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Prior Experience as a Moderator of Disaster Impact on Anxiety Symptoms in Older Adults
Abstract
As participants in a panel study, 234 older adults were interviewed before, as well as after, serious flooding occurred in southeastern Kentucky. Floods are not uncommon in this area, but these were more widespread than most, and resulted in both previously exposed and newly exposed subsamples of disaster victims. Flood impact was measured at both personal and community levels. With preflood symptoms controlled, there were modest flood effects on both trait anxiety and weather-specific distress in older adults without prior flood experience, but no flood effects in older adults who had been in floods before. Thus, the study provides support for the "inoculation hypothesis" and other conceptualizations that emphasize the advantage of being familiar or experienced with a stressor that is at hand. An implication is that "experienced" victims could be a valuable resource in prevention efforts.
... That said, it is also possible that individuals with a history of prior trauma may in some ways be able to use their past experience to better cope with later traumatic events. This idea is central to a competing hypothesis to the stress sensitization model, known as inoculation theory (13). Inoculation theory suggests that prior experience successfully coping with stressors actually increases resistance to subsequent stress, and so ultimately has a protective effect. ...
... Prior earthquake experience was shown to be associated with lower depression scores in the wake of another earthquake, although rumination was apparently unaffected (18). Similarly, another study found that flood victims who had experienced a previous flood were less likely to experience trait anxiety or weather-related distress related to personal loss in a second flood (13). A more recent study (9), also looking at flooding, compared individuals who experienced no home or property damage to those who experienced it in either a recent flood (single disaster) or both a recent and a past flood (double disaster). ...
... It should be noted that while most of these inoculation studies look at previous experience with the same event, it is possible that coping strategies and reactions learned by one event can generalize to an unrelated future trauma. Norris and Murrell (13) argue that increased resistance to a new stressor may represent a type of "cross tolerance", such that "exposure to one type of stressor prevents a different stressor from impairing performance". In support of this contention, one study found that previous exposure to the September 11 terrorist attack moderated PTSD symptomatology in response to Shrira A et al. (19). ...
Background: In our analysis of adolescents affected by the 2016 Fort McMurray wildfire, we observed many negative mental health effects in individuals with a prior history of psychological trauma. Elevated rates of depression and markers of post-traumatic stress disorder (PTSD) were observed, consistent with the hypothesis that prior trauma may reduce sensitivity thresholds for later psychopathology (stress sensitization). Surprisingly, levels of anxiety did not differ based on prior trauma history, nor were retraumatized individuals at increased risk for recent (past month) suicidal ideation. These results are more suggestive of inoculation by prior trauma than stress sensitization. This led us to consider whether individuals with a prior trauma history showed evidence of Post-Traumatic Growth (PTG), a condition in which the experience of a previous trauma leads to areas of sparing or even improvement.
Method: To investigate this issue, we generated a structural equation model (SEM) exploring the role of anxiety in previously traumatized (n = 295) and wildfire trauma alone (n = 740) groups. Specifically, models were estimated to explore the relationship between hopelessness, anxiety, PTSD symptoms, self-efficacy and potential protective factors such as friend and family support in both groups. The model was tested using a cross-sectional sample of affected youth, comparing effects between the two groups.
Results: While both models produced relatively good fit, differences in the effects and chi-squared values led us to conclude that the groups are subject to different causal specifications in a number of areas, although details warrant caution pending additional investigation.
Discussion: We found that adolescents with a prior trauma history appear to have a more realistic appraisal of potential difficulties associated with traumatic events, and seem less reactive to potentially unsettling PTSD symptoms. They also seemed less prone to overconfidence as they got older, an effect seen in the adolescents without a history of trauma. Our findings provide preliminary evidence that the construct of anxiety may work differently in newly traumatized and retraumatized individuals, particularly in the context of mass trauma events.
... On the contrary, Norris and Murrell [38] find that people who experienced previous disasters were not influenced by trait anxiety and not stressed by particular weather. They emphasize that it ensued since experience might role as an excellent preventive measure for victims. ...
... On the other side, survivors can use previous disaster experiences as a preventive measure to minimize anxiety and stress [38]. Afterwards, Seery et al. [39] summarize that individuals' resilience will build when they have disaster experiences or bad experiences. ...
This study aims to analyse the impact of the 2006 Yogyakarta earthquake on the mental health and welfare of victims in Bantul and to examine whether disasters they experienced before might increase or decrease their mental health when facing indirect exposure to repeated disasters. This study employs several methods: descriptive analysis; logit; a combination of propensity score matching; and difference in differences. The results find that 7 people (1.78%) in 2007 and 31 people (7.89%) in 2014 have experienced symptoms of depression. Age is confirmed as a significant factor in increasing this probability. The results of this study reveal that direct exposure to the 2006 Yogyakarta earthquake increased the average mental disorder score and decreased the victims’ education expenditure 1 year after the disaster. The direct exposure to the 2006 Yogyakarta earthquake also affected the increase in mental disorder score and decrease in household expenditure of victims 1 year after the disaster, although the effects were insignificant.
... Alongside coping with personal life events, participants emphasized previous coping with security and terrorist events as building resilience that helps them at present, as found in previous studies of older adults in the Gaza Envelope (Chaitin et al., 2013). This coping resource is consistent with the inoculation hypothesis, according to which previous exposure to stressful events helps individuals use previous coping resources, improving their coping ability, which confers an advantage on older adults (Norris & Murrell, 1988). The participants' view of their rich experience with security threats as a coping resource is not consistent; however, with the vulnerability approach, according to which individuals' coping resources are depleted with each stressful event (Hyer et al., 1995). ...
... Our findings showing that older adults who live alone under CTS use a variety of coping strategies and identify internal resources support theories emphasizing older adults' resilience and their ability to cope with stress and distress (Norris et al., 2002;Norris & Murrell, 1988;Shmotkin, 2003). Our study joins several others showing that older adults living in CTS can demonstrate adaptability and resilience (Chaitin et al., 2013). ...
Continuous traumatic situations (CTS) caused by prolonged exposure to terrorist threat can harm individuals’ mental and physical health. For older adults living alone in CTS, this risk joins the challenges of aging and loneliness, creating a triple vulnerability. No previous research has explored this particular vulnerability and specifically addressed the coping strategies and internal resources used by older adults to manage these stressful circumstances. The present study aimed to fill this lacuna, by exploring how older adults living alone in CTS cope with these challenges and the internal resources that help them do so. In-depth interviews with 15 persons aged 65+ years living alone in Sderot, an Israeli city exposed to a continuous terror threat, were conducted and analyzed thematically. Participants described various coping strategies. Some are deployed at the psychological level: positive thinking, deliberate disengagement, perception of being alone as an advantage, and social comparison; others have behavioral implications: acknowledging reality and dealing with it and “turning it into an engine.” Participants also identified four internal resources that helped them cope: functional independence, faith, character traits, and previous experience with stressful life events. Participants coped with the difficulties of living alone in CTS actively and creatively, relying on various psychological and functional resources. The findings support theories that emphasize older adults’ resilience and ability to cope with stress and trauma, suggesting ways to strengthen the resilience of older adults facing CTS, particularly those living alone.
... This hypothesis considers that a successful adaptation response to adversity is retained in individual memory and generates behavioral (Davydov et al., 2010). Hence, Norris and Murrell (1988) find that flood survivors show lower anxiety levels than individuals who have not experienced flooding when exposed to another flood disaster. ...
... Environmental stressors such as weather can be reminders of past negative events as described in the PTS scenario with the effect of heavy rainfall. A weather-specific distress index tapping feelings of apprehension during mildly threatening weather has, for example, been used to capture the mental health effects of flooding, and the effects of covariates on this index are observed which are similar to those of anxiety indices (Norris & Murrell, 1988). The weather conditions of the day of the interview are used here and it is found that rainy or cloudy days can act as reminders that trigger individual willingness to avoid suffering anxiety. ...
Demand for reducing mental health impacts from flooding through collective flood defence is elicited using a contingent valuation method with a sequential hypothetical scenario, which accounts for human resilience and experience. A two‐step model fits the survey data: it combines a binary sample selection rule to distinguish protesters and participants with a Tobit model to accommodate true zero responses among participants. Results show that non‐symptoms‐specific information on mental health risk may bias the willingness to pay downward. Risk‐averse individuals who have taken self‐insurance protection measures are willing to pay for additional protection through collective defence. Feelings, such as worries and anxiety related to flooding, drive the demand, which supports the risk‐as‐feelings hypothesis for mental health protection from flooding. Inexperience rather than experience of flooding is found to increase demand, which indicates that individual mental resilience to flooding may increase after an event as posited by the inoculation hypothesis.
... Two prominent theoretical accounts offer different predictions about older adults' well-being after a disaster. According to the inoculation hypothesis (Norris & Murrell, 1988), prior disaster experience acts to protect older people from distress and strong emotional reactions to subsequent disasters. Based on Eysenck (1983) original inoculation hypothesis, prior disaster experience is assumed to increase tolerance of future disaster-related stressors. ...
... There was no evidence of age moderation in the regression analyses. However, age alone was inversely associated with symptoms of depression and worry consistent with the inoculation hypothesis (Norris & Murrell, 1988;Shrira et al., 2014). The finding that older adults may be less prone to depression and worry symptoms aligns with other evidence of older adults as resilient (Knight et al., 2000;Shrira et al., 2014; but see Phifer, 1990). ...
We examined the inoculation and stress sensitization explanations concerning mental health outcomes in 223 predominately middle-aged and older adults after a flood (M age = 49.6 years, SD = 17.7 years, range: 18-88 years). In multiple linear regression models, having flood damage was associated with higher levels of posttraumatic stress disorder (PTSD) and depressive symptoms, while social support was associated with fewer symptoms. Greater lifetime trauma and flood-related stress were associated with more symptoms of depression and PTSD, respectively. Older age was associated with more religious coping and fewer depressive and worry symptoms. Future directions for research on postdisaster vulnerabilities and resilience are discussed. (PsycInfo Database Record (c) 2021 APA, all rights reserved).
... Significant changes and losses are common in older adulthood and include retirement, erosion of social networks, and reductions in functioning and mobility. It has been proposed that experiencing trauma and stressors before late adulthood may "inoculate" and help enhance coping skills in older adults (52,64). It has been hypothesized that experiencing trauma or stressors earlier in life may promote psychological resilience to future traumas and stressors (52,64). ...
... It has been proposed that experiencing trauma and stressors before late adulthood may "inoculate" and help enhance coping skills in older adults (52,64). It has been hypothesized that experiencing trauma or stressors earlier in life may promote psychological resilience to future traumas and stressors (52,64). Using data from the NHRVS, Pietrzak and Cook (52) found that among older veterans who endured a high number of traumas in their lifetimes, nearly 70% were psychologically resilient in later life. ...
