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Heanoy EZ, Brown NR. Impact of Natural Disasters on Mental Health: Evidence and Implications. Healthcare (Basel) 2024; 12:1812. [PMID: 39337153 PMCID: PMC11430943 DOI: 10.3390/healthcare12181812] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2024] [Revised: 09/06/2024] [Accepted: 09/07/2024] [Indexed: 09/30/2024] Open
Abstract
Natural disasters are large-scale catastrophic events, and they are increasing in frequency and severity. Converging evidence indicates that the mental health consequences of disasters are extensive and are often associated with trauma and the disruption of personal and socioeconomic factors in people's lives. Although most individuals experiencing disaster-related traumatic events do not develop mental illnesses, some experience adverse psychological effects of disasters. These mental health effects begin immediately following a disaster and may persist for extended periods. In this article, we summarize the literature findings to provide a narrative review that focuses on the mental health consequences of natural disasters. An overview of the disaster mental health research field is provided, and the findings are ordered into theoretical frameworks. Then, the development and course of psychopathology regarding disaster aftermath are described in a methodological context. Next, understanding a disaster as an event of transition is highlighted, and the impact of this disaster-specific transition is discussed. Lastly, a potential relationship between the transitional impact of a disaster and mental health consequences is speculated on, and the implications are discussed. The impact of disasters on mental health can be direct or indirect, short-term or long-term, and to some extent depends on the recovery process of the affected community. Also, we propose the possible merits of using the Transitional Impact Scale in the context of disaster mental health research by assessing the features of disaster-related transition and its effects on mental health. We conclude by suggesting a direction for future research in terms of measuring the disaster mental health effects in community settings (affected vs. non-affected) and also considering cross-cultural and cross-regional differences. In recent decades, a large amount of knowledge has been gathered from disaster mental health research, but, still, more research is needed to resolve some irregular findings through refining the methodological variations.
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Affiliation(s)
- Eamin Z. Heanoy
- Department of Psychology, University of Alberta, Edmonton, AB T6G 2E9, Canada;
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Maya S, Mirzazadeh A, Kahn JG. Effect of wildfire on the prevalence of opioid misuse through anxiety among young adults in the United States: a modeling study. BMC Public Health 2024; 24:1915. [PMID: 39014350 PMCID: PMC11253393 DOI: 10.1186/s12889-024-19417-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2024] [Accepted: 07/09/2024] [Indexed: 07/18/2024] Open
Abstract
BACKGROUND Exposure to climate change events like wildfires can lead to health and mental health problems. While conceptual frameworks have been hypothesized describing the potential relationship between disaster exposure and substance use, the association remains under-researched and unquantified. METHODS We constructed a quantitative portrayal of one proposed conceptual framework that focuses on the intermediary role of anxiety. We used the Monte Carlo simulation to estimate the impact of wildfire exposure on opioid misuse outcomes through increased anxiety. We searched for and extracted prior empirical evidence on the associations between wildfire anxiety and anxiety-opioid misuse. Three scenarios were devised: in S1 the impact of wildfire on opioid misuse was limited to increasing anxiety incidence; in S2 we also considered the additive role of altered anxiety phenotype; and in S3 we further considered the role of increased opioid-related consequences of pre-existing anxiety due to wildfire exposure. RESULTS Models show that the prevalence of opioid misuse post-wildfire may rise to 6.0%-7.2% from a baseline of 5.3%. In S1, the opioid misuse prevalence ratio was 1.12 (95% uncertainty interval [UI]: 1.00 - 1.27). The two exploratory scenarios, with less stringent assumptions, yielded prevalence ratios of 1.23 (95% UI: 1.00 - 1.51) and 1.34 (95% UI: 1.11 - 1.63). CONCLUSIONS Our modeling study suggests that exposure to wildfires may elevate opioid misuse through increasing anxiety incidence and severity. This can lead to substantial health burdens, possibly beyond the duration of the wildfire event, which may offset recent gains in opioid misuse prevention.
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Affiliation(s)
- Sigal Maya
- Philip R. Lee Institute for Health Policy Studies, University of California San Francisco, San Francisco, CA, USA.
| | - Ali Mirzazadeh
- Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, CA, USA
| | - James G Kahn
- Philip R. Lee Institute for Health Policy Studies, University of California San Francisco, San Francisco, CA, USA
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El Haddad M, Zeghnoun A, Richard JB, Saoudi A, Pédrono G, Perrine AL, Motreff Y, Blanchard M, Morel P, Le Lay E, Golliot F, Empereur-Bissonnet P. Health-related quality of life 1 year after a large-scale industrial fire among exposed inhabitants of Rouen, France: 'The Post Fire 76 Health' study. Eur J Public Health 2024; 34:550-556. [PMID: 38507556 PMCID: PMC11161166 DOI: 10.1093/eurpub/ckae047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/22/2024] Open
Abstract
BACKGROUND A large-scale industrial fire occurred in Rouen, France, in 2019. This study assessed the health-related quality of life of people exposed to its consequences 1 year later. METHODS The study population comprised inhabitants of the exposed area and a non-exposed area. A representative sample was randomly selected using a stratified design. Data were collected using a standardized questionnaire to describe fire exposure and to calculate three health-related quality of life scores according to the SF12-v2 scale. After adjustment, descriptive and multivariate analyses were conducted. RESULTS The sample comprised 4773 participants (response rate 47.7%). In the exposed area, the average mental, physical and overall health scores were 47.5, 52.0 and 73.8 out of 100, respectively. Mean mental and overall health scores were higher in the non-exposed area (49.0 and 76.0, respectively). After adjustment, a lower mental health score was associated with a higher number of perceived types of exposure, reaching -3.72 points [-5.41; -2.04] for five or more different types of perceived exposure. A lower mental health score was associated with soot deposits (-1.04 [-1.70; -0.39]), perceiving odours [(-2.04 [-3.22; -0.86]) up to the day of data collection], and having seen, heard or been awakened by the fire (-1.21 [-1.90; -0.52]). A slightly lower physical health score was associated with soot deposits (-0.57 [-1.07; -0.08]). CONCLUSION This study highlighted associations between exposure to the consequences of the industrial fire in Rouen and a deterioration of perceived health-related quality of life 1 year later, particularly the mental health dimension.
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Affiliation(s)
- Maria El Haddad
- Data Science Division, French National Public Health Agency, Saint Maurice, France
| | - Abdelkrim Zeghnoun
- Data Science Division, French National Public Health Agency, Saint Maurice, France
| | | | - Abdessattar Saoudi
- Data Science Division, French National Public Health Agency, Saint Maurice, France
| | - Gaëlle Pédrono
- Data Science Division, French National Public Health Agency, Saint Maurice, France
| | - Anne-Laure Perrine
- Data Science Division, French National Public Health Agency, Saint Maurice, France
| | - Yvon Motreff
- Non-Communicable Diseases and Trauma Division, French National Public Health Agency, Saint Maurice, France
- Department of Social Epidemiology, Inserm, Sorbonne Université, Institut Pierre Louis d’Epidémiologie et de Santé Publique (IPLESP), Paris, France
| | - Myriam Blanchard
- Regional Division, French National Public Health Agency, Normandy, France
| | - Pauline Morel
- Regional Division, French National Public Health Agency, Normandy, France
| | - Emmanuelle Le Lay
- International Scientific Division, French National Public Health Agency, Saint Maurice, France
| | - Franck Golliot
- Regional Division, French National Public Health Agency, Saint Maurice, France
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Obuobi-Donkor G, Shalaby R, Agyapong B, da Luz Dias R, Agyapong VIO. 2023 Wildfires in Canada: Living in Wildfire Regions in Alberta and Nova Scotia Doubled the Odds for Residents to Experience Likely Generalized Anxiety Disorder Symptoms. J Clin Med 2024; 13:3234. [PMID: 38892945 PMCID: PMC11172488 DOI: 10.3390/jcm13113234] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2024] [Revised: 05/20/2024] [Accepted: 05/26/2024] [Indexed: 06/21/2024] Open
Abstract
Background: Wildfires have become increasingly prevalent in various regions, resulting in substantial environmental and psychological consequences that have garnered increasing attention. Objective: This study aims to examine the prevalence of likely Generalized Anxiety Disorder (GAD) and explore the determinants of likely GAD during the wildfires in Alberta and Nova Scotia. Methods: Data were collected online through a cross-sectional survey from 14 May-23 June 2023. Alberta and Nova Scotia participants self-subscribed to the program by texting 'HopeAB' or 'HopeNS' to a short code, respectively. The GAD-7-validated tool was used to collect information on likely GAD. Results: This study included 298 respondents while one hundred and twelve respondents lived in a region of Alberta/Nova Scotia affected by the wildfires (37.7%). The prevalence of likely GAD among the respondents was 41.9%. Respondents who lived in a region of Alberta/Nova Scotia recently impacted by the wildfires were twice as likely to experience GAD symptoms (OR = 2.4; 95% C.I. 1.3-4.3). Conclusions: The study's identification of a statistically significant relationship between residing in a wildfire-impacted region and likely GAD shows the association between environmental and psychological well-being. However, the relatively small sample size and self-reported assessment of GAD symptoms may limit the generalizability of the findings. Further research involving a larger sample size delving into potential predictors could facilitate strategies for mitigating the mental health consequences of natural disasters.
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Affiliation(s)
- Gloria Obuobi-Donkor
- Department of Psychiatry, Faculty of Medicine, Dalhousie University, Halifax, NS B3H 4R2, Canada; (G.O.-D.); (R.d.L.D.)
| | - Reham Shalaby
- Department of Psychiatry, University of Alberta, Edmonton, AB T6G 2R3, Canada; (R.S.); (B.A.)
| | - Belinda Agyapong
- Department of Psychiatry, University of Alberta, Edmonton, AB T6G 2R3, Canada; (R.S.); (B.A.)
| | - Raquel da Luz Dias
- Department of Psychiatry, Faculty of Medicine, Dalhousie University, Halifax, NS B3H 4R2, Canada; (G.O.-D.); (R.d.L.D.)
| | - Vincent Israel Opoku Agyapong
- Department of Psychiatry, Faculty of Medicine, Dalhousie University, Halifax, NS B3H 4R2, Canada; (G.O.-D.); (R.d.L.D.)
- Department of Psychiatry, University of Alberta, Edmonton, AB T6G 2R3, Canada; (R.S.); (B.A.)
