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Meadows MC, Serino N, Camacho-Monclova DM, Joshipura K, Lowe SR. Beyond the storms: Exploring predictors of posttraumatic stress and posttraumatic growth among survivors of hurricanes Irma and Maria in Puerto Rico. THE JOURNAL OF CLIMATE CHANGE AND HEALTH 2025; 21:100365. [PMID: 40026672 PMCID: PMC11870674 DOI: 10.1016/j.joclim.2024.100365] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/05/2025]
Abstract
Background Within disaster-affected communities, residents' exposures and post-disaster mental health outcomes can vary widely. Yet, few studies have explored the relationship between such diverse disaster-related exposures and posttraumatic growth (PTG) in a Puerto Rican context. Methods To address this gap, we used data from the Preparedness to Reduce Exposures and Diseases Post-hurricanes and Augment Resilience (PREPARE) study, a cohort of mainly Hispanic Puerto Ricans who experienced Hurricanes Maria and Irma in 2017. This analysis focused on 484 individuals who completed structured interviews 20 to 34 months after the hurricanes. We evaluated the associations between five different disaster exposures (e.g., financial, home damage, personal health, and familial health), posttraumatic stress (PTS), and PTG and its five domains (personal strength, new possibilities, improved relationships, spiritual growth, and appreciation of life), controlling for demographic, geographic, and social factors. Results In multivariable models, higher total disaster score was associated with higher levels of both PTS and PTG (2.91 and 3.87, respectively). Personal health impacts were consistently associated with higher levels on all PTG subscales, ranging from 0.89 to 1.94, which was not the case for other exposures. Specifically, home damage was associated with higher levels on all PTG subscales except spiritual growth, and financial and familial health impacts were associated with greater identification with new possibilities and appreciation of life only. Conclusion These findings provide novel evidence that different disaster-related exposures have distinct associations with the different PTG domains in Puerto Rico. These findings can inform future efforts to address post-disaster mental health ailments by bolstering different aspects of PTG.
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Affiliation(s)
- Marie-Claire Meadows
- Division of Environmental Health Sciences, University of Minnesota School of Public Health, Minneapolis, MN, USA
| | - Noelle Serino
- Department of Social and Behavioral Sciences, Yale School of Public Health, New Haven, CT, USA
| | - Dahianira M. Camacho-Monclova
- Center for Clinical Research and Health Promotion, University of Puerto Rico Medical Sciences Campus, San Juan, Puerto Rico, USA
| | - Kaumudi Joshipura
- Center for Clinical Research and Health Promotion, University of Puerto Rico Medical Sciences Campus, San Juan, Puerto Rico, USA
- School of Public Health, Ahmedabad University, Gujarat, India
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Sarah R. Lowe
- Department of Social and Behavioral Sciences, Yale School of Public Health, New Haven, CT, USA
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Zhao L, Wang H, Wang K, Shen C, Tao M. Study on the relationship between PTSD and academic control and academic emotion in primary and middle school students after flood disaster. Front Psychol 2024; 15:1429238. [PMID: 39171232 PMCID: PMC11336700 DOI: 10.3389/fpsyg.2024.1429238] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2024] [Accepted: 07/25/2024] [Indexed: 08/23/2024] Open
Abstract
Purpose To explore the relationship between post-traumatic stress disorder (PTSD) and students' academic control and academic emotion in the aftermath of a flood disaster. The findings will offer educators and relevant departments valuable insights to understand and facilitate the restoration of learning capabilities among students affected by the disaster. Methods This study employed a combined approach of questionnaire surveys and longitudinal tracking. Students from Guangling Primary and Secondary School (Shouguang City, Weifang, Shandong Province) participated in surveys administered in September 2018, December 2018, and September 2019. The instruments utilized included the Post-Disaster Trauma Assessment Questionnaire, the Adolescent Academic Control Scale, and the mathematical version of the Achievement Emotions Questionnaire. Data analysis involved two-factor correlation and mediation effect testing. Results Significant differences were observed in overall PTSD scores and its three dimensions between the 1-week and 1-year post-disaster assessments. Both the average PTSD score and the detection rate were higher 1 year after the disaster compared to the first week. Students' academic control demonstrated a strong positive correlation with positive academic emotions and a significant negative correlation with anxiety-related academic emotions. Cross-lagged regression analysis indicated a predictive relationship: academic control measured 3 months post-disaster significantly predicted academic emotions at the 9-month assessment, and conversely, academic emotions at the 3-month point were predictive of academic control at 9 months. In addition, academic control appears to play a complete mediating role in the relationship between PTSD and academic emotions. Conclusion Students exhibited a range of PTSD symptoms following the disaster, with a higher prevalence noted in the first year compared to the initial week. PTSD negatively affects academic standing in these students, and is predictive of both their sense of academic control and their emotional responses to learning. Crucially, academic control and academic emotions exhibit a strong correlation and can mutually affect one another. Interventions aimed at reducing PTSD symptoms, cultivating positive academic emotions, and strengthening students' sense of academic control must therefore consider the relationship between these factors. This holistic approach will enhance psychological well-being and improve academic performance.
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Affiliation(s)
| | | | | | | | - Mingda Tao
- Normal College, Qingdao University, Qingdao, China
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Majumder J, Saha I, Bagepally BS, Kalita M, Munikrishnappa D, Ray S, Saha A, Chakrabarti A. Mental health burden following extreme weather events in South-east Asia: A systematic review and meta-analysis. Indian J Psychiatry 2024; 66:683-694. [PMID: 39398512 PMCID: PMC11469557 DOI: 10.4103/indianjpsychiatry.indianjpsychiatry_348_24] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/17/2024] [Revised: 07/26/2024] [Accepted: 07/31/2024] [Indexed: 10/15/2024] Open
Abstract
Background Exposure to extreme weatherly events potentially develops mental disorders among affected individuals. Aim To synthesize the burden of mental disorders following impact of extreme weather events in South-east Asian (SEA) countries. Methods Proposal was registered in PROSPERO register [CRD42023469788] and reported as per PRISMA-2020 guidelines. Studies reporting prevalence of mental health disorders following extreme weather events from SEA countries during 1990 and 2023 were searched on Embase, PubMed, and Scopus databases. Study quality was assessed using Appraisal tool for Cross-Sectional Studies. Overall pooled prevalence was computed using DerSimonian-Laird method for random-effects model and reported as 95% confidence intervals. Results On screening 12,046 records, we included 155 studies (2,04,474 participants) for analysis. Overall burden of mental disorders was 35.31% (95%CI: 30.42%-40.21%). In subgroup analysis, studies on cyclones, India, local residents, children and adolescents, rural settings, and community settings reported higher burden of mental disorders. Depression (28.58%; 95%CI: 24.05%-33.1%) and PTSD (29.36%; 95%CI: 26.26%-32.46%) had similar prevalence. Visiting tourists to SEA region experienced fear, fear of recurrence of tsunami, nightmares, and sense of helplessness. Mental health outcomes were relatively higher in studies conducted within 1 year of events. Heterogeneity and possibility of publication bias exists among the reported studies. Conclusion With the significant rise in episodes of extreme weather events in SEA region over the last three decades, mental disorders are documented in different proportions. We suggest prioritizing well-informed policies to formulate inclusive and resilient strategies on effectively identifying and treating mental health concerns among victims of extreme weather events.
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Affiliation(s)
- Joydeep Majumder
- Scientist E, ICMR-Centre for Ageing and Mental Health, Kolkata, West Bengal, India
| | - Indranil Saha
- Scientist E, ICMR-Centre for Ageing and Mental Health, Kolkata, West Bengal, India
| | - Bhavani Shankara Bagepally
- Scientist E, Health Systems Research Division, ICMR-National Institute of Epidemiology, Chennai, India and Associate Professor (Honorary), Faculty of Medical Research, Academy of Scientific and Innovative Research (AcSIR) (An Institution of National Importance Established by an Act of Parliament)
| | - Manoj Kalita
- Scientist C, ICMR-Centre for Ageing and Mental Health, Kolkata, West Bengal, India
| | | | - Sujoy Ray
- Specialty Doctor in Psychiatry, Solent NHS Trust, Portsmouth, UK
| | - Asim Saha
- Scientist F, ICMR-Centre for Ageing and Mental Health, Kolkata, West Bengal, India
| | - Amit Chakrabarti
- Scientist G and Officer-in-Charge, ICMR-Centre for Ageing and Mental Health, Kolkata, West Bengal, India
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Menzies RE, Richmond B, Sharpe L, Skeggs A, Liu J, Coutts-Bain D. The 'revolving door' of mental illness: A meta-analysis and systematic review of current versus lifetime rates of psychological disorders. BRITISH JOURNAL OF CLINICAL PSYCHOLOGY 2024; 63:178-196. [PMID: 38197576 DOI: 10.1111/bjc.12453] [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: 11/01/2023] [Revised: 12/13/2023] [Accepted: 12/18/2023] [Indexed: 01/11/2024]
Abstract
OBJECTIVES Therapists have long observed a phenomenon referred to as the 'revolving door' of mental health services, in which individuals often develop, seek treatment for, and recover from multiple mental illnesses across their life. However, this has not been systematically examined. If this phenomenon is widespread, one would expect that the number of lifetime disorders would exceed that of current disorders. The aim of this meta-analysis was to test this hypothesis. METHODS A search was conducted of the following databases: MEDLINE, PsycINFO and Web of Science. In total, 38 studies were included in the current review; 27 of these contained sufficient quantitative data to be included in the meta-analysis, addressing the primary research aim. The remaining 11 studies were included in the systematic review only. RESULTS Meta-analyses of the 27 studies indicated that the average number of lifetime disorders was 1.84 times that of current disorders. Previous treatment significantly moderated this relationship, while the clinical nature of the sample did not. Examination of the remaining studies revealed common temporal sequences, indicating disorders which typically develop first or consequently to other disorders. CONCLUSIONS These findings provide support for the revolving door of mental illness, suggesting a need for transdiagnostic treatments and broader conceptualisation of relapse prevention.
