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Van Overmeire R, Six S, Deschepper R, Vandekerckhove M, Bilsen J. Association Between Feeling Threatened, Behaviour and Symptoms of Anxiety and Depression: Two and a Half Years After the Terrorist Attacks in Belgium. Community Ment Health J 2022; 58:657-665. [PMID: 34241739 DOI: 10.1007/s10597-021-00867-w] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Accepted: 06/27/2021] [Indexed: 10/20/2022]
Abstract
Feeling threatened by terrorism can be associated with mental health problems and behavioural changes. However, few studies look at the association in the long-term. Using a survey, the population in Brussels, Belgium was studied using a representative database delivered by the national post service. The Patient Health Questionnaire-4 (PHQ-4) assessed mental health, and self-made questions avoidance behaviour. 170 people answered: 60% women and 50% higher educated, 28.2% between 56 and 65 years and 62.4% had a partner. 43.5% felt threatened by the terrorist attacks and 45.9% experienced no mental health problems. Both terrorist threat (p < 0.001) and avoidance behaviour (p < 0.001) significantly predicted PHQ-4 scores, while controlling for gender, age, social support, education level, and traumatic events. There is a relation between terrorist threat and anxiety/depressive symptoms 2.5 years after the last study on terrorist threat in Brussels, but it has weakened. Avoidance behaviour seems to be more present than threat.
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Affiliation(s)
- Roel Van Overmeire
- Mental Health & Wellbeing Research Group, Vrije Universiteit Brussel, Brussels, Belgium.
| | - Stefaan Six
- Mental Health & Wellbeing Research Group, Vrije Universiteit Brussel, Brussels, Belgium
| | - Reginald Deschepper
- Mental Health & Wellbeing Research Group, Vrije Universiteit Brussel, Brussels, Belgium
| | - Marie Vandekerckhove
- Department of Psychology, Biological Psychology, Vrije Universiteit Brussel, Brussels, Belgium
| | - Johan Bilsen
- Mental Health & Wellbeing Research Group, Vrije Universiteit Brussel, Brussels, Belgium
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The association between socioeconomic status and reactions to radiation exposure: a cross-sectional study after the Fukushima Daiichi nuclear power station accident. PLoS One 2018; 13:e0205531. [PMID: 30379864 PMCID: PMC6209195 DOI: 10.1371/journal.pone.0205531] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2018] [Accepted: 09/26/2018] [Indexed: 11/21/2022] Open
Abstract
Risk perception and individual reactions to risk are not necessarily comparable, and socioeconomic status may affect individual reactions to risk. This study aimed to investigate the association between socioeconomic status and reactions to radiation exposure risk. This cross-sectional study, based on a self-reported online survey was conducted between 3 March and 21 March 2012, one year after the accident at Fukushima Daiichi nuclear power station. We used feelings of anxiety and risk-averse behavior concerning radiation exposure as dependent variables, and equivalent income and educational attainment as independent variables. Multiple logistic regression analysis was applied to estimate adjusted odds ratios (aORs) and 95% confidence intervals (95% CIs) with adjustment for possible confounders. Among 10 000 participants, 23.0% felt anxious and 12.0% engaged in risk-averse behavior for radiation exposure. Participants with a higher socioeconomic status tended not to feel anxious but undertook risk-averse behavior. Participants in the highest quartile income category did not report feeling anxious but showed prevalent undertaking of risk-averse behavior for radiation exposure compared to the lowest income category (for anxiety, aOR, 0.77; 95% CI, 0.64–0.93, for risk-averse behavior, aOR, 1.33; 95% CI, 1.04–1.69). University or graduate-school graduates were associated with greater risk-averse behavior compared to junior high school or high school graduates (aOR, 1.49; 95% CI, 1.29–1.73). Socioeconomic status may affect reactions to radiation exposure risk. Risk communication strategies should consider the socioeconomic status of those affected.
