经历9·11灾难的人群在桑迪飓风后出现的创伤后应激障碍
Posttraumatic Stress Disorder after Hurricane Sandy among Persons Exposed to the 9/11 Disaster.
作者信息
Caramanica Kimberly, Brackbill Robert M, Stellman Steven D, Farfel Mark R
机构信息
New York City Department of Health and Mental Hygiene, USA.
New York City Department of Health and Mental Hygiene, USA ; Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, USA.
出版信息
Int J Emerg Ment Health. 2015;17(1):356-362. doi: 10.4172/1522-4821.1000173.
BACKGROUND
Traumatic exposure during a hurricane is associated with adverse mental health conditions post-event. The World Trade Center Health Registry provided a sampling pool for a rapid survey of persons directly affected by Hurricane Sandy in the New York City (NYC) metropolitan area in late October 2012. This study evaluated the relationship between Sandy experiences and Sandy-related posttraumatic stress disorder (PTSD) among individuals previously exposed to the September 11, 2001 (9/11) disaster.
METHODS
A total of 4,558 surveys were completed from April 10-November 7, 2013. After exclusions for missing data, the final sample included 2,214 (53.5%) respondents from FEMA-defined inundation zones and 1,923 (46.5%) from non-inundation zones. Sandy exposures included witnessing terrible events, Sandy-related injury, fearing for own life or safety of others, evacuation, living in a home that was flooded or damaged, property loss, and financial loss. Sandy-related PTSD was defined as a score of ≥44 on a Sandy-specific PTSD Checklist.
RESULTS
PTSD prevalence was higher in the inundation zones (11.3%) and lower in the non-inundation zones (4.4%). The highest prevalence of Sandy-related PTSD was among individuals in the inundation zone who sustained an injury (31.2%), reported a history of 9/11-related PTSD (28.8%), or had low social support prior to the event (28.6%). In the inundation zones, significantly elevated adjusted odds of Sandy-related PTSD were observed among persons with a prior history of 9/11-related PTSD, low social support, and those who experienced a greater number of Sandy traumatic events.
CONCLUSIONS
Sandy-related stress symptoms indicative of PTSD affected a significant proportion of persons who lived in flooded areas of the NYC metropolitan area. Prior 9/11-related PTSD increased the likelihood of Sandy-related PTSD, while social support was protective. Public health preparation for events similar to Sandy should incorporate outreach and linkages to care for persons with prior disaster-related trauma.
背景
飓风期间遭受创伤与灾后心理健康状况不佳有关。世界贸易中心健康登记处为2012年10月下旬对纽约市（NYC）大都市地区受桑迪飓风直接影响的人员进行快速调查提供了抽样群体。本研究评估了2001年9月11日（9/11）灾难的幸存者中，桑迪飓风经历与桑迪相关创伤后应激障碍（PTSD）之间的关系。
方法
2013年4月10日至11月7日共完成了4558份调查问卷。在排除缺失数据后，最终样本包括来自联邦应急管理局（FEMA）定义的淹没区的2214名（53.5%）受访者和来自非淹没区的1923名（46.5%）受访者。桑迪飓风暴露经历包括目睹可怕事件、与桑迪飓风相关的伤害、担心自己或他人的生命安全、撤离、居住在被洪水淹没或受损的房屋中、财产损失和经济损失。桑迪相关创伤后应激障碍被定义为在特定于桑迪飓风的创伤后应激障碍检查表上得分≥44分。
结果
淹没区创伤后应激障碍患病率较高（11.3%），非淹没区较低（4.4%）。与桑迪飓风相关的创伤后应激障碍患病率最高的是淹没区中受伤的个体（31.2%）、报告有9/11相关创伤后应激障碍病史的个体（28.8%）或事件发生前社会支持较低的个体（28.6%）。在淹没区，有9/11相关创伤后应激障碍病史、社会支持较低以及经历了更多桑迪飓风创伤事件的人群中，与桑迪飓风相关的创伤后应激障碍调整后的患病几率显著升高。
结论
表明创伤后应激障碍的与桑迪飓风相关的应激症状影响了纽约市大都市地区洪水泛滥地区的很大一部分人。先前的9/11相关创伤后应激障碍增加了与桑迪飓风相关创伤后应激障碍的可能性，而社会支持具有保护作用。针对类似桑迪飓风的事件进行公共卫生准备应包括对有先前灾难相关创伤的人员进行宣传和提供护理联系。
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