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Affiliation(s)
| | | | - Louise Sharpe
- The University of Sydney, Sydney, New South Wales, Australia
| | - Amira Skeggs
- The University of Sydney, Sydney, New South Wales, Australia
| | - Janessa Liu
- The University of Sydney, Sydney, New South Wales, Australia
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Çiftci N, Yildiz M, Uçar M. Relationship Between Posttraumatic Stress Disorder, Death Anxiety, and Insomnia in Adults After the Earthquake. OMEGA-JOURNAL OF DEATH AND DYING 2024:302228241256267. [PMID: 38785216 DOI: 10.1177/00302228241256267] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/25/2024]
Abstract
This study aimed to determine the relationship between posttraumatic stress disorder, death anxiety, and insomnia in adults after the earthquake. This study, designed in a relational-cross-sectional-descriptive model, was conducted with 624 adult individuals living in a province affected by the earthquake that occurred in Turkey on February 6, 2023. The study data were collected using a personal information form, Posttraumatic Stress Disorder Checklist, Turkish Death Anxiety Scale, and Bergen Insomnia Scale. The analysis of the study data was performed by using SPSS 25.0, AMOS 24.0, and G*Power 3.1 Statistical package software. A significant positive correlation was found between posttraumatic stress disorder and Insomnia and Death Anxiety (p < .05). There was a significant positive correlation between Death Anxiety and Insomnia (p < .05). It was determined that Death Anxiety has a mediating role in the impact of posttraumatic stress disorder on insomnia (95% Confidence Interval: 0.572/1.407) (p < .05). It was determined that the model created in line with the hypotheses was compatible and the model fit indices were within the desired limits, with x2/df = 1.795, RMSEA = 0.03, CFI = 0.95, GFI = 0.946, AGFI = 0.93, IFI = 0.95. It was determined that posttraumatic stress disorder increased death anxiety and insomnia after the earthquake. Conducting longitudinal studies on the post-earthquake period is recommended.
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Affiliation(s)
- Necmettin Çiftci
- Department of Nursing, Faculty of Health Sciences, Muş Alparslan University, Muş, Turkey
| | - Metin Yildiz
- Department of Midwifery, Faculty of Health Sciences, Sakarya University, Sakarya, Turkey
| | - Mehmet Uçar
- Department of Medical Services and Techniques, Varto Vocational School, Muş Alparslan University, Muş, Turkey
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Pavlacic JM, Ruggiero KJ, Andrews AR, Price M, Rheingold AA. Behavioral activation is associated with post-disaster mental health: Secondary longitudinal analysis from a population-based study. J Clin Psychol 2024; 80:291-305. [PMID: 37851207 PMCID: PMC10843073 DOI: 10.1002/jclp.23610] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2023] [Revised: 07/21/2023] [Accepted: 09/30/2023] [Indexed: 10/19/2023]
Abstract
OBJECTIVE Interventions in post-disaster environments may be accelerated by identifying protective behavioral factors adding incremental value to models of psychopathology using longitudinal methods. One protective behavior applicable to post-disaster contexts is behavioral activation (BA). BA is defined here as a behavioral pattern involving presence of valued activity engagement. While relevant post-disaster, the incremental value of BA behaviors in predicting longitudinal post-disaster outcomes is not well understood. We hypothesized that higher baseline engagement in behaviors consistent with a BA framework would predict decreased posttraumatic stress disorder (PTSD) symptom severity, depression symptom severity, and sleep disturbance approximately 3, 6, and 12 months after hurricane survivors completed baseline measures. METHODS The current study is a secondary analysis from a randomized controlled trial of a disaster mental health digital intervention. Participants completed surveys at baseline and approximately 3, 6, and 12 months post-enrollment. Correlations and hierarchical regression analyses were calculated following data screening to predict PTSD symptom severity, depression symptom severity, and sleep disturbances. RESULTS Controlling for alcohol use, prior trauma, displacement, and intervention condition, higher baseline BA consistently predicted less PTSD symptom severity, depression symptom severity, and sleep disturbances. CONCLUSION Results suggest that post-disaster interventions should consider addressing BA. The study provides evidence that BA is potentially an important protective factor longitudinally predicting sleep disturbances and psychopathology after natural disasters.
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Affiliation(s)
- Jeffrey M. Pavlacic
- Mental Health Service, Ralph H. Johnson VA Healthcare System
- Department of Psychiatry & Behavioral Sciences, Medical University of South Carolina
| | - Kenneth J. Ruggiero
- Department of Psychiatry & Behavioral Sciences, Medical University of South Carolina
- College of Nursing, Medical University of South Carolina
| | | | - Matthew Price
- Department of Psychological Science, University of Vermont
| | - Alyssa A. Rheingold
- Department of Psychiatry & Behavioral Sciences, Medical University of South Carolina
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Dmytriv TR, Tsiumpala SA, Semchyshyn HM, Storey KB, Lushchak VI. Mitochondrial dysfunction as a possible trigger of neuroinflammation at post-traumatic stress disorder (PTSD). Front Physiol 2023; 14:1222826. [PMID: 37942228 PMCID: PMC10628526 DOI: 10.3389/fphys.2023.1222826] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Accepted: 10/09/2023] [Indexed: 11/10/2023] Open
Abstract
Post-traumatic stress disorder (PTSD) is a neuropsychiatric disorder that occurs in approximately 15% of people as a result of some traumatic events. The main symptoms are re-experiencing and avoidance of everything related to this event and hyperarousal. The main component of the pathophysiology of PTSD is an imbalance in the functioning of the hypothalamic-pituitary-adrenal axis (HPA) and development of neuroinflammation. In parallel with this, mitochondrial dysfunction is observed, as in many other diseases. In this review, we focus on the question how mitochondria may be involved in the development of neuroinflammation and its maintaining at PTSD. First, we describe the differences in the operation of the neuro-endocrine system during stress versus PTSD. We then show changes in the activity/expression of mitochondrial proteins in PTSD and how they can affect the levels of hormones involved in PTSD development, as well as how mitochondrial damage/pathogen-associated molecule patterns (DAMPs/PAMPs) trigger development of inflammation. In addition, we examine the possibility of treating PTSD-related inflammation using mitochondria as a target.
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Affiliation(s)
- Tetiana R. Dmytriv
- Department of Biochemistry and Biotechnology, Vasyl Stefanyk Precarpathian National University, Ivano-Frankivsk, Ukraine
| | - Sviatoslav A. Tsiumpala
- Department of Biochemistry and Biotechnology, Vasyl Stefanyk Precarpathian National University, Ivano-Frankivsk, Ukraine
| | - Halyna M. Semchyshyn
- Department of Biochemistry and Biotechnology, Vasyl Stefanyk Precarpathian National University, Ivano-Frankivsk, Ukraine
| | - Kenneth B. Storey
- Department of Biology, Institute of Biochemistry, Carleton University, Ottawa, ON, Canada
| | - Volodymyr I. Lushchak
- Department of Biochemistry and Biotechnology, Vasyl Stefanyk Precarpathian National University, Ivano-Frankivsk, Ukraine
- Research and Development University, Ivano-Frankivsk, Ukraine
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8
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Wang X, Yang X, Zhou X. Perceived parental depression, intrusive rumination, and internalizing problems: A three-wave longitudinal study in adolescents. Int J Clin Health Psychol 2023; 23:100366. [PMID: 36714277 PMCID: PMC9845799 DOI: 10.1016/j.ijchp.2023.100366] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2022] [Accepted: 01/03/2023] [Indexed: 01/15/2023] Open
Abstract
Research suggests that perceiving parental depression elicits internalizing problems in adolescents, but certain studies have indicated that adolescents' internalizing problems also increase their perception of parental emotion. To further investigate the inconsistent findings about the nature of this relationship, the current study used longitudinal data to examine the causal association between adolescents' internalizing problems and the parental depression they perceived, as well as the role of intrusive rumination in the relationship. Method: In this longitudinal study, 392 adolescents who experienced the catastrophic Jiuzhaigou earthquake in 2017 were surveyed at three time points after the earthquake: 12 months (T1), 21 months (T2) and 27 months (T3). A cross-lagged panel model was used to carry out the data analysis. Results: Mutual cause-and-effect relationships were found between intrusive rumination and both perceived parental depression and internalizing problems, respectively; a unilateral causal relationship in which internalizing problems positively predicted perceived parental depression was also found. In addition, internalizing problems predicted perceived parental depression via the mediating role of intrusive rumination; similarly, intrusive rumination predicted perceived parental depression via internalizing problems. Conclusions: Internalizing problems were a risk factor for perceived parental depression, and intrusive rumination played an important role in the relationship between internalizing problems and perceived parental depression.
