Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine.
Department of Biostatistics and Bioinformatics, Tulane University School of Public Health and Tropical Medicine.
Psychol Trauma. 2018 Sep;10(5):533-541. doi: 10.1037/tra0000345. Epub 2017 Dec 4.
To test whether effects of multiple (up to 5) disasters on mental health responses were cumulative (additive effects), or whether an earlier disaster produced sensitization (higher) or habituation (lower) responses to a later one.
The Gulf Resilience on Women's Health study interviewed 1,366 southern Louisiana women regarding their exposure to Hurricanes Katrina, Rita, Gustav, and Ike and the Gulf oil spill (measured several ways), and administered validated measures of symptoms of depression and posttraumatic stress disorder (PTSD). Multiple linear and logistic regression with disaster exposures entered singly, combined, and as an interaction were used to model mental health.
Both exposure to the oil spill and hurricane disaster were associated with likely depression and PTSD, consistent with a cumulative model, but we did not find statistical interactions that would suggest sensitization or habituation. When results were examined with continuous symptom measures of depression and PTSD, they were similar, with the exception that exposure to the oil spill and experiencing illness or injury because of the hurricane disaster showed a significant interaction (p < .05) in a manner consistent with a sensitization effect when predicting PTSD symptoms. The results of this study point mainly to a cumulative risk for the mental health effects of multiple disasters, although some indication of sensitization occurred among those with particularly severe experiences. There was no evidence for habituation.
These findings may guide efforts to assist those in regions experiencing multiple disasters that occur in close sequence. (PsycINFO Database Record
检验多次（多达 5 次）灾害对心理健康反应的影响是累积的（累加效应），还是先前的灾害对后续灾害产生了敏感化（更高）或习惯化（更低）反应。
海湾妇女健康弹性研究对路易斯安那州南部的 1366 名女性进行了访谈，了解她们对卡特里娜飓风、丽塔飓风、古斯塔夫飓风和艾克飓风以及墨西哥湾漏油事件（以多种方式衡量）的暴露情况，并采用经过验证的抑郁和创伤后应激障碍（PTSD）症状量表进行评估。使用单独、组合和相互作用的灾害暴露进行多元线性和逻辑回归，以建立心理健康模型。
石油泄漏和飓风灾害的暴露都与可能的抑郁和 PTSD 有关，这与累积模型一致，但我们没有发现表明敏感化或习惯化的统计学相互作用。当使用抑郁和 PTSD 的连续症状测量结果进行检查时，结果相似，只是石油泄漏暴露和因飓风灾害而患病或受伤的经历在预测 PTSD 症状时表现出显著的相互作用（p<.05），这与敏感化效应一致。这项研究的结果主要指向多次灾害对心理健康影响的累积风险，尽管在经历特别严重的人中有一些敏感化的迹象。没有习惯化的证据。
这些发现可能有助于指导那些在连续发生多次灾害的地区提供援助的努力。