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Johnston FH, Williamson G, Borchers-Arriagada N, Henderson SB, Bowman DMJS. Climate Change, Landscape Fires, and Human Health: A Global Perspective. Annu Rev Public Health 2024; 45:295-314. [PMID: 38166500 DOI: 10.1146/annurev-publhealth-060222-034131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2024]
Abstract
Landscape fires are an integral component of the Earth system and a feature of prehistoric, subsistence, and industrial economies. Specific spatiotemporal patterns of landscape fire occur in different locations around the world, shaped by the interactions between environmental and human drivers of fire activity. Seven distinct types of landscape fire emerge from these interactions: remote area fires, wildfire disasters, savanna fires, Indigenous burning, prescribed burning, agricultural burning, and deforestation fires. All can have substantial impacts on human health and well-being directly and indirectly through (a) exposure to heat flux (e.g., injuries and destructive impacts), (b) emissions (e.g., smoke-related health impacts), and (c) altered ecosystem functioning (e.g., biodiversity, amenity, water quality, and climate impacts). Minimizing the adverse effects of landscape fires on population health requires understanding how human and environmental influences on fire impacts can be modified through interventions targeted at individual, community, and regional levels.
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Affiliation(s)
- Fay H Johnston
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia;
- National Health and Medical Research Council (NHMRC) Centre for Safe Air, Hobart, Tasmania, Australia
| | - Grant Williamson
- School of Natural Sciences, University of Tasmania, Hobart, Tasmania, Australia
- National Health and Medical Research Council (NHMRC) Centre for Safe Air, Hobart, Tasmania, Australia
| | | | - Sarah B Henderson
- Environmental Health Services, British Columbia Centre for Disease Control, Vancouver, British Columbia, Canada
| | - David M J S Bowman
- School of Natural Sciences, University of Tasmania, Hobart, Tasmania, Australia
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Adu MK, Shalaby R, Agyapong B, Dias RDL, Agyapong VIO. Exploring the prevalence and predictors of low resilience and likely PTSD in residents of two provinces in Canada during the 2023 wildfires. Front Public Health 2024; 12:1343399. [PMID: 38590805 PMCID: PMC10999595 DOI: 10.3389/fpubh.2024.1343399] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2023] [Accepted: 02/29/2024] [Indexed: 04/10/2024] Open
Abstract
Background The recent wildfires in Canada serve as a stark example of the substantial and enduring harm they cause to the health of individuals and communities. Assessing the prevalence and correlates of Post-traumatic stress disorder (PTSD) and low resilience is valuable for policymakers in public health. Objectives The study aimed to assess the prevalence and predictors of low resilience and likely PTSD among subscribers of Text4Hope, an e-mental health program that delivered daily supportive messages to residents of Nova Scotia (NS) and Alberta(AB) during the recent wildfires. Method Data collection was through a self-administered online survey completed by residents of the affected regions of NS and AB from May 14 to June 23, 2023. Data were analyzed using Statistical Package for the Social Sciences. Results Out of 298 respondents, the prevalence of low resilience and likely PTSD in our sample were 52.0 and 39.3%, respectively. Unemployed respondents were about 3 times more likely to experience both low resilience and PTSD symptoms compared to those employed. Respondents with a history of mental health diagnosis were about 4 times more likely to experience likely PTSD compared to those with no history of mental health diagnosis. Conclusion This study established that unemployment and a history of mental health diagnosis predicted likely PTSD, while unemployment was associated with low resilience during the wildfire. These findings offer insights for clinical interventions and the creation of psychosocial support programs for vulnerable populations.
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Affiliation(s)
- Medard K. Adu
- Department of Psychiatry, Dalhousie University, Halifax, NS, Canada
| | - Reham Shalaby
- Department of Psychiatry, University of Alberta, Edmonton, AB, Canada
| | - Belinda Agyapong
- Department of Psychiatry, University of Alberta, Edmonton, AB, Canada
| | | | - Vincent I. O. Agyapong
- Department of Psychiatry, Dalhousie University, Halifax, NS, Canada
- Department of Psychiatry, University of Alberta, Edmonton, AB, Canada
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Maya S, Mirzazadeh A, Kahn JG. Effect of wildfire on the prevalence of opioid misuse through anxiety among young adults in the United States: A modeling study. RESEARCH SQUARE 2024:rs.3.rs-3940689. [PMID: 38464027 PMCID: PMC10925450 DOI: 10.21203/rs.3.rs-3940689/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/12/2024]
Abstract
Background Exposure to climate change events like wildfires can lead to health and mental health problems. While conceptual frameworks have been hypothesized describing the potential relationship between disaster exposure and substance use, the association remains under-researched and unquantified. Methods We constructed a quantitative portrayal of one proposed conceptual framework that focuses on the intermediary role of anxiety. We used the Monte Carlo simulation to estimate the impact of wildfire exposure on opioid misuse outcomes through increased anxiety. We searched for and extracted prior empirical evidence on the associations between wildfire anxiety and anxiety-opioid misuse. A base case scenario (S1) was devised in which the impact of wildfire on opioid misuse was limited to increasing anxiety incidence. Two exploratory scenarios investigated the additive roles of altered anxiety phenotype (S2) and increased severity of pre-existing anxiety (S3) due to wildfire exposure. Results Models show that the prevalence of opioid misuse post-wildfire may rise to 6.0%-7.2%. In S1 (base case), the opioid misuse prevalence ratio was 1.12 (95% uncertainty interval [UI]: 1.00 - 1.27). The two exploratory scenarios, with less stringent assumptions, yielded prevalence ratios of 1.23 (95% UI: 1.00 - 1.51) and 1.34 (95% UI: 1.11 - 1.63). Conclusions Our modeling study suggests that exposure to wildfires may elevate opioid misuse through increasing anxiety incidence and severity. This may lead to substantial health burdens that may persist long after the initial wildfire event, which may offset recent gains in opioid misuse prevention.
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Obuobi-Donkor G, Shalaby R, Agyapong B, Dias RDL, Agyapong VIO. Mitigating Psychological Problems Associated with the 2023 Wildfires in Alberta and Nova Scotia: Six-Week Outcomes from the Text4Hope Program. J Clin Med 2024; 13:865. [PMID: 38337558 PMCID: PMC10856019 DOI: 10.3390/jcm13030865] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2023] [Revised: 01/21/2024] [Accepted: 01/30/2024] [Indexed: 02/12/2024] Open
Abstract
Background: In 2023, wildfires led to widespread destruction of property and displacement of residents in Alberta and Nova Scotia, Canada. Previous research suggests that wildfires increase the psychological burden of impacted communities, necessitating population-level interventions. Cognitive Behavioural Therapy (CBT)-based text message interventions, Text4HopeAB and Text4HopeNS, were launched in Alberta and Nova Scotia, respectively, during the 2023 wildfire season to support the mental health of impacted individuals. Objectives: The study examines the effectiveness of Text4HopeNS and Text4HopeAB in alleviating psychological symptoms and improving wellbeing among subscribers. Methods: The study involved longitudinal and naturalistic controlled trial designs. The longitudinal study comprised subscribers who completed program surveys at baseline and six weeks post-enrolment, while the naturalistic controlled study compared psychological symptoms in subscribers who had received daily supportive text messages for six weeks (intervention group) and new subscribers who had enrolled in the program during the same period but had not yet received any text messages (control group). The severity of low resilience, poor mental wellbeing, likely Major Depressive Disorder (MDD), likely Generalized Anxiety Disorder (GAD), likely Post-Traumatic Stress Disorder (PTSD), and suicidal ideation were measured on the Brief Resilience Scale (BRS), the World Health Organization-5 Wellbeing Index (WHO-5), Patient Health Questionnaire 9 (PHQ-9), Generalized Anxiety Disorder 7 (GAD-7) scale, PTSD Checklist-Civilian Version (PCL-C), and the ninth question on the PHQ-9, respectively. The paired and independent sample t-tests were employed in data analysis. Results: The results from the longitudinal study indicated a significant reduction in the mean scores on the PHQ-9 (-12.3%), GAD-7 (-14.8%), and the PCL-C (-5.8%), and an increase in the mean score on the WHO-5, but not on the BRS, from baseline to six weeks. In the naturalistic controlled study, the intervention group had a significantly lower mean score on the PHQ-9 (-30.1%), GAD-7 (-29.4%), PCL-C (-17.5%), and the ninth question on the PHQ-9 (-60.0%) which measures the intensity of suicidal ideation, and an increase in the mean score on the WHO-5 (+24.7%), but not on the BRS, from baseline to six weeks compared to the control group. Conclusions: The results of this study suggests that the Text4Hope program is an effective intervention for mitigating psychological symptoms in subscribers during wildfires. This CBT-based text messaging program can be adapted to provide effective support for individuals' mental health, especially in the context of traumatic events and adverse experiences such as those induced by climate change. Policymakers and mental health professionals should consider these findings when shaping strategies for future disaster response efforts, emphasizing the value of scalable and culturally sensitive mental health interventions.
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Affiliation(s)
- Gloria Obuobi-Donkor
- Department of Psychiatry, Faculty of Medicine, Dalhousie University, Halifax, NS B3H 4R2, Canada; (G.O.-D.); (R.d.L.D.)
| | - Reham Shalaby
- Department of Psychiatry, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB T6G 2B7, Canada; (R.S.); (B.A.)
| | - Belinda Agyapong
- Department of Psychiatry, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB T6G 2B7, Canada; (R.S.); (B.A.)
| | - Raquel da Luz Dias
- Department of Psychiatry, Faculty of Medicine, Dalhousie University, Halifax, NS B3H 4R2, Canada; (G.O.-D.); (R.d.L.D.)
| | - Vincent Israel Opoku Agyapong
- Department of Psychiatry, Faculty of Medicine, Dalhousie University, Halifax, NS B3H 4R2, Canada; (G.O.-D.); (R.d.L.D.)
- Department of Psychiatry, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB T6G 2B7, Canada; (R.S.); (B.A.)
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Zhang CL, Wu Y, Bao Y, Jiang WY, Hu XJ. Psychological Journey and Coping Styles of Parents of Infants With Biliary Atresia: A Single-Center Qualitative Study. Adv Neonatal Care 2023; 23:E107-E113. [PMID: 37442109 PMCID: PMC10467806 DOI: 10.1097/anc.0000000000001093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/15/2023]
Abstract
BACKGROUND Biliary atresia is a rare and serious neonatal disease that affects the quality of life of both infants and parents. There is currently limited literature on the experiences of parents with infants diagnosed with biliary atresia. PURPOSE To explore the psychological journey and coping styles of parents of infants with biliary atresia in a single center in Shanghai, China. METHODS A qualitative study design was used. Face-to-face and semistructured interviews were conducted with 10 parents of infants with biliary atresia. Colaizzi's method of data analysis was utilized, using NVivo 11.0 software. RESULTS The psychological journey and coping styles of parents could be divided into 4 stages. Different themes were extracted at different stages: before diagnosis, parents experienced complex emotions and actively sought treatment; at the diagnosis stage, negative emotions dominated and parents convinced themselves to accept reality; in the postoperative stage, positive emotions, accepting reality, active response, and the need to learn to take care of their infant gradually appeared; and at the discharge stage, parents accepted the coexistence of positive and negative emotions and the variety of needs that emerged. IMPLICATIONS FOR PRACTICE The findings of the study may help healthcare professionals identify and focus on the psychological needs of parents of infants with biliary atresia, leading them to implement effective coping strategies to increase the caregiving ability of parents. IMPLICATIONS FOR RESEARCH Future research should explore the effects of supportive interventions for parents of infants with serious chronic illnesses.