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Power S, Symons C, Carter H, Jones E, Amlôt R, Larner J, Matar H, Chilcott RP. Mass Casualty Decontamination in the United States: An Online Survey of Current Practice. Health Secur 2016; 14:226-36. [PMID: 27442794 DOI: 10.1089/hs.2016.0047] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Mass casualty decontamination is a public health intervention that would be employed by emergency responders following a chemical, biological, or radiological incident. The decontamination of large numbers of casualties is currently most often performed with water to remove contaminants from the skin surface. An online survey was conducted to explore US fire departments' decontamination practices and their preparedness for responding to incidents involving mass casualty decontamination. Survey respondents were asked to provide details of various aspects of their decontamination procedures, including expected response times to reach casualties, disrobing procedures, approaches to decontamination, characteristics of the decontamination showering process, provision for special populations, and any actions taken following decontamination. The aim of the survey was to identify any differences in the way in which decontamination guidance is implemented across US states. Results revealed that, in line with current guidance, many US fire departments routinely use the "ladder-pipe system" for conducting rapid, gross decontamination of casualties. The survey revealed significant variability in ladder-pipe construction, such as the position and number of fire hoses used. There was also variability in decontamination characteristics, such as water temperature and water pressure, detergent use, and shower duration. The results presented here provide important insights into the ways in which implementation of decontamination guidance can vary between US states. These inconsistencies are thought to reflect established perceived best practices and local adaptation of response plans to address practical and logistical constraints. These outcomes highlight the need for evidence-based national guidelines for conducting mass casualty decontamination.
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Developing a Conceptual Framework for Investigating Communication Supporting Community Resilience. SOCIETIES 2015. [DOI: 10.3390/soc5030583] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Cheng Z, Ma N, Yang L, Agho K, Stevens G, Raphael B, Cui L, Liu Y, Yan B, Ma H, Yu X. Depression and posttraumatic stress disorder in temporary settlement residents 1 year after the Sichuan earthquake. Asia Pac J Public Health 2013; 27:NP1962-72. [PMID: 23666829 DOI: 10.1177/1010539513485971] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
The authors sought to determine the prevalence and risk factors for major depressive disorder and posttraumatic stress disorder (PTSD) among survivors living in temporary accommodation in the Yongxing settlement in Mianyang city 1 year after the Sichuan earthquake for further interventions. They interviewed 182 residents, using the Structured Clinical Interview for DSM-IV Axis I Disorders and a self-report questionnaire. The 12-month prevalence of depressive disorder and PTSD were 48.9% and 39.6%, respectively. Multivariate analysis indicated that bereaved survivors were 5.51 times (adjusted odds ratio [AOR] = 5.51; 95% confidence interval [CI] =2.14-14.22) more likely to report PTSD and 2.42 times (AOR = 2.42; 95%CI =1.00-5.48) more likely to report depressive disorder than nonbereaved survivors. Older age and receipt of government financial support were significantly associated with 12-month PTSD. Depressive disorder 12 months after the earthquake was associated with receipt of government financial support, pre-earthquake physical illness, single marital status, being currently employed, and Han ethnicity.
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Affiliation(s)
| | - Ning Ma
- Peking University, Beijing, China
| | - Lei Yang
- Peking University, Beijing, China
| | - Kingsley Agho
- University of Western Sydney, Parramatta, New South Wales, Australia
| | - Garry Stevens
- University of Western Sydney, Parramatta, New South Wales, Australia
| | - Beverley Raphael
- University of Western Sydney, Parramatta, New South Wales, Australia
| | - Lijun Cui
- Hebei Province Mental Health Center, Hebei, China
| | - Yongqiao Liu
- Hebei Province Mental Health Center, Hebei, China
| | - Baoping Yan
- Hebei Province Mental Health Center, Hebei, China
| | - Hong Ma
- Peking University, Beijing, China
| | - Xin Yu
- Peking University, Beijing, China
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Stevens G, Agho K, Taylor M, Jones AL, Barr M, Raphael B. Perceived coping & concern predict terrorism preparedness in Australia. BMC Public Health 2012; 12:1117. [PMID: 23270424 PMCID: PMC3552997 DOI: 10.1186/1471-2458-12-1117] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2012] [Accepted: 12/22/2012] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND In the aftermath of major terrorist incidents research shows population shifts towards protective behaviours, including specific preparedness and avoidance responses. Less is known about individual preparedness in populations with high assumed threat but limited direct exposure, such as Australia. In this study we aimed to determine whether individuals with high perceived coping and higher concern would show greater preparedness to respond to terrorism threats. METHODS Adults in New South Wales (NSW) completed terrorism perception and response questions as part of computer assisted telephone interviews (CATI) in 2010 (N=2038). Responses were weighted against the NSW population. Multiple logistic regression analyses were conducted to evaluate the relationship between personal coping/concern factors and terrorism-related preparedness and avoidance behaviours, and to control for potential confounders such as socio-demographic and threat perception factors. RESULTS Increased vigilance for suspicious behaviours was the most commonly reported behavioural response to perceived terrorism threat. Multivariate analyses showed that the factor combination of high perceived coping and higher concern was the most consistent predictor of terrorism preparedness behaviours and evacuation intentions, including increased vigilance (Adjusted Odd Ratios (AOR)=2.07, p=0.001) learning evacuation plans (AOR=1.61, p=0.05), establishing emergency contact plans (AOR=2.73, p<0.001), willingness to evacuate homes (AOR=2.20, p=0.039), and willingness to evacuate workplaces or public facilities (AOR=6.19, p=0.015) during potential future incidents. CONCLUSION The findings of this study suggest that terrorism preparedness behaviours are strongly associated with perceived high coping but that this relationship is also mediated by personal concerns relating to this threat. Cognitive variables such as coping self-efficacy are increasingly targeted as part of natural hazard preparedness and are a viable intervention target for terrorism preparedness initiatives. Raising individual coping perceptions may promote greater general and incident-specific preparedness and could form an integral element of community resilience strategies regarding this threat.