United States (U.S.) veterans are substantially older than their non-veteran counterparts. However, nationally representative, population-based data on the unique health needs of this population are lacking. Such data are critical to informing the design of large-scale outreach initiatives, and to ensure the effectiveness of service care delivery both within and outside of the Veterans Affairs healthcare system. The National Health and Resilience in Veterans Study (NHRVS) is a contemporary, nationally representative, prospective study of two independent cohorts (n = 3,157 and n = 1,484) of U.S. veterans, which is examining longitudinal changes, and key risk and protective factors for several health outcomes. In this narrative review, we summarize the main findings of all NHRVS studies (n = 82) published as of June 2020, and discuss the clinical implications, limitations, and future directions of this study. Review of these articles was organized into six major topic areas: post-traumatic stress disorder, suicidality, aging, resilience and post-traumatic growth, special topics relevant to veterans, and genetics and epigenetics. Collectively, results of these studies suggest that while a significant minority of veterans screen positive for mental disorders, the majority are psychologically resilient. They further suggest that prevention and treatment efforts designed to promote protective psychosocial characteristics (i.e., resilience, gratitude, purpose in life), and social connectedness (i.e., secure attachment, community integration, social engagement) help mitigate risk for mental disorders, and promote psychological resilience and post-traumatic growth in this population.
... Die Zustimmung nimmt zu, wenn die Betroffenen miteinbezogen werden (Dombrowsky, 1981), wenn Rücksicht genommen wird auf die sozioökonomischen Verhältnisse (Hofstede, 2011). Sie wird außerdem gefördert durch die Vorbereitungsmöglichkeit auf eine Katastrophe (Norris & Murrell, 1988), die Einbettung in soziale Unterstützung (Brewin et al., 2000), ganz wesentlich durch die Art und durch Experten gestützte Krisenkommunikation mit Bereitstellung von Informationen (Juen et al., 2020), durch Partizipation der Bevölkerung (Juen et al., 2021), und durch einen nachvollziehbaren, erfolgreichen Verlauf (Dombrowsky, 1983)6. ...
Das Auf treten der Covid-19-Pandemie dient als Beispiel, wie Personen sich und andere in einer Gefährdungssituation erleben, sich damit auseinandersetzen und schließlich die Situation bewältigen. Ausgehend von der Alltagsbeobachtung stark unterschiedener Bewältigungsprozesse stellt sich dieser Beitrag die Frage, welche persönlichen, sozialen und gesellschaftlichen Strukturen Einfluss auf den Bewältigungsprozess haben. Mit 15 Personen unterschiedlicher Einstellungen wurden zu Beginn der Pandemie 2020/2021 und an ihrem Ende 2023 semistrukturierte Interviews durchgeführt. Die qualitative Auswertung zeigte bei allen die Beschäftigung mit den Themen Krankheit und Gesundheit und die Bedeutung sozialer Kontakte, aber durch die relevante soziale Umwelt geprägte große Unterschiede in der Gesundheitserhaltung, in der Einschätzung von Gefährdung und im Maß, behördlichen Verordnungen zuzustimmen, sie kritisch zu hinterfragen oder sie abzulehnen. Die Ergebnisse werden aus personzentrierter Sicht interpretiert.
... Specifically, temporal disintegration scores in the immediate aftermath of the fires were lowest for individuals who had experienced acute trauma prior to the fires (M = 2.08), moderate for individuals who had never experienced prior trauma (M = 2.47), and highest for individuals who had experienced chronic trauma prior to the fires (M = 3.18). To the extent that temporal disintegration is linked with subsequent emotional distress, these findings offer partial support for the hypothesis that prior exposure to acute trauma may help minimize the negative effects of subsequent exposure to acute trauma (see Eysenck, 1983;Norris & Murrell, 1988; but see Wallbaum & Silver, 1998, for alternative findings). That is, acute prior trauma may have inoculated these residents against the negative effects of the fires (cf. ...
The relations between temporal orientation and long-term psychological distress were studied cross-sectionally and longitudinally in 3 samples of traumatized individuals: adult victims of childhood incest, Vietnam War veterans, and residents of 2 southern California communities devastated by fire. Results indicated that a past temporal orientation—focusing attention on prior life experiences—was associated with elevated levels of distress long after the trauma had passed, even when controlling for the degree of rumination reported. Temporal disintegration at the time of the trauma—whereby the present moment becomes isolated from the continuity of past and future time—was associated with a high degree of past temporal orientation over time and subsequent distress. Temporal disintegration was highest among individuals who had experienced the most severe loss, had previously experienced chronic trauma, and had had their identities threatened by their traumatic experience.
... These provisions of support, of course, must be balanced by sufficient receipt of support. On the basis of their results, Norris and Murrell (1988) also described older adults as a potentially useful resource for disaster-stricken settings. Our findings are certainly compatible with this view. ...
At 12, 18, and 24 months after Hurricane Hugo, 831 adults were interviewed regarding their disaster-related stressors and present psychological state. The study’s purposes were to assess whether age influenced one’s vulnerability to postdisaster stress and to evaluate four different perspectives on disaster recovery that have been previously used to explain age differences. Regression analyses demonstrated that disaster exposure had substantial and pervasive psychological effects. The analyses also revealed a curvilinear interaction between disaster exposure and age. Younger people exhibited the most distress in the absence of disaster, but middle-aged people did so in its presence. Differential exposure, resources, and inoculation all failed to explain these differences; however, the burden perspective had considerable explanatory power.
... Several factors may account for the relative resiliency of the older old. Although older adults may endure more severe exposure to disaster, have poorer health, and have less social and economic resources, they also possess two advantages that may promote the process of adaptation to disasters: a higher incidence of past resolved stressful experiences (Norris & Murrell, 1988) and a lower incidence of current unresolved stressful experiences (Hughes, Blazer, & George, 1988;Masuda & Holmes, 1978). The first advantage for older adults stems from their rich histories of coping with prior crises. ...
In a panel study, more than 200 older adults were interviewed before and after a severe flood in southeastern Kentucky in 1984. The issue in this study was whether older adult flood victims were differentially vulnerable to increases in psychological and physical symptoms on the basis of their age, sex, marital status, occupational status, education level, and preflood symptom levels. Flood exposure was related to increases in depressive, anxiety, and somatic symptoms at 18 months postflood. Within this older adult sample, men, those with lower occupational status, and persons aged 55–64 were at significantly greater risk for increases in psychological symptoms. Sociodemographic status did not moderate the impact of flood exposure on physical health. Implications for crisis-intervention services to older adult disaster victims are discussed.
... The fact that greater cumulative environmental stress led to significantly improved emotional outcomes may reflect what Zimmerman et al. (2013) refer to as the challenge model of resilience, where exposure to average risk inoculates children and adolescents to the effects of subsequent, more severe risk exposure by helping them develop coping mechanisms. The inoculation hypothesis has been well-established in disaster literature on older adults due to the ability to retrospectively examine their traumatic exposures (Norris & Murrell, 1988). Studies on the inoculation hypothesis in the disaster context argue that "because older adults have accumulated challenging experiences over their lifetimes that they possess better coping abilities and are more resilient. ...
This study examines how community-level cumulative environmental stress affects child and adolescent emotional distress and chronic health conditions both directly and indirectly through stressors at the household, family, and individual levels. Data comes from the Women and their Children’s Health (WaTCH) Study, which sought to understand the health implications of exposure to the 2010 Deepwater Horizon oil spill (DHOS) among a cohort of 596 mothers with children ages 10 to 17 in southeastern Louisiana. Community-level environmental stress was measured using a newly developed geospatial index. Household-level stressors included previous hurricane impacts, impacts of DHOS, degree of financial difficulty, and degree of housing physical decay. Family stressors included maternal depression, self-rated physical health, and degree of parenting stress. Child stress was based on perceived stress; child mental health was based on serious emotional disturbance; and child physical health was based on diagnosis of chronic illness. Structural equation modeling used weighted least squares means and variance and theta parameterization. Results showed a significant negative direct path between community-level cumulative environmental stress and child/adolescent serious emotional disturbance and chronic illness. However, the indirect relationship through household, family, and individual-level stressors was significant and positive for both child/adolescent serious emotional disturbance and chronic illness. These findings point to the centrality of the household and family in determining child and adolescent physical and mental health outcomes in communities exposed to frequent disasters and ongoing environmental stressors.
... Of particular relevance to understanding these impacts is the notion of "biographical context," which refers to "the effect of past experience, both in terms of timing and content, on the 'meaning' of current stress" ( Wheaton 1999, p. 295). Across human development, this essentially means that past experiences condition the impact of later experiences, by either increasing or decreasing vulnerability to the impacts of subsequent maltreatment ( Norris and Murrell 1988;Lynch and Cicchetti 1998;Pearlin et al. 2005). When victimization happens in the context of other life adversities, or if it is a recurring form of trauma, its impacts may not be the same as if it were experienced as a singular, isolated event (Norris, Tracy, and Galea 2009;Turner 2010;Turanovic 2019a). ...
... It has been shown that the stress experienced may be of benefit against the detrimental impacts of future stress (Eysenck, 1983). This concept is also researched in relation to disaster related stressors (Norris & Murrell, 1988). It is further demonstrated that prior experience for responders increases their resilience to dealing with future stresses (Ersland, Weisaeth, & Sund, 1989;McCarroll, Fullerton, Ursano, & Hermsen, 1996). ...
Abstract: The Incident Command System (ICS) exists as the nationwide standard for onsite
incident management, as called for under the National Incident Management System
(NIMS). However, the effectiveness of ICS is debated, both for its systemic efficacy as a
response model and for its inconsistent application. Since the development of ICS,
individual responders have trained to work together as Incident Management Teams
(IMTs). Even though little research exists on IMTs, their use has increased widely since
the release of the NIMS. The alternative to IMTs is implementing ICS through a
collection of individuals in an ad hoc manner, often referred to as an Emergent Multi-
Organizational Network (EMON). This study strives to determine the impact of IMTs
versus EMONs on the effectiveness of emergency and disaster response. It is
hypothesized that the use of IMTs will increase the perceived effectiveness of a response,
specifically in the application of the Incident Command System. The population for this
study is emergency and disaster responders at large, regardless of disciplinary or
jurisdictional demographics. The sample population is individual responders comprising
both members and non-members of Incident Management Teams. The responders were
from across the four state area of FEMA Region VII (Iowa, Kansas, Missouri and
Nebraska). Non-IMT responders serve as a control group of EMONs to determine
whether IMT membership has any effect on response. This study is limited in that it is
not based on specific responses. Instead, respondents provide feedback to a survey based
on what their normal actions were for their last biggest response.
