Hostname: page-component-8448b6f56d-sxzjt Total loading time: 0 Render date: 2024-04-19T20:58:15.364Z Has data issue: false hasContentIssue false
  • English
  • Français

The importance of secondary trauma exposure for post-disaster mental disorder

Published online by Cambridge University Press:  10 January 2012

R. C. Kessler ,
K. A. McLaughlin ,
K. C. Koenen ,
M. Petukhova  and
E. D. Hill
R. C. Kessler*
Affiliation:
Department of Health Care Policy, Harvard Medical School, Boston, MA, USA
K. A. McLaughlin
Affiliation:
Division of General Pediatrics, Children's Hospital Boston and Harvard Medical School, Boston, MA, USA
K. C. Koenen
Affiliation:
Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA
M. Petukhova
Affiliation:
Department of Health Care Policy, Harvard Medical School, Boston, MA, USA
E. D. Hill
Affiliation:
Department of Health Care Policy, Harvard Medical School, Boston, MA, USA
*
*Address for correspondence: R.C. Kessler, PhD, Department of Health Care Policy, Harvard Medical School, 180 Longwood Avenue, Boston, MA 02115, USA. (Email: kessler@hcp.med.harvard.edu)
Get access Rights & Permissions [Opens in a new window]

Abstract

Background.

Interventions to treat mental disorders after natural disasters are important both for humanitarian reasons and also for successful post-disaster physical reconstruction that depends on the psychological functioning of the affected population. A major difficulty in developing such interventions, however, is that large between-disaster variation exists in the prevalence of post-disaster mental disorders, making it difficult to estimate need for services in designing interventions without carrying out a post-disaster mental health needs assessment survey. One of the daunting methodological challenges in implementing such surveys is that secondary stressors unique to the disaster often need to be discovered to understand the magnitude, type, and population segments most affected by post-disaster mental disorders.

Methods.

This problem is examined in the current commentary by analyzing data from the WHO World Mental Health (WMH) Surveys. We analyze the extent to which people exposed to natural disasters throughout the world also experienced secondary stressors and the extent to which the mental disorders associated with disasters were more proximally due to these secondary stressors than to the disasters themselves.

Results.

Lifetime exposure to natural disasters was found to be high across countries (4.4–7.5%). 10.7–11.4% of those exposed to natural disasters reported the occurrence of other related stressors (e.g. death of a loved one and destruction of property). A monotonic relationship was found between the number of additional stressors and the subsequent onset of mental disorders

Conclusions.

These results document the importance of secondary stressors in accounting for the effects of natural disasters on mental disorders. Implications for intervention planning are discussed.

Keywords

Natural disastersneeds assessmentpost-disaster intervention planning
Type
Special Articles
Information
Epidemiology and Psychiatric Sciences , Volume 21 , Issue 1 , March 2012 , pp. 35 - 45
Copyright
Copyright © Cambridge University Press 2012

