Reseach Institute for Flexicurity, Labour Market Dynamics and Social Cohesion (ReflecT), Tilburg University, Tilburg, The Netherlands.
International Victimology Institute Tilburg (INTERVICT), Tilburg University, Tilburg, The Netherlands.
J Trauma Stress. 2018 Jun;31(3):460-466. doi: 10.1002/jts.22282.
Population studies have shown that employed adults are healthier than unemployed adults. In this study, we examined whether this "healthy worker effect" is relevant in postdisaster mental health by examining whether trauma-exposed employed individuals have lower postdisaster initial mental health problems and/or whether they recover faster than trauma-exposed unemployed individuals. We compared the course of postevent intrusion and avoidance reactions, anxiety, depression, and sleeping difficulties of employed residents (n = 291) and unemployed residents (n = 269) affected by a fireworks disaster in a residential area of Enschede, The Netherlands. Measurements took place at 2-3 weeks (T1), 18 months (T2), and 4 years (T3) postdisaster. We used linear mixed-effect models to examine the course of mental health problems. Employment status was relevant, to a degree, in posttrauma recovery; although affected employed residents had significantly lower levels of mental health problems (initially and over time) than the unemployed, ds = 0.41-0.72, the recovery rate was the same for both groups. At T1 (neglecting the DSM 1-month criterion), T2, and T3, the prevalence of probable posttraumatic stress disorder was 45.4%, 18.9%, and 11%, respectively, among employed individuals, and 70.1%, 32.5%, and 30% among unemployed individuals. We concluded that research into the mental health of disaster victims should take employment status into account. Regarding postdisaster care, unemployed individuals may need special attention; although they may recover at the same rate as employed individuals, they suffer from more severe mental health problems, even years after the disaster.
人群研究表明，在职成年人比失业成年人更健康。在这项研究中，我们通过考察创伤暴露的在职个体是否具有更低的灾后初始心理健康问题，或者他们是否比创伤暴露的失业个体恢复得更快，来研究这种“健康工人效应”在灾后心理健康中是否存在。我们比较了受烟花爆炸灾害影响的埃森市（荷兰）住宅区的 291 名在职居民和 269 名失业居民的创伤后侵入和回避反应、焦虑、抑郁和睡眠困难的发展过程。测量时间分别在灾后 2-3 周（T1）、18 个月（T2）和 4 年（T3）。我们使用线性混合效应模型来研究心理健康问题的发展过程。就业状况在创伤后恢复方面有一定的影响；尽管受影响的在职居民在心理健康问题方面（最初和随时间推移）的水平明显低于失业居民，ds = 0.41-0.72，但两组的恢复速度相同。在 T1（忽略 DSM 1 个月标准）、T2 和 T3，创伤后应激障碍的患病率分别为 45.4%、18.9%和 11%，在就业者中，分别为 70.1%、32.5%和 30%，在失业者中。我们得出结论，针对灾害受害者心理健康的研究应该考虑就业状况。关于灾后护理，失业个体可能需要特别关注；尽管他们的恢复速度可能与就业个体相同，但他们在灾难发生多年后，仍会遭受更严重的心理健康问题。