... Stress process models have been widely used to study responses to stressful life events (DeLongis et al., 1982;Lazarus & Folkman, 1984). Such stress exposures include disasters (Norris et al., 1999;Norris & Murrell, 1988;Wadsworth et al., 2009) and family caregiving for persons living with dementia and other chronic conditions (Haley et al., 1987;Pearlin et al., 1990;Vitaliano et al, 2003). Research has also considered that caregivers face secondary stressors, such as work strains due to caregiving and stressful life events unrelated to caregiving including crime and poverty (Aneshensel et al., 1995;Owen et al., 2002). ...
Background and objectives:
Disaster preparedness is an urgent concern, particularly for caregivers of persons with dementia. Developing and executing plans for oneself and another person who needs care can be difficult when the care recipient is cognitively impaired. We sought to better understand caregivers' disaster preparedness for the purpose of generating guidance for future interventions to increase caregiver resilience.
Research design and methods:
We conducted a qualitative descriptive study of caregiver disaster experiences and perceptions of their preparedness. Fifty-two participants from diverse backgrounds participated in a focus group or interview. Deductive thematic data analysis was utilized to identify themes. Stress process models guided the interpretation of our findings.
Results:
Analyses of caregivers' experiences and observations revealed that disaster preparedness was challenging for caregivers, though also perceived to be an important responsibility. We identified three main themes: (1) barriers to preparing for a disaster as a caregiver for a person living with dementia, (2) why it is important for a caregiver to develop a disaster plan and (3) how to facilitate preparedness for caregivers of persons living with dementia.
Discussion and implications:
This study highlighted the difficulties of preparing for a disaster while caring for a person with dementia. Applying stress process models to our results provided strong evidence that interventions could be developed to bolster caregivers' resources to cope with stressors associated with disaster preparedness. A key issue for public officials is the question of whether disaster shelters are appropriate for persons with dementia.
... Flood Experience (FLEX). Flood experience has been measured by using a 14-item scale derived from Tyler and Hoyt (2000) and Norris and Murrell (1998). This has been measured on a scale of 1 = not exposed to flood to 5 = very severely exposed to flood. ...
... Together, our findings along with others from the literature on aging and post-disaster well-being, have theoretical and applied implications that warrant brief mention. From a theoretical perspective, our findings are consistent with an inoculation explanation of post-disaster psychological reactions (Ferraro, 2003;Norris & Murrell, 1988), where older persons' life experiences may lessen their emotional reactions to disaster-related losses (Cherry et al., 2021c;Shrira et al., 2014). The finding that older adults may be less prone to depression and worry symptoms has also been interpreted as evidence that older adults are more resilient to post-disaster adversity than are younger adults (Knight et al., 2000;Shrira et al., 2014), although symptom under-reporting among older respondents should be considered (Bei et al., 2013). ...
Objectives:
Severe weather events have mental health consequences for survivors that may change over time. We assessed post-flood mental health longitudinally in three groups of mostly middle-aged and older adults who varied in current and prior severe weather experiences.
Method:
Predictors of central interest were age, perceived social support, state hope (including agency and pathways), recovery stressors, and prior lifetime trauma. Criterion variables included symptoms of depression, post-traumatic stress disorder (PTSD), and worry.
Results:
Analyses of variance yielded significant Disaster Exposure Group x Wave interactions for depression and PTSD symptoms. Those with flooded homes and properties had elevated symptoms at Wave 1 which were reduced at Wave 2. Older age was associated with fewer symptoms of depression, PTSD, and worry. Recovery stressors and lifetime trauma predicted more PTSD symptoms. Greater agency predicted less PTSD and depression symptoms, whereas pathways predicted less worry.
Conclusion:
These data show that mental health symptoms may decrease over time for those directly impacted by severe flooding. State hope appears to contribute to better mental health after exposure to a devastating flood. Implications for understanding the dynamic relationships among risk variables and positive factors that promote post-disaster mental health in the years after a flood are considered.
... Conversely, evidence for the inoculation hypothesis shows that previous exposure to disaster can protect older individuals from distress when facing subsequent disasters (Eysenck, 1983;Ferraro, 2003;Knight et al., 2000;Norris & Murrell, 1988;Rafiey et al., 2016;Shrira et al., 2014). For example, Shrira et al. (2014) found that, unlike younger adults, older adults did not experience a positive relationship between high exposure to 9/11 and current PTSD symptoms following exposure to Hurricane Sandy. ...
Following a stressful life event, there is considerable variation in how individuals respond and adapt. Multiple models of risk and resilience show that adverse childhood experiences may be associated with an individual's response to stress later in life. While there is considerable support that early adversity can sensitize the stress response system and lead to adverse outcomes later in life, there is mounting evidence that in adolescence and young adulthood, certain biological predispositions to stress may be associated with resilience in the context of subsequent stressors. In this study, we evaluated how individual differences in vagally mediated heart rate variability moderated the relationship between childhood maltreatment and grief among a sample of individuals experiencing a stressful life event (i.e., spousal bereavement) over time. Data were collected at approximately 3, 4.5, and 6.5 months after the death of a spouse (n = 130). Heart rate variability moderated the relationship between childhood maltreatment and grief symptoms over time (b = -0.03, p < .001), such that among individuals with more severe experiences of childhood maltreatment, those with higher heart rate variability had a faster recovery from grief than those with low heart rate variability. This research highlights an overall pattern of resilience among older adult's following spousal bereavement, as well as the relationships between childhood maltreatment, heart rate variability, and differential responses to grief following the loss of a spouse. (PsycInfo Database Record (c) 2023 APA, all rights reserved).
... Studies on the consequences of disasters have shown that many victims may experience clinically significant symptoms due to exposure to stressful events, loss, social disintegration, disruption of social networks, and destruction of community structures or traditional support mechanisms (Kokai et al., 2004;Seto et al., 2019). The most commonly found specific psychological problems include anxiety, distress, grief, depression, and PTSD (Hackbarth et al., 2012;McFarlane et al., 2012;Norris & Murrell, 1988;North, 2016;Wang et al., 2011), followed by non-specific psychological distress, as well as various health problems and worries (Madakasira & O'Brien, 1987;Norris et al., 2002;Young et al., 1999). In addition, scholars have studied the longitudinal changes in the mental health of survivors after a disaster and found that mental health tends to deteriorate sharply after a disaster but gradually recovers over time (Calvo et al., 2015;Ni et al., 2015;Priebe et al., 2011;Sugano, 2016;Wang et al., 2000). ...
Using the three-wave longitudinal survey data of the Wenchuan disaster area, this study employed Hierarchical Linear Modeling (HLM) to explore the recovery trajectory from depression of rural survivors after the Wenchuan earthquake. Across the three waves, 221 respondents (118 male, 103 female) provided complete data. We found that, at the individual level, the survivors’ individual social networks had a significant effect on the change in depression scores in the four years following the earthquake, implying that a strong social network could help survivors recover from depression. At the community level, community trust had a significant effect both on the initial depression score at the time of the earthquake and on the survivors’ change in depression scores after the earthquake. Survivors with high community trust had significantly lower depression scores, compared with those with low community trust at the time of the earthquake; however, the depression scores of the former increased in the four years following the earthquake and gradually approached the average depression level. At the social level, relief resource allocation also had a significant effect on the change in survivors’ post-disaster depression; those who deemed the resource allocation to be very fair had a decrease in depression scores. The results of our study show that rich individual social networks and allocation of relief resources contribute to earthquake survivors’ recovery from depression. Therefore, besides providing more adequate relief resources to survivors, we should also emphasize the rebuilding of their social networks.
... While a majority of studies reviewed suggested that risk perceptions positively influenced relocation intentions, many studies suggest that relationship is complex, nuanced, and is not often enough by itself to convince individuals to move. Norris and Murrell (1988) note that when a disaster occurs, people tend to evaluate their risk based on the chances that the disaster will reoccur at the same site, often anchoring magnitude of potential impacts to the previous event. In an ethnographic study of Kinston, NC, following Hurricanes Fran and Floyd, de Vries (2017) reaches a similar conclusion, finding that residents anchor their risk to previous events, suggesting that recent experience with a hazard makes residents more likely to want to relocate after subsequent events. ...
Household relocation decisions after disasters are influenced by many factors. Among others, these include pre- and post-event community conditions, disaster experience, available financial and social resources, place attachment, risk perceptions, and demographics. This paper provides a synthesis of the body of knowledge surrounding voluntary household relocation decisions. Simply stated, we are focused on better understanding what influences the decision to stay somewhere that has been affected by disaster or permanently leave it. This work provides two main contributions by characterizing and synthesizing research exploring relocation drivers. First, we provide several new directions for the study of this issue by proposing theoretical models not commonly used in this area of research with potential to provide insight. Second, we critically discuss the need for improvements in the conceptualization and measurement of these concepts.
... Children growing up in conditions of high or low adversity display heightened stress responses compared to children growing up in conditions of moderately stressful adversity (Shakiba et al., 2020). Survivors of floods or earthquakes exhibit lower anxiety (Norris and Murrell, 1988;Weems et al., 2014) and less depressed affect (Knight et al., 2000) after re-experiencing the same natural disaster compared to inexperienced survivors. Exposure to natural disasters is associated with fewer anxiety and depressive disorders compared to technological disasters such as oil spills or nuclear accidents (Neria et al., 2008;Norris et al., 2002). ...
Laboratory mouse models offer opportunities to bridge the gap between basic neuroscience and applied stress research. Here we consider the ecological validity of social defeat stressors in mouse models of emotional vulnerability and resilience. Reports identified in PubMed from 1980 to 2020 are reviewed for the ecological validity of social defeat stressors, sex of subjects, and whether results are discussed in terms of vulnerability alone, resilience alone, or both vulnerability and resilience. Most of the 318 reviewed reports (95%) focus on males, and many reports (71%) discuss vulnerability and resilience. Limited ecological validity is associated with increased vulnerability and decreased resilience. Elements of limited ecological validity include frequent and repeated exposure to defeat stressors without opportunities to avoid or escape from unfamiliar conspecifics that are pre-screened and selected for aggressive behavior. These elements ensure defeat and may be required to induce vulnerability, but they are not representative of naturalistic conditions. Research aimed at establishing causality is needed to determine whether ecologically valid stressors build resilience in both sexes of mice.
... For reasons of comprehensiveness, it should be mentioned that life span development is, according to Baltes et al., (2006), also shaped by non-normative (idiosyncratic) influences, i.e. "individual-idiosyncratic biological and environmental events" (e.g., an accident). In particular, life events that occurred to individuals prior to or during the pandemic could have -depending on personal resources and various other factors -either "inoculated" (Norris & Murrell, 1988) or steeled them, so that their well-being is quite "pandemic-resilient", or, quite the opposite, such events might have sensitized them, so that their well-being is particularly susceptible to detrimental COVID-19 influences. ...