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Canino, GJ, Bravo, M, Rubio-Stipec, M, Woodbury, M (1990). The impact of disaster on mental health: Prospective and retrospective analyses. International Journal of Mental Health 19, 51–69.CrossRefGoogle Scholar
Cao, H, McFarlane, AC, Klimidis, S (2003). Prevalence of psychiatric disorder following the 1988 Yun Nan (China) earthquake – the first 5-month period. Social Psychiatry and Psychiatric Epidemiology 38, 204–212.CrossRefGoogle Scholar
Efron, B (1988). Logistic regression, survival analysis, and the Kaplan–Meier curve. Journal of the American Statistical Association 83, 414–425.CrossRefGoogle Scholar
First, MB, Spitzer, RL, Gibbon, M, Williams, JBW (2002). Structured Clinical Interview for DSM-IV Axis I Disorders, Research Version, Non-patient Edition (SCID-I/NP). Biometrics Research, New York State Psychiatric Institute: New York.Google Scholar
Galea, S, Brewin, CR, Gruber, M, Jones, RT, King, DW, King, LA, McNally, RJ, Ursano, RJ, Petukhova, M, Kessler, RC (2007). Exposure to hurricane-related stressors and mental illness after Hurricane Katrina. Archives of General Psychiatry 64, 1427–1434.CrossRefGoogle ScholarPubMed
Galea, S, Tracy, M, Norris, F, Coffey, SF (2008). Financial and social circumstances and the incidence and course of PTSD in Mississippi during the first two years after Hurricane Katrina. Journal of Traumatic Stress 21, 357–368.CrossRefGoogle ScholarPubMed
Guha-Sapir, D, Hargitt, D, Hoyois, P (2004). Thirty Years of Natural Disasters, 1974–2003: The Numbers. Presses Universitaires de Louvain: Louvain, Belgium.Google Scholar
Harkness, J, Pennell, B-P, Villar, A, Gebler, N, Aguilar-Gaxiola, S, Bilgen, I (2008). Translation procedures and translation assessment in the World Mental Health Survey Initiative. In The WHO World Mental Health Surveys: Global Perspectives on the Epidemiology of Mental Disorders (ed. Kessler, RC and Üstun, TB), pp. 91–113. Cambridge University Press: New York.Google Scholar
Haro, JM, Arbabzadeh-Bouchez, S, Brugha, TS, de Girolamo, G, Guyer, M, Jin, R, Lepine, JP, Mazzi, F, Reneses, B, Vilagut Saiz, G, Sampson, NA, Kessler, RC (2006). Concordance of the Composite International Diagnostic Interview Version 3.0 (CIDI 3.0) with standardized clinical assessments in the WHO World Mental Health Surveys. International Journal of Methods in Psychiatric Research 15, 167–180.CrossRefGoogle ScholarPubMed
Heeringa, SG, Wells, EJ, Hubbard, F, Mneimneh, ZN, Chiu, WT, Sampson, NA, Berglund, PA (2008). Sample designs and sampling procedures. In The WHO World Mental Health Surveys: Global Perspectives on the Epidemiology of Mental Disorders (ed. Kessler, RC and Üstun, TB), pp. 14–32. Cambridge University Press: New York.Google Scholar
International Federation of Red Cross and Red Crescent Societies (2006). World Disasters Report: Focus on Neglected Crises. Kumarian Press: Bloomfield, CT.Google Scholar
Kessler, RC, Üstun, TB (2004). The World Mental Health (WHM) Survey Initiative Version of the World Health Organization (WHO) Composite International Diagnostic Interview (CIDI). International Journal of Methods in Psychiatric Research 13, 93–121.CrossRefGoogle Scholar
Kessler, RC, Keane, TM, Ursano, RJ, Mokdad, A, Zaslavsky, AM (2008). Sample and design considerations in post-disaster mental health needs assessment tracking surveys. International Journal of Methods in Psychiatric Research 17 (Suppl. 2), S6–S20.CrossRefGoogle ScholarPubMed
Kessler, RC, Aguilar-Gaxiola, S, Alonso, J, Chatterji, S, Lee, S, Ormel, J, Üstun, TB, Wang, PS (2009). The global burden of mental disorders: an update from the WHO World Mental Health (WMH) Surveys. Epidemiologia e Psichiatria Sociale 18, 23–33.CrossRefGoogle ScholarPubMed
Knauper, B, Cannell, CF, Schwarz, N, Bruce, ML, Kessler, RC (1999). Improving the accuracy of major depression age of onset reports in the US National Comorbidity Survey. International Journal of Methods in Psychiatric Research 8, 39–48.CrossRefGoogle Scholar
