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

BMC Psychiatry

Linda Grievink³  Hendriek C Boshuizen³  Peter G van der Velden²  Albert Wong³  Bellis van den Berg¹ 

[1] Regioplan Policy Research, Nieuwezijds Voorburgwal 35, Amsterdam, RD, 1012, the Netherlands;INTERVICT, Tilburg University, Tilburg, the Netherlands;National Institute for Public Health and the Environment (RIVM), A. van Leeuwenhoeklaan 9, Bilthoven, BA, 3720, The Netherlands

关键词: Stress Disorders, Post-Traumatic;    Stress, Psychological;    Risk Factors;    Longitudinal studies;    Disasters;   

Others  :  1124284
DOI  :  10.1186/1471-244X-12-147

 received in 2012-01-03, accepted in 2012-09-11,  发布年份 2012

【 摘 要 】

Background

Disaster experiences have been associated with higher prevalence rates of (mental) health problems. The objective of this study was to examine the independent relation between a series of single disaster experiences versus the independent predictive value of a accumulation of disaster experiences, i.e. a sum score of experiences and symptoms of distress and post-traumatic stress disorder (PTSD).

Methods

Survivors of a fireworks disaster participated in a longitudinal study and completed a questionnaire three weeks (wave 1), eighteen months (wave 2) and four years post-disaster (wave 3). Ten years post-disaster (wave 4) the respondents consisted of native Dutch survivors only. Main outcome measures were general distress and symptoms of PTSD.

Results

Degree of disaster exposure (sum score) and some disaster-related experiences (such as house destroyed, injured, confusion) were related to distress at waves 2 and 3. This relation was mediated by distress at an earlier point in time. None of the individual disaster-related experiences was independently related to symptoms of distress. The association between the degree of disaster exposure and symptoms of PTSD at waves 2 and 3 was still statistically significant after controlling for symptoms of distress and PTSD at earlier point in time. The variable ‘house destroyed’ was the only factor that was independently related to symptoms of PTSD at wave 2. Ten years after the disaster, disaster exposure was mediated by symptoms of PTSD at waves 2 and 3. Disaster exposure was not independently related to symptoms of PTSD ten years post-disaster.

Conclusions

Until 4 years after the disaster, degree of exposure (a sum score) was a risk factor for PTSD symptoms while none of the individual disaster experiences could be identified as an independent risk factor. Ten years post-disaster, disaster exposure was no longer an independent risk factor for symptoms of PTSD. Since symptoms of PTSD and distress at earlier waves perpetuate the symptoms at later waves, health care workers should aim their resources at those who still have symptoms after one and a half year post-disaster, to prevent health problems at medium and long-term.

【 授权许可】

   
2012 van den Berg et al.; licensee BioMed Central Ltd.

