitute buprenorphine from family and friends was common. Remote telephone refill support and a temporary back-up location that provided written prescription refills and medication dispensing for uninsured patients enabled some patients to maintain an adequate medication supply. Such adaptive strategies to ensure medication maintenance continuity pre/post natural disasters likely minimize poor treatment outcomes.
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Affiliation(s)
- Babak Tofighi
- Department of Population Health, New York University School of Medicine, 227 E,30th St, 7th floor, New York, NY 10016, USA.
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Large-scale disaster and gastrointestinal diseases. Clin J Gastroenterol 2013; 6:99-104. [DOI: 10.1007/s12328-013-0369-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2013] [Accepted: 02/07/2013] [Indexed: 10/27/2022]
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Peirce JM, Brooner RK, Kolodner K, Schacht RL, Kidorf MS. Prospective effects of traumatic event re-exposure and post-traumatic stress disorder in syringe exchange participants. Addiction 2013; 108:146-53. [PMID: 22775291 PMCID: PMC3518559 DOI: 10.1111/j.1360-0443.2012.04003.x] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2012] [Revised: 03/27/2012] [Accepted: 06/20/2012] [Indexed: 12/18/2022]
Abstract
AIM Determine the effect of traumatic event re-exposure and post-traumatic stress disorder (PTSD) symptom severity on proximal drug use and drug abuse treatment-seeking in syringe exchange participants. DESIGN Prospective longitudinal 16-month cohort study of new syringe exchange registrants enrolled in a parent study of methods to improve treatment engagement. SETTING Data were collected in a research van next to mobile syringe exchange distribution sites in Baltimore, Maryland. PARTICIPANTS Male and female (n = 162) injecting drug users (IDUs) registered for syringe exchange. MEASUREMENTS Traumatic event re-exposure was identified each month with the Traumatic Life Events Questionnaire. PTSD symptoms were measured with the Modified PTSD Symptom Scale-Revised, given every 4 months. Outcome measures collected monthly were days of drug use (heroin, cocaine) and drug abuse treatment-seeking behavior (interest, calls to obtain treatment, treatment participation). FINDINGS Each traumatic event re-exposure was associated with about 1 more day of cocaine use after accounting for the previous month's cocaine use [same month adjusted B, standard error = 1.16 (0.34); 1 month later: 0.99 (0.34)], while PTSD symptoms had no effect. Traumatic event re-exposure increased interest in drug abuse treatment [same month adjusted odds ratios with 95% confidence intervals = 1.34 (1.11-1.63)] and calling to obtain treatment [same month 1.58 (1.24-2.01); 1 month later 1.34 (1.03-1.75)]. Each 10% increase in PTSD symptom severity was associated with persistent increased interest in treatment [same month 1.25 (1.10-1.42); 1 month later 1.16 (1.02-1.32); 2 months later 1.16 (1.02-1.32)] and calling to obtain treatment [same month 1.16 (1.02-1.32)]. Neither traumatic events nor PTSD symptoms were associated with participants receiving treatment. CONCLUSIONS Becoming exposed again to traumatic events among injecting drug users is associated with an increase in cocaine use up to 1 month later, but drug use is not related to post-traumatic stress disorder symptoms. Both traumatic event re-exposure and post-traumatic stress disorder symptoms predict drug abuse treatment-seeking behavior for up to 2 months.