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Affiliation(s)
- Cheng-Lu Zhang
- Departments of General Surgery (Mss Zhang, Wu, Bao, and Jiang) and Nursing (Dr Hu), National Children's Medical Center, Children's Hospital of Fudan University, Shanghai, China
| | - Ying Wu
- Departments of General Surgery (Mss Zhang, Wu, Bao, and Jiang) and Nursing (Dr Hu), National Children's Medical Center, Children's Hospital of Fudan University, Shanghai, China
| | - Ying Bao
- Departments of General Surgery (Mss Zhang, Wu, Bao, and Jiang) and Nursing (Dr Hu), National Children's Medical Center, Children's Hospital of Fudan University, Shanghai, China
| | - Wen-Yi Jiang
- Departments of General Surgery (Mss Zhang, Wu, Bao, and Jiang) and Nursing (Dr Hu), National Children's Medical Center, Children's Hospital of Fudan University, Shanghai, China
| | - Xiao-Jing Hu
- Departments of General Surgery (Mss Zhang, Wu, Bao, and Jiang) and Nursing (Dr Hu), National Children's Medical Center, Children's Hospital of Fudan University, Shanghai, China
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Woodland L, Ratwatte P, Phalkey R, Gillingham EL. Investigating the Health Impacts of Climate Change among People with Pre-Existing Mental Health Problems: A Scoping Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:ijerph20085563. [PMID: 37107845 PMCID: PMC10138675 DOI: 10.3390/ijerph20085563] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Revised: 03/02/2023] [Accepted: 03/14/2023] [Indexed: 05/11/2023]
Abstract
Climate change is the greatest threat to global public health, although the impacts on mental health are relatively understudied. Furthermore, there is a lack of consensus about the effects of climate change on individuals with pre-existing mental health problems. This review aimed to identify the health impacts of climate change on people with pre-existing mental health problems. The search was conducted across three databases; studies were included if they involved participants who had mental health problem(s) before a climate-driven event and reported on health outcomes post-event. A total of thirty-one studies met the full inclusion criteria. The study characteristics included 6 climate-driven events: heat events, floods, wildfires, wildfire and flood, hurricanes, and droughts, and 16 categories of pre-existing mental health problems, with depression, and non-specified mental health problems being the most common. The majority of the studies (90%, n = 28) suggest an association between the presence of pre-existing mental health problems and the likelihood of adverse health impacts (e.g., increased mortality risk, new symptom presentation, and an exacerbation of symptoms). To mitigate the exacerbation of health inequalities, people with pre-existing mental health problems should be included in adaption guidance and/or plans that mitigate the health impacts of climate change, future policy, reports, and frameworks.
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Affiliation(s)
- Lisa Woodland
- Department of Psychological Medicine, King’s College London, London SE5 9RJ, UK
- NIHR Health Protection Research Unit in Emergency Preparedness and Response, King’s College London, London SE5 9RJ, UK
- Correspondence:
| | - Priyanjali Ratwatte
- Climate Change and Health Unit, UK Health Security Agency, Chilton OX11 0RQ, UK
- Behavioural Science and Insights Unit, UK Health Security Agency, Porton Down, Salisbury SP4 0JG, UK
| | - Revati Phalkey
- Climate Change and Health Unit, UK Health Security Agency, Chilton OX11 0RQ, UK
| | - Emma L. Gillingham
- Climate Change and Health Unit, UK Health Security Agency, Chilton OX11 0RQ, UK
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Lavin R, Couig MP, Kelley PW, Schwarts T, Ramos F. Healthcare Impacts Associated with Federally Declared Disasters-Hurricanes Gustave and Ike. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:5388. [PMID: 37048001 PMCID: PMC10094278 DOI: 10.3390/ijerph20075388] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Revised: 03/17/2023] [Accepted: 03/24/2023] [Indexed: 06/19/2023]
Abstract
People impacted by disasters may have adverse non-communicable disease health effects associated with the disaster. This research examined the independent and joint impacts of federally declared disasters on the diagnosis of hypertension (HTN), diabetes (DM), anxiety, and medication changes 6 months before and after a disaster. Patients seen in zip codes that received a federal disaster declaration for Hurricanes Gustave or Ike in 2008 and who had electronic health records captured by MarketScan® were analyzed. The analysis included patients seen 6 months before or after Hurricanes Gustav and Ike in 2008 and who were diagnosed with HTN, DM, or anxiety. There was a statistically significant association between post-disaster and diagnosis of hypertension, X2 (1, n = 19,328) = 3.985, p = 0.04. There was no association post-disaster and diabetes X2 (1, n = 19,328) = 0.778, p = 0.378 or anxiety, X2 (1, n = 19,328) = 0.017, p = 0.898. The research showed that there was a change in the diagnosis of HTN after a disaster. Changes in HTN are an additional important consideration for clinicians in disaster-prone areas. Data about non-communicable diseases help healthcare disaster planners to include primary care needs and providers in the plans to prevent the long-term health impacts of disasters and expedite recovery efforts.
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Affiliation(s)
- Roberta Lavin
- College of Nursing, University of New Mexico, Albuquerque, NM 87131, USA
| | - Mary Pat Couig
- College of Nursing, University of New Mexico, Albuquerque, NM 87131, USA
| | | | - Thais Schwarts
- Clinical and Translational Science Center, University of New Mexico, Albuquerque, NM 87131, USA
| | - Fermin Ramos
- College of Nursing, University of New Mexico, Albuquerque, NM 87131, USA
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Gao Y, Huang W, Yu P, Xu R, Yang Z, Gasevic D, Ye T, Guo Y, Li S. Long-term impacts of non-occupational wildfire exposure on human health: A systematic review. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2023; 320:121041. [PMID: 36639044 DOI: 10.1016/j.envpol.2023.121041] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Revised: 12/14/2022] [Accepted: 01/06/2023] [Indexed: 06/17/2023]
Abstract
The intensity and frequency of wildfires is increasing globally. The systematic review of the current evidence on long-term impacts of non-occupational wildfire exposure on human health has not been performed yet. To provide a systematic review and identify potential knowledge gaps in the current evidence of long-term impacts of non-occupational exposure to wildfire smoke and/or wildfire impacts on human health. We conducted a systematic search of the literature via MEDLINE, Embase and Scopus from the database inception to July 05, 2022. References from the included studies and relevant reviews were also considered. The Newcastle-Ottawa Scale (NOS) and a validated quality assessment framework were used to evaluate the quality of observational studies. Study results were synthesized descriptively. A total of 36 studies were included in our systematic review. Most studies were from developed countries (11 in Australia, 9 in Canada, 7 in the United States). Studies predominantly focused on mental health (21 studies, 58.33%), while evidence on long-term impacts of wildfire exposure on health outcomes other than mental health is limited. Current evidence indicated that long-term impacts of non-occupational wildfire exposure were associated with mortality (COVID-19 mortality, cardiovascular disease mortality and acute myocardial disease mortality), morbidity (mainly respiratory diseases), mental health disorders (mainly posttraumatic stress disorder), shorter height of children, reduced lung function and poorer general health status. However, no significant associations were observed for long-term impacts of wildfire exposure on child mortality and respiratory hospitalizations. The population-based high-quality evidence with quantitative analysis on this topic is still limited. Future well-designed studies considering extensive wildfire smoke air pollutants (e.g., particulate matter, ozone, nitrogen oxides) and estimating risk coefficient values for extensive health outcomes (e.g., mortality, morbidity) are warranted to fill current knowledge gaps.
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Affiliation(s)
- Yuan Gao
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, 3004, Australia
| | - Wenzhong Huang
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, 3004, Australia
| | - Pei Yu
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, 3004, Australia
| | - Rongbin Xu
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, 3004, Australia
| | - Zhengyu Yang
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, 3004, Australia
| | - Danijela Gasevic
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, 3004, Australia; Centre for Global Health, Usher Institute, The University of Edinburgh, Edinburgh, UK
| | - Tingting Ye
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, 3004, Australia
| | - Yuming Guo
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, 3004, Australia
| | - Shanshan Li
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, 3004, Australia.
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Obuobi-Donkor G, Eboreime E, Shalaby R, Agyapong B, Adu MK, Owusu E, Mao W, Oluwasina F, Pazderka H, Agyapong VIO. Evaluating Community Resilience and Associated Factors One Year after the Catastrophic Fort McMurray Flood. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:16153. [PMID: 36498243 PMCID: PMC9741375 DOI: 10.3390/ijerph192316153] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/10/2022] [Revised: 11/28/2022] [Accepted: 11/29/2022] [Indexed: 06/17/2023]
Abstract
BACKGROUND Resilience after natural disasters is becoming an increasingly key area of research. In April 2020, parts of Fort McMurray were affected by severe floods. The flooding caused the loss of properties, evacuation of some residents, and effects on their mental health. OBJECTIVE This study explores the prevalence and associated factors between flood experience and low resilience a year after the 2020 floods in Fort McMurray. METHOD Data collection was accomplished one year after the flood, from 24 April to 2 June 2021, using an online survey. The data were analyzed with SPSS version 25 using univariate analysis with the chi-squared test and binary logistic regression analysis. RESULTS The prevalence of low resilience was 37.4%. Respondents under 25 years were nearly 26 times more likely to show low resilience (OR = 0.038; 95% CI 0.004-0.384) than respondents 40 years and above. Responders with a history of depression (OR = 0.258 95% CI: 0.089-0.744) and a history of anxiety (OR = 0.212; CI 95% 0.068-0.661) were nearly four to five times more likely to show low resilience than those without a history. Similarly, respondents willing to receive mental health counselling (OR = 0.134 95% CI: 0.047-0.378) were 7.5 times more likely to show low resilience. Participants residing in the same house before the flood were almost 11 times more likely to show low resilience (OR = 0.095; 95% CI 0.021-0.427) than those who relocated. Participants who received support from the Government of Alberta were less likely to express low resilience than those who received no or limited support (OR = 208.343; 95% CI 3.284-13,218.663). CONCLUSION The study showed a low resilience rate among respondents following the 2020 flooding in Fort McMurray. Factors contributing to low resilience include age, history of depression or anxiety, and place of residence after the flood. After the flood, receiving support from the government was shown to be a protective factor. Further studies are needed to explore robust risk factors of low resilience and measures to promote normal to high resilience among flood victims in affected communities.