The COVID-19 pandemic has resulted in profound changes of individuals’ everyday lives. Restrictions in social contacts and in leisure activities and the threatening situation of a spreading virus might have resulted in compromised well-being. At the same time, the pandemic could have promoted specific aspects of psychosocial well-being, e.g., due to intensified relationships with close persons during lockdown periods. We investigated this potentially multidimensional and multi-directional pattern of pandemic-specific change in well-being by analyzing changes over up to 8 years (2012-2020) in two broad well-being domains, hedonic well-being (life satisfaction) and eudaimonic well-being (one overarching eudaimonic well-being indicator as well as environmental mastery, personal growth, positive relations with others, and self-acceptance), among 423 adults who were aged 40-98 years in 2012. By modelling longitudinal multilevel regression models and allowing for a measurement-specific intra-individual deviation component from the general slope in 2020, i.e. after the pandemic outbreak, we analyzed potential normative history-graded changes due to the pandemic. All mean-level history-graded changes were nonsignificant, but most revealed substantial interindividual variability, indicating that individuals’ pandemic-related well-being changes were remarkably heterogeneous. Only for personal growth and self-acceptance, adding a pandemic-related change component (and interindividual variability thereof) did not result in a better model fit. Individuals with poorer self-rated health at baseline in 2012 revealed a pandemic-related change toward lower life satisfaction. Our findings suggest that not all well-being domains - and not all individuals - are equally prone to “COVID-19 effects”, and even pandemic-associated gains were observed for some individuals in certain well-being domains.
... For the "Steady increase" class, each event had played a good catalytic role, and the PTG growth rate is increasing year by year. According to the inoculation theory, individuals who have encountered past trauma may have learned cognitive management strategies making them better able to navigate difficult situations, which is consistent with the trait of their PTG in the "Steady increase" class (29). Although there was a significant decrease in PTG levels in the "Fluctuated rise" class at the first follow-up, there was a more rapid increase in PTG levels at the second follow-up, eventually reaching levels significantly higher than those in the "Steady increase" group. ...
Objectives
The COVID-19 pandemic has taken a significant toll on people worldwide for more than 2 years. Previous studies have highlighted the negative effects of COVID-19 on the mental health of healthcare workers (HCWs) more than the positive changes, such as post-traumatic growth (PTG). Furthermore, most previous studies were cross-sectional surveys without follow-ups. This study draws on PTG follow-up during the COVID-19 outbreak at 12-month intervals for 2 years since 2020. The trajectories and baseline predictors were described.
Methods
A convenience sampling method was used to recruit frontline nurses or doctors at the COVID-19-designated hospital who were eligible for this study. A total of 565 HCWs completed the 2 years follow-up and were used for final data analysis. The latent growth mixture models (GMM) was used to identify subgroups of participants with different PTG trajectories. Multinomial logistic regression model was used to find predictors among sociodemographic characteristics and resilience at baseline.
Results
Four trajectory PTG types among HCWs were identified: ‘Persistent, “Steady increase”, “High with drop”, and “Fluctuated rise.” Comparing the “Persistent low” type, the other three categories were all associated with older age, higher education. Furthermore, “Persistent low” was also negatively associated with resilience at baseline.
Conclusion
The PTG of HCWs with different characteristics showed different trends over time. It is necessary to increase the measure frequency to understand the PTG status in different times. Improving HCW’s resilience could help improve staff PTG.
... These included age in years (e.g., Scott et al., 2013;Thompson et al., 1993), gender (Hetzel-Riggin & Roby, 2013; male, female, intersex/nonbinary, prefer not to say), pet ownership (Arambaši c et al., 2000; yes/no), education level (Frankenberg et al., 2013;Smith et al., 2014; high school, Diploma/Certificate/TAFE, undergraduate degree, postgraduate degree), prior diagnosis of a psychological disorder (e.g., Horan et al., 2007; 'Have you ever been told by a doctor or psychologist that you have a psychological disorder': yes/no), prior mental health assistance ('Have you received any mental health assistance following the bushfires?': yes/no), number of natural disasters previously experienced (Norris & Murrell, 1988; open-ended), and current location (state/territory). A large proportion of qualitative responses related to the prior exposure to natural disaster item (e.g., 'too many to count', 'enough for a lifetime'); therefore, this variable was recoded into yes/no prior to analyses. ...
Objective: We investigated how Australian community members (N = 318) indirectly and/or directly exposed to Australia’s 2019/20 bushfire season differed in terms of psychological distress, posttraumatic growth, coping, physical health, and COVID-19 anxiety. Method: This was a cross-sectional study with a nonequivalent groups design. Participants were over 18 years old, English proficient, and Australian permanent residents or citizens living in Australia at some point between June 2019 and February 2020. Participants completed a 10-minute anonymous online survey 5 to 8 weeks following the bushfires. Results: A descriptive discriminant analysis revealed a statistically significant difference between bushfire exposure groups when considering our dependent variables of interest simultaneously and adjusting for prior mental health assistance and prior exposure to natural disasters: F(10, 624) = 2.83, p = .002; V = .087, partial η² = .043. The group centroid for the indirect-only exposure group (−.374) was substantially lower than that for the other 2 groups (direct only: .137; direct + indirect: .224), indicating that the indirect-only exposure group could be differentiated by the fact that they more frequently reported avoidant coping strategies and endorsed lower posttraumatic growth scores than the direct-only and direct + indirect exposure groups. The variance accounted for by these discriminant variables was 8.4%, indicating a very small effect. Conclusion: Our results point to a need to tailor and/or expand disaster preparedness, response, and recovery efforts such that they might benefit community members both directly and indirectly exposed to bushfire events in Australia.
... Interestingly, prior encounters with tragedies are also helpful in reducing the impact of stressor (see Norris & Murrel, 1988). Bandura (1989) has conceptualized that an optimistic sense of personal efficacy in life is associated with many positive consequences, including the ability to persevere under difficult conditions, the capacity to keep oneself together emotionally in coping, and the ability to avoid situations that cannot be handled. ...
p>A substantial body of mainly US research has suggested the mental health benefits of religiosity and spirituality and that this relationship is mediated by extrinsic factors such as health behaviours, social support and sense of personal meaning or coherence. However, as Pargament argues, it is also possible that religion has unique benefits through providing contact with the sacred. Such benefits can be expected to be more evident in a religious society such as Iran. In order to assess religious coping in Iran, a religious coping scale modelled on Pargament’s scale was developed specifically for Iranian Muslims and tested in a sample of university students (N = 185). Similarly, the validity and reliability of Reker’s Personal Meaning scale was tested on a sample of university students (N = 136) and school teachers (N = 162). These studies also demonstrated the associations with well-being variables of both religious coping and personal meaning. To investigate the relative efficacy of religious coping and personal meaning in dealing with physical disability and traumatic experiences, a sample of disabled war veterans of the Iran-Iraq conflict was studied (N = 78). Many Iranian veterans perceived the war as a sacred defence. It was expected that such sanctification would have helped protect them from mental health problems and distress. Results showed that religious coping had a significant contribution to mental health of veterans beyond and above other predictor variables such as physical function, social support and personal meaning. These predictor variables did not explain the relationship between religious coping and mental health. This research also indicated that participants used positive religious coping strategies more frequently than negative religious coping strategies in coping with their physical disability problems and traumatic experiences. The limitations of this study are discussed and suggestions made for the sanctification hypothesis in other samples.</p
... Exposure to the same stressor could reduce the subsequent impact of the stressor through developing tolerance (Eysenck, 1983). Individuals may use their past exposure to similar events to shift trauma from "outside the realm of an individual's experience" to the "normative" range of experiences that people deal with during their lives (Norris and Murrell, 1988). Individuals might actually be more, rather than less, resilient to repeated exposures to trauma. ...
Background and aim
The World Health Organization has identified child abuse, intimate partner violence (IPV), and elder abuse (EA) as common types of interpersonal violence. Research showed individuals exposed to interpersonal violence in one life stage were at higher risks of exposure to interpersonal violence in other life stages. This study aims to examine the relationship between cumulative interpersonal violence and cognitive function.
Methods
Data were derived from the PINE Study in which 3157 Chinese older adults aged 60 and above received interviews in Chicago. We used a 56-item modified Conflict Tactics Scale to evaluate EA. Abuse history was defined as exposure to child abuse (before age 18) and/or IPV (age 18–59) measured respectively by the Extended Hurt, Insult, Threaten, Scream scale. We divided participants into four groups: EA and abuse history (n = 204), EA only (n = 439, reference group), abuse history only (n = 310), and no interpersonal violence (n = 2181). Global cognition was evaluated by episodic memory, working memory, processing speed, and MMSE. Linear regression was used.
Results
Older adults with EA and abuse history (b = 0.147, SE = 0.052, p < .01) or abuse history only (b = 0.118, SE = 0.046, p < .01) had higher global cognition than the EA only group.
Conclusions
Individuals with abuse history might develop resilience in the face of interpersonal violence in old age through gaining a sense of mastery and developing effective coping skills from prior experience. Healthcare professionals could assess older adults’ prior victimizations and recent victimizations to plan family violence counseling and promote healthy cognitive aging.
... People keep living in some locations despite frequent natural disasters (hurricanes, floods) or attacks, suggesting that prior experience with disasters and terror may inoculate against the possible psychological harm in subsequent disasters, improving their chances for a resilient outcome. Repeated exposure to similar stressors reduces the intensity of the stress-hormone response (see Andersen et al., 2013 for shootings at US universities; Norris & Murrell, 1988 for repeated flooding in Kentucky or Bleich et al., 2003 for terror in Israel). ...
This paper evaluates the effect on mental health of consecutive terrorist attacks in France in 2015 and 2016. We compile information about the three main terrorist attacks that struck France over this period and assess whether the potential effect on mental health (i.e., depression) of a terrorist attack is smoothed once people consider terrorist attacks as “the new normality.” We exploit data from the French Constances epidemiological survey and combine an event study strategy with a difference-in-difference approach to compare before-after changes in mental health the year of the attack with the same changes the year before. We show that the negative effect of a terrorist attack on mental health decreases over time from one attack to another, and disappears completely for the last attack. Socio-demographic composition of the sample, geographical or socio-demographic proximity to the victims or media exposure do not arise as factors responsible for this changing effect of terrorist attacks on mental health.
