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The psychosocial Impact of an earthquake on the elderly
Abstract
The psychosocial effects of an earthquake which occurred in Newcastle, Australia in 1989 are the focus of the Quake Impact Study, a four-phase community survey conducted over 2 years. Comparisons were made between adults aged less than 65 years (N=2371) and those aged 65 years and older (N=636). Results revealed that older subjects reported fewer threat and disruption experiences and used fewer general and disaster-related support services. However, older subjects reported higher overall levels of post-traumatic stress symptoms on the Impact of Event Scale (IES) compared with younger subjects. On both the IES and a general measure of morbidity (General Health Questionnaire: GHQ-12) the effects of earthquake exposure were more marked among the elderly. Within the older group, subjects who had high levels of post-traumatic stress symptoms (IES>25,N=117) were more likely to be female, report higher levels of exposure and use behavioural and avoidance coping styles. Although psychological distress declined with time, post-traumatic stress symptoms remained higher for the high exposure group throughout the study. We conclude that older people may be more at risk for experiencing post-traumatic stress reactions despite having fewer disaster-related experiences. They may also underutilize support services following a disaster. Older women in particular and people with an avoidance coping style appear to be most vulnerable.
... Some studies have suggested that increasing age is associated with an overall greater risk of mental health outcomes during a disaster (Yang et al., 2003;Jia et al., 2010). This is possibly because older adults are often in worse health before a disaster, and less able to seek assistance after a natural disaster, with increase in resulting morbidity and mortality (Ticehurst et al., 1996;Jia et al., 2010). The older adults also appear to have a greater sense of loss, with even a minor injury provoking the fear of loss of selfreliance (Goldstraw et al., 2012). ...
... The burden hypothesis suggests that it is the middle-aged adults, rather than the older adults, who are at the highest risk of psychological distress because of greater social and financial responsibilities in the wake of a natural disaster (Thompson et al., 1993;Cherry, 2009). Lastly, the exposure hypothesis proposes that older adults are at the greatest risk of mental health outcomes because of a lower likelihood of receiving advanced warnings, reluctance to evacuate, disruption to accustomed patterns of life, and a sense of deprivation resulting from their personal, physical, and social losses post disaster (Ticehurst et al., 1996;Yang et al., 2003;Jia et al., 2010). ...
... The samples came from five countries, including two highincome (Australia and Taiwan), one upper-middle income (China), and two lower-middle income (India and Indonesia) countries as defined by the World Bank (2013). Four studies were on earthquakes (Ticehurst et al., 1996;Yang et al., 2003;Jia et al., 2010;Kun et al., 2013) and two were on tsunami (Viswanath et al., 2012;Musa et al., 2014). Table 1. ...
Background: Natural disasters affect the health and well-being of adults throughout the world. There is some debate in the literature as to whether older persons have increased risk of mental health outcomes after exposure to natural disasters when compared with younger adults. To date, no systematic review has evaluated this. We aimed to synthesize the available evidence on the impact of natural disasters on the mental health and psychological distress experienced by older adults.
Design: A meta-analysis was conducted on papers identified through a systematic review. The primary outcomes measured were post-traumatic stress disorder (PTSD), depression, anxiety disorders, adjustment disorder, and psychological distress.
Results: We identified six papers with sufficient data for a random effects meta-analysis. Older adults were 2.11 times more likely to experience PTSD symptoms and 1.73 more likely to develop adjustment disorder when exposed to natural disasters when compared with younger adults.
Conclusions: Given the global rise in the number of older adults affected by natural disasters, mental health services need to be prepared to meet their needs following natural disasters, particularly around the early detection and management of PTSD.
... Some studies have suggested that increasing age is associated with an overall greater risk of mental health outcomes during a disaster (Yang et al., 2003;Jia et al., 2010). This is possibly because older adults are often in worse health before a disaster, and less able to seek assistance after a natural disaster, with increase in resulting morbidity and mortality (Ticehurst et al., 1996;Jia et al., 2010). The older adults also appear to have a greater sense of loss, with even a minor injury provoking the fear of loss of selfreliance (Goldstraw et al., 2012). ...