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Affiliation(s)
| | - Ejemai Eboreime
- Department of Psychiatry, University of Alberta, Edmonton, AB T6G 2R3, Canada
| | - Reham Shalaby
- Department of Psychiatry, University of Alberta, Edmonton, AB T6G 2R3, Canada
| | - Belinda Agyapong
- Department of Psychiatry, University of Alberta, Edmonton, AB T6G 2R3, Canada
| | - Medard K. Adu
- Department of Psychiatry, Dalhousie University, Halifax, NS B3H 4R2, Canada
| | - Ernest Owusu
- Department of Psychiatry, University of Alberta, Edmonton, AB T6G 2R3, Canada
| | - Wanying Mao
- Department of Psychiatry, University of Alberta, Edmonton, AB T6G 2R3, Canada
| | - Folajinmi Oluwasina
- Department of Psychiatry, University of Alberta, Edmonton, AB T6G 2R3, Canada
| | - Hannah Pazderka
- Department of Psychiatry, University of Alberta, Edmonton, AB T6G 2R3, Canada
| | - Vincent I. O. Agyapong
- Department of Psychiatry, Dalhousie University, Halifax, NS B3H 4R2, Canada
- Department of Psychiatry, University of Alberta, Edmonton, AB T6G 2R3, Canada
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Mirabelli MC, Vaidyanathan A, Pennington AF, Ye D, Trenga CA. Wildfire smoke and symptoms affecting mental health among adults in the U.S. state of Oregon. Prev Med 2022; 164:107333. [PMID: 36336164 PMCID: PMC9691586 DOI: 10.1016/j.ypmed.2022.107333] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2022] [Revised: 09/20/2022] [Accepted: 10/30/2022] [Indexed: 11/06/2022]
Abstract
The physical and mental health impacts of wildfires are wide-ranging. We assessed associations between exposure to wildfire smoke and self-reported symptoms affecting mental health among adults living in Oregon. We linked by interview date and county of residence survey responses from 5807 adults who responded to the 2018 Behavioral Risk Factor Surveillance System's depression and anxiety module with smoke plume density, a proxy for wildfires and wildfire smoke exposure. Associations between weeks in the past year with medium and heavy smoke plume densities and symptoms affecting mental health during the two weeks before the interview date were estimated using predicted marginal probabilities from logistic regression models. In the year before completing the interview, 100% of respondents experienced ≥2 weeks of medium or heavy smoke, with an average exposure duration of 32 days. Nearly 10% reported being unable to stop or control their worrying more than half the time over the past two weeks. Medium or heavy smoke for 6 or more weeks in the past year, compared to ≤4 weeks in the past year, was associated with a 30% higher prevalence of being unable to stop or control worrying more than half the time during the past two weeks (prevalence ratio: 1.30, 95% confidence interval: 1.03, 1.65). Among adults in Oregon, selected symptoms affecting mental health were associated with extended durations of medium and heavy smoke. These findings highlight the burden of such symptoms among adults living in communities affected by wildfires and wildfire smoke.
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Affiliation(s)
- Maria C Mirabelli
- Asthma and Community Health Branch, Division of Environmental Health Science and Practice, National Center for Environmental Health, Centers for Disease Control and Prevention, 4770 Buford Highway, NE, Mailstop S106-6, Atlanta, GA 30341, United States of America.
| | - Ambarish Vaidyanathan
- Climate and Health Program, Division of Environmental Health Science and Practice, National Center for Environmental Health, Centers for Disease Control and Prevention, 4770 Buford Highway, NE, Mailstop S106-6, Atlanta, GA 30341, United States of America.
| | - Audrey F Pennington
- Asthma and Community Health Branch, Division of Environmental Health Science and Practice, National Center for Environmental Health, Centers for Disease Control and Prevention, 4770 Buford Highway, NE, Mailstop S106-6, Atlanta, GA 30341, United States of America.
| | - Dongni Ye
- Asthma and Community Health Branch, Division of Environmental Health Science and Practice, National Center for Environmental Health, Centers for Disease Control and Prevention, 4770 Buford Highway, NE, Mailstop S106-6, Atlanta, GA 30341, United States of America; Oak Ridge Institute for Science and Education, P.O. Box 117, Oak Ridge, TN 37831, United States of America
| | - Carol A Trenga
- Public Health Division, Oregon Health Authority, 800 NE Oregon St., Suite 640, Portland, OR 97232, United States of America.
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Agyapong B, Shalaby R, Eboreime E, Wei Y, Agyapong VIO. Self-Reported Alcohol Abuse and the Desire to Receive Mental Health Counselling Predict Suicidal Thoughts/Thoughts of Self-Harm among Female Residents of Fort McMurray. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:13620. [PMID: 36294198 PMCID: PMC9602661 DOI: 10.3390/ijerph192013620] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Revised: 10/11/2022] [Accepted: 10/16/2022] [Indexed: 06/16/2023]
Abstract
Suicidal ideation and thoughts of self-harm continue to be challenging public health problems. It is presently unknown what the prevalence and correlates of suicidal thoughts and self-harm are in female residents of Fort McMurray, a city that has endured wildfires, flooding, and the COVID-19 pandemic in the last five years. This study aimed to determine the prevalence and correlates of suicidal ideation and thoughts of self-harm among female residents of Fort McMurray. A cross-sectional study using an online survey questionnaire was used to collect sociodemographic and clinical information from the residents of Fort McMurray between 24 April and 2 June 2021. Suicidal ideation and thoughts of self-harm among females were assessed using the ninth question of the Patient Health Questionnaire-9, a validated screening tool used to assess depression symptoms. Likely generalized anxiety disorder (GAD), major depressive disorder (MDD), post-traumatic stress disorder (PTSD) and low resilience were measured using standardized rating scales. Data were analyzed with SPSS version 25 using chi-squared tests and multivariate logistic regression analysis. Among Fort McMurray residents, 249 accessed the online survey, while 186 ultimately completed it, yielding a survey completion rate of 74.7%. Of these, 159 (85%) were females. After controlling for other variables in the regression model, respondents who expressed a desire to receive mental health counselling were more than seven times more likely to report suicidal ideation and thoughts of self-harm compared to the respondents who did not desire to receive mental health counselling (OR: 7.29; 95% CI: 1.19-44.58). Similarly, respondents who reported having abused alcohol in the past year were nearly four times more likely to report suicidal ideation or thoughts of self-harm compared to the respondents who said they had not abused alcohol in the past year (OR: 3.91; 95% CI: 1.05-14.57). A high prevalence of suicidal thoughts and thoughts of self-harm were reported among female residents of Fort McMurray. Timely access to adequate mental health support should be offered to female residents of communities impacted by multiple natural disasters, particularly residents who self-report alcohol abuse or desire to receive mental health counselling.
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Affiliation(s)
- Belinda Agyapong
- Department of Psychiatry, University of Alberta, Edmonton, AB T6G 2B7, Canada
| | - Reham Shalaby
- Department of Psychiatry, University of Alberta, Edmonton, AB T6G 2B7, Canada
| | - Ejemai Eboreime
- Department of Psychiatry, University of Alberta, Edmonton, AB T6G 2B7, Canada
| | - Yifeng Wei
- Department of Psychiatry, University of Alberta, Edmonton, AB T6G 2B7, Canada
| | - Vincent I. O. Agyapong
- Department of Psychiatry, University of Alberta, Edmonton, AB T6G 2B7, Canada
- Department of Psychiatry, Dalhousie University, Halifax, NS B3H 2E2, Canada
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16
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Mao W, Adu M, Eboreime E, Shalaby R, Nkire N, Agyapong B, Pazderka H, Obuobi-Donkor G, Owusu E, Oluwasina F, Zhang Y, Agyapong VIO. Post-Traumatic Stress Disorder, Major Depressive Disorder, and Wildfires: A Fifth-Year Postdisaster Evaluation among Residents of Fort McMurray. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:9759. [PMID: 35955114 PMCID: PMC9368448 DOI: 10.3390/ijerph19159759] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/25/2022] [Revised: 07/25/2022] [Accepted: 08/03/2022] [Indexed: 06/15/2023]
Abstract
Background: Over 90,000 residents had to be evacuated from Fort McMurray (FMM), Alberta, Canada due to the wildfire that engulfed the city in May 2016. Overall, about 2400 homes or 10% of the housing stock in Fort McMurray were destroyed. The fire consumed about 200,000 hectors of forest, reaching into Saskatchewan. During major disasters, communities’ infrastructure is disrupted, and psychological, economic, and environmental effects are felt for years afterwards. Objective: Five years after the wildfire disaster, this study assessed the prevalence rate of major depressive disorder (MDD) and post-traumatic stress disorder (PTSD) in Fort McMurray residents and determined the demographic, clinical, and other risk factors of probable MDD and PTSD. Methodology: A quantitative cross-sectional survey was conducted to collect data through an online questionnaire administered via REDCap between 24 April and 2 June 2021. The Patient Health Questionnaire (PHQ-9) was used to assess the presence of MDD symptoms in respondents. The PTSD Checklist for DSM-5 (PCL-C) was used to assess likely PTSD in respondents. Descriptive, univariate, and multivariate regression analyses were employed. Results: 186 out of 249 individuals who accessed the survey link completed it (74.7% response rate). The median age of the subscribers was 42. The sample included a majority of 159 (85.5%) females; 98 (52.7%) > 40 years of age; 175 (94.1%) employed; and 132 (71%) in a relationship. The overall prevalence of MDD symptoms in our study sample was 45.0% (76). Four variables independently predicted MDD symptoms in the multivariate logistic regression model, including: unemployed (OR = 12.39; 95% CI: 1.21−126.37), have received a mental diagnosis of MDD (OR = 4.50; 95% CI: 1.57−12.92), taking sedative-hypnotics (OR = 5.27; 95% CI: 1.01−27.39), and willingness to receive mental health counseling (OR = 4.90; 95% CI: 1.95−12.31). The prevalence of likely PTSD among our respondents was 39.6% (65). Three independent variables: received a mental health depression diagnosis from a health professional (OR = 4.49; 95% CI: 1.40−14.44), would like to receive mental health counseling (OR = 4.36, 95% CI: 1.54−12.34), and have only limited or no support from family (OR = 11.01, 95% CI: 1.92−63.20) contributed significantly to the model for predicting likely PTSD among respondents while controlling the other factors in the regression model. Conclusions: According to this study, unemployment, taking sleeping pills, having a prior depression diagnosis, and the willingness to receive mental health counseling significantly increase the odds of having MDD and PTSD following wildfires. Family support may protect against the development of these conditions.