Krey, NC (2006). Accident Trends and Factors for 2005. AOPA Air Safety Foundation: Frederick, MD.Google Scholar
Madakasira, S, O'Brien, KF (1987). Acute posttraumatic stress disorder in victims of a natural disaster. Journal of Nervous and Mental Disease 175, 286–290.CrossRefGoogle ScholarPubMed
McLaughlin, KA, Fairbank, JA, Gruber, MJ, Jones, RT, Lakoma, MD, Pfefferbaum, B, Sampson, NA, Kessler, RC (2009). Serious emotional disturbance among youths exposed to Hurricane Katrina 2 years postdisaster. Journal of the American Academy of Child and Adolescent Psychiatry 48, 1069–1078.CrossRefGoogle ScholarPubMed
McLaughlin, KA, Berglund, P, Gruber, MJ, Kessler, RC, Sampson, NA, Zaslavsky, AM (2011). Recovery from PTSD following Hurricane Katrina. Depression and Anxiety 28, 439–446.CrossRefGoogle ScholarPubMed
Norris, FH, Perilla, JL, Riad, JK, Kaniasty, K, Lavizzo, EA (1999). Stability and change in stress, resources, and psychological distress following natural disaster: Findings from Hurricane Andrew. Anxiety, Stress, and Coping 12, 363–396.CrossRefGoogle ScholarPubMed
North, CS, Norris, FH (2006). Choosing research methods to match research goals in studies of disaster or terrorism. In Methods for Disaster Mental Health Research (ed. Norris, FH, Galea, S and Friedman, MJ), pp. 45–61. Guilford: New York.Google Scholar
Pennell, B-P, Mneimneh, Z, Bowers, A, Chardoul, S, Wells, JE, Viana, MC (2008). Implementation of the World Mental Health Surveys. In The WHO World Mental Health Surveys: Global Perspectives on the Epidemiology of Mental Disorders (ed. Kessler, RC and Üstun, TB), pp. 33–57. Cambridge University Press: New York.Google Scholar
Pielke, RA Jr. (2006). Disasters, death and destruction: making sense of recent calamities. Oceanography 19, 138–147.CrossRefGoogle Scholar
Research Triangle Institute (2002). SUDAAN: Professional Software for Survey Data Analysis [Computer Program]. Research Triangle Institute: Research Triangle Park, NC.Google Scholar
Rodriguez, JJ, Kohn, R (2008). Use of mental health services among disaster survivors. Current Opinion in Psychiatry 21, 370–378.CrossRefGoogle ScholarPubMed
Shalev, AY, Ankri, Y, Israeli-Shalev, Y, Peleg, T, Adessky, R, Freedman, S (2011). Prevention of posttraumatic stress disorder by early treatment: results from the Jerusalem trauma outreach and prevention study. Archives of General Psychiatry. Published online October 3, 2011. doi:10.1001/archgenpsychiatry.2011.127Google ScholarPubMed
Shear, K, Frank, E, Houck, PR, Reynolds, III CF (2005). Treatment of complicated grief: a randomized controlled trial. Journal of the American Medical Association 293, 2601–2608.CrossRefGoogle ScholarPubMed
Shear, KM, McLaughlin, KA, Ghesquiere, A, Gruber, MJ, Sampson, NA, Kessler, RC (2011). Complicated grief associated with Hurricane Katrina. Depression and Anxiety 28, 648–657.CrossRefGoogle ScholarPubMed
Shultz, JM, Russell, J, Espinel, Z (2005). Epidemiology of tropical cyclones: the dynamics of disaster, disease, and development. Epidemiologic Reviews 27, 21–35.CrossRefGoogle ScholarPubMed
van Griensven, F, Chakkraband, MLS, Thienkrua, W, Pengjuntr, W, Cardozo, BL, Tantipiwatanaskul, P, Mock, PA, Ekassawin, S, Varangrat, A, Gotway, C, Sabin, M, Tappero, JW, The Thailand Post-Tsunami Mental Health Study Group (2006). Mental health problems among adults in tsunami-affected areas in southern Thailand. Journal of the American Medical Association 296, 537–548.CrossRefGoogle ScholarPubMed
Wang, PS, Gruber, MJ, Powers, RE, Schoenbaum, M, Speier, AH, Wells, KB, Kessler, RC (2008). Disruption of existing mental health treatments and failure to initiate new treatment after Hurricane Katrina. American Journal of Psychiatry 165, 34–41.CrossRefGoogle ScholarPubMed
Wolter, KM (1985). Introduction to Variance Estimation. Springer-Verlag: New York.Google Scholar
World Bank (2008). Data and Statistics. http://go.worldbank.org/D7SN0B8YU0 (accessed 12 May 2009).Google Scholar