Baylor College of Medicine, USA.
Disaster Med Public Health Prep. 2011 Sep;5 Suppl 2:S227-34. doi: 10.1001/dmp.2011.47.
Identifying individuals at risk for mental health problems after a disaster often involves assessing potentially traumatic exposures inherent to the disaster. Survivors of disasters also may have been exposed, both before and during the event, to trauma not directly related to the disaster. A substantial literature suggests exposure to interpersonal violence may have more severe negative outcomes than exposure to non-violent events; however, it is unclear whether violent vs nonviolent exposures before and during a disaster have differential effects on postdisaster psychological functioning.
We examined the associations of violent and nonviolent exposures before and during Hurricane Katrina with postdisaster psychological functioning in a sample of male military veterans.
Violent and nonviolent exposures post-Hurricane Katrina as well as pre-Katrina violent exposures were significantly associated with symptoms of posttraumatic stress disorder, panic, and generalized anxiety disorder more than 2 years after the storm. Moreover, veterans who reported violent exposures pre-Katrina were more than 4 times more likely to have reexperienced interpersonal violence during Katrina than those who did not report such exposures.
Results suggest assessing disaster-specific experiences in addition to predisaster interpersonal violence may be important for identifying and triaging individuals at risk for postdisaster mental health problems.
识别灾难后心理健康问题的高危个体通常需要评估与灾难相关的潜在创伤暴露。灾难幸存者在灾难发生之前和期间，也可能接触到与灾难本身无关的创伤。大量文献表明，与非暴力事件相比，接触人际暴力可能会产生更严重的负面后果；然而，目前尚不清楚在灾难前后，暴力暴露与非暴力暴露是否会对灾后心理功能产生不同的影响。
我们研究了在卡特里娜飓风前后，男性退伍军人样本中，暴力和非暴力暴露与灾后心理功能的关系。
飓风卡特里娜过后的暴力和非暴力暴露，以及卡特里娜飓风前的暴力暴露，与创伤后应激障碍、惊恐和广泛性焦虑障碍的症状显著相关，这些症状在风暴发生 2 年多后仍存在。此外，与没有报告此类暴露的退伍军人相比，报告卡特里娜飓风前暴力暴露的退伍军人在卡特里娜飓风中再次经历人际暴力的可能性高出 4 倍以上。
结果表明，评估灾难特有的经历以及灾难前的人际暴力可能对识别和确定灾后心理健康问题高危个体具有重要意义。