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Affiliation(s)
- Wanying Mao
- Department of Psychiatry, University of Alberta, Edmonton, AB T6G 2B7, Canada
| | - Medard Adu
- Department of Psychiatry, University of Alberta, Edmonton, AB T6G 2B7, Canada
| | - Ejemai Eboreime
- Department of Psychiatry, University of Alberta, Edmonton, AB T6G 2B7, Canada
| | - Reham Shalaby
- Department of Psychiatry, University of Alberta, Edmonton, AB T6G 2B7, Canada
| | - Nnamdi Nkire
- Department of Psychiatry, University of Alberta, Edmonton, AB T6G 2B7, Canada
| | - Belinda Agyapong
- Department of Psychiatry, University of Alberta, Edmonton, AB T6G 2B7, Canada
- Global Psychological E-Health Foundation, Edmonton, AB T6G 2B7, Canada
| | - Hannah Pazderka
- Department of Psychiatry, University of Alberta, Edmonton, AB T6G 2B7, Canada
| | | | - Ernest Owusu
- Department of Psychiatry, University of Alberta, Edmonton, AB T6G 2B7, Canada
| | - Folajinmi Oluwasina
- Department of Psychiatry, University of Alberta, Edmonton, AB T6G 2B7, Canada
| | - Yanbo Zhang
- Department of Psychiatry, University of Alberta, Edmonton, AB T6G 2B7, Canada
| | - Vincent I O Agyapong
- Department of Psychiatry, University of Alberta, Edmonton, AB T6G 2B7, Canada
- Department of Psychiatry, Faculty of Medicine, Dalhousie University, 5909 Veterans Memorial Lane, 8th Floor, Abbie J. Lane Memorial Building, QEII Health Sciences Centre, Halifax, NS B3H 2E2, Canada
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Gao L, Deng X, Yang W, Fang J. COVID-19 related stressors and mental health outcomes of expatriates in international construction. Front Public Health 2022; 10:961726. [PMID: 35910933 PMCID: PMC9334886 DOI: 10.3389/fpubh.2022.961726] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2022] [Accepted: 06/24/2022] [Indexed: 11/16/2022] Open
Abstract
The construction industry is labor-intensive, and employees' mental health has a significant impact on occupational health and job performance. In particular, expatriates in international projects under the normalization of the epidemic are under greater pressure than domestic project employees. This paper aims to explore the association of stressors and mental health in international constructions during COVID-19. Furthermore, test the mediation effect of psychological resilience and moderating effort of international experience in this relationship. A survey of 3,091 expatriates in international construction projects was conducted. A moderating mediation model was employed to test the effect of psychological resilience and international experience. Then, statistical analysis with a bootstrap sample was used to test the mediation effect of the model, and a simple slope was used to test the moderating effect. Moderated by experience, the slope of the effect of stressors on psychological resilience changed from -1.851 to -1.323. And the slope of the effect of psychological resilience on mental health outcomes reduced by about 0.1. This suggests that experience is one of the buffering factors for individual psychological resilience of expatriates to regulate stress. Theoretically, this study verifies the mediation effect of psychological resilience between COVID-19 related stressors and mental health outcomes and importance of an expatriate's experience in an international assignment. Practically, this study provides guidelines for international construction enterprises and managers to make an assistant plan for expatriates during this pandemic time and pay more attention to their psychological status. The research also suggests that the best choice for challenging assignments is choosing a more experienced employee.
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Affiliation(s)
- Lili Gao
- Department of Construction and Real Estate, Southeast University, Nanjing, China
- Department of Architecture and Civil Engineering, City University of Hong Kong, Kowloon, Hong Kong SAR, China
| | - Xiaopeng Deng
- Department of Construction and Real Estate, Southeast University, Nanjing, China
| | - Weimin Yang
- School of Trade and Logistics, Jiangsu Vocational Institute of Commerce, Nanjing, China
| | - Jie Fang
- SINOPEC Engineering (Group) Co. Ltd. (SEG), Beijing, China
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Hong JS, Hyun SY, Lee JH, Sim M. Mental health effects of the Gangwon wildfires. BMC Public Health 2022; 22:1183. [PMID: 35701801 PMCID: PMC9195206 DOI: 10.1186/s12889-022-13560-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2021] [Accepted: 05/20/2022] [Indexed: 11/21/2022] Open
Abstract
Background The April 2019 wildfires in Gangwon Province, South Korea forced the evacuation of 1500 individuals and cost more than $100 million in damages, making it the worst wildfire disaster in Korean history. The purpose of this paper was to investigate the mental health effects on survivors following the wildfires. Methods Between April and May 2019, outreach psychological support services were delivered to people impacted by the wildfires. Post-disaster psychological responses using a checklist and the Clinical Global Impression Scale-Severity (CGI-S) were evaluated for 206 wildfires survivors. The CGI-S was administered consequently at 1, 3, and 6 months after baseline measurement. Results Among four response categories, somatic responses (76.2%) were most frequently observed among the wildfire survivors. Specifically, insomnia (59.2%), anxiety (50%), chest tightness (34%), grief (33%), flashbacks (33%), and depression (32.5%) were reported by over 30% of the participants. The mean CGI-S scores were significantly decreased at 1 month (mean score = 1.94; SE = 0.09) compared to baseline (mean score = 2.94; SE = 0.08) and remained at the decreased level until 6 months (mean score = 1.66; SE = 0.11). However, participants with flashbacks showed significantly higher CGI-S scores compared to those without flashback at 6 months. Conclusions Wildfire survivors have various post-disaster responses, especially somatic responses. While most participants’ mental health improved over time, a few of them may have experienced prolonged psychological distress after 6 months. Flashbacks were particularly associated with continuing distress. These results suggest that the characteristics of responses should be considered in early phase intervention and in follow-up plans for disaster survivors.
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Affiliation(s)
- Ji Sun Hong
- Department of Psychiatry, Chung-Ang University Gwangmyeong Hospital, Gyeonggi-do, Korea
| | - So Yeon Hyun
- National Center for Disaster and Trauma, National Center for Mental Health, Seoul, Korea
| | - Jung Hyun Lee
- National Center for Disaster and Trauma, National Center for Mental Health, Seoul, Korea
| | - Minyoung Sim
- National Center for Disaster and Trauma, National Center for Mental Health, Seoul, Korea.
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Evaluating the Prevalence and Predictors of Moderate to Severe Depression in Fort McMurray, Canada during the COVID-19 Pandemic. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19127090. [PMID: 35742346 PMCID: PMC9222250 DOI: 10.3390/ijerph19127090] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/15/2022] [Revised: 05/31/2022] [Accepted: 06/06/2022] [Indexed: 11/17/2022]
Abstract
Background: The Coronavirus disease (COVID-19) pandemic has produced adverse health consequences, including mental health consequences. Studies indicate that residents of Fort McMurray, a community which has experienced trauma from flooding and wildfires in the past, may be more vulnerable to the mental health effects of the pandemic. Objective: This study aimed to examine the prevalence and predictors of likely Major Depressive Disorder (MDD) among residents of Fort McMurray during the COVID-19 pandemic. Methods: A cross-sectional approach was adopted utilizing an online survey questionnaire to gather sociodemographic data, COVID-19 related data, and clinical information, including likely MDD using the Patient Health Questionnaire (PHQ-9) scale, from the residents of Fort McMurray between the period of 24 April to 2 June 2021. Results: Overall, 186 individuals completed the survey out of 249 residents who accessed the online survey, yielding a completion rate of 74.7%. The prevalence of likely MDD among respondents was 45%. Respondents willing to receive mental health counselling were five times more likely to experience MDD during the COVID-19 pandemic (OR = 5.48; 95% CI: 1.95–15.40). Respondents with a history of depression were nearly five folds more likely to report MDD during the era of the pandemic than residents without a history of depression (OR = 4.64; 95% CI: 1.49–14.44). Similarly, respondents with a history of taking hypnotics (sleeping tablets) were nearly six-fold more likely to express MDD than respondents with no history of receiving sleeping tablets (OR = 5.72; 95% CI: 1.08–30.30). Finally, respondents who reported receiving only partial support from the employer had three times higher odds of having likely MDD than those who received absolute support from the employer (OR = 3.50; 95% CI: 1.24–9.82). Conclusion: In addition to the effect of the pandemic and other measures taken to curb the psychopathological impact of the pandemic, policymakers need to implement policies to manage individuals with preexisting mental health conditions and provide strong employer support.
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Pike A, Mikolas C, Tompkins K, Olson J, Olson DM, Brémault-Phillips S. New Life Through Disaster: A Thematic Analysis of Women's Experiences of Pregnancy and the 2016 Fort McMurray Wildfire. Front Public Health 2022; 10:725256. [PMID: 35646808 PMCID: PMC9135962 DOI: 10.3389/fpubh.2022.725256] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2021] [Accepted: 03/16/2022] [Indexed: 11/13/2022] Open
Abstract
BackgroundOn May 3, 2016, residents of Fort McMurray Wood Buffalo, Alberta were evacuated due to an uncontrolled wildfire. The short-notice evacuation had destabilizing consequences for residents, including changes in routines, loss of control, and increased uncertainty. These consequences were especially detrimental to women who were pregnant or pre-conception during the evacuation. Pregnant and pre-conception women are particularly susceptible to a vast range of negative consequences during and post natural disasters, including elevated stress and higher incidence of pregnancy complications including gestational diabetes mellitus, pregnancy induced hypertension and C-section. The aim of this study was to understand the experiences, perceived stress and resilience of women who were pregnant during the wildfire. As well as to explore potential interventions to promote the health and enhance resilience of pregnant women and to assist in recovery after exposure to a natural disaster or other traumatic events.MethodsA qualitative thematic analysis of 16 narratives penned by pregnant women and recounted in Ashley Tobin's compilations 93/88,000 and 159 More/ 88,000: Stories of Evacuation, Re-Entry and the In-Between was conducted.ResultsAnalysis revealed five key themes: (1) experience of stress responses due to personal and external factors, (2) social connectedness and support as a facilitator of resilience, (3) performance of resilience-enhancing activities, (4) the roles of pregnancy and motherhood in the experiences of loss and resilience, and (5) the importance of home.ConclusionPregnant women have unique barriers that may negatively impact them during a natural disaster or other form of stressful event. They may benefit from assistance with navigating role transition during pregnancy, training in stress management strategies, and writing interventions to build resiliency and begin the process of recovery from trauma.
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Affiliation(s)
- Ashley Pike
- Corbett Hall, Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, AB, Canada
- Faculty of Rehabilitation Medicine, Heroes in Mind Advocacy and Research Consortium (HiMARC), University of Alberta, Edmonton, AB, Canada
- *Correspondence: Ashley Pike
| | - Cynthia Mikolas
- Faculty of Rehabilitation Medicine, Heroes in Mind Advocacy and Research Consortium (HiMARC), University of Alberta, Edmonton, AB, Canada
| | - Kathleen Tompkins
- Corbett Hall, Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, AB, Canada
| | - Joanne Olson
- Edmonton Clinic Health Academy, Faculty of Nursing, University of Alberta, Edmonton, AB, Canada
| | - David M. Olson
- Faculty of Medicine, Heritage Medical Research Centre, University of Alberta, Edmonton, AB, Canada
| | - Suzette Brémault-Phillips
- Corbett Hall, Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, AB, Canada
- Faculty of Rehabilitation Medicine, Heroes in Mind Advocacy and Research Consortium (HiMARC), University of Alberta, Edmonton, AB, Canada
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21
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One Year after the Flood: Prevalence and Correlates of Post-Traumatic Stress Disorder among Residents in Fort McMurray. Behav Sci (Basel) 2022; 12:bs12030069. [PMID: 35323388 PMCID: PMC8944971 DOI: 10.3390/bs12030069] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2022] [Revised: 02/18/2022] [Accepted: 02/25/2022] [Indexed: 12/15/2022] Open
Abstract
Background: The 2020 Fort McMurray (FMM) and area flood caused more than $228 million in insured damage, affected over 1200 structures, and more than 13,000 people were evacuated. Objective: This study sought to determine the prevalence of post-traumatic stress disorder (PTSD)-like symptoms and the risk predictors among the population of FMM one year after the 2020 flooding. Methods: An online quantitative cross-sectional survey was distributed to residents of FMM via REDCap between 24 April to 2 June 2021 to collect sociodemographic, clinical, and flood-related information. The PTSD checklist for DSM-5 (PCL-C) was used to assess likely PTSD among respondents. Results: 186 of 249 respondents completed all essential self-assessment questionnaires in the analysis, yielding a response rate of 74.7%. The prevalence of likely PTSD was 39.6% (65). Respondents with a history of depression were more likely to develop PTSD symptoms (OR = 5.71; 95% CI: 1.68–19.36). Similarly, responders with limited and no family support after the disaster were more prone to report PTSD symptoms ((OR = 2.87; 95% CI: 1.02–8.05) and (OR = 2.87; 95% CI: 1.06–7.74), respectively). Conclusions: Our research indicated that history of depression and the need for mental health counseling significantly increased the risk of developing PTSD symptoms following flooding; family support is protective. Further studies are needed to explore the relations between the need to receive counseling and presenting with likely PTSD symptoms.