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Affiliation(s)
- Xuan Wang
- Department of Psychology and Behavioral Sciences, Zhejiang University, No. 148 Tianmushan Road, Xihu District, Hangzhou, Zhejiang 310028, China
| | - Xima Yang
- Department of Psychology and Behavioral Sciences, Zhejiang University, No. 148 Tianmushan Road, Xihu District, Hangzhou, Zhejiang 310028, China
| | - Xiao Zhou
- Department of Psychology and Behavioral Sciences, Zhejiang University, No. 148 Tianmushan Road, Xihu District, Hangzhou, Zhejiang 310028, China
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Brown RL, Innes PA, Carter JD, Wood A, Love S, Kannis-Dymand L. Beliefs About Traumatic Memories, Thought Control Strategies, and the Impact on PTSD Symptoms After a Natural Disaster. J Nerv Ment Dis 2023; 211:182-189. [PMID: 36095259 DOI: 10.1097/nmd.0000000000001586] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
ABSTRACT This study aimed to investigate the relationships among self-reported meta-memory beliefs, thought control strategies ( i.e. , distraction, reappraisal, worry, social control, and punishment), and posttraumatic stress disorder (PTSD) symptomology, among a sample of earthquake survivors ( N = 412). Correlational analysis and structural equation modeling were used on the responses and showed that stronger positive and negative meta-memory beliefs, and greater worry and punishment, were associated with greater PTSD symptom severity. The results also indicated that meta-memory beliefs had a prominent indirect influence toward PTSD symptomology via their effects toward thought control strategies. Follow-up analysis of variance indicated that those with a history of mental health difficulties reported higher levels of PTSD symptom severity, were more likely to score in the range of clinically relevant PTSD, and had a stronger tendency to negatively appraise unwanted thinking styles. The results of this research provide overall support for the validity of the metacognitive model for PTSD.
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Affiliation(s)
| | | | - Janet D Carter
- Department of Psychology, Speech, and Hearing, University of Canterbury, Christchurch, New Zealand
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Lushchak O, Strilbytska O, Koliada A, Storey KB. An orchestrating role of mitochondria in the origin and development of post-traumatic stress disorder. Front Physiol 2023; 13:1094076. [PMID: 36703926 PMCID: PMC9871262 DOI: 10.3389/fphys.2022.1094076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Accepted: 12/22/2022] [Indexed: 01/11/2023] Open
Abstract
Post-traumatic stress disorder (PTSD) is one of the most discussed and actively researched areas in medicine, psychiatry, neurophysiology, biochemistry and rehabilitation over the last decades. Multiple causes can trigger post-traumatic stress disorder. Humans subjected to violence, participants in hostilities, victims of terrorist attacks, physical or psychological persecution, witnessing scenes of cruelty, survival of natural disasters, and more, can strongly affect both children and adults. Pathological features of post-traumatic stress disorder that are manifested at molecular, cellular and whole-organism levels must be clearly understood for successful diagnosis, management, and minimizing of long-term outcomes associated with post-traumatic stress disorder. This article summarizes existing data on different post-traumatic stress disorder causes and symptoms, as well as effects on homeostasis, genetic instability, behavior, neurohumoral balance, and personal psychic stability. In particular, we highlight a key role of mitochondria and oxidative stress development in the severity and treatment of post-traumatic stress disorder. Excessive or prolonged exposure to traumatic factors can cause irreversible mitochondrial damage, leading to cell death. This review underlines the exceptional importance of data integration about the mechanisms and functions of the mitochondrial stress response to develop a three-dimensional picture of post-traumatic stress disorder pathophysiology and develop a comprehensive, universal, multifaceted, and effective strategy of managing or treatment post-traumatic stress disorder.
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Affiliation(s)
- Oleh Lushchak
- Department of Biochemistry and Biotechnology, Vasyl Stefanyk Precarpathian National University, Ivano-Frankivsk, Ukraine,Research and Development University, Ivano-Frankivsk, Ukraine,*Correspondence: Oleh Lushchak,
| | - Olha Strilbytska
- Department of Biochemistry and Biotechnology, Vasyl Stefanyk Precarpathian National University, Ivano-Frankivsk, Ukraine
| | - Alexander Koliada
- Institute of Food Biotechnology and Genomics, NAS of Ukraine, Kyiv, Ukraine
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Lawrance EL, Thompson R, Newberry Le Vay J, Page L, Jennings N. The Impact of Climate Change on Mental Health and Emotional Wellbeing: A Narrative Review of Current Evidence, and its Implications. Int Rev Psychiatry 2022; 34:443-498. [PMID: 36165756 DOI: 10.1080/09540261.2022.2128725] [Citation(s) in RCA: 85] [Impact Index Per Article: 28.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Converging global evidence highlights the dire consequences of climate change for human mental health and wellbeing. This paper summarises literature across relevant disciplines to provide a comprehensive narrative review of the multiple pathways through which climate change interacts with mental health and wellbeing. Climate change acts as a risk amplifier by disrupting the conditions known to support good mental health, including socioeconomic, cultural and environmental conditions, and living and working conditions. The disruptive influence of rising global temperatures and extreme weather events, such as experiencing a heatwave or water insecurity, compounds existing stressors experienced by individuals and communities. This has deleterious effects on people's mental health and is particularly acute for those groups already disadvantaged within and across countries. Awareness and experiences of escalating climate threats and climate inaction can generate understandable psychological distress; though strong emotional responses can also motivate climate action. We highlight opportunities to support individuals and communities to cope with and act on climate change. Consideration of the multiple and interconnected pathways of climate impacts and their influence on mental health determinants must inform evidence-based interventions. Appropriate action that centres climate justice can reduce the current and future mental health burden, while simultaneously improving the conditions that nurture wellbeing and equality. The presented evidence adds further weight to the need for decisive climate action by decision makers across all scales.
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Affiliation(s)
- Emma L Lawrance
- Institute of Global Health Innovation, Imperial College London, UK.,Mental Health Innovations, UK.,Grantham Institute of Climate and the Environment, Imperial College London, UK
| | | | | | - Lisa Page
- Brighton & Sussex Medical School, UK
| | - Neil Jennings
- Grantham Institute of Climate and the Environment, Imperial College London, UK
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12
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Begum TF, Lin Z, Primeau M, Lin S. Assessing short-term and long-term mental health effects among older adults after Hurricane Sandy. THE SCIENCE OF THE TOTAL ENVIRONMENT 2022; 825:153753. [PMID: 35151740 DOI: 10.1016/j.scitotenv.2022.153753] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/14/2021] [Revised: 01/29/2022] [Accepted: 02/04/2022] [Indexed: 05/16/2023]
Abstract
BACKGROUND Few studies have evaluated the long-term effects of disasters on older adults. We examined if older individuals experienced increased mental health (MH) effects immediately and long-term after Hurricane Sandy and if these effects varied by socioeconomic status (SES), disease subtypes, number of comorbidities, and length of stay. METHODS We identified older patients (≥64 years) with hospital admissions and Emergency Department (ED) visits (2001-2015) with primary diagnosis of MH diseases using the New York State discharged data. We quantified both short-term (immediately post-Sandy) and long-term effects (3-month, 1-year, 2-year, and 3-year) following Hurricane Sandy, and used the pre-Sandy period in the affected counties as the control period. Poisson regression was used to compare daily counts of MH cases overall and by multiple strata pre-/post Sandy. FINDINGS Older individuals had significantly increased risk of MH ED visits immediately (32%), and 3-months, 1, 2, and 3-years after Sandy (2%, 9%, 15%, and 10%, respectively). MH hospital admissions did not increase immediately, but significantly increased by 8% a year later. Males and those with low SES had delayed, but increased risks of MH 1-3 years after Sandy (RRs range: 1.14-1.71). The top MH subtypes after Sandy were psychosis, mood disorders, substance abuse, suicide, and anxiety (RRs range: 1.12-2.62). After Sandy, patients with ≥8 comorbidities increased from 15% to >25%, along with their length of hospital stay. CONCLUSION We found long-term adverse effects of MH after Sandy, especially among vulnerable populations, which may help plan future disaster preparedness and recovery efforts.
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Affiliation(s)
- Thoin F Begum
- Department of Environmental Health Sciences, University at Albany, State University of New York, Rensselaer, NY, United States
| | - Ziqiang Lin
- Department of Environmental Health Sciences, University at Albany, State University of New York, Rensselaer, NY, United States; Department of Psychiatry, NYU Grossman School of Medicine, New York, NY, United States
| | - Mike Primeau
- Office of Health Emergency Preparedness, New York State Department of Health, Albany, NY, United States
| | - Shao Lin
- Department of Environmental Health Sciences, University at Albany, State University of New York, Rensselaer, NY, United States; Department of Epidemiology and Biostatistics, University at Albany, State University of New York, Rensselaer, NY, United States.
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Pratiwi A, Muhlisin A, Mardiyo M, Yuniartika W, Widodo A. Mother’s Concern in the Family about Her Child with Post-Traumatic Due to the Tornado in Central Java, Indonesia – A Qualitative Study. Open Access Maced J Med Sci 2022. [DOI: 10.3889/oamjms.2022.7741] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
BACKGROUND: Natural disasters continue to occur worldwide, influencing the economy, finances, and psychological problems. Traumatic on children is an impact of the catastrophe likely a burden on the family, especially mothers who accompany their children as caregivers.
AIM: The purpose of the study was to explore children’s traumatic experiences from mothers in a family in a rural community in Indonesia.
METHODS: We conducted six focus groups with mothers to explore their traumatic children’s experiences using a qualitative research design. Thirty mothers with children 3−10 years old contributed to the focus groups across all sites. We formed focus groups with six mothers and continued in-depth interviews, including nine mothers.
RESULTS: The mothers had similar experiences understanding their children’s trauma due to natural tornado disasters. This study revealed three overarching themes shaping the mothers’ experience: anxiety in children, trauma trigger, and lingering distress. All themes lead to the main theme is psychological distress in the face of a child suffering from PTSD. From the hermeneutical perspective, topics can be identified as terms, including being-thrownness, being-fallenness and being-alongside.
CONCLUSION: Children with post-traumatic stress disorder may impact family physiological problems, especially the mother. The study found that may place the burden of care for children on the person’s families.
