Department of Epidemiology, Columbia University, Mailman School of Public Health, New York, New York, USA.
J Trauma Stress. 2013 Dec;26(6):753-61. doi: 10.1002/jts.21872.
Previous research has documented that individuals exposed to more stressors during disasters and their immediate aftermath (immediate stressors) are at risk of experiencing longer-term postdisaster stressors. Longer-term stressors, in turn, have been found to play a key role in shaping postdisaster psychological functioning. Few studies have simultaneously explored the links from immediate to longer-term stressors, and from longer-term stressors to psychological functioning, however. Additionally, studies have inadequately explored whether postdisaster psychological symptoms influence longer-term stressors. In the current study, we aimed to fill these gaps. Participants (N = 448) were from population-based study of Hurricane Ike survivors and completed assessments 2-5 months (Wave 1), 5-9 months (Wave 2) and 14-18 months (Wave 3) postdisaster. Through path analysis, we found that immediate stressors, assessed at Wave 1, were positively associated with Wave 2 and Wave 3 stressors, which in turn were positively associated with Wave 2 and Wave 3 posttraumatic stress and depressive symptoms. Wave 2 posttraumatic stress symptoms were positively associated with Wave 3 stressors, and Wave 1 depressive symptoms were positively associated with Wave 2 stressors. The findings suggest that policies and interventions can reduce the impact of disasters on mental health by preventing and alleviating both immediate and longer-term postdisaster stressors.
先前的研究记录表明,个体在灾害及其后续期间(即时压力源)中面临更多压力源的暴露,其面临长期灾后压力源的风险更高。反过来,长期压力源被发现对塑造灾后心理功能起着关键作用。然而,很少有研究同时探讨即时压力源与长期压力源之间的联系,以及长期压力源与心理功能之间的联系。此外,研究未能充分探讨灾后心理症状是否会影响长期压力源。在本研究中,我们旨在填补这些空白。参与者(N=448)来自飓风 Ike 幸存者的基于人群的研究,并在灾后 2-5 个月(第 1 波)、5-9 个月(第 2 波)和 14-18 个月(第 3 波)进行评估。通过路径分析,我们发现第 1 波评估的即时压力源与第 2 波和第 3 波压力源呈正相关,而第 2 波和第 3 波压力源又与第 2 波和第 3 波创伤后应激和抑郁症状呈正相关。第 2 波创伤后应激症状与第 3 波压力源呈正相关,第 1 波抑郁症状与第 2 波压力源呈正相关。研究结果表明,通过预防和减轻即时和长期的灾后压力源,政策和干预措施可以减轻灾难对心理健康的影响。