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22
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Sugg MM, Runkle JD, Hajnos SN, Green S, Michael KD. Understanding the concurrent risk of mental health and dangerous wildfire events in the COVID-19 pandemic. THE SCIENCE OF THE TOTAL ENVIRONMENT 2022; 806:150391. [PMID: 34844328 PMCID: PMC8455091 DOI: 10.1016/j.scitotenv.2021.150391] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/13/2021] [Revised: 09/10/2021] [Accepted: 09/13/2021] [Indexed: 05/31/2023]
Abstract
Little research has examined the mental health risks of concurrent disasters. For example, disasters like wildfires have been shown to have a strong association with psychological symptoms-the 2020 U.S. Western wildfire season was the worst on record and occurred while the country was still navigating the COVID-19 pandemic. We implemented two quasi-experimental analyses, an interrupted time series analysis, and a difference-in-difference analysis to evaluate the impacts of wildfires and COVID-19 on mental health crisis help-seeking patterns. Both methods showed no statistical association between exposure to wildfires and the seeking of mental health support during the COVID-19 pandemic. Results highlighted that 2020 wildfires were not associated with an acute increase in crisis texts for youth in the two months after the events, likely due to an already elevated text volume in response to the COVID-19 pandemic from March 2020 throughout the fall wildfire season (Aug to Oct 2020). Future research is needed outside of the context of the pandemic to understand the effects of extreme and concurrent climatic events on adolescent mental health, and targeted interventions are required to ensure youth and adolescents are receiving adequate support during these types of crisis events.
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Affiliation(s)
- Margaret M Sugg
- Department of Geography and Planning, Appalachian State University, P.O. Box 32109, Boone, NC 28608, United States.
| | - Jennifer D Runkle
- North Carolina Institute for Climate Studies, North Carolina State University, 151 Patton Avenue, Asheville, NC 28801, United States.
| | - Sarah N Hajnos
- Department of Geography and Planning, Appalachian State University, P.O. Box 32109, Boone, NC 28608, United States
| | - Shannon Green
- Crisis Text Line, 24 W. 25th St, 6th Floor, New York, NY 10010, United States
| | - Kurt D Michael
- Department of Psychology, Appalachian State University, P.O. Box 32109, Boone, NC 28608, United States
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23
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COVID-19 Pandemic in a Vulnerable Population: Prevalence and Correlates of Anxiety. Behav Sci (Basel) 2022; 12:bs12010013. [PMID: 35049624 PMCID: PMC8772915 DOI: 10.3390/bs12010013] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2021] [Revised: 12/29/2021] [Accepted: 01/09/2022] [Indexed: 01/09/2023] Open
Abstract
Background: The COVID-19 pandemic has produced negative mental health outcomes. These effects were more prominent in vulnerable communities that experienced prior similar disasters. The study aimed to examine the likelihood and correlates of anxiety symptoms among Fort McMurray (FMM) residents, during the COVID-19 pandemic. Methods: A cross-sectional online survey questionnaire was applied between 24 April and 2 June 2021, at FMM, to gather sociodemographic, COVID-19, and clinical information, including generalized anxiety disorder (using GAD-7 scale). Results: Overall, 186 individuals completed the survey (response rate 74.7%). Most of the respondents were females (159, 85.5%); above 40 years (98, 52.7%); employed (175, 94.1%); and in relationship (132, 71%). The prevalence of moderate-to-severe anxiety was (42.5%, 71) on GAD-7 self-reported scale. Subscribers who reported that they would like to receive mental health support; have received no family support since COVID-19 declaration; and have lost their job during the pandemic were all more likely to report moderate-to-severe anxiety (OR = 3.39; 95% CI: 1.29–8.88), (OR = 4.85; 95% CI: 1.56–15.03), and (OR = 4.40; 95% CI: 1.01–19.24), respectively. Conclusions: Anxiety levels were high among FMM residents, compared to levels before COVID-19. Clinical and social factors significantly predicted likely anxiety in the Fort McMurray population, during the COVID-19 pandemic. It is imperative that resources are mobilized to support vulnerable communities during the COVID-19 pandemic.
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Obuobi-Donkor G, Eboreime E, Shalaby R, Agyapong B, Agyapong VIO. Prevalence and correlates of cannabis abuse among residents in the community of Fort McMurray, a city in Northern Alberta which had endured multiple natural disasters. Front Psychiatry 2022; 13:962169. [PMID: 36213902 PMCID: PMC9533067 DOI: 10.3389/fpsyt.2022.962169] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2022] [Accepted: 08/22/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Cannabis is one of the widely used drugs for relaxation and may be abuse among users. Researchers have given attention to cannabis use among the general population while vulnerable populations who have experience multiple traumas may be at risk of cannabis abuse. Other factors may influence cannabis abuse among people exposed to traumas. OBJECTIVE The study aims to determine the prevalence and correlates of self-reported cannabis abuse among residents of Fort McMurray, a city in Northern Alberta, Canada. METHODS A cross-sectional survey was conducted using an online questionnaire. Sociodemographic data, trauma exposure, and clinical characteristics were collected to identify the possible risk factor of cannabis abuse. Data were analyzed with SPSS version 25 using a chi-square test and binary logistic regression analysis. Correlation analysis was also performed to ascertain likely cannabis abuse and the association with other mental health conditions. RESULTS Overall, participants who completed the survey were one hundred and eighty-sixed out of the two hundred and forty-nine residents who accessed the online survey, giving a response rate of 74.7%. The prevalence of self-reported cannabis abuse among participants was 14%. Most of the participants were females (159, 85.5%), more than 40 years of age (98, 52.7%), employed (175, 94.1%), owned their house (145, 78.0%), and 103 (60.6%) reported being exposed to at least a trauma (COVID-19, flooding, or wildfire). Regarding regression analysis results, participants living in a rented accommodation were nearly four times more likely to abuse cannabis (OR = 3.86; 95% CI: 1.34-11.14) than those owning their houses. Similarly, male participants were more than 6-folds more likely to abuse cannabis than the female gender (OR= 6.25; 95% CI: 1.89-20), and participants in a relationship were six times more likely to abuse cannabis than participants not in a relationship (OR = 6.33; 95% CI: 1.67-24.39). The study also found significant association of depressive symptoms (X 2 = 4.561; p = 0.033) and anxiety symptoms (X 2 = 4.700; p = 0.030) with likely cannabis abuse. CONCLUSION Demographic factors significantly predicted likely cannabis abuse in the Fort McMurray population, and cannabis abuse significantly correlated with presence of moderate to high anxiety and depression symptoms. It is essential to mobilized resources to support vulnerable communities and manage cannabis abuse.
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Affiliation(s)
| | - Ejemai Eboreime
- Department of Psychiatry, University of Alberta, Edmonton, AB, Canada
| | - Reham Shalaby
- Department of Psychiatry, University of Alberta, Edmonton, AB, Canada
| | - Belinda Agyapong
- Department of Psychiatry, University of Alberta, Edmonton, AB, Canada.,Global Psychological E-Health Foundation, Edmonton, AB, Canada
| | - Vincent I O Agyapong
- Department of Psychiatry, University of Alberta, Edmonton, AB, Canada.,Department of Psychiatry, Dalhousie University, Halifax, NS, Canada
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Agyapong B, Shalaby R, Eboreime E, Obuobi-Donkor G, Owusu E, Adu MK, Mao W, Oluwasina F, Agyapong VIO. Cumulative trauma from multiple natural disasters increases mental health burden on residents of Fort McMurray. Eur J Psychotraumatol 2022; 13:2059999. [PMID: 35599978 PMCID: PMC9116266 DOI: 10.1080/20008198.2022.2059999] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND Fort McMurray, a city in northern Alberta, Canada, has experienced multiple traumatic events in the last five years, including the 2016 wildfire, the 2020 floods, and the COVID-19 pandemic. Traumatic events often lead to increased mental health burdens in affected communities. OBJECTIVE To assess if the number of traumatic events experienced by residents of Fort McMurray correlates with the prevalence and severity of mental health issues experienced. METHODOLOGY A cross-sectional study using an online survey questionnaire was used to gather demographic, trauma (wildfire, flooding, and COVID-19), and clinical information from the resident of Fort McMurray between April 24 to June 2 2021. Likely Generalized Anxiety Disorder (GAD), Major Depressive Disorder (MDD), Post-Traumatic Stress Disorder (PTSD) and low resilience were measured using standardised rating scales. Data were analyzed with SPSS version 26 using Chi-Square tests and multivariate regression analysis. RESULTS Respondents who experienced COVID-19 and either flood or wildfire traumas (N = 101) were eleven times more likely to have GAD symptoms (OR: 11.39; 95% CI: 1.43-91.04), four times more likely to have likely MDD, (OR: 3.85; 95% CI: .995-14.90), ten times more likely to have likely PTSD (OR: 10.47; 95% CI: 1.28-85.67), and low resilience (OR: 10.56; 95% CI: 1.21-92.17). Respondents who experienced COVID-19, flooding, and wildfire traumas (N = 47) were eighteen times more likely to express GAD symptoms (OR: 18.30; 95% CI: 2.20-152.45) and more than eleven times likely to have likely PTSD (OR: 11.41; 95% CI: 1.34-97.37) in comparison to the respondents who experienced COVID-19 only trauma (N = 19). CONCLUSION Measures to reduce climate change and associated natural disasters could reduce the impact of cumulative trauma and associated mental health burden in vulnerable populations. It is essential that more mental health resources are mobilised to support communities impacted by multiple natural disasters. HIGHLIGHTS The number of traumatic disasters experienced in residents of Fort McMurray five years after the 2016 wildfires, a year after the 2020 flooding, and during the COVID-19 pandemic correlates with the prevalence and severity of the mental health conditions reported in this study.