... This places a greater demand on their capacity for resilience, potentially putting the oldest individuals at higher risk to reach a certain tipping point beyond which they will experience considerable declines in QoL. On the other hand, research has also shown that old age is associated with more beneficial outcomes in the face of adversity (Wilson et al., 2020;Fuller and Huseth-Zosel, 2021;Lind et al., 2021), in agreement with the notion that the accumulation of life events leads to an enlarged repertoire of knowledge and (coping) skills that can help the oldest individuals to deal with the challenges they are confronted with (Norris and Murrell, 1988;Seery et al., 2010;Crane et al., 2019). While the controversial question on the impact of age was beyond the scope of the current study, this important issue will need to be addressed in future work (within our own lab, for one). ...
Age-related challenges and transitions can have considerable social, psychological, and physical consequences that may lead to significant changes in quality of life (QoL). As such, maintaining high levels of QoL in later life may crucially depend on the ability to demonstrate resilience (i.e., successful adaptation to late-life challenges). The current study set out to explore the interplay between several resilience factors, and how these contribute to the realization and maintenance of (different facets of) QoL. Based on the previous work, we identified behavioral coping, positive appraisal, self-management ability, and physical activity as key resilience factors. Their interplay with (various facets of) QoL, as measured with the WHOQOL-OLD, was established through network analysis. In a sample of community-dwelling older adults (55+; N=1,392), we found that QoL was most strongly (and directly) related to positive appraisal style and self-management ability. Among those, taking care of multifunctional resources (i.e., yielding various benefits at the same time) seemed to be crucial. It connected directly to “satisfaction with past, present, and future activities,” a key facet of QoL with strong interconnections to other QoL facets. Our analysis also identified resilience factor(s) with the potential to promote QoL when targeted by training, intervention, or other experimental manipulation. The appropriate set of resilience factors to manipulate may depend on the goal and/or facet of QoL that one aims to improve.
... In our study, age was found to be a [45]. Level of education was not a significant predictor of either outcome, which is consistent with some studies [45,72,73], but not others [39-44, 47, 74]. In our study, this lack of relationship may be attributable to the relatively low education level in our respondents overall. ...
Background
Depression and anxiety are common mental health conditions in the older adult population. Understanding the trajectories of these will help implement treatments and interventions.
Aims
This study aims to identify depression and anxiety trajectories in older adults, evaluate the interrelationship of these conditions, and recognize trajectory-predicting characteristics.
Methods
Group-based dual trajectory modeling (GBDTM) was applied to the data of 3983 individuals, aged 65 years or older who participated in the Korean Health Panel Study between 2008 and 2015. Logistic regression was used to identify the association between characteristics and trajectory groups.
Results
Four trajectory groups from GBDTM were identified within both depression and anxiety outcomes. Depression outcome fell into “low-flat (87.0%)”, “low-to-middle (8.8%)”, “low-to-high (1.3%)” and “high-stable (2.8%)” trajectory groups. Anxiety outcome fell into “low-flat (92.5%)”, “low-to-middle (4.7%)”, “high-to-low (2.2%)” and “high-curve (0.6%)” trajectory groups. Interrelationships between depression and anxiety were identified. Members of the high-stable depression group were more likely to have “high-to-low” or “high-curved” anxiety trajectories. Female sex, the presence of more than three chronic diseases, and being engaged in income-generating activity were significant predictors for depression and anxiety.
Conclusions
Dual trajectory analysis of depression and anxiety in older adults shows that when one condition is present, the probability of the other is increased. Sex, having more than three chronic diseases, and not being involved in income-generating activity might increase risks for both depression and anxiety. Health policy decision-makers may use our findings to develop strategies for preventing both depression and anxiety in older adults.
... In our study, age was a signi cant univariate in uence of depression only, accordant with [36]. Level of education was not a signi cant predictor of either outcome, which is consistent with some studies [36,62,63], but not others [30,31,32,33,34,35,38,64]. In our study, this lack of relationship may be attributable to the relatively low education level in our respondents overall. ...
Background: Depression and anxiety are common mental health conditions for elderly population. Understanding the trajectory developments of them will help us implementing treatments and interventions.
Aims: This study aims to identify depression and anxiety trajectories in the elderly, evaluate the interrelationship of these conditions, and recognize trajectory-predicting characteristics.
Methods: Group-based dual trajectory modeling (GBDTM) was applied to the data of 3,983 individuals, aged 65 years or older who participated in the Korean Health Panel Study between 2008 and 2015. Logistic regression was used to identify the association between characteristics and trajectory groups.
Results: Four trajectory groups from GBDTM were identified in both the depression and anxiety outcomes. Depression has: “low-flat (87.0%)”, “low-to-middle (8.8%)”, “low-to-high (1.3%)” and “high-stable (2.8%)” trajectory groups. Anxiety has: “low-flat (92.5%)”, “low-to-middle (4.7%)”, “high-to-low (2.2%)” and “high-curve (0.6%)” trajectory groups. Interrelationship between depression and anxiety were identified. Members of the high-stable depression group were more likely to have “high-to-low” or “high-curved” anxiety trajectories. Female sex, the presence of more than three chronic diseases, and having income generating activity were significant factors in depression and anxiety.
Conclusions: Dual trajectory analysis of depression and anxiety in older adults shows that when one condition is present, the probability of the other is increased. Sex, having more chronic disease, and income generating activity might be at increased risks for both depression and anxiety. Health policy decision-makers can use our findings in developing strategies for prevention of both depression and anxiety in older adults.
... It is also possible that immigrants are more resilient to many of the health damaging effects of incarceration given that the conditions in their countries of origin may be similar to, or worse than, those within American correctional facilities. To the extent that immigrants have already been exposed to poor living conditions, inadequate nutrition, social unrest, and violence within their sending countries, it is possible that incarceration represents less of a "shock" to their system, and that its effects on health are more subdued (Norris & Murrell, 1988;Turney, 2017). ...
Background
In the United States, foreign-born persons often have better health outcomes than their native-born peers, despite exposure to adversity. Nevertheless, it is unclear whether this pattern extends to the consequences of life events, such as incarceration, that separate immigrants from their supportive networks and increase exposure to adversity. Accordingly, using four waves of data from the National Longitudinal Study of Adolescent to Adult Health, hierarchical generalized linear models were used to examine within-individual changes in self-rated health following first incarceration (N = 31,202 person-waves).
Results
The results showed that incarceration was associated with modest health declines that were similar in magnitude for immigrant and native-born persons. Supplemental analyses revealed that these effects did not vary by immigrant race or ethnicity, or by age at immigration. The only exception was for immigrants from low- and middle-income countries, who were marginally less likely to experience health declines following incarceration.
Conclusions
In general, incarceration appears to be similarly health damaging for immigrants and non-immigrants. These findings raise important questions about how incarceration is linked to health declines for foreign- and native-born populations and emphasize the importance of access to healthcare for individuals released from correctional facilities. More research is needed, however, to further examine the cumulative impacts of incarceration on immigrants’ health across the life course, and to assess a broader spectrum of health outcomes.
Stress, encompassing psychological, physical, and physiological challenges, is an important factor affecting an individual's well-being and potentially leading to psychiatric, neurodegenerative, immune, and metabolic disorders. However, not everyone exposed to stress develops these conditions, highlighting the concept of resilience. Resilience is a dynamic process categorized into four dimensions: pre-existing resilience capacity, ongoing resilience processes, post-stress resilience outcomes, and recovery from psychopathologies. These dimensions involve genomic, cellular, and systemic interactions influenced by genetic factors, early life experiences, adult life experiences in addition to community/environmental factors, and health behaviors. The biological response to stress encompasses endocrine, autonomic, immunological, and behavioral components, modulated by stressor characteristics and individual traits. Due to the limitations in studying stress and resilience in humans, translational models using rodents and cell cultures are essential. Rodent models include acute, chronic, and traumatic stress paradigms, aiding the study of stress-related behavioral and molecular outcomes. Additionally, early life stress models, such as prenatal stress and maternal separation, provide insights into developmental impacts. In this review, first, rodent models for lifelong stress exposure will be summarized considering their validity, advantages, and limitations. Subsequently, an overview of models designed to enhance resilience capacity and process in rodents, and later the behavioral models employed to study the outcomes of resilience will be given. Lastly, the focus will be shifted to cell culture and iPSCs models. Finally, future considerations focused on improving translational models used to study stress and resilience will be discussed. It is aimed to provide an overview of designs for translational stress and resilience models to access more effective translational biomarkers associated with stress and resilience. Stress and resilience are complex phenomena influenced by various factors, spanning molecular to behavioral levels. Integrating data across dimensions remains crucial for unraveling the complexities of stress-related disorders and resilience.
Cross-sectional studies have found older adults to have lower levels of emotional distress after natural disasters. The maturation hypothesis suggests that older adults are less reactive to stress events, whereas the inoculation hypothesis argues that prior experience with disaster is protective. One hundred and sixty-six adults aged 30 to 102 were interviewed regarding the 1994 Northridge earthquake. Longitudinal data were available on depressed mood before and after the earthquake. The maturation hypothesis was generally not supported. The young–old were least depressed; however, this age difference was present prior to the earthquake. The old–old showed lowest levels of earthquake-specific rumination, but age did not buffer the relationship between damage exposure and rumination. The inoculation hypothesis was supported for depressed mood. Prior earthquake experience was related to lower postearthquake depression scores.
Resilience can be conceptualized as a network of interacting mental-health constructs characterized by weak autoconnections and/or interconnections. We investigated whether positive appraisal style (PAS), the ability to bounce back or recover from stress (BRS), age, education level, and urbanization grade can confer such desirable network properties within a network comprising depression, anxiety, loneliness, and mental well-being. Longitudinal data (five time points during the COVID-19 pandemic) were derived from a sample of older adults ( N = 1,270, 55+). Individuals who were 67 or older, highly educated, or scored high on PAS and BRS exhibited more resilient network dynamics and generally better overall mental-health outcomes. Findings pertaining to urbanization grade and the (subgroup-dependent) dynamics among the mental-health constructs are also discussed. These findings may inform theorizing and interventions aimed at resilience during a challenging life phase.
While cold weather disasters are likely to become more frequent under climate change, most health research is focused on heat waves, flooding or hurricanes. Oriented by a “cascading disaster health inequities” approach, we examine anxiety and depression after a cold-weather disaster using survey data (n = 790) collected in eight Texas metropolitan statistical areas following Winter Storm Uri (2021). 14.9% of respondents experienced anxiety (GAD-2) and 15.1% experienced depression (PHQ-2) six months after the event. In multivariable models, disability status and having more adverse event experiences during the storm increased odds of depression and anxiety. Minority racial/ethnic status was associated with greater odds of depression, but not anxiety. Those who were Black and disabled, Hispanic and disabled, disabled and Uri impacted, Black and Uri impacted or Hispanic and Uri impacted faced increased odds of depression compared to the applicable “doubly privileged” reference category. Those who were Hispanic and disabled or disabled and Uri impacted experienced elevated odds of anxiety compared to the applicable “doubly privileged” reference category. Results demonstrate the utility of a “cascading disasters mental health inequities” approach for illuminating how social factors intersect with disaster experiences to shape disparate risks.