【 参考文献 】

• [1]Norris FH, Friedman MJ, Watson PJ: 60,000 disaster victims speak. Part I: an empirical review of the empirical literature, 1981–2001. Psychiatry 2002, 65:207-239.
• [2]van den Berg B, Grievink L, Stellato RK, Yzermans CJ, Lebret E: Symptoms and related functioning in a traumatized community. Arch Intern Med 2005, 165:2402-2407.
• [3]Watson PJ, Shalev AY: Assessment and treatment of adult acute responses to traumatic stress following mass traumatic events. CNS Spectr 2005, 10:123-131.
• [4]van den Berg B, Grievink L, Gutschmidt K, Lang T, Palmer S, Ruijten M, Stumpel R, Yzermans CJ: The public health dimension of disasters - health outcome assessment of disasters. Prehosp Disaster Med 2008, 23(suppl):55S-59S.
• [5]Marshall GN, Schell TL, Elliott MN, Rayburn NR, Jaycox LH: Psychiatric disorders among adults seeking emergency disaster assistance after a wildland-urban interface fire. Psychiatr Serv 2007, 58:509-514.
• [6]Uscher-Pines L: Health effects of relocation following disaster: a systematic review of the literature. Disasters 2009, 33:1-22.
• [7]Brewin CR, Andrews B, Valentine JD: Meta-analysis of risk factors for posttraumatic stress disorder in trauma-exposed adults. J Consult Clin Psychol 2000, 68:748-766.
• [8]Galea S, Nandi A, Vlahov D: The epidemiology of post-traumatic stress disorder after disasters. Epidemiol Rev 2005, 27:78-91.
• [9]Ozer EJ, Best SR, Lipsey TL, Weiss DS: Predictors of posttraumatic stress disorder and symptoms in adults: A meta-analysis. Psychol Bull 2003, 129:52-73.
• [10]Dirkzwager AJ, Grievink L, van der Velden PG, Yzermans CJ: Risk factors for psychological and physical health problems after a man-made disaster. Br J Psychiatry 2006, 189:144-149.
• [11]van der Velden PG, Kleber RJ, Christiaanse B, Gersons BP, Marcelissen FG, Drogendijk AN, Grievink L, Olff M, Meewisse ML: The independent predictive value of peritraumatic dissociation for posttraumatic intrusions, avoidance reactions, and PTSD symptom severity: a 4-year prospective study. J Trauma Stress 2006, 19:493-506.
• [12]Silver RC, Holman EA, McIntosh DN, Poulin M, Gil-Rivas V: Nationwide longitudinal study of psychological responses to September 11. JAMA 2002, 288:1235-1243.
• [13]Hobfoll S: Traumatic stress: A theory based on rapid loss of resources. Anxiety Res 1991, 4:187-197.
• [14]Grievink L, van der Velden PG, Yzermans CJ, Roorda J, Stellato RK: The importance of estimating selection bias on prevalence estimates shortly after a disaster. Ann Epidemiol 2006, 16:782-788.
• [15]Grievink L, van der Velden PG, Stellato RK, Dusseldorp A, Gersons BPR, Kleber RJ, Lebret E: A longitudinal comparative study of the physical and mental health problems of affected residents of the firework disaster Enschede, The Netherlands. Public Health 2007, 121:367-374.
• [16]van Kamp I, van der Velden PG, Stellato RK, Roorda J, van Loon J, Kleber RJ, Gersons BPR, Lebret E: Physical and mental health shortly after a disaster: first results from the Enschede firework disaster study. Eur J Public Health 2006, 16:253-258.
• [17]Van der Velden PG, Yzermans CJ, Grievink L: Enschede fireworks disaster. In Mental health and disasters. Edited by Neria Y, Galeo S, Norris F. Cambridge: Cambridge University; 2009:94-115.
• [18]Arrindell WA, Ettema JHM: SCL-90 Handleiding [SCL-90 Manual]. Lisse, The Netherlands: Swets & Zeitlinger; 1986.
• [19]Brom D, Kleber RJ, Defares PB: Traumatische ervaringen en psychotherapie [Traumatic experiences and psychotherapy]. Amsterdam/Lisse, the Netherlands: Swets & Zeitlinger; 1986.
• [20]Horowitz M, Wilner M, Alvare W: Impact of event scale: A measure of subjective stress. Psychosom Med 1979, 41:209-218.
• [21]van den Berg B, van der Velden P, Stellato R, Grievink L: Selective attrition and bias in a longitudinal health survey among survivors of a disaster. BMC Med Res Methodol 2007, 7:8. BioMed Central Full Text
• [22]Van der Velden PG, Grievink L, Olff M, Gersons BPR, Kleber RJ: Smoking as a risk factor for mental health disturbances after a disaster: a prospective comparative study. J Clin Psychiatry 2007, 68:87-92.
• [23]Verhaak PF, Heijmans MJ, Peters L, Rijken M: Chronic disease and mental disorder. Soc Sci Med 2005, 60:789-797.
• [24]Polsky D, Doshi JA, Marcus S, Oslin D, Rothbard A, Thomas N, Thompson CL: Long-term risk for depressive symptoms after a medical diagnosis. Arch Intern Med 2005, 165:1260-1266.
• [25]Benjamini Y, Hochberg Y: Controlling the false discovery rate: a practical and powerful approach to multiple testing. J R Statist Soc B 1995, 57:289-300.
• [26]Van Buuren S, Groothuis-Oudshoorn K: MICE: Multivariate Imputation by Chained Equations in R. Journal Stat Software 2011, 45:1-67.
• [27]Rubin DB: Multiple Imputation for nonresponse in surveys. New York: John Wiley & Sons; 1987.
• [28]Marquardt DW: Generalized inverses, ridge regression, biased linear estimation, and nonlinear estimation. Technometrics 1970, 12:591-612.
• [29]Hobfoll SE, Tracy M, Galea S: The impact of resource loss and traumatic growth on probable PTSD and depression following terrorist attacks. J Trauma Stress 2006, 19:867-878.
• [30]Rona RJ, Hooper R, Jones M, Iversen AC, Hull L, Murphy D, Hotopf M, Wessely S: The contribution of prior psychological symptoms and combat exposure to post Iraq deployment mental health in the UK military. J Trauma Stress 2009, 22:11-19.
• [31]Wadworth ME, DeCarlo Santiago C, Einhorn L: Coping with displacement from Hurricane Katrina: predictors of one-year post-traumatic stress and depression symptom trajectories. Anxiety Stress Coping 2009, 22:413-432.
• [32]Layne CM, Olsen JA, Baker A, Legerski JP, Isakson B, Pasalić A, Duraković-Belko E, Dapo N, Campara N, Arslanagić B, Saltzman WR, Pynoos RS: Unpacking trauma exposure risk factors and differential pathways of influence: predicting postwar mental distress in Bosnian adolescents. Child Dev 2010, 81:1053-1076.
• [33]Elhai JD, North TC, Frueh BC: Health Service use predictors among trauma survivors: A critical review. Psychol Serv 2005, 2:3-19.
• [34]van der Velden PG, Grievink L, Dorresteijn AM, van Kamp I, Drogendijk AN, Christiaanse B, Roskam AJ, Marcelissen F, Olff M, Meewisse M, Gersons BPR, Kleber RJ: Psychological problems and the use of mental health services after the fireworks disaster at Enschede. A longitudinal comparative study [in Dutch]. Tijdschr Psychiatr 2005, 47:571-582.
• [35]van der Velden PG, Grievink L, Kleber RJ, Drogendijk AN, Roskam AJR, Marcelissen FGH, Olff M, Meewisse ML, Gersons BPR: Post-disaster mental health problems and the utilization of mental health services: A four-year longitudinal comparative study. Admin Adm Policy Ment Health 2006, 33:279-288.
• [36]van der Velden PG, Grievink L, Yzermans CJ, Kleber RJ, Gersons BPR: Correlates of mental health services utilization 18 months and almost 4 years postdisaster among adults with mental health problems. J Trauma Stress 2007, 20:1029-1039.