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Affiliation(s)
| | | | - Ken Kolodner
- Johns Hopkins University School of Medicine; Baltimore; MD; USA
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Mental Health and Psychosocial Support after the Great East Japan Earthquake. Keio J Med 2012; 61:15-22. [DOI: 10.2302/kjm.61.15] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Dell'osso L, Carmassi C, Stratta P, Massimetti G, Akiskal KK, Akiskal HS, Maremmani I, Rossi A. Gender Differences in the Relationship between Maladaptive Behaviors and Post-Traumatic Stress Disorder. A Study on 900 L' Aquila 2009 Earthquake Survivors. Front Psychiatry 2012; 3:111. [PMID: 23293608 PMCID: PMC3537190 DOI: 10.3389/fpsyt.2012.00111] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/25/2012] [Accepted: 12/12/2012] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND Post-traumatic stress disorder (PTSD) represents one of the most frequently psychiatric sequelae to earthquake exposure. Increasing evidence suggests the onset of maladaptive behaviors among veterans and adolescents with PTSD, with specific gender differences emerging in the latter. Aims of the present study were to investigate the relationships between maladaptive behaviors and PTSD in earthquake survivors, besides the gender differences in the type and prevalence of maladaptive behaviors and their association with PTSD. METHODS 900 residents of the town of L'Aquila who experienced the earthquake of April 6th 2009 (Richter Magnitude 6.3) were assessed by means of the Trauma and Loss Spectrum-Self Report (TALS-SR). RESULTS Significantly higher maladaptive behavior prevalence rates were found among subjects with PTSD. A statistically significant association was found between male gender and the presence of at least one maladaptive behavior among PTSD survivors. Further, among survivors with PTSD significant correlations emerged between maladaptive coping and symptoms of re-experiencing, avoidance and numbing, and arousal in women, while only between maladaptive coping and avoidance and numbing in men. CONCLUSIONS Our results show high rates of maladaptive behaviors among earthquake survivors with PTSD suggesting a greater severity among men. Interestingly, post-traumatic stress symptomatology appears to be a better correlate of these behaviors among women than among men, suggesting the need for further studies based on a gender approach.
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Affiliation(s)
- Liliana Dell'osso
- Section of Psychiatry, Department of Clinical and Experimental Medicine, University of Pisa Pisa, Italy
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Stressful life experiences, alcohol consumption, and alcohol use disorders: the epidemiologic evidence for four main types of stressors. Psychopharmacology (Berl) 2011; 218:1-17. [PMID: 21373787 PMCID: PMC3755727 DOI: 10.1007/s00213-011-2236-1] [Citation(s) in RCA: 271] [Impact Index Per Article: 20.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/11/2010] [Accepted: 02/16/2011] [Indexed: 02/07/2023]
Abstract
BACKGROUND Exposure to stress is potentially important in the pathway to alcohol use and alcohol use disorders. Stressors occur at multiple time points across the life course, with varying degrees of chronicity and severity. METHOD We review evidence from epidemiologic studies on the relationship between four different stressors (fateful/catastrophic events, child maltreatment, common adult stressful life events in interpersonal, occupational, financial, and legal domains, and minority stress) and alcohol consumption and alcohol use disorders. RESULTS Studies generally demonstrate an increase in alcohol consumption in response to exposure to terrorism or other disasters. Research has demonstrated little increase in incident alcohol use disorders, but individuals with a history of alcohol use disorders are more likely to report drinking to cope with the traumatic event. Childhood maltreatment is a consistent risk factor for early onset of drinking in adolescence and adult alcohol use disorders, and accumulating evidence suggests that specific polymorphisms may interact with child maltreatment to increase risk for alcohol consumption and disorder. Stressful life events such as divorce and job loss increase the risk of alcohol disorders, but epidemiologic consensus on the specificity of these associations across gender has not been reached. Finally, both perceptions of discrimination and objective indicators of discrimination are associated with alcohol use and alcohol use disorders among racial/ethnic and sexual minorities. CONCLUSION Taken together, these literatures demonstrate that exposure to stress is an important component in individual differences in risk for alcohol consumption and alcohol use disorders. However, many areas of this research remain to be studied, including greater attention to the role of various stressors in the course of alcohol use disorders and potential risk moderators when individuals are exposed to stressors.
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Desapriya E, Fujiwara T, Dutt N, Arason N, Pike I. Impact of the 1994 alcohol production and sales deregulation policy on traffic crashes and fatalities in Japan. Asia Pac J Public Health 2011; 24:776-85. [PMID: 21527435 DOI: 10.1177/1010539511404398] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
INTRODUCTION . Many studies have demonstrated a strong relationship between alcohol availability and traffic crashes involving alcohol-impaired drivers. The present analysis focuses on the evaluation of the impact of alcohol availability on the Japanese population by comparing fatal and nonfatal motor vehicle crash rates before and after implementation of the alcohol deregulation policy in 1994. Participants and method. Poisson regression with robust standard error was used to model the before-to-after change in incidence rate ratios (IRRs) in the population. To control for potential confounders, per capita alcohol consumption, unemployment rate, and vehicle miles travelled (VMT) were also added to the model. The exponents of the fitted coefficients are equivalent to the IRRs. RESULTS . Implementation of the policy deregulating alcohol sales and production did not appear to increase traffic fatalities and other traffic crashes in Japan. In the overall study results, nighttime fatalities were reduced statistically significantly by 6% since the implementation of the alcohol deregulation policy in 1994. Discussion. Contrary to previous research, the findings of this study demonstrated lower rates of fatalities and higher compliance with alcohol-related driving legislation. Further well-designed, nonaligned studies on alcohol availability and traffic fatalities in other countries are urgently needed.