The goal of this research was to model the relationship between stress and natural disasters, with a view to explaining levels of stress among women. Following flooding in Iowa, in 1993, two in-depth questionnaire surveys were administered, one to residents in high flood exposure areas, and another to the general population as a control. Results indicated that gender plays a significant role in interpreting stress responses to natural hazards, with women consistently exhibiting greater stress than men. However, it was evident that a complex web of factors influenced stress levels including marital status, structure of the family unit, age, socio-economic status, health, levels of social involvement, and degree of hazard experience. These findings suggest that more research should focus on determining structural constraints that exacerbate stress levels for women.
Guided by influential theories of disaster research and gerontology, this study examines health resilience associated with tornadoes, particularly focusing on how individuals’ tornado-associated stress, financial losses, and family members’ well-being affected posttraumatic distress (PTD), posttraumatic growth (PTG), and self-reported changes in health among adults. To reach this goal, this study collected data from residents affected by two violent tornadoes in 2013, with the assistance of a professional survey lab which implemented a random-digit-dialling telephone survey. The working sample included 517 respondents with oversampled older adults. Multinomial logistic regression, Poisson regression, and Ordinary Least Square Regression were conducted separately for younger and older adults. The results indicated a significant effect of stress levels on PTG among older adults only. Nonetheless, the differences in effect sizes between the two groups were not significant. Meanwhile, respondents’ financial losses and their family members’ declined health were significant predictors of improved health among older adults. Similarly, family members’ declined mental health was a significant predictor of PTD among older adults, but not younger adults. Compared to young adults, older adults were more vulnerable to their family members’ declined mental health, but also more resilient to stressful situations, financial losses, and family members’ declined physical health. Lastly, although risk and resilience factors could be constructed with the same set of items, they function differently among different groups of people. Hence, more studies on heterogeneity are needed to further refine resilience frameworks.
Studies of the negative mental health consequences of natural disasters form an important interface between environmental sociology and medical sociology. Building upon recent developments in both fields, we develop an expanded model of the disaster framing of the stress process and test its main effects and buffer specifications with data on the preparation and short-term recovery phases of Hurricane Andrew. We found that instrumental forms of social support ameliorated psychological distress, but we found only weak support for the buffer model. Our results suggest that expanding the range of environmental changes that is included in conceptualizations of stress and exploring contextual effects at the personal network and local community levels would improve our understanding of the stress process inside and outside the disaster context. They also highlight the importance of paying close attention to the types and timing of support transactions following life-threatening events.
Purpose
The aim of this paper is to respond to a gap in the literature around resilience in later life for older people from minority groups of identity or experience. Specifically, it argues that we need to pay greater attention to how access to different types of social capital may leave some older people more or less able to cope with adverse events and how experiences of social exclusion can limit access to important networks of support during times of crisis.
Design/methodology/approach
This paper draws on research conducted to inform the resilience strategy of Greater Manchester in 2019, and specifically looked at how this strategy could better address the needs of the regions’ diverse ageing population. It used a qualitative design including focus groups with older women of Punjabi heritage living in Greater Manchester, interviews with staff from a community and voluntary organisation working with these women, and interviews with staff at an organisation supporting refugees and asylum seekers in Greater Manchester who specifically worked with older adults.
Findings
The research found that belonging to a minority group and experiences of social exclusion gave participants in this study both resources and vulnerabilities when it came to dealing with external shocks in later life. Whilst participants in this study had access to strong networks of bonding capital based on shared identity and experience, social exclusion often meant they faced barriers to accessing network of support outside of these communities.
Research limitations/implications
Findings from this study have implications for both future research and policy. In the case of the latter there are implications for those working in resilience planning in terms of how to address the needs of diverse older populations. For researchers, this paper has implications for how we understand the impacts on inequality in later life particularly in the context of the COVID-19 pandemic.
Originality/value
The originality of this paper lies in its consideration of the impact of inequalities and social exclusion on the resilience of older people in times of crisis. It included older people from minority groups of identity and experience addressing an important gap in the literature.
This Chapter presents the critical learnings and application of community resilience from flood-affected communities in the United Kingdom (UK). Focus groups and interviews (N = 77) with people from Kent, UK, and Surrey, UK, about their 2013–2014 flooding experiences provided insights into the resilience of these communities and the nine themes discussed in the previous chapter. The reported associations between the outcomes of psychological impact, social disruption, and economic harm and the elements of community resilience were anecdotally mentioned by the majority of the focus group participants. Based on their personal experience with flooding, participants confirmed that if the activities related to the elements of community resilience were consistently applied in their community before the flood, then they would have felt less or none of the flooding impacts. The qualitative findings from the focus group discussions supported a taxonomy of the community resilience elements as being relevant and having the potential to help communities against flooding.
This Chapter reviews the scientific literature to examine previously established associations of elements common to community resilience and the security and health harm caused by severe flooding. Using an analytical narrative review approach, 16 studies tested the association between the elements of community resilience and a community’s psychological, social, and economic impacts caused by severe flooding. Most included publications (84%) assessed the association of community resilience with psychological impact, while fewer assessed social disruption (31%) or economic harm (21%). Past studies’ gaps were critically reviewed to understand better how community resilience connects to positive and negative outcomes seen after severe flooding. Future studies can clarify whether the community resilience elements are protective factors against harmful outcomes and when best to apply the concept in the disaster cycle.
Importance:
During the past century, more than 100 catastrophic hurricanes have impacted the Florida coast; climate change will likely be associated with increases in the intensity of future storms. Despite these annual threats to residents, to our knowledge, no longitudinal studies of representative samples at risk of hurricane exposure have examined psychological outcomes associated with repeated exposure.
Objective:
To assess psychosocial and mental health outcomes and functional impairment associated with repeated hurricane exposure.
Design, setting, and participants:
In this survey study, a demographically representative sample of Florida residents was assessed in the 60 hours prior to Hurricane Irma (wave 1: September 8-11, 2017). A second survey was administered 1 month after Hurricane Irma (wave 2: October 12-29, 2017), and a third survey was administered after Hurricane Michael (wave 3: October 22 to November 6, 2018). Data were analyzed from July 19 to 23, 2021.
Exposure:
Hurricanes Irma and Michael.
Main outcomes and measures:
The main outcomes were posttraumatic stress symptoms (PTSS), global distress, worry about future events (generalized worries), and functional impairment. Path models were used to assess associations of individual-level factors (prior mental health, recent adversity), prior storm exposures (loss and/or injury, evacuation), and direct, indirect, and media-based exposures to hurricanes Irma and Michael with those outcomes. Poststratification weights were applied to facilitate population-based inferences.
Results:
Of 2873 individuals administered the survey in wave 1, 1637 responded (57.0% completion rate) (894 [54.6%, weighted] women; mean [SD] age, 51.31 [17.50] years); 1478 in wave 2 (90.3% retention from wave 1) and 1113 in wave 3 (75.3% retention from wave 2) responded. Prior mental health ailments (b, 0.18; 95% CI, 0.07-0.28), prior hurricane-related loss and/or injury (b, 0.09; 95% CI, 0.02-0.17), hours of Hurricane Irma-related media exposure (b, 0.03; 95% CI, 0.02-0.04), being in an evacuation zone during Hurricane Irma and not evacuating (b, 0.14; 95% CI, 0.02-0.27), and loss and/or injury in Hurricane Irma (b, 0.35; 95% CI, 0.25-0.44) were positively associated with PTSS after Hurricane Irma; most associations persisted and were associated with responses to Hurricane Michael. Prior mental health ailments (b, 0.10; 95% CI, 0.03-0.17), hours of Hurricane Michael-related media exposure (b, 0.01; 95% CI, 0.003-0.02), hurricane Irma-related PTSS (b, 0.42; 95% CI, 0.34-0.50), recent individual-level adversity (b, 0.03; 95% CI, 0.005-0.05), being in an evacuation zone during Hurricane Irma and evacuating (b, 0.10; 95% CI, 0.002-0.19), and direct (b, 0.36; 95% CI, 0.16-0.55) and indirect (b, 0.12; 95% CI, 0.05-0.18) Hurricane Michael-related exposures were directly associated with Hurricane Michael-related PTSS. After Hurricane Michael, prior mental health ailments (b, 0.17; 95% CI, 0.06-0.28), and PTSS related to hurricanes Irma (b, 0.11; 95% CI, 0.001-0.22) and Michael (b, 0.58; 95% CI, 0.47-0.69) were associated with respondents' functional impairment. Analogous analyses using global distress and generalized worries as mediators of functional impairment yielded a similar pattern of results.
Conclusions and relevance:
In this survey study, repeated direct, indirect, and media-based exposures to hurricanes were associated with increased mental health symptoms among Florida residents who experienced hurricanes Irma and Michael, suggesting that people were sensitized to respond with more psychological symptoms over time. These results may inform targeted public health intervention efforts for natural disasters.
In this study, we examined religiosity and social support as predictors of resilience after a devastating flood. Three flood exposure groups of primarily middle-aged and older adults were compared: (1) non-flooded adults as controls, (2) once-flooded adults with structural damage to homes and property in the 2016 flood, and (3) twice-flooded adults who had relocated inland because of prior catastrophic losses in the 2005 Hurricanes Katrina and Rita and then flooded again in 2016. Resilience was assessed using the Connor-Davidson Resilience Scale (CD-RISC). Correlation analyses confirmed that older age was correlated with higher religiosity, charitable work done for others, and resilience. Regression analyses indicated that religious beliefs and coping, social support, and charitable work done for others were associated with higher levels of resilience, whereas flood damage was unrelated to resilience. Implications for current views on post-disaster adversity and resilience in later life are discussed.
