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大量墨西哥湾沿岸居民的累积灾难暴露与心理和生理健康症状。

Cumulative Disaster Exposure and Mental and Physical Health Symptoms Among a Large Sample of Gulf Coast Residents.

机构信息

Department of Psychology, Montclair State University, Montclair, New Jersey, USA.

Social & Scientific Systems, Inc., Silver Spring, Maryland, USA.

出版信息

J Trauma Stress. 2019 Apr;32(2):196-205. doi: 10.1002/jts.22392. Epub 2019 Mar 26.

Abstract

A large body of research has linked disaster exposure to adverse mental and physical health outcomes. Few studies, however, have explored the cumulative impact of exposure to multiple disasters. Participants (N = 8,366) from the National Institute of Environmental Health Sciences Gulf Long-Term Follow-Up Study were classified as having been exposed to both, either, or neither Hurricane Katrina and the Deepwater Horizon oil spill (DHOS). Participants also reported on a range of mental and physical health symptoms. Logistic regression models found that participants who were exposed to both disasters had significantly higher odds of probable generalized anxiety disorder, odds ratio (OR) = 1.72, 95% CI [1.52, 1.96]; major depression, OR = 1.53, 95% CI [1.32, 1.77]; and posttraumatic stress disorder, OR = 2.51, 95% CI [2.03, 3.10], than participants who were exposed to only one disaster, ps < .001. Additionally, a linear regression model found that participants who were exposed to both disasters had significantly more physical health symptoms at the time of the spill than those who were exposed to only one disaster, B = 0.99, SE = .20, p < .001. The results indicate that cumulative disaster exposure confers enhanced risk for adverse mental and physical health outcomes. The findings demonstrate that screening for prior exposure among disaster-affected individuals might identify those at greatest risk for adverse health outcomes.

摘要

大量研究将灾害暴露与不良心理和身体健康结果联系起来。然而,很少有研究探索过多次灾害暴露的累积影响。来自国家环境卫生科学研究所海湾长期随访研究的参与者(N=8366)被分为经历过卡特里娜飓风和深水地平线石油泄漏(DHOS)、只经历过其中之一或两者都没有经历过的三种情况。参与者还报告了一系列心理和身体健康症状。逻辑回归模型发现,同时经历过两次灾害的参与者患广泛性焦虑症、重性抑郁症和创伤后应激障碍的可能性显著更高,优势比(OR)分别为 1.72(95%CI [1.52, 1.96])、1.53(95%CI [1.32, 1.77])和 2.51(95%CI [2.03, 3.10]),而只经历过一次灾害的参与者,p<.001。此外,线性回归模型发现,与只经历过一次灾害的参与者相比,同时经历过两次灾害的参与者在泄漏时的身体健康症状明显更多,B=0.99,SE=0.20,p<.001。研究结果表明,累积的灾害暴露会增加不良心理和身体健康结果的风险。这些发现表明,对受灾个体进行先前暴露的筛查可能会识别出那些健康结果最不利的个体。

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