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Affiliation(s)
- Garry Stevens
- University of Western Sydney, School of Medicine, Building EV, Parramatta Campus, Locked Bag 1797, Penrith, NSW 2751, Australia
| | - Kingsley Agho
- University of Western Sydney, School of Medicine, Building EV, Parramatta Campus, Locked Bag 1797, Penrith, NSW 2751, Australia
| | - Melanie Taylor
- University of Western Sydney, School of Medicine, Building EV, Parramatta Campus, Locked Bag 1797, Penrith, NSW 2751, Australia
| | - Alison L Jones
- University of Wollongong, Graduate School of Medicine, Building 28, Wollongong, NSW 2522, Australia
- Illawarra Health and Medical Research Institute, Wollongong, NSW, Australia
| | - Margo Barr
- Centre for Epidemiology and Research, New South Wales Ministry of Health, 73 Miller Street, North Sydney, NSW 2060, Australia
| | - Beverley Raphael
- University of Western Sydney, School of Medicine, Building EV, Parramatta Campus, Locked Bag 1797, Penrith, NSW 2751, Australia
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Stevens G, Agho K, Taylor M, Jones AL, Jacobs J, Barr M, Raphael B. Alert but less alarmed: a pooled analysis of terrorism threat perception in Australia. BMC Public Health 2011; 11:797. [PMID: 21992446 PMCID: PMC3205065 DOI: 10.1186/1471-2458-11-797] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2011] [Accepted: 10/12/2011] [Indexed: 11/25/2022] Open
Abstract
Background Previous Australian research has highlighted disparities in community perceptions of the threat posed by terrorism. A study with a large sample size is needed to examine reported concerns and anticipated responses of community sub-groups and to determine their consistency with existing Australian and international findings. Methods Representative samples of New South Wales (NSW) adults completed terrorism perception questions as part of computer assisted telephone interviews (CATI) in 2007 (N = 2081) and 2010 (N = 2038). Responses were weighted against the NSW population. Data sets from the two surveys were pooled and multivariate multilevel analyses conducted to identify health and socio-demographic factors associated with higher perceived risk of terrorism and evacuation response intentions, and to examine changes over time. Results In comparison with 2007, Australians in 2010 were significantly more likely to believe that a terrorist attack would occur in Australia (Adjusted Odd Ratios (AOR) = 1.24, 95%CI:1.06-1.45) but felt less concerned that they would be directly affected by such an incident (AOR = 0.65, 95%CI:0.55-0.75). Higher perceived risk of terrorism and related changes in living were associated with middle age, female gender, lower education and higher reported psychological distress. Australians of migrant background reported significantly lower likelihood of terrorism (AOR = 0.52, 95%CI:0.39-0.70) but significantly higher concern that they would be personally affected by such an incident (AOR = 1.57, 95%CI:1.21-2.04) and having made changes in the way they live due to this threat (AOR = 2.47, 95%CI:1.88-3.25). Willingness to evacuate homes and public places in response to potential incidents increased significantly between 2007 and 2010 (AOR = 1.53, 95%CI:1.33-1.76). Conclusion While an increased proportion of Australians believe that the national threat of terrorism remains high, concern about being personally affected has moderated and may reflect habituation to this threat. Key sub-groups remain disproportionately concerned, notably those with lower education and migrant groups. The dissonance observed in findings relating to Australians of migrant background appears to reflect wider socio-cultural concerns associated with this issue. Disparities in community concerns regarding terrorism-related threat require active policy consideration and specific initiatives to reduce the vulnerabilities of known risk groups, particularly in the aftermath of future incidents.