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Affiliation(s)
- Belinda Agyapong
- Department of Psychiatry, University of Alberta, Edmonton, Canada.,Global Psychological E-Health Foundation, Edmonton, Canada
| | - Reham Shalaby
- Department of Psychiatry, University of Alberta, Edmonton, Canada
| | - Ejemai Eboreime
- Department of Psychiatry, University of Alberta, Edmonton, Canada.,Global Psychological E-Health Foundation, Edmonton, Canada
| | | | - Ernest Owusu
- Department of Psychiatry, University of Alberta, Edmonton, Canada
| | - Medard K Adu
- Department of Psychiatry, University of Alberta, Edmonton, Canada
| | - Wanying Mao
- Department of Psychiatry, University of Alberta, Edmonton, Canada
| | | | - Vincent I O Agyapong
- Department of Psychiatry, University of Alberta, Edmonton, Canada.,Global Psychological E-Health Foundation, Edmonton, Canada.,Department of Psychiatry, Dalhousie University, Halifax, Canada
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26
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Agyapong B, Eboreime E, Shalaby R, Pazderka H, Obuobi-Donkor G, Adu MK, Mao W, Oluwasina F, Owusu E, Greenshaw AJ, Agyapong VIO. Mental Health Impacts of Wildfire, Flooding and COVID-19 on Fort McMurray School Board Staff and Other Employees: A Comparative Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 19:ijerph19010435. [PMID: 35010692 PMCID: PMC8744856 DOI: 10.3390/ijerph19010435] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/19/2021] [Revised: 12/20/2021] [Accepted: 12/28/2021] [Indexed: 11/24/2022]
Abstract
Background: Fort McMurray, a city in northern Alberta, Canada, has experienced multiple traumas in the last five years, including the 2016 wildfire, the 2020 floods, and the COVID-19 pandemic. Eighteen months after the wildfire, major depressive disorder (MDD), generalized anxiety disorder (GAD), and Post Traumatic Stress Disorder (PTSD) symptoms were elevated among school board employees in the city. Objective: This study aimed to compare employees of the school board and other employees of Fort McMurray in respect to the impact the 2016 wildfires, the 2019 COVID pandemic, and the 2020 floods had on their mental health. Methodology: A quantitative cross-sectional survey was conducted in Fort McMurray from 24 April to 2 June 2021. Online questionnaires were administered through REDCap and were designed to capture socio-demographic characteristics, clinical as well as wildfire, COVID-19, and flooding-related variables. Mental health outcome variables were captured using self-reported standardized assessment scales. Data were analysed with descriptive statistics, Chi-square/Fisher’s Exact tests, and binary regression analysis. Results: Of the 249 residents who accessed the online survey, 186 completed the survey, giving a response rate of 74.7%. Of these respondents, 93.5% (174) indicated their employment status and were included in the Chi-square analysis. Most of the respondents were female (86.2%, (150)), above 40 years (53.4%, (93)), and were in a relationship (71.3%, (124)). The prevalence values for MDD, GAD and PTSD among respondents were 42.4%, 41.0, and 36.8%, respectively. There was a statistically significant difference between employees of the school board and other employees with respect to likely PTSD prevalence (28% vs. 45%, respectively, p < 0.05), although with other factors controlled for, in a binary logistic regression model, employer type did not significantly predict likely PTSD. Conclusions: The study has established that likely PTSD symptoms were significantly higher in other employees compared to those of school board employees. Greater exposure to the traumatic events and a greater perceived lack of support from other employers might have contributed to the significantly higher prevalence of PTSD in other employees.
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Affiliation(s)
- Belinda Agyapong
- Global Psychological e-Health Foundation, Edmonton, AB T6G 2E1, Canada;
- Department of Psychiatry, University of Alberta, Edmonton, AB T6G 2E1, Canada; (E.E.); (R.S.); (H.P.); (G.O.-D.); (M.K.A.); (W.M.); (F.O.); (E.O.); (A.J.G.)
| | - Ejemai Eboreime
- Department of Psychiatry, University of Alberta, Edmonton, AB T6G 2E1, Canada; (E.E.); (R.S.); (H.P.); (G.O.-D.); (M.K.A.); (W.M.); (F.O.); (E.O.); (A.J.G.)
| | - Reham Shalaby
- Department of Psychiatry, University of Alberta, Edmonton, AB T6G 2E1, Canada; (E.E.); (R.S.); (H.P.); (G.O.-D.); (M.K.A.); (W.M.); (F.O.); (E.O.); (A.J.G.)
| | - Hannah Pazderka
- Department of Psychiatry, University of Alberta, Edmonton, AB T6G 2E1, Canada; (E.E.); (R.S.); (H.P.); (G.O.-D.); (M.K.A.); (W.M.); (F.O.); (E.O.); (A.J.G.)
| | - Gloria Obuobi-Donkor
- Department of Psychiatry, University of Alberta, Edmonton, AB T6G 2E1, Canada; (E.E.); (R.S.); (H.P.); (G.O.-D.); (M.K.A.); (W.M.); (F.O.); (E.O.); (A.J.G.)
| | - Medard K. Adu
- Department of Psychiatry, University of Alberta, Edmonton, AB T6G 2E1, Canada; (E.E.); (R.S.); (H.P.); (G.O.-D.); (M.K.A.); (W.M.); (F.O.); (E.O.); (A.J.G.)
| | - Wanying Mao
- Department of Psychiatry, University of Alberta, Edmonton, AB T6G 2E1, Canada; (E.E.); (R.S.); (H.P.); (G.O.-D.); (M.K.A.); (W.M.); (F.O.); (E.O.); (A.J.G.)
| | - Folajinmi Oluwasina
- Department of Psychiatry, University of Alberta, Edmonton, AB T6G 2E1, Canada; (E.E.); (R.S.); (H.P.); (G.O.-D.); (M.K.A.); (W.M.); (F.O.); (E.O.); (A.J.G.)
| | - Ernest Owusu
- Department of Psychiatry, University of Alberta, Edmonton, AB T6G 2E1, Canada; (E.E.); (R.S.); (H.P.); (G.O.-D.); (M.K.A.); (W.M.); (F.O.); (E.O.); (A.J.G.)
| | - Andrew J. Greenshaw
- Department of Psychiatry, University of Alberta, Edmonton, AB T6G 2E1, Canada; (E.E.); (R.S.); (H.P.); (G.O.-D.); (M.K.A.); (W.M.); (F.O.); (E.O.); (A.J.G.)
| | - Vincent I. O. Agyapong
- Department of Psychiatry, University of Alberta, Edmonton, AB T6G 2E1, Canada; (E.E.); (R.S.); (H.P.); (G.O.-D.); (M.K.A.); (W.M.); (F.O.); (E.O.); (A.J.G.)
- Vincent Israel Opoku Agyapong Department of Psychiatry, Faculty of Medicine, Dalhousie University, 5909 Veterans Memorial Lane, 8th Floor, Abbie J. Lane Memorial Building, QEII Health Sciences Centre, Halifax, NS B3H 2E2, Canada
- Correspondence: ; Tel.: +1-780-215-7771; Fax: +902-473-4887
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Thériault L, Belleville G, Ouellet MC, Morin CM. The Experience and Perceived Consequences of the 2016 Fort McMurray Fires and Evacuation. Front Public Health 2021; 9:641151. [PMID: 34858911 PMCID: PMC8632018 DOI: 10.3389/fpubh.2021.641151] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2020] [Accepted: 10/18/2021] [Indexed: 11/13/2022] Open
Abstract
Few studies have examined the scope of the subjective experience during and after a natural disaster. This qualitative study explored the perceptions of persons affected by the wildfires and evacuation of Fort McMurray in 2016. The objectives were to document (1) the experience of the evacuation, and (2) the biopsychosocial consequences of the wildfires as perceived by evacuees from Fort McMurray 3 months and 3 years after evacuation. This study included two data collections, one from 393 evacuees 3 months after evacuation using an online questionnaire, and the other from 31 participants (among those who participated in the 3-month evaluation) interviewed by telephone 3 years after evacuation. Eight themes describing the evacuation experience emerged from the qualitative analysis: the preparation for evacuation, the perceived traumatic nature of the evacuation, problems encountered while on the move, assistance received and provided, vulnerability conditions, presence of physical discomfort, relocation and no problem/no response. Seven categories of negative consequences emerged: material and financial loss, emotional/mental health disorders, cognitive impairments, behavioral changes, spiritual/existential reflections, social alterations, and physical conditions. Four categories of positive consequences emerged: posttraumatic growth, resilience/absence of consequences, altruism and community cohesion. This study showed a wide range of perceived consequences of fires and evacuations by Fort McMurray residents. The results highlight the importance of tailoring responses to the needs of evacuees and providing assistance to victims over a long period of time.
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The Impact of Wildfires on Mental Health: A Scoping Review. Behav Sci (Basel) 2021; 11:bs11090126. [PMID: 34562964 PMCID: PMC8466569 DOI: 10.3390/bs11090126] [Citation(s) in RCA: 49] [Impact Index Per Article: 16.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Revised: 09/07/2021] [Accepted: 09/16/2021] [Indexed: 01/27/2023] Open
Abstract
One of the many consequences of climate change is an increase in the frequency, severity, and, thus, impact of wildfires across the globe. The destruction and loss of one's home, belongings, and surrounding community, and the threat to personal safety and the safety of loved ones can have significant consequences on survivors' mental health, which persist for years after. The objective of this scoping review was to identify primary studies examining the impact of wildfires on mental health and to summarize findings for PTSD, depression, anxiety, and substance use. Literature searches on Pubmed and Embase were conducted in February and April of 2021, respectively, with no date restrictions. A total of 254 studies were found in the two database searches, with 60 studies meeting the inclusion criteria. Three other studies were identified and included based on relevant in-text citations during data abstraction. The results show an increased rate of PTSD, depression, and generalized anxiety at several times of follow-up post-wildfire, from the subacute phase, to years after. An increased rate of mental health disorders post-wildfire has been found in both the adult and pediatric population, with a number of associated risk factors, the most significant being characteristics of the wildfire trauma itself. Several new terms have arisen in the literature secondary to an increased awareness and understanding of the impact of natural disasters on mental health, including ecological grief, solastalgia, and eco-anxiety. There are a number of patient factors and systemic changes that have been identified post-wildfire that can contribute to resilience and recovery.