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Cepeda A, Valdez A, Kaplan C, Hill LE. Patterns of substance use among hurricane Katrina evacuees in Houston, Texas. DISASTERS 2010; 34:426-446. [PMID: 19863564 PMCID: PMC3008163 DOI: 10.1111/j.1467-7717.2009.01136.x] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
This paper focuses on changing patterns of substance use among low income, African American drug users evacuated from New Orleans, Louisiana, during Hurricane Katrina of August 2005. It examines the relationship between increases and decreases in alcohol and tobacco (AT) use and illicit drug (ID) use after Katrina and pre-disaster and within-disaster factors. Data from structured interviews with 200 Katrina evacuees currently living in Houston were collected 8-14 months after the disaster. Multivariate analysis revealed that rises in AT use were positively associated with education. Females and younger evacuees were more likely to have increased AT use. ID use increase was positively associated with resource loss and leaving the city before Katrina. Decreases in AT and ID use were found to be associated with disaster-related exposure. The paper discusses the specific consequences of disasters on disadvantaged minority substance users and the importance of developing public health disaster policies that target this population.
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Affiliation(s)
- Alice Cepeda
- Department of Sociology, Center for Drug and Social Policy Research, University of Houston, TX, USA.
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Wu P, Liu X, Fang Y, Fan B, Fuller CJ, Guan Z, Yao Z, Kong J, Lu J, Litvak IJ. Alcohol abuse/dependence symptoms among hospital employees exposed to a SARS outbreak. Alcohol Alcohol 2008; 43:706-12. [PMID: 18790829 DOI: 10.1093/alcalc/agn073] [Citation(s) in RCA: 234] [Impact Index Per Article: 14.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
AIMS The aim of this study was to examine alcohol abuse/dependence symptoms among hospital employees exposed to a severe acute respiratory syndrome (SARS) outbreak, and the relationship between types of exposure to the SARS outbreak and subsequent alcohol abuse/dependence symptoms. METHODS A survey was conducted among 549 randomly selected hospital employees in Beijing, China, concerning the psychological impact of the 2003 SARS outbreak. Subjects were assessed on sociodemographic factors and types of exposure to the outbreak, and on symptoms of post-traumatic stress (PTS), alcohol abuse/dependence and depression. RESULTS Current alcohol abuse/dependence symptom counts 3 years after the outbreak were positively associated with having been quarantined, or worked in high-risk locations such as SARS wards, during the outbreak. However, having had family members or friends contract, SARS was not related to alcohol abuse/dependence symptom count. Symptoms of PTS and of depression, and having used drinking as a coping method, were also significantly associated with increased alcohol abuse/dependence symptoms. The relationship between outbreak exposure and alcohol abuse/dependence symptom count remained significant even when sociodemographic and other factors were controlled for. When the intrusion, avoidance and hyperarousal PTS symptom clusters were entered into the model, hyperarousal was found to be significantly associated with alcohol abuse/dependence symptoms. CONCLUSIONS Exposure to an outbreak of a severe infectious disease can, like other disaster exposures, lead not only to PTSD but also to other psychiatric conditions, such as alcohol abuse/dependence. The findings will help policy makers and health professionals to better prepare for potential outbreaks of diseases such as SARS or avian flu.
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Affiliation(s)
- Ping Wu
- Mailman School of Public Health, New York State Psychiatric Institute, Columbia University, 1051 Riverside Drive, Unit 43, NY 10032, USA.