Objective: An earthquake is a natural disaster that seriously affects individuals physically and psychologically. Although there has been a great deal of research on the psychological effects of earthquakes, few have focused on local health workers and its early effects. In this study, it is aimed to determine the levels and predictors of early post-earthquake trauma of the local health workers working in the affected area in the earthquake that occurred on January 24, 2020, Malatya-Elazig. Methods: This cross-sectional descriptive study was carried out on a sample of 201 healthcare workers after three weeks from of the earthquake. In order to determine the factors that may affect the trauma response in the participants, a questionnaire was applied to question demographic variables, previous traumatic experiences, concerns and losses at the time of the earthquake, and institutional and social expectations. Post-Earthquake Trauma Level Determining Scale was used to record post-earthquake trauma levels, and TEMPS-A was used to determine dominant temperament characteristics. Results: Severe trauma level was detected in 25.8% of the participants. Trauma scores were higher in women, those who were married, those who had children, those who experienced the earthquake for the first time and those who had anxiety about losing their own life or their relative's life during the earthquake. In the logistic regression analysis, it was determined that anxious temperament and fear of losing a loved one during an earthquake increased the severity of the trauma, whereas a previous earthquake history decreased it. Conclusions: Detection of the factors associated with the trauma response is important both in terms of protecting the mental health of health workers and ensuring the continuity of health services in disasters such as earthquakes that affect millions of people.
Teachers are key agents in fostering community resilience given their role as educators, their influence on children's development, and their emotional support of children exposed to natural hazards-induced psychosocial impacts. Teacher training does not include the skills necessary for fostering adaptive capacity or cultivating personal resilience necessary for maintaining pedagogical practices during and post natural hazards. This paper explores the adaptive strategies teachers employ to develop personal resilience. In-depth interviews are conducted with secondary school teachers, residing in a natural hazards-prone community, namely the United States Virgin Islands (USVI). The findings indicate that reliance on social networks and the espousal of a narrative of recovery were vital adaptive strategies deployed by teachers. Their personal resilience was contingent on engagement with members of their social circles and it was also strengthened by the positive attitudes they espoused. The accounts from participants augment knowledge on the lived experiences of teachers and move beyond transactional views of this group (i.e., essential workers who help youth at point of trauma) to holistic frames of them as social beings with psychosocial needs and with the capacity to contribute to community narratives of empowerment and resilience. Further research on this relatively nascent dimension of disaster research is needed so as to provide further insights that can help inform the creation of mitigation related outreach programs. The current study is specific to the USVI, however the methods deployed can be replicated in the other vulnerable locations to better understand the role of teachers in mitigation efforts.
Psychological and social factors are thought to influence risk for a range of physical illnesses including coronary heart disease, high blood pressure, type 2 diabetes, infectious illness, bronchial asthma and musculoskeletal pain. These associations are underpinned by the impact of psychological stress and other biobehavioral stimuli on the systemic biological responses implicated in disease risk. Several systems are involved, with cardiovascular, neuroendocrine, immune, inflammatory, metabolic and musculoskeletal responses all being relevant. The nature and extent of influence on health outcomes varies across diseases, and different types of study design are needed to evaluate these processes in different health conditions.
Understanding and improving the public perception and attitude has become an important issue regarding flood hazard and risk management worldwide. Extreme floods have serious social and economic impacts on environment and livelihood pattern of the world community. This paper reports a study of the perceptions, awareness and attitude of the Namasudra community regarding flood-hazard and its impact on their social lives and livelihoods pattern in Dakshin Dinajpur district, West Bengal. The research adopted both quantitative and qualitative techniques using pre-tested households questionnaires, group discussions, perception study and Life History Methods for key informants. A sample of 753 (1.73 %) Namasudra households were interviewed applying Purposive Multi-Stage Stratified Random Sampling method and sample size was validated by using the Fisher formula. Descriptive statistics were used for the analysis of the data. Microsoft Excel v2007, SPSS v17.0, QGIS v2.8 software platform were used for statistical analysis and preparation of map and diagrams. The present study revealed that previous flood experience, proximity to the river, and length of residence were positively related to perception and awareness level. The paper also highlighted that flood hazard has become a serious threat in the eyes of the Namasudra community and severe floods destroyed their livelihood patterns with its tangible and intangible elements.
This study used the Conservation of Resources stress model to examine the role of psychosocial resource loss in the aftermath of Midwest flooding. Questionnaires were distributed through churches and completed by 131 adults in flood‐affected communities 6 weeks and 6 months after the flood's crest. Frequent psychosocial losses included losses of routine, sense of control, sense of optimism, accomplishing goals, and lime with loved ones. Path analysis revealed that psychosocial resource loss mediated the effects of flood exposure on both psychological distress and physical symptoms at 6 months postflood. The findings suggest that interventions designed to prevent psychosocial resource loss may reduce the long‐term effects of disasters.
The prevalence and severity of hurricanes are increasing. This chapter examines the physical and mental health effects of hurricane exposure within our changing climate. We explore a range of physical health effects, including mortality, morbidity, injuries, infectious disease, chronic disease, and mold-related illnesses. We also examine several mental health consequences of hurricane exposure, including post-traumatic stress disorder (PTSD) and risk factors for poor post-disaster mental health outcomes, as well as factors that protect against poor mental health. We use evidence from public health, sociology, psychology, and geography to highlight the health effects from the most recent, as well as most powerful, hurricanes to strike the continental United States. Our goal is to provide evidence of the wide-range health consequences caused by direct and indirect hurricane exposure, and bring attention to areas that need further investigation as the intensity of hurricanes grows due to our changing climate.
This paper reviews the literature on communitywide disaoters and their relationships to subsequent mental health problems. In addition, it describes the theoretical notions of psychological stress which have guided past research and it outlines the dimensions of a comprehensive stress paradigm. This paradigm is based on an integration of research findings from three separate fields of inquiry: disaster research; studies of psychosocial stress; and, psychiatric epidemiology. The theoretical propositions on which the paradigm is based are outlined and offered as guidelines for future research. The paper concludes with a brief discussion of some of the problems confronting researchers interested in disasters and their mental health sequelae.
Aversive events occur frequently in the life histories of all organisms. Long-lasting behavior pecularities, emotional illnesses, and anomalies of perception and thinking are attributed to such events. Apart from genetic or constitutional variables that might lead to individual differences in reactivity to aversive stimuli, there are a host of environmental variables that help to understand such individual differences. Two such environmental variables are the predictability and controllability of aversive events. This chapter reviews some of the behavioral and physiological consequences of aversive events that are either unpredictable, uncontrollable by a subject, or both. Unpredictable painful events turn out to be more distressing than are predictable ones. They generate more ulcers and intensify subjective reports of painfulness and anxiety. Both people and animals choose, if given the choice, predictable painful events over unpredictable ones. Uncontrollable painful events can interfere with an organism's ability later to solve problems to escape or avoid these events. They can lead to a phenomenon labeled “helplessness.” The chapter discusses the current status of research and theory concerning these phenomena. It describes a two-dimensional representation of the operations involved in instrumental training and Pavlovian conditioning. The chapter further reviews a number of theoretical interpretations of the effects of uncontrollable shocks on subsequent escape/avoidance learning and discusses the theoretical interpretations of the effects of unpredictable shocks on behavioral and physiological responses: the preparatory response hypothesis and the safety signal hypotheses.
Social and behavioral scientists have recently undertaken to describe and analyze human behavior under the extreme conditions of disaster, an interest with compelling practical and applied value that has attracted considerable research support, particularly through the former Committee on Disaster Studies of the National Academy of Sciences - National Research Council. In the resultant body of literature various problems and approaches have been identified and defined, usually couched in terms of the personal and social consequences of sudden, unexpected disasters. The archetype paradigm seeks to establish empirically in natural disasters laboratories modeled after projections of surprise attack and looks for classes of "disaster behavior" that can be predicted in such events. While it is generally conceded that the pre-impact situation (variously defined) has a bearing on emergent behavior in a disaster, relatively little of the effort has been devoted to conceptualizing and defining research problems with this seriously in mind. Considered in the context of the long-standing concerns of the social and behavioral sciences with continuities, disasters have generally been thought of as irregularities, and most of the research has followed upon their abnormal and disruptive characteristics. To place such study in a larger and hopefully more revealing context, this paper focuses primarily on antecedent conditions and considers the problem of recognizing and coping with the threat of disaster and how such anticipations occur within the frames of reference in whose terms reactions take place.
Clinicians have gained considerable knowledge about psychopathology and treatment but this knowledge is poorly systematized and hard to transmit. One way to organize clinical knowledge is to circumscribe a limited area and describe within it the interactions between personality dispositions, states of disorder, and treatment techniques.
This report models such an approach by limiting disorder to stress response syndromes, personality to obsessional and hysterical neurotic styles, and treatment to focal dynamic psychotherapy. Within this domain, an information processing approach to working through conflicted ideas and feeling is developed. The result is a series of assertions about observable behavior and nuances of technique. Since these assertions are localized conceptually, they can be checked, revised, refuted, compared, or extended into other disorders, dispositions, and treatments.
A field study investigated the role of knowledge, experience, and warning in medi-ating the stress associated with urban flooding. Among residents of an urban floodplain, knowledge about flooding was associated with less trauma during the last flood and reluctance to support indiscriminate government intervention. Increased prior warning of a flood, however, was related to intensified residual fear and feelings of desperation, to more frequent somatic manifestations of stress, and to greater support for all government intervention programs. Previous flood experience (especially recurring experience) was associated with increased fear, depression, and health-stress outcomes. Commitment to adaptive community intervention programs was related to recency of one's flood experience. Having flood insurance was unrelated to stress measures.
Interviewed 22 Buffalo Creek (West Virginia) flood survivors, ministers, and volunteer workers to assess the psychological impact of the disaster on the community. Results of the interviews and analyses of the other data indicate that the overwhelming number of individuals in the Buffalo Creek disaster have experienced some or all of the following manifestations of the general constellation of the survivor: death imprint and death anxiety, death guilt, psychic numbing, counterfeit nurturing and unfocused rage, and the struggle for significance. It is concluded that the Buffalo Creek disaster had a profound effect on all symbolizations of life continuity; the persistence of resulting psychic numbing was caused by the collective inability to overcome imagery of disintegration, separation, and stasis, or to achieve any new sense of purpose that might reactivate imagery of integrity, connection, and movement. (32 ref) (PsycINFO Database Record (c) 2012 APA, all rights reserved)
A single exposure to a severe stressor (either cold swim or inescapable shock) impairs subsequent performance in a shuttle avoidance-escape task (1), a deficit attributed to reduction in brain noradrenergic activity produced by these stressors. In the present paper, two experiments are described which examine how repeated exposure to such stressors affects (a) shuttle avoidance-escape performance (Experiment 1), and (b) aspects of brain norepinephrine metabolism (Experiment 2). Experiment 1 showed that, whereas subjects receiving the single exposure to cold swim or shock showed a large avoidance-escape deficit, subjects that received repeated exposure to these stressors for 14 days performed similarly to the control group that received no stressor. Experiment 2 showed that, whereas subjects that received one session of the inescapable shock stressor showed a lower level of norepinephrine in hypothalamus and cortex than did subjects that received no shock, subjects that received repeated exposure to inescapable shock or cold swim showed neurochemical "habituation." Subjects that received repeated shock showed elevated tyrosine hydroxylase activity and no depletion of norepinephrine level, and both repeated shock and cold swim caused a decrease in uptake of 3H-norepinephrine by slices of cortex in vitro. Thus, it is concluded that the behavioral and neurochemical changes that were observed after the stressful conditions studied are consistent with the hypothesis that changes in avoidance-escape responding following exposure to these stressful events are due to changes in brain noradrenergic activity.
