Disaster exposure as a risk factor for mental health problems, eighteen months, four and ten years post-disaster – a longitudinal study

Abstract

BackgroundDisaster experiences have been associated with higher prevalence rates of (mental) health problems. The objective of this study was to examine the independent relation between a series of single disaster experiences versus the independent predictive value of a accumulation of disaster experiences, i.e. a sum score of experiences and symptoms of distress and post-traumatic stress disorder (PTSD).MethodsSurvivors of a fireworks disaster participated in a longitudinal study and completed a questionnaire three weeks (wave 1), eighteen months (wave 2) and four years post-disaster (wave 3). Ten years post-disaster (wave 4) the respondents consisted of native Dutch survivors only. Main outcome measures were general distress and symptoms of PTSD.ResultsDegree of disaster exposure (sum score) and some disaster-related experiences (such as house destroyed, injured, confusion) were related to distress at waves 2 and 3. This relation was mediated by distress at an earlier point in time. None of the individual disaster-related experiences was independently related to symptoms of distress. The association between the degree of disaster exposure and symptoms of PTSD at waves 2 and 3 was still statistically significant after controlling for symptoms of distress and PTSD at earlier point in time. The variable ‘house destroyed’ was the only factor that was independently related to symptoms of PTSD at wave 2. Ten years after the disaster, disaster exposure was mediated by symptoms of PTSD at waves 2 and 3. Disaster exposure was not independently related to symptoms of PTSD ten years post-disaster.ConclusionsUntil 4 years after the disaster, degree of exposure (a sum score) was a risk factor for PTSD symptoms while none of the individual disaster experiences could be identified as an independent risk factor. Ten years post-disaster, disaster exposure was no longer an independent risk factor for symptoms of PTSD. Since symptoms of PTSD and distress at earlier waves perpetuate the symptoms at later waves, health care workers should aim their resources at those who still have symptoms after one and a half year post-disaster, to prevent health problems at medium and long-term.

Clinical Decision-Making Following Disasters: Efficient Identification of PTSD Risk in Adolescents

“…These findings highlight the utility of the ROC approach. A plethora of research has shown that traumatic event incident characteristics, such as degree of property damage (Goenjian et al, 1995; Goenjian et al, 2005; van den Berg, Wong, van der Velden, Boshuizen, & Grievink, 2012), are significantly related to post-disaster mental health symptoms (Goenjian et al, 2001; Parson, Fussell, Rhodes, & Waters, 2012; Zhang, Shi, Wang, & Liu, 2011). The current study suggests that while such disaster incident characteristics may contribute to the etiology and/or maintenance of PTSD per prior research, assessing these variables in post-disaster screenings may not improve prediction of PTSD beyond chance—and other variables are more effective for identifying those at highest risk.…”

Trends in psychological distress and alcoholism after The Great East Japan Earthquake of 2011

“…This is consistent with a previous study reporting an association between home damage and a higher prevalence of depression after a disaster ( Tang et al, 2014 ). Additionally, another study showed that destruction of a home was independently associated with a higher level of PTSD (Posttraumatic Stress Disorder) 18 months after a disaster ( Berg et al, 2012 ). Home damage or destruction could lead to several adversities, including loss of a family member and property, relocation, and lack of a social network, which may cause the observed outcomes.…”

“…Home damage or destruction could lead to several adversities, including loss of a family member and property, relocation, and lack of a social network, which may cause the observed outcomes. For example, bereavement after natural disasters increases the risk of psychological problems ( Berg et al, 2012 ; Wadworth, DeCarlo Santiago & Einhorn, 2009 ). Female sex predicted increased psychological distress at follow-up in the present study.…”

Mental Health Interventions Provided by Volunteer Psychiatrists after the Sewol Ferry Disaster: April 16–November 30, 2014

“…Psychiatrists have a key role, such as caring for the victims and the overall community, in a disaster response [1]. And their activity in disaster is one of the very important factors for recovery [2-4].…”

“…And their activity in disaster is one of the very important factors for recovery [2-4]. Volunteer psychiatrists could access mental health problems of survivors of disaster exposure and suggest appropriate interventions shortly after the disaster [1]. After Hurricane Katrina, it showed that the volunteer psychiatrists provided the mental health services and conducted a distinct role of intervening for evacuees [5].…”