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Yang YS, Bae SM. Association between resilience, social support, and institutional trust and post-traumatic stress disorder after natural disasters. Arch Psychiatr Nurs 2022; 37:39-44. [PMID: 35337437 DOI: 10.1016/j.apnu.2022.01.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/09/2021] [Revised: 12/04/2021] [Accepted: 01/10/2022] [Indexed: 11/29/2022]
Abstract
Disasters can cause significant personal and social distress and adversely affect mental health. Compared with research on the risk factors of post-disaster post-traumatic stress disorder (PTSD), limited studies have reported protective factors against PTSD. We investigated whether resilience, social support, and trust in government were associated with PTSD in disaster survivors, after adjustment for the perceived damage and demographic variables including sex, age, and economic status. We investigated 2311 disaster survivors, using data from the "Long-term survey on the change of life of Disaster victim" performed by NDMI(National Disaster Management Research Institute). Hierarchical regression analysis was used in this study. A high level of trust in institutions was associated with few PTSD symptoms after adjustment for resilience and social support. Among the subfactors of institutional trust, psychological counseling and environmental and facility restoration were associated with PTSD. Psychological counseling and environmental and facility restoration support for disaster survivors were associated with reduced PTSD symptoms. Post-disaster policy support, including psychological counseling and environmental and facility restoration services, is important. Our findings highlight the protective factors against PTSD symptoms and may serve as guidelines for specific interventions for the management of post-disaster PTSD.
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Affiliation(s)
- Ye-Seul Yang
- Department of Psychology, Graduate School, Dankook University, Cheonan, Republic of Korea
| | - Sung-Man Bae
- Department of Psychology, Graduate School, Dankook University, Cheonan, Republic of Korea; Department of Psychology and Psychotherapy, College of Health Science, Dankook University, Cheonan, Republic of Korea.
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15
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Zhen B, Yao B, Zhou X. Pandemic Exposure, Post-traumatic Stress Disorder, Conflict Behaviors, and Online Aggressive Behaviors Among College Students During the COVID-19 Pandemic: Examining the Moderating Role of Gender. Front Psychiatry 2022; 13:809173. [PMID: 35370842 PMCID: PMC8967964 DOI: 10.3389/fpsyt.2022.809173] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/05/2021] [Accepted: 02/17/2022] [Indexed: 11/13/2022] Open
Abstract
The COVID-19 pandemic impacts people's mental health and behaviors, but the influence mechanism between pandemic exposure, conflict behaviors, and online aggressive behaviors during the COVID-19 outbreak remains unclear. This study will address this gap. Data were collected from 1,153 college students in an online survey that included an pandemic experiences scale, a post-traumatic stress disorder (PTSD) scale, a conflict behaviors scale, and an online aggressive behaviors scale. Structural equation modeling and multi-group comparisons were used to analyze the data. Pandemic exposure positively predicted conflict and online aggressive behaviors through hyperarousal symptoms, and negatively predicted these behaviors through intrusive symptoms. The mediating roles of avoidance and negative alterations in cognition and mood symptoms in the relations between pandemic exposure and conflict behaviors and online aggressive behaviors were non-significant. Among male students, pandemic exposure directly predicted conflict and online aggressive behaviors, but for female students, pandemic exposure indirectly influenced these behaviors through intrusive and hyperarousal symptoms. The intrusive and hyperarousal symptoms play mediating roles in the relations between pandemic exposure and conflict behaviors and online aggressive behaviors. Gender plays a moderating role in the above mediating mechanism.
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Affiliation(s)
- Baohua Zhen
- College of Educational Science, Anhui Normal University, Wuhu, China
| | - Benxian Yao
- College of Educational Science, Anhui Normal University, Wuhu, China
| | - Xiao Zhou
- Department of Psychology and Behavioral Sciences, Zhejiang University, Hangzhou, China
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16
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Mitchell JT. Continuum of care for disasters and catastrophes. Int Rev Psychiatry 2021; 33:728-739. [PMID: 35412427 DOI: 10.1080/09540261.2022.2030678] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Disasters and their more extensive and more serious variant, catastrophes, are different than most human experiences. They are inherently quite complex. Extensive and diverse resources are required to assist disaster survivors as well as disaster response personnel, and hospital medical staffs. Except for warfare, there are few other human predicaments that require such a massive and highly coordinated response. Traditional psycho-therapeutic interventions have little chance of being helpful in the acute stages of a disaster. Research demonstrates that selected crisis intervention processes provided by crisis-trained psychological support personnel have been quite successful in assisting both the survivors and responders in coping with disasters and catastrophes. Assistance to military personnel, emergency operations personnel, and survivors must be carefully crafted to assure that the right type of help is provided at the right time by the most appropriate, well-trained, and experienced personnel. This paper employed a scoping review methodology synthesizing the lessons gleaned from wars and past disasters beginning in the late 1800's up to the present. It sets a course for the appropriate management of the psychological impacts of future disasters and catastrophes. Evidence suggests effective psychiatric and psychological services provided during and in the aftermath of a disaster must be simple, brief, immediate, practical, and innovative. Most importantly, disaster mental health support services must consist of an integrated and comprehensive continuum of mental health services spanning all levels of intensity of support and care.
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Affiliation(s)
- Jeffrey T Mitchell
- Emergency Health Services, University of Maryland, Baltimore County, Baltimore, MD, USA
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Abstract
This paper focuses on climate anxiety and its role in the psychology of climate change, compared with responses to the COVID-19 global pandemic. Four psychological hypotheses for why we do not act on climate change will be reviewed, and the role of anxiety for each, as well as potential solutions. Different types of climate anxiety both inside and outside the clinic will be explored, along with associated defence mechanisms and treatment.
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Affiliation(s)
- Joseph Dodds
- Psychology Faculty, University of New York in Prague, Czech Republic
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18
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Zhou YG, Shang ZL, Zhang F, Wu LL, Sun LN, Jia YP, Yu HB, Liu WZ. PTSD: Past, present and future implications for China. Chin J Traumatol 2021; 24:187-208. [PMID: 33994278 PMCID: PMC8343811 DOI: 10.1016/j.cjtee.2021.04.011] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Revised: 03/30/2021] [Accepted: 04/18/2021] [Indexed: 02/04/2023] Open
Abstract
There has been a long history since human beings began to realize the existence of post-traumatic symptoms. Posttraumatic stress disorder (PTSD), a diagnostic category adopted in 1980 in the Diagnostic and Statistical Manual of Mental Disorders-Ⅲ, described typical clusters of psychiatric symptoms occurring after traumatic events. Abundant researches have helped deepen the understanding of PTSD in terms of epidemiological features, biological mechanisms, and treatment options. The prevalence of PTSD in general population ranged from 6.4% to 7.8% and was significantly higher among groups who underwent major public traumatic events. There has been a long way in the studies of animal models and genetic characteristics of PTSD. However, the high comorbidity with other stress-related psychiatric disorders and complexity in the pathogenesis of PTSD hindered the effort to find specific biological targets for PTSD. Neuroimage was widely used to elucidate the underlying neurophysiological mechanisms of PTSD. Functional MRI studies have showed that PTSD was linked to medial prefrontal cortex, anterior cingulate cortex and sub-cortical structures like amygdala and hippocampus, and to explore the functional connectivity among these brain areas which might reveal the possible neurobiological mechanism related to PTSD symptoms. For now, cognitive behavior therapy-based psychotherapy, including combination with adjunctive medication, showed evident treatment effects on PTSD. The emergence of more effective PTSD pharmacotherapies awaits novel biomarkers from further fundamental research. Several natural disasters and emergencies have inevitably increased the possibility of suffering from PTSD in the last two decades, making it critical to strengthen PTSD research in China. To boost PTSD study in China, the following suggestions might be helpful: (1) establishing a national psychological trauma recover project, and (2) exploring the mechanisms of PTSD with joint effort and strengthening the indigenized treatment of PTSD.
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Affiliation(s)
- Yao-Guang Zhou
- Lab for Post-traumatic Stress Disorder, Faculty of Psychology and Mental Health, Naval Medical University, Shanghai, 200433, China
| | - Zhi-Lei Shang
- The Emotion & Cognition Lab, Faculty of Psychology and Mental Health, Naval Medical University, Shanghai, 200433, China
| | - Fan Zhang
- Faculty of Psychology and Mental Health, Naval Medical University, Shanghai, 200433, China
| | - Li-Li Wu
- Lab for Post-traumatic Stress Disorder, Faculty of Psychology and Mental Health, Naval Medical University, Shanghai, 200433, China,The Emotion & Cognition Lab, Faculty of Psychology and Mental Health, Naval Medical University, Shanghai, 200433, China
| | - Lu-Na Sun
- Lab for Post-traumatic Stress Disorder, Faculty of Psychology and Mental Health, Naval Medical University, Shanghai, 200433, China,The Emotion & Cognition Lab, Faculty of Psychology and Mental Health, Naval Medical University, Shanghai, 200433, China
| | - Yan-Pu Jia
- Lab for Post-traumatic Stress Disorder, Faculty of Psychology and Mental Health, Naval Medical University, Shanghai, 200433, China,The Emotion & Cognition Lab, Faculty of Psychology and Mental Health, Naval Medical University, Shanghai, 200433, China
| | - Hai-Bo Yu
- Faculty of Psychology and Mental Health, Naval Medical University, Shanghai, 200433, China,Corresponding author.
| | - Wei-Zhi Liu
- Lab for Post-traumatic Stress Disorder, Faculty of Psychology and Mental Health, Naval Medical University, Shanghai, 200433, China,The Emotion & Cognition Lab, Faculty of Psychology and Mental Health, Naval Medical University, Shanghai, 200433, China,Corresponding author. Lab for Post-traumatic Stress Disorder, Faculty of Psychology and Mental Health, Naval Medical University, Shanghai, 200433, China.