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Affiliation(s)
- Garry Stevens
- School of Medicine, University of Western Sydney, Penrith NSW DC2751, Australia.
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Taylor M, Barr M, Stevens G, Bryson-Taylor D, Agho K, Jacobs J, Raphael B. Psychosocial stress and strategies for managing adversity: measuring population resilience in New South Wales, Australia. Popul Health Metr 2010; 8:28. [PMID: 20942975 PMCID: PMC2965129 DOI: 10.1186/1478-7954-8-28] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2010] [Accepted: 10/14/2010] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Populations around the world are facing an increasing number of adversities such as the global financial crisis, terrorism, conflict, and climate change. The aim of this paper was to investigate self-reported strategies and sources of support used to get through "tough times" in an Australian context and to identify patterns of response in the general population and differences in potentially vulnerable subgroups. METHODS Data were collected through a cross-sectional survey of the New South Wales population in Australia. The final sample consisted of 3,995 New South Wales residents aged 16 years and above who responded to the question: "What are the things that get you through tough times?" RESULTS Respondents provided brief comments that were coded into 14 main subject-area categories. The most frequently reported responses were family and self (52%); friends and neighbors (21%); use of positive emotional and philosophical strategies (17%), such as sense of humor, determination, and the belief that things would get better; and religious beliefs (11%). The responses of four population subgroups were compared, based on gender, household income, level of psychological distress, and whether a language other than English was spoken at home. Women reported greater use of friends and neighbors and religious or spiritual beliefs for support, whereas men reported greater use of drinking/smoking and financial supports. Those with lower incomes reported greater reliance on positive emotional and philosophical strategies and on religious or spiritual beliefs. Those with high levels of psychological distress reported greater use of leisure interests and hobbies, drinking/smoking, and less use of positive lifestyle strategies, such as adequate sleep, relaxation, or work/life balance. Those who spoke a language other than English at home were less likely to report relying on self or others (family/friends) or positive emotional and philosophical strategies to get through tough times. CONCLUSIONS Understanding strategies and sources of support used by the population to get through adversity is the first step toward identifying the best approaches to build and support strengths and reduce vulnerabilities. It is also possible to reflect on how large-scale threats such as pandemics, disasters, conflict, bereavement, and loss could impact individual and population resilience.
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Affiliation(s)
- Melanie Taylor
- School of Medicine, University Western Sydney, Building EV, Parramatta South Campus, Locked Bag 1797, Penrith South DC, NSW, 1797, Australia.
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Stevens G, Taylor M, Barr M, Jorm L, Giffin M, Ferguson R, Agho K, Raphael B. Public perceptions of the threat of terrorist attack in Australia and anticipated compliance behaviours. Aust N Z J Public Health 2009; 33:339-46. [PMID: 19689594 DOI: 10.1111/j.1753-6405.2009.00405.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
OBJECTIVE To determine the perceived threat of terrorist attack in Australia and preparedness to comply with public safety directives. METHODS A representative sample of 2,081 adults completed terrorism perception questions as part of the New South Wales Population Health Survey. RESULTS Overall, 30.3% thought a terrorist attack in Australia was highly likely, 42.5% were concerned that self or family would be directly affected and 26.4% had changed the way they lived due to potential terrorist attacks. Respondents who spoke a language other than English at home were 2.47 times (Odds Ratios (OR=2.47, 95% CI:1.58-3.64, p<0.001) more likely to be concerned self or family would be affected and 2.88 times (OR=2.88, 95% CI:1.95-4.25, p<0.001) more likely to have changed the way they lived due to the possibility of terrorism. Those with high psychological distress perceived higher terrorism likelihood and greater concern that self or family would be directly affected (OR=1.84, 95% CI:1.05-3.22, p=0.034). Evacuation willingness was high overall but those with poor self-rated health were significantly less willing to leave their homes during a terrorism emergency. CONCLUSION Despite not having experienced recent terrorism within Australia, perceived likelihood of an attack was higher than in comparable western countries. Marginalisation of migrant groups associated with perceived terrorism threat may be evident in the current findings. IMPLICATIONS This baseline data will be useful to monitor changes in population perceptions over time and determine the impact of education and other preparedness initiatives.
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Affiliation(s)
- Garry Stevens
- School of Medicine, University of Western Sydney, New South Wales, Australia.
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