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COVID-19 Pandemic: Stress, Anxiety, and Depression Levels Highest amongst Indigenous Peoples in Alberta. Behav Sci (Basel) 2021; 11:bs11090115. [PMID: 34562953 PMCID: PMC8467538 DOI: 10.3390/bs11090115] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2021] [Revised: 06/11/2021] [Accepted: 08/20/2021] [Indexed: 12/18/2022] Open
Abstract
This study explores differences in stress, anxiety, and depression experienced by different ethnic groups during the COVID-19 pandemic. This was a cross-sectional online survey of subscribers of the COVID-19 Text4Hope text messaging program in Alberta. Stress, anxiety, and depression were measured among Caucasian, Indigenous, Asian, and other ethnic groups using the Perceived Stress Scale (PSS)-10, Generalized Anxiety Disorder (GAD)-7, and Patient Health Questionnaire (PHQ)-9 scales, respectively. The burden of depression and stress were significantly higher in Indigenous populations than in both Caucasian and Asian ethnic groups. The mean difference between Indigenous and Caucasian for PHQ-9 scores was 1.79, 95% CI of 0.74 to 2.84, p < 0.01 and for PSS-10 it was 1.92, 95% CI of 0.86 to 2.98, p < 0.01). The mean difference between Indigenous and Asian for PHQ-9 scores was 1.76, 95% CI of 0.34 to 3.19, p = 0.01 and for PSS-10 it was 2.02, 95% CI of 0.63 to 3.41, p < 0.01. However, Indigenous participant burden of anxiety was only significantly higher than Asian participants’ (mean difference for GAD-7 was 1.91, 95% CI of 0.65 to 3.18, p < 0.01). Indigenous people in Alberta have higher burden of mental illnesses during the COVID-19 pandemic. These findings are helpful for service planning and delivery.
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Exposure to Stress and Air Pollution from Bushfires during Pregnancy: Could Epigenetic Changes Explain Effects on the Offspring? INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18147465. [PMID: 34299914 PMCID: PMC8305161 DOI: 10.3390/ijerph18147465] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/21/2021] [Revised: 07/09/2021] [Accepted: 07/09/2021] [Indexed: 12/20/2022]
Abstract
Due to climate change, bushfires are becoming a more frequent and more severe phenomenon which contributes to poor health effects associated with air pollution. In pregnancy, environmental exposures can have lifelong consequences for the fetus, but little is known about these consequences in the context of bushfire smoke exposure. In this review we summarise the current knowledge in this area, and propose a potential mechanism linking bushfire smoke exposure in utero to poor perinatal and respiratory outcomes in the offspring. Bushfire smoke exposure is associated with poor pregnancy outcomes including reduced birth weight and an increased risk of prematurity. Some publications have outlined the adverse health effects on young children, particularly in relation to emergency department presentations and hospital admissions for respiratory problems, but there are no studies in children who were exposed to bushfire smoke in utero. Prenatal stress is likely to occur as a result of catastrophic bushfire events, and stress is known to be associated with poor perinatal and respiratory outcomes. Changes to DNA methylation are potential epigenetic mechanisms linking both smoke particulate exposure and prenatal stress to poor childhood respiratory health outcomes. More research is needed in large pregnancy cohorts exposed to bushfire events to explore this further, and to design appropriate mitigation interventions, in this area of global public health importance.
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Mao W, Agyapong VIO. The Role of Social Determinants in Mental Health and Resilience After Disasters: Implications for Public Health Policy and Practice. Front Public Health 2021; 9:658528. [PMID: 34095062 PMCID: PMC8170026 DOI: 10.3389/fpubh.2021.658528] [Citation(s) in RCA: 37] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2021] [Accepted: 04/19/2021] [Indexed: 12/30/2022] Open
Abstract
In this general literature review, we will explore the impacts and contribution of social determinants to mental health and resiliency following both natural and man-made disasters. Natural disasters, such as wildfires, earthquakes, tsunamis, and hurricanes, as well as man-made disasters, such as civil wars, have been known to inflict significant damage to the mental health of the victims. In this paper, we mainly explore some most studied vulnerability and protective social determinant factors such as gender, age, ethnicity, socials support and socioeconomic status for the mental health and resiliency in survivors of such disasters. Several other possible factors such as previous trauma, childhood abuse, family psychiatric history, and subsequent life stress that were explored by some studies were also discussed. We conducted a literature search in major scientific databases, using keywords such as: mental health, social determinants, disasters, wildfires, earthquakes, terrorist attacks, and resilience. We discuss the implications for public health policy and practice.
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Affiliation(s)
- Wanying Mao
- Department of Psychiatry, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada
| | - Vincent I O Agyapong
- Department of Psychiatry, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada
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32
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Belleville G, Ouellet MC, Lebel J, Ghosh S, Morin CM, Bouchard S, Guay S, Bergeron N, Campbell T, MacMaster FP. Psychological Symptoms Among Evacuees From the 2016 Fort McMurray Wildfires: A Population-Based Survey One Year Later. Front Public Health 2021; 9:655357. [PMID: 34017813 PMCID: PMC8130827 DOI: 10.3389/fpubh.2021.655357] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2021] [Accepted: 03/30/2021] [Indexed: 11/30/2022] Open
Abstract
Background: The 2016 wildfires in Fort McMurray (Alberta, Canada) led to a massive displacement of 88,000 people and destroyed 2,400 homes. Although no direct human fatality resulted, many individuals feared for their lives or those of their loved ones. Objectives: (1) To estimate the prevalence of post-traumatic stress, major depressive, insomnia, generalized anxiety, and substance use disorders in the adult population of Fort McMurray 1 year after the evacuation; (2) To identify pre-, peri-, and post-disaster correlates of mental health disorders. Methods: A phone survey using random digit sampling was used to survey evacuees. A total of 1,510 evacuees (response rate = 40.2%, 55.5% women, mean age = 44.11, SD = 12.69) were interviewed between May 9th and July 28th, 2017. Five validated scales were administered: the PTSD Symptoms Checklist (PCL-5), the Insomnia Severity Index (ISI), the depression and anxiety subscales of the Patient Health Questionnaire (PHQ-9, GAD-7), and the CAGE Substance Abuse Screening Tool. Results: One year after the wildfires, 38% had a probable diagnosis of either post-traumatic stress, major depressive, insomnia, generalized anxiety, or substance use disorder, or a combination of these. Insomnia disorder was the most common, with an estimated prevalence of 28.5%. Post-traumatic stress, major depressive and generalized anxiety disorders were almost equally prevalent, with ~15% each. The estimated prevalence of substance use disorder was 7.9%. For all five mental health disorders, having a mental health condition prior to the fires was a significant risk factor, as well as having experienced financial stress or strain due to the economic decline already present in Fort McMurray. Five post-disaster consequences were significant predictors of four of the five disorders: decrease in work, decrease in social life, poorer current health status, increase in drug and alcohol use, and higher level of stress experienced since the fires. Conclusion: One year after the fires, more than one third of the evacuees had clinically significant psychological symptoms, including those of insomnia, post-traumatic stress, depression, anxiety, and substance use. This study helped identify individuals more at risk for mental health issues after a natural disaster and could guide post-disaster psychosocial support strategies.
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Affiliation(s)
| | | | - Jessica Lebel
- École de Psychologie, Université Laval, Quebec City, QC, Canada
| | | | - Charles M Morin
- École de Psychologie, Université Laval, Quebec City, QC, Canada
| | - Stéphane Bouchard
- Département de Psychoéducation et de Psychologie, Université du Québec en Outaouais, Gatineau, QC, Canada
| | - Stéphane Guay
- Centre de Recherche de l'Institut Universitaire en Santé Mentale de Montréal, Montréal, QC, Canada
| | - Nicolas Bergeron
- Département de Psychiatrie et d'Addictiologie, Université de Montréal, Montréal, QC, Canada.,Doctors of the World Canada, Montréal, QC, Canada
| | - Tavis Campbell
- Department of Psychology, University of Calgary, Calgary, AB, Canada
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Chen S, Bagrodia R, Pfeffer CC, Meli L, Bonanno GA. Anxiety and resilience in the face of natural disasters associated with climate change: A review and methodological critique. J Anxiety Disord 2020; 76:102297. [PMID: 32957002 DOI: 10.1016/j.janxdis.2020.102297] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2020] [Revised: 08/29/2020] [Accepted: 08/31/2020] [Indexed: 12/17/2022]
Abstract
In the past two decades, climate change-related natural disasters, such as hurricanes, floods, and droughts have become increasingly frequent and severe, impacting the emotional and psychological well-being of those who are directly or indirectly exposed to them. Despite great interest in understanding differences in anxiety and resilience in response to natural disasters, enthusiasm appears to outstrip empirical clarity, as there remains considerable ambiguity as to determinants of resilient or pathological outcomes following exposure to natural disasters. In addition, there are several major methodological limitations in climate change and related natural disaster research, including the use of univariate analyses, cross-sectional design, and retrospective measures. Keeping these limitations in mind, we first review literature examining the mental health outcomes of natural disasters. Findings suggest that, overall, resilience is more common than pathological outcomes. Second, we use a multi-dimensional framework of resilience to selectively review factors at the event, individual, as well as family and community levels that could help inform resilient or pathological outcomes. Finally, we consider key limitations and future directions for research and practice in the field of anxiety and resilience in response to climate disasters.
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Affiliation(s)
- Shuquan Chen
- Department of Clinical and Counseling Psychology, Teachers College, Columbia University, United States.
| | - Rohini Bagrodia
- Department of Clinical and Counseling Psychology, Teachers College, Columbia University, United States
| | - Charlotte C Pfeffer
- Department of Clinical and Counseling Psychology, Teachers College, Columbia University, United States
| | - Laura Meli
- Department of Clinical and Counseling Psychology, Teachers College, Columbia University, United States
| | - George A Bonanno
- Department of Clinical and Counseling Psychology, Teachers College, Columbia University, United States.
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Hrabok M, Delorme A, Agyapong VIO. Threats to Mental Health and Well-Being Associated with Climate Change. J Anxiety Disord 2020; 76:102295. [PMID: 32896782 DOI: 10.1016/j.janxdis.2020.102295] [Citation(s) in RCA: 46] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2020] [Revised: 08/02/2020] [Accepted: 08/10/2020] [Indexed: 01/16/2023]
Abstract
Climate change is a contributor to extreme weather events and natural disasters. The mental health effects of climate change are multifaceted, with post-traumatic stress disorder and depression predominant. This paper aims to describe the impact of climate change on mental health conditions, including risk and protective factors related to the expression of mental health conditions post-disaster, as well as a discussion of our local experience with a devastating wildfire to our region within Canada. The risk of the development of mental health conditions post-disaster is not equally distributed; research has consistently demonstrated that specific risk factors (e.g., gender, socioeconomic status and education, pre-existing mental health symptomatology), are associated with increased vulnerability to mental health conditions following natural disasters. There are multiple strategies that must be undertaken by communities to enhance adjustment and coping post-disaster, including improved access to care, inter-agency cooperation, enhanced community resiliency, and adequate preparation.
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Affiliation(s)
- Marianne Hrabok
- Dission of Community Psychiatry, Department of Psychiatry, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada; Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Aaron Delorme
- Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Vincent I O Agyapong
- Dission of Community Psychiatry, Department of Psychiatry, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada.
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