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19
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Mental Health Impacts of Climate Change: Perspectives for the ED Clinician. J Emerg Nurs 2021; 46:590-599. [PMID: 32828480 PMCID: PMC7435280 DOI: 10.1016/j.jen.2020.05.014] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2020] [Revised: 05/20/2020] [Accepted: 05/21/2020] [Indexed: 02/06/2023]
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20
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Kabir H, Maple M, Islam MS, Usher K. Prevalence of Suicide Thoughts and Behaviours among Female Garment Workers Who Survived the Rana Plaza Collapse: An In-Depth Inquiry. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:6326. [PMID: 34207986 PMCID: PMC8296151 DOI: 10.3390/ijerph18126326] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/15/2021] [Revised: 06/09/2021] [Accepted: 06/09/2021] [Indexed: 11/17/2022]
Abstract
The Rana Plaza building collapse occurred on 24 April 2013 in Savar, near the capital city of Bangladesh, killing more than 1130 garment workers and injured about 2500, mostly females. Those who survived face ongoing challenges, including socio-cultural constraints, economic hardship, post-traumatic stress disorders (PTSD), depression, and critical health issues, which may lead to suicidal ideation and death. The aim of this article is to explore why and how female garment workers who survived the Rana Plaza collapse are now at risk of suicide thoughts and behaviours, and suicide death. Unstructured face-to-face interviews were held from April to July 2018 with 11 female garment workers who survived the Rana Plaza building collapse. Interviews continued until data saturation was reached. The interviews were tape-recorded and transcribed verbatim while simultaneously being translated into English from Bengali/Bangla. Transcripts were coded and thematically analysed. The study found that all participants were living with multiple risk factors of suicidal ideation (including low socio-economic status, poverty, social stigma, psychological distress, and trauma) which the participants directly linked to the collapse of the Rana Plaza building. Our analysis uses the three-step theory of suicide (3ST, Klonsky & May, 2015) to understand female Rana Plaza survivors' suicide risk. Female survivors' overall vulnerability requires urgent attention while taking the socio-cultural setting of Bangladesh into account. In addition, a lifelong caring system (combining financial security and free healthcare) needs to be initiated to accommodate the female survivors with mainstream society to avoid possible future suicides. They require long-term social and economic security and psychological support.
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Affiliation(s)
- Humayun Kabir
- School of Health, Faculty of Medicine and Health, University of New England, Armidale, NSW 2351, Australia; (M.M.); (M.S.I.); (K.U.)
- Department of Sociology, University of Dhaka, Dhaka 1000, Bangladesh
| | - Myfanwy Maple
- School of Health, Faculty of Medicine and Health, University of New England, Armidale, NSW 2351, Australia; (M.M.); (M.S.I.); (K.U.)
| | - Md Shahidul Islam
- School of Health, Faculty of Medicine and Health, University of New England, Armidale, NSW 2351, Australia; (M.M.); (M.S.I.); (K.U.)
| | - Kim Usher
- School of Health, Faculty of Medicine and Health, University of New England, Armidale, NSW 2351, Australia; (M.M.); (M.S.I.); (K.U.)
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21
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Miki Y, Tase T, Tokunaga H, Yaegashi N, Ito K. Cervical cancer screening rates before and after the Great East Japan Earthquake in the Miyagi Prefecture, Japan. PLoS One 2020; 15:e0229924. [PMID: 32160221 PMCID: PMC7065810 DOI: 10.1371/journal.pone.0229924] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2019] [Accepted: 02/17/2020] [Indexed: 11/18/2022] Open
Abstract
After disasters, issues pertaining to women’s health such as irregular periods and bleeding are well surveyed. However, the management of women’s health, especially changes in the rate of health checkups, has not been investigated. In the present study, we focused on the change in the cervical cancer screening rates (CCS-Rs) before and after the Great East Japan Earthquake in Miyagi Prefecture, Japan. The earthquake had a magnitude of 9.0, a profound disaster. We examined the CCS-R from 2009 to 2016 in 45 areas of the Miyagi Prefecture. Screening was completed using mobile vans. In the 4 areas impacted by the tsunami after the earthquake, a marked decrease in the CCS-R was observed in 2011 when the earthquake took place (more than a 3% decrease compared with that in the previous year). The CCS-Rs in these 4 regions remained lower in 2016 than in the previous year. In 2009–2016 except for 2014, CCS-Rs in coastal areas (9 areas) were significantly lower than those in the non-coastal areas (36 areas). A delay in seeking healthcare, also known as “patient’s delay,” is considered as one of the problems of cancer treatment in affected areas. It is possible that a decrease in the CCS-R may lead to low detection of advanced stages of cancer. Therefore, the establishment of a comprehensive medical system including medical screening after a disaster is important for the management of women’s health.
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Affiliation(s)
- Yasuhiro Miki
- Department of Disaster Obstetrics and Gynecology, International Research Institute of Disaster Science, Tohoku University, Sendai, Japan
| | - Toru Tase
- Cancer Detection Center, Miyagi Cancer Society, Sendai, Japan
| | - Hideki Tokunaga
- Department of Obstetrics and Gynecology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Nobuo Yaegashi
- Department of Obstetrics and Gynecology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Kiyoshi Ito
- Department of Disaster Obstetrics and Gynecology, International Research Institute of Disaster Science, Tohoku University, Sendai, Japan
- Disaster Medical Science Group, Core Research Cluster of Disaster Science, Tohoku University, Sendai, Japan
- * E-mail:
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Asnakew S, Shumet S, Ginbare W, Legas G, Haile K. Prevalence of post-traumatic stress disorder and associated factors among Koshe landslide survivors, Addis Ababa, Ethiopia: a community-based, cross-sectional study. BMJ Open 2019; 9:e028550. [PMID: 31256034 PMCID: PMC6609084 DOI: 10.1136/bmjopen-2018-028550] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2018] [Revised: 05/31/2019] [Accepted: 06/03/2019] [Indexed: 12/28/2022] Open
Abstract
OBJECTIVES To assess the prevalence of post-traumatic stress disorder (PTSD) and associated factors among the survivors of Koshe landslide, Addis Ababa, Ethiopia, 2018. DESIGN Community-based cross-sectional design. SETTING Koshe landslide, Addis Ababa, Ethiopia. PARTICIPANTS We recruited 830 participants for interviews using the simple random sampling technique. MEASUREMENT We collected data by face-to-face interviews. The civilian version of the PTSD checklist was used to measure the symptoms of the disorder. The Perceived Stress Scale and the Oslo-3 social support instruments were used to assess the factors. Coded variables were entered into Epi data V.4.2 and exported to SPSS V.24 for analysis. Bivariate and multivariate logistic regressions with OR and 95% CI were employed. RESULT A total of 830 participants were interviewed, with a response rate of 98.2%. The prevalence of PTSD was 37.3% with 95% CI 34.1 to 40.8. In the multivariate logistic regression, female sex (adjusted odds ratio (AOR)=1.74, 95% CI 1.21 to 2.50), divorce (AOR=2.08, 95% CI 1.26 to 3.43), sustained physical injury (AOR=8.28, 95% CI 5.04 to 13.61), history of mental illness (AOR=5.55, 95% CI 2.30 to 13.36), family history of mental illness (AOR=2.82, 95% CI 1.48 to 5.37), poor social support (AOR=3.64, 95% CI 1.99 to 6.69) and high perceived stress (AOR=3.08, 95% CI 1.43 to 6.64) were associated with PTSD. CONCLUSION AND RECOMMENDATIONS The prevalence of PTSD among the survivors of Koshe landslide was high. We recommend that an early PTSD-focused regular screening be carried out by trained health professionals; linkage with mental health service providers also needs to be considered.
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Affiliation(s)
| | | | - Worknesh Ginbare
- Psychiatry, Amanuel Mental Specialized Hospital, Addis Ababa, Ethiopia
| | - Getasew Legas
- Psychiatry, Debretabor University, Debretabor, Ethiopia
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Tang W, Lu Y, Yang Y, Xu J. An epidemiologic study of self-reported sleep problems in a large sample of adolescent earthquake survivors: The effects of age, gender, exposure, and psychopathology. J Psychosom Res 2018; 113:22-29. [PMID: 30190044 DOI: 10.1016/j.jpsychores.2018.07.006] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2017] [Revised: 06/12/2018] [Accepted: 07/12/2018] [Indexed: 02/05/2023]
Abstract
BACKGROUND This study investigated the prevalence of sleep problems and their associated risk factors in child and adolescent survivors three years after the 2013 Ya'an earthquake. METHODS A total of 6132 adolescent survivors aged 9-18 years were invited to complete the Pittsburgh Sleep Quality Index, Children's Revised Impact of Event Scale-13, Short Mood and Feelings Questionnaire, and Screen for Child Anxiety-Related Emotional Disorders. Logistic analysis was used to identify possible relationships of sleep disturbance scores with earthquake exposures, mental health and demographic characteristics. RESULTS More than a quarter of the sample showed sleep problems of some kind, with 23.1% sleeping fewer than 7 h per night, 32.5% having difficulty falling asleep, 24.2% having difficulty remaining asleep, 25.3% having poor sleep quality, 17.4% having nightmares and 44.6% having difficulty functioning during daytime hours. Older participants were at a significantly higher risk of sleep issues than younger children (OR 2.89), and the subjects had significantly elevated risks of probable anxiety (OR 3.47), probable depression (OR 2.45), and probable posttraumatic stress disorder (OR 1.89). Other risk factors for sleep problems were earthquake exposure variables, including being injured (OR 1.42), having a parent injured (OR 1.27), witnessing death (OR 1.32) or feeling extremely scared (OR 1.22) in the Ya'an earthquake. CONCLUSIONS Sleep disturbances are common in adolescent earthquake survivors, and they are associated with age, gender, psychiatric symptoms and factors related to earthquake exposure. These results highlight the importance of development- and gender-specific interventions to prevent sleep disturbances after a major earthquake.