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Bluthenthal RN, Cohen DA, Farley TA, Scribner R, Beighley C, Schonlau M, Robinson PL. Alcohol availability and neighborhood characteristics in Los Angeles, California and southern Louisiana. J Urban Health 2008; 85:191-205. [PMID: 18228148 PMCID: PMC2430119 DOI: 10.1007/s11524-008-9255-1] [Citation(s) in RCA: 48] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2007] [Accepted: 01/08/2008] [Indexed: 11/25/2022]
Abstract
The objective of this study was to examine the associations between alcohol availability types and community characteristics in randomly selected census tracts in Southern California and Southeastern Louisiana. Outlet shelf space and price by beverage type was collected from all off-sale alcohol outlets in 189 census tracts by trained research personnel. Three aspects of alcohol availability at the census tract level were considered--outlets per roadway mile, shelf space, and least price by beverage type. Using multivariate analyses, we examined the associations between census tract socioeconomic and demographic characteristics and alcohol availability types. Fifteen measures of alcohol availability were calculated-total shelf space and shelf space by beverage types (beer, malt liquor, and distilled spirits); outlets per roadway mile, per tract, and per capita; and least price by beverage type (including wine). In multivariate analyses controlling for state, male unemployment rate was inversely associated with total shelf space (p = 0.03) and distilled spirit shelf space (p = 0.05). Malt liquor shelf space was inversely associated with percent White (p = 0.02). Outlets per roadway mile was positively associated with household poverty (p < 0.0001), whereas percent African American was inversely associated with outlets per roadway mile (p = 0.03). Beverage-specific least prices were not associated with any socioeconomic or demographic community characteristics. Alcohol availability types, but not least price, were associated with some community characteristics. More research exploring how alcohol availability types vary by community and their relationship to alcohol-related harms should be conducted.
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Affiliation(s)
- Ricky N Bluthenthal
- Health Program and Drug Policy Research Center, RAND Corporation, 1776 Main Street, P.O. Box 2138, Santa Monica, CA 90407-2138, USA.
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North CS, Kawasaki A, Spitznagel EL, Hong BA. The course of PTSD, major depression, substance abuse, and somatization after a natural disaster. J Nerv Ment Dis 2004; 192:823-9. [PMID: 15583503 DOI: 10.1097/01.nmd.0000146911.52616.22] [Citation(s) in RCA: 139] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Flood research has used a variety of methods, yielding inconsistent findings. Universal definitions of illness are paramount to the science of psychiatric epidemiology of disasters. St. Louis area survivors (N = 162) of the Great Midwestern Floods of 1993 received a structured diagnostic assessment at 4 and 16 months postdisaster, with 88% follow-up. The purpose of the assessment was to examine predisaster and postdisaster rates of disorders and symptoms. Flood-related posttraumatic stress disorder was diagnosed in 22% and 16% at index and follow-up, respectively. Comorbidity with major depression determined whether the posttraumatic stress disorder would have remitted by 1 year later. Nearly one half of the men in the sample had a pre-existing alcohol use disorder. Virtually no new substance abuse followed the floods, and hence, substance abuse did not develop in response to the disaster or as part of coping with its aftermath. Somatization disorder was not observed; new somatoform symptoms represented a fraction of postflood somatic complaints. Findings are inconsistent with causal attribution of floods in the etiology of alcohol abuse and somatization. Methodological differences may account for much of the apparent discrepancy of these findings, with recent reports of increased alcohol use and somatic symptoms observed after other disasters.
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Affiliation(s)
- Carol S North
- Washington University School of Medicine, Department of Psychiatry, St. Louis, Missouri 63110, USA
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Stewart SH, Mitchell TL, Wright KD, Loba P. The relations of PTSD symptoms to alcohol use and coping drinking in volunteers who responded to the Swissair Flight 111 airline disaster. J Anxiety Disord 2004; 18:51-68. [PMID: 14725868 DOI: 10.1016/j.janxdis.2003.07.006] [Citation(s) in RCA: 99] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
We investigated the effects of the 1998 Swissair Flight 111 (SA 111) disaster on a variety of indices of alcohol use among volunteer responders. We retrospectively administered standardized questionnaires and a semi-structured interview to 13 volunteer disaster workers recruited from the community. According to the interview, 54% of the volunteers were exposed to human remains. According to Modified Post-Traumatic Stress Disorder (PTSD) Symptoms Scale responses, 46% met DSM-IV criteria for PTSD. Frequency and severity of PTSD symptoms, but not human remains exposure, per se, were positively correlated with coping-motivated drinking (but not social or mood enhancement drinking) and with alcohol use to forget. The re-experiencing and hyper-arousal PTSD symptom dimensions showed the strongest and most consistent correlations with the alcohol use indices. We discuss ways in which the information gleaned from this sample can be used to improve disaster response planning to minimize the probability of maladaptive coping drinking among volunteers.
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Affiliation(s)
- Sherry H Stewart
- Department of Psychology, Dalhousie University, 1355 Oxford St, Halifax, NS, Canada B3H 4J1.
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