Complicated grief associated with Hurricane Katrina

Abstract

Background Although losses are important consequences of disasters, few epidemiological studies of disasters have assessed complicated grief (CG) and none assessed CG associated with losses other than death of loved one. Methods Data come from the baseline survey of the Hurricane Katrina Community Advisory Group (CAG), a representative sample of 3,088 residents of the areas directly affected by Hurricane Katrina. A brief screen for CG was included containing four items consistent with the proposed DSM 5 criteria for a diagnosis of bereavement-related adjustment disorder. Results 58.5% of respondents reported a significant hurricane-related loss: Most-severe losses were 29.0% tangible, 9.5% interpersonal, 8.1% intangible, 4.2% work-financial, and 3.7% death of loved one. 26.1% of respondents with significant loss had possible CG and 7.0% moderate-severe CG. Death of loved one was associated with the highest conditional probability of moderate-severe CG (18.5%, compared to 1.1–10.5% conditional probabilities for other losses) but accounted for only 16.5% of moderate-severe CG due to its comparatively low prevalence. Most moderate-severe CG was due to tangible (52.9%) or interpersonal (24.0%) losses. Significant predictors of CG were mostly unique to either bereavement (racial-ethnic minority status, social support) or other losses (pre-hurricane history of psychopathology, social competence.). Conclusions Non-bereavement losses accounted for the vast majority of hurricane-related possible CG despite risk of CG being much higher in response to bereavement than to other losses. This result argues for expansion of research on CG beyond bereavement and alerts clinicians to the need to address post-disaster grief associated with a wide range of losses.

Prevalence and risk factors of complicated grief among Sichuan earthquake survivors

“…However, the present study did not find a significant effect of gender when other earthquake related or death related variables were considered, which is similar to a number of previous studies (Kristensen et al, 2010;Schaal et al, 2010;Shear, McLaughlin, et al, 2011). Such inconsistent findings may due to the different samples involved and the statistical method used (bi-variate regression vs. multivariate regression).…”

“…Meanwhile, social support did not show significant association with CG either. Even though there have been studies reporting a buffering effect of social support against CG among disaster survivors (Kristensen et al, 2010), the findings in previous studies remain inconsistent (Shear, McLaughlin, et al, 2011;Stroebe et al, 2005). The present study only assessed the availability of general support, not specific to their grief.…”

“…This type of loss, which exacerbates the decline of their economic condition, may induce secondary severe stress on the bereaved, depleting their resources for coping with bereavement, and impeding their adjustment. The devastating effect of economic loss on CG has been documented among disaster survivors (Shear, McLaughlin, et al, 2011). Therefore, efforts to help the bereaved find new economic sources after the earthquake and improve their economic condition may be a helpful means of ameliorating the risk of CG.…”

“…This disparity may be related to differences in population, types of disasters, and length of investigation time after the death in each study. The risk factors usually evaluated were mainly demographic variables and relationship to the deceased (Johannesson et al, 2009;Kristensen et al, 2010;Shear, McLaughlin, et al, 2011). Other factors related to the nature of the bereavement (such as number of loved ones lost) and specific characteristics of severe earthquake (such as collateral economic decline, traumatic disaster experiences, incapacity of recovering of the deceased's body) were less explored.…”

Using mental well-being impact assessment to understand factors influencing well-being after a disaster

“…Natural disasters can overwhelm local resources, and alter the normal activities of communities, causing significant impact on mental health and well-being (Norris et al 2002;Shear et al 2011;Ursano et al 2007). Ursano et al (2007, p. 4) defines disaster:…”