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Affiliation(s)
- Wanjie Tang
- Institute of Emergency Management and Post-disaster Reconstruction, Sichuan University, Chengdu, China; Centre for Educational and Health Psychology, Sichuan University, Chengdu, China; Mental Health Center, State Key Lab of Biotherapy, West China Hospital, Sichuan University, Chengdu, China
| | - Yi Lu
- Institute of Emergency Management and Post-disaster Reconstruction, Sichuan University, Chengdu, China
| | - Yanchun Yang
- Mental Health Center, State Key Lab of Biotherapy, West China Hospital, Sichuan University, Chengdu, China
| | - Jiuping Xu
- Institute of Emergency Management and Post-disaster Reconstruction, Sichuan University, Chengdu, China.
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Fitch TJ, Yu X, Chien LC, Karim MM, Alamgir H. Traumatic life events and development of post-traumatic stress disorder among female factory workers in a developing country. Int J Soc Psychiatry 2018. [PMID: 29517393 DOI: 10.1177/0020764018761502] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Post-traumatic stress disorder (PTSD) may be more prevalent and burdensome in developing countries. AIMS The goals of this study were to (1) determine the prevalence of PTSD, (2) identify types and number of traumas related to screening positive for PTSD and (3) determine other sociodemographic risk factors and health/medical conditions that may be correlated to PTSD among garment-factory workers and a comparable working population in Bangladesh. METHOD A survey was administered to a convenient sample of 607 lower socio-economic status (SES) working women in Bangladesh, 310 of who were garment workers. The primary outcome PTSD was measured by the PTSD Checklist. The Life Events Checklist determined the number and type of traumatic events. RESULTS The prevalence of PTSD was found to be 17.79% - 7.25% in garment workers and 21.55% in the comparison worker group. In multivariate analysis, PTSD was found to be significantly associated with age, income, chronic pain and number of stressful events. Participants between 45-50 years of age had the greatest odds of reporting PTSD - 15.68 fold (95% confidence interval (CI) = 4.08, 60.29) compared with those younger than 24 years. PTSD was more common in those with lower income (2,000-4,000 taka) (odds ratio (OR) = 1.60; 95% CI = 0.79, 3.26), who had chronic pain (OR = 2.48; 95% CI = 1.51, 4.07) and who experienced over three traumatic life events (OR = 11.25; 95% CI = 4.59, 27.59). The mean number of traumatic events experienced by this entire population was 4.9 with PTSD being more likely in those who experienced physical assault (OR = 6.35; 95% CI = 4.07, 9.90), who caused serious harm or death to someone else (OR = 4.80; 95% CI = 1.36, 16.87) and who had exposure to combat or war (OR = 4.76; 95% CI = 1.17, 19.34). CONCLUSION Undiagnosed and untreated PTSD impacts the quality of life and decrease worker productivity among working-age women in this developing country.
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Affiliation(s)
| | - Xiao Yu
- 2 Department of Biostatistics and Data Science, School of Public Health, The University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Lung-Chang Chien
- 3 Epidemiology and Biostatistics Program, Department of Environmental and Occupational Health, University of Nevada, Las Vegas, Las Vegas, NV, USA
| | | | - Hasanat Alamgir
- 5 Department of Health Policy and Management, New York Medical College, Valhalla, NY, USA
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Cernvall M, Sveen J, Bergh Johannesson K, Arnberg F. A pilot study of user satisfaction and perceived helpfulness of the Swedish version of the mobile app PTSD Coach. Eur J Psychotraumatol 2018; 9:1472990. [PMID: 29805783 PMCID: PMC5965023 DOI: 10.1080/20008198.2018.1472990] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2017] [Accepted: 04/19/2018] [Indexed: 11/30/2022] Open
Abstract
Background: There is a need for accessible interventions in the aftermath of traumatic events with documented efficacy for preventing or reducing negative mental health consequences. The PTSD Coach is a mobile app that has shown to be effective in reducing symptoms of posttraumatic stress (PTSS). Objective: The purpose of the current study was to evaluate the user satisfaction, perceived helpfulness and potential reductions of PTSS and symptoms of depression among participants using the Swedish version of the PTSD Coach. Method: This was an uncontrolled pre-test post-test open trial including participants recruited from the community via advertisement and from an ongoing observational study who had experienced a potentially traumatic event in the last five years. Participants had access to the Swedish PTSD Coach app for four weeks. Results: Eleven participants (mean age = 38.6, female = 8) completed the study. Nine of the participants met criteria for full or partial PTSD. Results from the PTSD Coach Survey indicated that participants found the app slightly to moderately helpful and were slightly to moderately satisfied with the app. Nominal but not statistically significant reductions of medium effect sizes in PTSS (PCL-5) and depression (PHQ-9) from pre- to post-assessment were found. In interviews, participants indicated that they found elements such as learning about PTSD, breathing exercises and monitoring symptoms helpful in managing symptoms. However, several participants indicated that they had not used the app as much as they had intended to. Participants also had suggestions for improvements such as enhanced app structure and better guidance regarding how to use the app. Conclusions: The perceived helpfulness and user satisfaction were slightly lower compared to research on the original version of the app. Experiences from the study are discussed and a future controlled study of the Swedish version of the PTSD Coach is suggested.
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Affiliation(s)
- Martin Cernvall
- Psychiatry, Department of Neuroscience, Uppsala University, Uppsala, Sweden
| | - Josefin Sveen
- Psychiatry, Department of Neuroscience, Uppsala University, Uppsala, Sweden
| | | | - Filip Arnberg
- Psychiatry, Department of Neuroscience, Uppsala University, Uppsala, Sweden
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26
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Asalgoo S, Tat M, Sahraei H, Pirzad Jahromi G. The Psychoactive Agent Crocin Can Regulate Hypothalamic-Pituitary-Adrenal Axis Activity. Front Neurosci 2017; 11:668. [PMID: 29249934 PMCID: PMC5717018 DOI: 10.3389/fnins.2017.00668] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2017] [Accepted: 11/16/2017] [Indexed: 11/13/2022] Open
Abstract
Post-traumatic stress disorder (PTSD) occurs following life-threatening events. The activity of the hypothalamic-pituitary-adrenal (HPA) axis, which serves as the first line of defense against stress, is dysfunctional in this disorder. The current study aimed to investigate the role of Crocin in normalizing HPA function in an animal model of PTSD induced by electric foot shock. Rats were treated with Crocin 5 min prior to stress induction. The stimulus was re-introduced after 21 days, and we measured individual behaviors such as sniffing, rearing, grooming, and freezing. Enzyme-linked immunosorbent assays were performed to measure plasma levels of Corticosterone. On day 28, after rats were weighed and sacrificed, the adrenal and thymus glands were removed and subjected to real-time polymerase chain reaction to quantify the gene expression of corticotrophin-releasing hormone (CRH), glucocorticoid receptor (GluR), and arginine vasopressin (AVP). Our results demonstrate that rats re-exposed to a stressor developed characteristic symptoms of PTSD, but these were attenuated by Crocin. Treated rats showed significant changes in CRH expression in the hypothalamus, GluR expression in the pituitary, plasma Corticosterone levels, and freezing behavior. Together, these findings suggest that Crocin can regulate HPA axis activity in PTSD. It may serve an appropriate treatment for subjects who experience a traumatic event.
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Affiliation(s)
- Sara Asalgoo
- Behavioral Sciences Research Center, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Mahdi Tat
- Applied Virology Research Center, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Hedayat Sahraei
- Neuroscience Research Centre, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Gila Pirzad Jahromi
- Neuroscience Research Centre, Baqiyatallah University of Medical Sciences, Tehran, Iran
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Cai D, Zhu Z, Sun H, Qi Y, Xing L, Zhao X, Wan Q, Su Q, Li H. Maternal PTSD following Exposure to the Wenchuan Earthquake Is Associated with Impaired Mental Development of Children. PLoS One 2017; 12:e0168747. [PMID: 28369095 PMCID: PMC5378320 DOI: 10.1371/journal.pone.0168747] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2016] [Accepted: 12/06/2016] [Indexed: 01/26/2023] Open
Abstract
The purpose of this study was to explore whether earthquake-related maternal Post-Traumatic Stress Disorder (PTSD) is associated with impaired development of infants. Participants included 86 women who were pregnant during or after the earthquake in Ningqiang county, and their children. Data were collected from February to March of 2012. PTSD questionnaire (PTSD Checklist, Civilian Version (PCL-C)) was used to measure the effect of the earthquake on mothers, and that the scores greater than 50 were used to indicate presence of PTSD. Each child was assessed using the mental Developmental Screening Test (DST) according to age. Among the 86 women, PTSD scores equal to or greater than 50 accounted for 20.93%. Among the 86 children, 25.60% of development quotient (DQ) scores and 19.80% of mental index (MI) scores were less than 85. The correlation coefficient analysis showed that PTSD scores were inversely related to DQ and MI scores. Maternal PTSD following earthquake exposure is associated with relatively lower intellectual development in children age 0–3 years. Further research is needed to assess the persistent effects of this influence on offspring of mothers exposed to earthquake.