Pre- and post-event data on the long-term effects of the 1966 Topeka tornado revealed a complex pattern of responses by the elderly. In comparison to younger victims, older victims: regarded the loss of exterior items and house-related damage as being more important; received aid from community resources far less frequently; were less likely to use insurance and other economic sources in recovery; less frequently increased insurance coverage, savings, bank credit, or the use of credit cards; and did not perceive any significant long-term negative consequences regarding their physical or mental health.
A study of the effects of the Teton Dam Disaster in 1976 upon the elderly provides a test of the assertion in the literature that the elderly are more likely to overreport their losses and express feelings of relative deprivation than younger cohorts. The findings suggest that elderly persons cope quite well with disaster situations and tend to report fewer adverse emotional effects and feelings of relative deprivation than younger victims. High agreement was found between subjective comparative estimations of loss and actual loss. Recommendation for disaster assistance planning is included.
A 3-year study of the impact of the 1972 flood in the Wilkes Barre, PA area on the elderly revealed that anticipated adverse long-term effects on elderly flood victims were not realized. The community steady state was restored within 100 days and was virtually complete within 1 year. Area Agencies on Aging are seen as having their greatest potential in assisting in producing hard services, quality control, and in undertaking early planning. AAAs do not appear to have coordinating powers in disaster services to the elderly.
The hypothesis, suggested by associations found in previous research, that stressful life events play a direct etiological role in psychological disorders was investigated. Preexistent methodological problems which permitted no clear inference regarding this role were treated. Competing hypotheses which posited that the life event psychological disorder associations represented confounded relationships among event, pathology, and sociocultural factors were examined and controlled. Data used were from a survey of mothers of 732 children ranging in age from 11 to 23 yr old, who constituted the followup sample collected 5 yr later from an original sample of 1,034 children randomly selected from a cross section of Manhattan households. Event scores differing as to the change and undesirability stress conceptions, each objectively and subjectively defined, were studied. No significant differences were found between correlations of event scores with behavioral pathology prior to and after the events. Multiple regression analyses which added event scores after controlling for stressful life processes demonstrated that events made no minimally meaningful contribution to the prediction of any disturbed behavior. The confounding hypothesis rather than the etiological hypothesis was supported and discussed.
Males and females aged fifty-five and older were interviewed before and after three types of bereavement/loss: attachment bereavement (child, spouse, parent), nonattachment bereavement (sibling, grandchild, close friend), and other losses (nonbereavements). Five measures of health were used. Before pre-event health was accounted for on self-report measures of health status and medical conditions, pre-event measures of environmental factors and impact measures of bereavement/loss events had significant but modest effects on post-event health. However, after pre-event health was taken into account, the effects of bereavement and other losses were pale in comparison. Bereavement/loss events were not related to subsequent deaths, health events, or the use of medical services. Environmental factors were modestly predictive of nonattachment bereavements and other losses. An unexpected finding was that other losses had stronger effects on health than bereavements. Trend analysis over eighteen months showed a modest decline in health status immediately after a loss event, followed by an improvement in health. In general, this older adult sample handled bereavements and other losses with minimal morbidity and mortality.
A probability sample of 1,429 adults aged 55 and older was interviewed in their homes three times at six-monthh intervals. Measures of symptoms, social support, and education were obtained before measures of life-event stress. A LISREL analysis of three waves and two intervals of data yielded a goodness of fit of .989 between the data and the model. For both intervals, increases in stress led to increases in symptoms, which supported the Dohrenwend hypothesis of a normative stress reaction. This reaction typically did not persist beyond six months unless there was high stress over both intervals. Contrary to Dohrenwend's resource mediation hypothesis, social support and education did not influence either the reaction to or the recovery from stress. Symptoms were very stable over the one-year period. Overall, the results depict older adults as quite consistent and resilient. Because life events were correlated over time and were predicted by person characteristics, they should not be considered as independent of person factors.
Relatively little attention has been paid to the post-disaster health status and well-being of older persons. The data discussed in this article were gathered through use of a retrospective cohort survey five years following a major flood in the Wyoming Valley of Pennsylvania. The subsample of women sixty-five years and older used in this analysis is composed of 122 female victims and forty-five controls from the same communities. The instruments used to measure mental status included Langner's 22-Item Scale, Zung's Self-rating Depression Scale, and a modified Self-Report Symptom Inventory (SCL-90). Additional items related to self-perceptions of health status, to influence of the flood on health and well-being, and to other issues. Significant differences occurred in self-perceptions, including state of mind after the flood (p less than .001), distress during recovery (p less than .001), quality of life after the flood (p less than .001), and frequency of thinking about the flood matters (p less than .025). Use of the instruments designed to assess mental status did not indicate greater levels of anxiety or depression in elderly victims as compared to non-victims.
This report raises conceptual issues about the validity of the posttraumatic stress disorder diagnosis as described in DSM-III. The helpfulness of DSM-III is acknowledged, but gaps in that classification are noted. These are organized into three areas: the etiology of the disorder, its natural history, and diagnostic specificity. Suggestions are made for conceptualizing these issues and for research that needs to be undertaken to help resolve them. The authors urge more theoretical and empirical attention to these important issues in the upcoming years, so that later diagnostic descriptions and understandings will be more precise.
Hypotheses from a prospective conceptual framework were tested on a sample of 1,166 adults, age 55 and older, who were interviewed three times at 6-month intervals. Older adults with stronger resources had significantly more positive psychological states initially than those with weaker resources, and this advantage was maintained regardless of the levels of life events. There were significant main effects for desirable events and for undesirable events. Those with higher desirable events showed less decline in positive affect. Contrary to the "booster" hypothesis, there was no significant interaction between resources and desirable events. There was a significant interaction between resources and undesirable events on depression but detailed analyses showed that increases in depression over time were limited to the combined condition of weak resources and high levels of undesirable events. Weak resource persons with low or moderate undesirable events, in fact, showed modest improvements in depression.
This paper reports on a prospective study designed to assess the impact of involuntary relocation from one community setting
to another on the self-perceived physical, functional, and emotional health status of older persons living in urban residential
hotels. The research design was quasiexperimental and took advantage of a naturally occurring urban renewal project. Older
persons (n = 38) living in five hotels marked for demolition and a randomly selected comparison group (n = 32) living in similar and contiguous hotels were interviewed 3 to 6 months prerelocation and again 3 to 6 months postrelocation.
In general, there were few adverse changes in health associated with relocation as it was implemented with this population.
Six longitudinal data sets were used to examine the consequences of retirement controlling for preretirement characteristics. Results show (a) about one-half to three-fourths of income differences between retired and working men was caused by retirement; (b) little, if any, of the health differences are caused by retirement; (c) there are few effects of retirement on social activity; and (d) there are few effects on attitudes such as life satisfaction and happiness. Early retirement, however, has stronger effects than retirement at normal ages. The results show that retirement has different effects depending on type of outcome and timing of retirement.
Five scales were assessed as mental health measures for older persons: Affect Balance, The Center for Epidemiological Studies
Depression scale, general well-being, LSI-Z life satisfaction, and trait-anxiety inventory. These scales were administered
to a community sample of 279 older persons and a clinical sample of 109 older persons who were in psychiatric inpatient units.
In both samples, the internal consistency reliabilities for the anxiety, depression, and well-being scales were moderately
high to high, for the life satisfaction scale they were acceptable, but the reliabilities for the affect balance scale suggest
some caution in its use. For validity, multivariate analyses of variance found that all scales significantly discriminated
between the two samples. The well-being and then depression scales were the strongest discriminators while the life satisfaction
scale had the weakest validity. Cutting points for the well-being and depression scales are suggested for estimating the proportions
of older persons who would be probable at-risk for disorder that requires intervention.
This article analyzes the effects of chronological age of disaster victims on their responses to stress effects of natural disasters. Previous research is reviewed and major findings of that research are noted. Findings regarding disaster losses, physical impacts, aid utilization patterns, kinship relations, relative deprivation, social-psychological impacts, neglect of elderly disaster victims, and differential recovery rates by age are retested on new data. Data described herein were gathered using survey techniques in two disaster stricken communities in Texas. Elderly victims' responses to the tornadoes are compared to a nonelderly (under sixty years of age) group to assess differences. Findings of previous research were, in many instances, supported although certain divergences between the current findings and preceding findings are noted, particularly in rates of recovery.
There is a consensus among clinicians treating patients who have experienced a trauma that a number of common themes emerge. Using a manual that codified ten of these themes, their frequency was measured in the case material of 30 psychotherapy patients treated for posttraumatic stress disorders after bereavement or personal injury. The themes found to be most prominent in bereavement cases included sadness over loss and discomfort over discovered personal vulnerability. In the personal-injury cases, fear of a repetition of the event and feelings of responsibility emerged most frequently. Rage at the source of the trauma figured prominently in both bereavement and personal-injury cases.
Through the joint efforts of the area community mental health center and an emergency relief organization, psychological reactions of flood victims were measured. A random sample of 124 adults and 54 children were interviewed, using scales reflecting measures of depression and stress. Results showed that adults perceived themselves to be significantly more depressed and stressed in areas such as adaptation and physical complaints. Children's results were mixed, depending on age, although problems existed with regressive and aggressive behaviors, fears, and in miscellaneous areas such as sleep difficulty. Recommendations are made for further community mental health involvement, as well as emphasizing the need for further empirical work in the assessment of postdisaster emotional sequelae.
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Patterns of victimization and the chronic technical disaster
- S R Couch
- J S Kroll-Smith
Stress and human health
- G Elliott
- Eisdorfer
Stress, disease, and personality: The inoculation effect
- H J Eysenck
Prolonged psychosocial effects of disaster: A study of Buffalo Creek
- G C Gleser
- B L Green
- C N Winget
An assessment of conflicting views on mental health: The consequences of traumatic eventsTrauma and its wake: The study and treatment of post-traumatic stress disorder
- E Quarantelli
What is disaster? The need for clarification in definition and conceptualization in researchDisasters and mental health: Selected contemporary perspectives
- E L Quarantelli
Flood exposure and anxiety in older adults: A prospective study
- F H Norris
Kentucky's social service needs assessment
- P Schulte
- S Murrell
Societal response to mass relocation of the elderly
- Cohen