Mills Mary Alice, Edmondson Donald, Park Crystal L
Department of Psychology, Clinical Division, University of Connecticut, Storrs, CT 06269, USA.
Am J Public Health. 2007 Apr;97 Suppl 1(Suppl 1):S116-23. doi: 10.2105/AJPH.2006.086678. Epub 2007 Apr 5.
Hurricane Katrina's impact on public health has been significant and multifaceted, with trauma-related psychological sequelae likely to result in a sizable burden of disease. Data were collected that assessed acute stress disorder (ASD) prevalence and factors related to ASD symptomatology among sheltered evacuees.
On days 12 to 19 after Katrina, evacuees at a major emergency shelter completed surveys that assessed demographics, Katrina-specific experiences, and ASD symptomatology.
Sixty-two percent of the sample met ASD threshold criterion. Projections based on the predictive power of ASD to posttraumatic stress disorder (PTSD) suggest that 38% to 49% of the sample will meet PTSD criteria 2 years post-disaster. Female gender (odds ratio [OR] = 4.08), positive psychiatric history (OR=5.84), injury (OR=2.75), increased life-threat perception (OR=1.37), and decreased sense of personal control (OR=1.56) were significantly related to ASD. Black race was associated with greater symptom severity (B=7.85, SE[B]=3.50).
Katrina-related trauma and its psychological sequelae will remain a significant public health issue for years to come. The identification of several vulnerability factors related to ASD and PTSD provides a brief sketch of those at greatest risk.
卡特里娜飓风对公众健康产生了重大且多方面的影响,与创伤相关的心理后遗症可能导致相当大的疾病负担。收集了相关数据,以评估避难撤离者中急性应激障碍(ASD)的患病率以及与ASD症状相关的因素。
在卡特里娜飓风过后的第12至19天,一个主要应急避难所的撤离者完成了调查,评估了人口统计学、与卡特里娜飓风相关的经历以及ASD症状。
62%的样本符合ASD阈值标准。基于ASD对创伤后应激障碍(PTSD)的预测能力进行的推算表明,38%至49%的样本在灾后两年将符合PTSD标准。女性(优势比[OR]=4.08)、有精神病史(OR=5.84)、受伤(OR=2.75)、生命威胁感知增加(OR=1.37)以及个人控制感降低(OR=1.56)与ASD显著相关。黑人种族与更严重的症状相关(B=7.85,标准误[B]=3.50)。
与卡特里娜飓风相关的创伤及其心理后遗症在未来数年仍将是一个重大的公共卫生问题。识别出与ASD和PTSD相关的几个脆弱因素,简要勾勒出了那些风险最大的人群。