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Affiliation(s)
- Dongge Cai
- Department of Obstetrics and Gynecology, the First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, Shaanxi, P. R. China
- Department of Obstetrics and Gynecology, the Second Affiliated Hospital of Xi’an Jiaotong University, Xi’an, Shaanxi, P. R. China
| | - Zhongliang Zhu
- Shaanxi Province Biomedicine Key Laboratory, College of Life Science, Northwest University, Xi’an, Shaanxi, P. R. China
- Department of Pharmacology, Xi'an Jiaotong University Health Science Center, Xi’an, Shaanxi, P. R. China
| | - Hongli Sun
- Shaanxi Institute of Pediatric Diseases, Xi’an Children’s Hospital, Shaanxi, P.R. China
| | - Yanhua Qi
- Department of Ultrasound, the Second Affiliated Hospital of Xi’an Jiaotong University, Xi’an, Shaanxi, P. R. China
| | - Lanying Xing
- Department of Obstetrics and Gynecology, the Second Affiliated Hospital of Xi’an Jiaotong University, Xi’an, Shaanxi, P. R. China
| | - Xiaogui Zhao
- Department of Obstetrics and Gynecology, the Second Affiliated Hospital of Xi’an Jiaotong University, Xi’an, Shaanxi, P. R. China
| | - Qiuyuan Wan
- Department of Obstetrics and Gynecology, the Second Affiliated Hospital of Xi’an Jiaotong University, Xi’an, Shaanxi, P. R. China
| | - Qian Su
- Department of Neonatology, the First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, Shaanxi, P. R. China
| | - Hui Li
- Department of Neonatology, the First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, Shaanxi, P. R. China
- * E-mail:
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Mordeno IG, Carpio JGE, Nalipay MJN, Saavedra RLJ. PTSD's Underlying Dimensions in Typhoon Haiyan Survivors: Assessing DSM-5 Symptomatology-Based PTSD Models and Their Relation to Posttraumatic Cognition. Psychiatr Q 2017; 88:9-23. [PMID: 26921207 DOI: 10.1007/s11126-016-9429-z] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
The recent changes in posttraumatic stress disorder (PTSD) symptomatology in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) call for a re-examination of PTSD's latent factor structure. The present study assessed six competing models of PTSD based on DSM-5 symptomatology using confirmatory factor analysis in a sample of young adult Filipino survivors of typhoon Haiyan, one of the strongest typhoons in the world ever recorded at the time of its landfall (N = 632). Furthermore, the differential relationships of the factors of the best-fitting model with posttraumatic cognitions were also investigated. Results showed the 7-factor hybrid model of PTSD comprised of intrusion, avoidance, negative affect, anhedonia, externalizing behaviors, anxious arousal, and dysphoric arousal, to be the best fitting model. In addition, the varying degrees of relationship with posttraumatic cognitions support the distinctiveness of each factor. These findings are pertinent in light of the changes in DSM-5 PTSD symptomatology, as well as in understanding the underlying dimensions of PTSD among Asian, particularly Filipino, survivors of a natural disaster.
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Affiliation(s)
- Imelu G Mordeno
- Mindanao State University - Iligan Institute of Technology, Iligan City, Philippines
| | - Jennifer Gay E Carpio
- Mindanao State University - Iligan Institute of Technology, Iligan City, Philippines
| | - Ma Jenina N Nalipay
- De La Salle University Manila, 2401 Taft Ave., Malate, 1004, Manila, Philippines.
| | - Rhea Lina J Saavedra
- Leyte Normal University, Tacloban City, Philippines
- University of the Philippines Visayas - Tacloban College, Tacloban City, Philippines
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29
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Sveen J, Pohlkamp L, Öhlén J, Sandberg J, Brandänge K, Gustavsson P. Posttraumatic Stress among Not-Exposed Traumatically Bereaved Relatives after the MS Estonia Disaster. PLoS One 2016; 11:e0166441. [PMID: 27893756 PMCID: PMC5125583 DOI: 10.1371/journal.pone.0166441] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2016] [Accepted: 10/28/2016] [Indexed: 11/18/2022] Open
Abstract
Background Little is known about posttraumatic stress (PTS) reactions in bereaved individuals following loss in disaster who were not directly exposed to disaster. The aim of the present study was to examine the course of PTS up to three years after losing relatives in the MS Estonia ferry disaster, one of the worst maritime disasters in modern times. Methods Seven postal surveys were sent out over three years post-disaster. The respondents were invited and added consecutively during the three years and 938 relatives participated in one or more of the surveys, representing 89% of the MS Estonia’s Swedish victims. The survey included the Impact of Event Scale (IES) to measure PTS. Latent growth curve modeling was used to analyze PTS over time. Results The majority of bereaved individuals had high levels of PTS. At three years post-loss, 62% of the respondents scored above the recommended cut-off value on the IES. Over time, PTS symptoms declined, but initially high symptoms of PTS were associated with a slower recovery rate. Conclusion The present finding suggests that being an indirectly-exposed disaster-bereaved close-relative can lead to very high levels of PTS which are sustained for several years.
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Affiliation(s)
- Josefin Sveen
- Palliative Research Centre, Ersta Sköndal University College, Stockholm, Sweden
- Department of Neuroscience, Psychiatry, Uppsala University, Uppsala, Sweden
- * E-mail:
| | - Lilian Pohlkamp
- Palliative Research Centre, Ersta Sköndal University College, Stockholm, Sweden
- Department of Neurobiology, Care Science and Society, Karolinska Institutet, Stockholm, Sweden
| | - Joakim Öhlén
- Palliative Research Centre, Ersta Sköndal University College, Stockholm, Sweden
- Institute of Health and Care Sciences, and University of Gothenburg Centre for Person-Centered Care, University of Gothenburg, Gothenburg, Sweden
| | - Jonas Sandberg
- Palliative Research Centre, Ersta Sköndal University College, Stockholm, Sweden
- Department of Nursing Science, School of Health and Welfare, Jönköping University, Jönköping, Sweden
| | | | - Petter Gustavsson
- Division of Psychology, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
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Vermetten E, Baker DG, Jetly R, McFarlane AC. Concerns Over Divergent Approaches in the Diagnostics of Posttraumatic Stress Disorder. Psychiatr Ann 2016. [DOI: 10.3928/00485713-20160728-02] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Abstract
Extended functional impairment characterized by sick leave and disability after a single disaster has not been documented before. This prospective, longitudinal, case-control study applied growth mixture modeling to predict trajectories of functional impairment in oil rig workers, survivors (n = 68) and a matched comparison group (n = 84), over 27 years after the 1980 North Sea oil rig disaster. In the initial 12 years post-disaster, survivors displayed higher rates of functional impairment than the comparison group. A minor group of survivors (n = 8, 11.8%) demonstrated persistent functional impairment from the start and remained unable to work during the subsequent three decades. Long-term sick leave and disability were related to perceived peritraumatic death threat and a propensity towards social withdrawal. Most survivors (n = 60) revealed no major functional impairment. The study indicates that functional impairment should be counteracted in the early support after a single disaster.
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An Investigation Into the Relationship Between Long-term Posttraumatic Stress Disorder Symptoms and Coping in Australian Volunteer Firefighters. J Nerv Ment Dis 2016; 204:530-6. [PMID: 27367600 DOI: 10.1097/nmd.0000000000000525] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
This study examined the relationship between coping style and long-term posttraumatic stress symptoms in an Australian sample of volunteer firefighters 84 months following a bushfire disaster. A total of 277 firefighters completed 4 questionnaires to assess patterns of psychiatric morbidity. A 2-way repeated-measures analysis of variance was conducted to investigate the effect of time and disorder on coping. Firefighters evidencing distress were more likely to use both problem- and emotion-focused methods of coping. Based on previous research, it was hypothesized that problem-focused coping strategies would be used after 84 months. The use of both problem- and emotion-focused coping may be due to the length of time following this disaster or unique characteristics of firefighters. These data suggest that present coping theories are not sufficient to account for the onset and pattern of psychiatric morbidity within a firefighter sample. The authors declare no conflicts of interest including financial, consultant, institutional, and other relationships that might lead to bias.
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Johannesson KB, Arinell H, Arnberg FK. Six years after the wave. Trajectories of posttraumatic stress following a natural disaster. J Anxiety Disord 2015; 36:15-24. [PMID: 26401968 DOI: 10.1016/j.janxdis.2015.07.007] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2015] [Revised: 06/29/2015] [Accepted: 07/11/2015] [Indexed: 10/23/2022]
Abstract
BACKGROUND The characteristics of long-term trajectories of distress after disasters are unclear, since few studies include a comparison group. This study examines trajectories of recovery among survivors in comparison to individuals with indirect exposure. METHODS Postal surveys were sent to Swedish tourists, repatriated from the 2004 Indian Ocean tsunami (n=2268), at 1, 3, and 6 years after the tsunami to assess posttraumatic stress (PTS) and poor mental health. Items were used to ascertain high and moderate disaster exposure groups and an indirect exposure comparison group. RESULTS Long-term PTS trajectories were best characterized by a resilient (72.3%), a severe chronic (4.6%), a moderate chronic (11.2%) and a recovering (11.9%) trajectory. Trajectories reported higher levels of PTS than the comparison group. Exposure severity and bereavement were highly influential risk factors. CONCLUSIONS These findings have implications regarding anticipation of long-term psychological adjustment after natural disasters and need for interventions after a single traumatic event with few secondary stressors.
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Affiliation(s)
- Kerstin Bergh Johannesson
- National Centre for Disaster Psychiatry, Department of Neuroscience, Uppsala University, Uppsala, Sweden.
| | - Hans Arinell
- Department of Neuroscience, Psychiatry, Uppsala University, Akademiska Sjukhuset, Ing. 10, SE 751 85 Uppsala, Sweden.
| | - Filip K Arnberg
- National Centre for Disaster Psychiatry, Department of Neuroscience, Uppsala University, Uppsala, Sweden.
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34
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Psychiatric disorders and suicide attempts in Swedish survivors of the 2004 southeast Asia tsunami: a 5 year matched cohort study. Lancet Psychiatry 2015; 2:817-24. [PMID: 26236006 DOI: 10.1016/s2215-0366(15)00124-8] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/08/2015] [Revised: 03/16/2015] [Accepted: 03/17/2015] [Indexed: 11/20/2022]
Abstract
BACKGROUND Survivors of natural disasters are thought to be at an increased risk of psychiatric disorders, however the extent of this risk, and whether it is linked to pre-existing psychopathology, is not known. We aimed to establish whether Swedish survivors of tsunamis from the 2004 Sumatra-Andaman earthquake had increased risks of psychiatric disorders and suicide attempts 5 years after repatriation. METHODS We identified Swedish survivors repatriated from southeast Asia (8762 adults and 3742 children) and 864 088 unexposed adults and 320 828 unexposed children matched for sex, age, and socioeconomic status. We retrieved psychiatric diagnoses and suicide attempts from the Swedish patient register for the 5 years after the tsunami (from Dec 26, 2004, to Jan 31, 2010) and estimated hazard ratios (HRs), then adjusted for pre-tsunami psychiatric disorders, and, for children, for parental pre-tsunami disorders. FINDINGS Exposed adults were more likely than unexposed adults to receive any psychiatric diagnosis (547 [6·2%] vs 47 734 [5·5%]; adjusted HR 1·21, 95% CI 1·11-1·32), particularly stress-related disorders (187 [2·1%] vs 8831 [1·0%]; 2·27, 1·96-2·62) and suicide attempts (38 [0·43%] vs 2752 [0·32%]; 1·54, 1·11-2·13), but not mood or anxiety disorders. Risk of psychiatric diagnoses did not differ between exposed and unexposed children and adolescents (248 [6·6] vs 22 081 [6·9%]; 0·98, 0·86-1·11), although exposed children and adolescents had a higher risk for suicide attempts with uncertain intent (1·43; 1·01-2·02) and stress-related disorders (1·79; 1·30-2·46), mainly during the first 3 months after the tsunami. INTERPRETATION The 2004 tsunami was, independently of previous psychiatric morbidity, associated with an increased risk of severe psychopathology, mainly stress-related disorders and suicide attempts, in children and adults. Survivors of natural disasters should be targeted with early interventions and active long-term follow-up to prevent, detect, and alleviate psychiatric disorders that might follow. FUNDING The Swedish Council for Working Life and Social Research, Swedish Board of Health and Welfare, Polish Ministry of Science and Higher Education, Swedish Society for Medical Research.
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Siqveland J, Nygaard E, Hussain A, Tedeschi RG, Heir T. Posttraumatic growth, depression and posttraumatic stress in relation to quality of life in tsunami survivors: a longitudinal study. Health Qual Life Outcomes 2015; 13:18. [PMID: 25889940 PMCID: PMC4326430 DOI: 10.1186/s12955-014-0202-4] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2014] [Accepted: 12/23/2014] [Indexed: 11/13/2022] Open
Abstract
Background Quality of life (QoL) may often be reduced in survivors of a natural disaster. This paper investigated how posttraumatic growth (PTG), depression and posttraumatic stress interact and independently predict QoL in a longitudinal study of disaster survivors. Methods A total of 58 Norwegian adults who were present in Khao Lak, Thailand at the time of the 2004 Southeast Asia Tsunami completed self-report questionnaires 2 and 6 years after the disaster. The participants reported symptoms of depression and posttraumatic stress as well as PTG and QoL. Multiple mixed effects regression analyses were used to determine the independent effects of PTG, depression and posttraumatic stress on QoL measured 2 and 6 years after the disaster. Results Posttraumatic stress and depression were negatively related to QoL. PTG was not significantly related to QoL in a bivariate analysis. However, considerable interaction effects were found. Six years after the tsunami, high levels of posttraumatic stress were related to lower QoL in those participants with low levels of PTG, whereas lower levels of depression were related to higher QoL in those participants with high levels of PTG. Conclusions Posttraumatic stress and depression are negatively associated with QoL after a natural disaster. PTG may serve as a moderating factor in this relationship. Electronic supplementary material The online version of this article (doi:10.1186/s12955-014-0202-4) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Johan Siqveland
- Department of Mental Health Services, Akershus University Hospital, R & D Mental Health Services, 1478, Lørenskog, Norway. .,Institute of Clinical Medicine, University of Oslo, Oslo, Norway.
| | - Egil Nygaard
- Norwegian Centre for Violence and Traumatic Stress Studies, Oslo, Norway. .,Department of Psychology, University of Oslo, Oslo, Norway.
| | - Ajmal Hussain
- Department of Mental Health Services, Akershus University Hospital, R & D Mental Health Services, 1478, Lørenskog, Norway.
| | - Richard G Tedeschi
- Department of Psychology, University of North Carolina at Charlotte, Charlotte, NC, USA.
| | - Trond Heir
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway. .,Norwegian Centre for Violence and Traumatic Stress Studies, Oslo, Norway.
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Ranjbar V, Näslund MS, Vingare EL, Hagelthorn C, Englund L, Karlsson I. The Swedish Psychotrauma Society: joining forces for a national psychotrauma platform from a multidisciplinary and holistic approach. Eur J Psychotraumatol 2015; 6:28546. [PMID: 26073210 PMCID: PMC4466305 DOI: 10.3402/ejpt.v6.28546] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- Vania Ranjbar
- Angered Hospital, Gothenburg, Sweden.,Department of Public Health and Community Medicine, University of Gothenburg, Gothenburg, Sweden;
| | - Monika S Näslund
- Crisis and Disaster Psychology Unit, Academic Primary Health Care Centre, Stockholm County Council, Stockholm, Sweden
| | - Emme-Li Vingare
- Department of Social Work, Linnaeus University, Växjö, Sweden.,Swedish Psychotrauma Society, Sweden
| | | | - Liselotte Englund
- Department of Environmental and Life Sciences, Karlstad University, Karlstad, Sweden
| | - Ingvar Karlsson
- Swedish Psychotrauma Society, Sweden.,Department of Psychiatry and Neurochemistry, University of Gothenburg, Gothenburg, Sweden
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Arnberg FK, Michel PO, Johannesson KB. Properties of Swedish posttraumatic stress measures after a disaster. J Anxiety Disord 2014; 28:402-9. [PMID: 24726240 DOI: 10.1016/j.janxdis.2014.02.005] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2013] [Revised: 02/17/2014] [Accepted: 02/18/2014] [Indexed: 11/24/2022]
Abstract
This study evaluated the properties of Swedish versions of self-report measures of posttraumatic stress disorder (PTSD), with emphasis on the Impact of Event Scale-Revised (IES-R). Survey data from adult survivors 1, 3, and 6 years after the 2004 Indian Ocean tsunami (n=1506) included the IES-R (from which the IES-6 was derived) and the 12-item General Health Questionnaire (GHQ-12). The PTSD Checklist (PCL) was included in one survey. A structured clinical interview was performed after 6 years (n=142). Factor analyses of the IES-R and PCL indicated that a dysphoric-arousal model provided good fit invariant across assessments. Both measures were accurate in excluding PTSD while all measures provided poorer positive predictive values. The IES-R, but not the IES-6 and GHQ-12, evidenced stability across assessments. In conclusion, the Swedish IES-R and PCL are sound measures of chronic PTSD, and the findings illustrate important temporal aspects of PTSD assessment.
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Affiliation(s)
- Filip K Arnberg
- National Centre for Disaster Psychiatry, Department of Neuroscience, Uppsala University, Akademiska sjukhuset ing 10, SE-751 85 Uppsala, Sweden.
| | - Per-Olof Michel
- National Centre for Disaster Psychiatry, Department of Neuroscience, Uppsala University, Akademiska sjukhuset ing 10, SE-751 85 Uppsala, Sweden.
| | - Kerstin Bergh Johannesson
- National Centre for Disaster Psychiatry, Department of Neuroscience, Uppsala University, Akademiska sjukhuset ing 10, SE-751 85 Uppsala, Sweden.
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He Z, Cui L, He B, Ferguson SA, Paule MG. A common genetic mechanism underlying susceptibility to posttraumatic stress disorder. World J Neurol 2013; 3:14-24. [DOI: 10.5316/wjn.v3.i3.14] [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: 06/13/2013] [Revised: 07/27/2013] [Accepted: 08/20/2013] [Indexed: 02/06/2023] Open
Abstract
We hypothesize that susceptibility to post-traumatic stress disorder (PTSD) may be determined in part by aberrant microtubule-associated protein tau expression in neurons of critical brain structures. The following lines of evidence support this hypothesis. First, epidemiologic data suggest the involvement of genetic factors in the susceptibility to PTSD. Second, the common features of both abnormal tau expression and PTSD include amygdalar and hippocampal atrophy, upregulation of norepinephrine biosynthetic capacity in the surviving locus coeruleus neurons and dysfunction of N-methyl-D-aspartate-receptors. Finally, our experiments using rTg4510 mice, a model that over-expresses human mutant tau and develops age-dependent tauopathy, demonstrate that these animals display circling behavior thought to be related to states of anxiety. To detect the potential molecular mechanisms underlying PTSD episodes, laser-assisted/capture microdissection can be used with microarray analysis as an alternative approach to identify changes in gene expression in excitatory and/or inhibitory neurons in critical brain structures (i.e., hippocampus and amygdala) in response to the onset of PTSD.
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