... The burden hypothesis suggests that it is the middle-aged adults, rather than the older adults, who are at the highest risk of psychological distress because of greater social and financial responsibilities in the wake of a natural disaster (Thompson et al., 1993;Cherry, 2009). Lastly, the exposure hypothesis proposes that older adults are at the greatest risk of mental health outcomes because of a lower likelihood of receiving advanced warnings, reluctance to evacuate, disruption to accustomed patterns of life, and a sense of deprivation resulting from their personal, physical, and social losses post disaster (Ticehurst et al., 1996;Yang et al., 2003;Jia et al., 2010). ...
... The samples came from five countries, including two highincome (Australia and Taiwan), one upper-middle income (China), and two lower-middle income (India and Indonesia) countries as defined by the World Bank (2013). Four studies were on earthquakes (Ticehurst et al., 1996;Yang et al., 2003;Jia et al., 2010;Kun et al., 2013) and two were on tsunami (Viswanath et al., 2012;Musa et al., 2014). Table 1. ...
In the above mentioned article by Parker
et al
., on the seventh page, in the final paragraph of column two, the following three sentences should have been removed:
“DSM-IV criteria specify a minimum six-month delay between the traumatic event and a diagnosis of PTSD (APA, 2000). Any diagnosis prior to this time would be an acute stress reaction. Based on these diagnostic criteria, it is possible that at least two studies were reporting acute stress reaction rather than PTSD.”
This error does not change the results or conclusions of the study.
... When Ticehurst et al (1996) compared older individuals with younger individuals in their study; they found that older individuals had higher overall post-traumatic stress levels. The effects of disaster exposure were more pronounced among the elderly. ...
... It has also been found that the elderly appear less vulnerable after a hurricane and tend to recover more quickly than younger victims do. It has also been determined that the elderly tend to report fewer problems than younger victims in a flood event do after a dam burst event (Ticehurst et al., 1996). ...
... Older adults are more prone to mental health issues such as post-traumatic stress disorder (PTSD) due to natural disasters [1][2][3][4][5], which diminishes their quality of life (QOL) [6][7][8]. The Great East Japan Earthquake (GEJE) struck in March 2011, causing an immense earthquake and tsunami that killed 19,729 people and forced more than 470,000 to evacuate [9]. ...
... Factors significantly related to subjective wellbeing for both groups were "poor health conditions", "difficulties resting while asleep", "poor financial wellbeing", "cannot chew certain foods", and "imminent fear of solitary death". As previous studies have reported similar findings regarding health conditions [32,34,35], sleep conditions [32,33,37], financial wellbeing [2], and chewing ability [37,38], they can be considered as issues shared among older adults in general. ...
This study examined older adults’ subjective wellbeing and related factors in the coastal area of Soma City nine and a half years after the Great East Japan Earthquake (GEJE). Data were collected from 65- to 84-year-old residents and 1297 participants via a questionnaire from October to November 2020. The participants were divided into two groups: housing complexes and non-housing complexes. The dependent variable was subjective wellbeing assessed via Lawton’s Philadelphia Geriatric Center Morale Scale (PGCMS). Using multivariate regression analysis, the factors most strongly related to a low PGCMS score for both groups were poor health conditions, difficulties resting while asleep, poor financial wellbeing, inability to chew certain foods, and fear of solitary death. The GEJE experience was further distinguished in the housing complex group by the loss of an important non-family individual; for the other group, important factors were female gender, junior high school education level or lower, limited social networks, and deterioration of a family member’s health. Older adults’ subjective wellbeing in Soma City was low after nine and a half years following the GEJE. For disaster victims and their families in both groups, it is crucial to implement measures such as long-term, continuous physical and mental health support.
... We present a few examples below. First, the emotional maturity hypothesis posits that older adults show less severe reactions to stressful life events and recover faster from these stressors (Kato et al. 1996;Ticehurst et al. 1996). Second, the socio-emotional selectivity theory suggests changes in emotion regulation with age which predict higher positive and lower negative affect, resulting in improved emotional well-being (e.g. ...
... This implies that old age per se may influence subjective well-being positively, and that decreases in evaluative well-being between age categories might be linked to objective challenges faced by older adults. These findings resonate with a range of theories from the psychology of aging, such as the emotional maturity hypothesis (Kato et al. 1996;Ticehurst et al. 1996), the socio-emotional selectivity (e.g. Carstensen 1995;Carstensen et al. 1999), or the selective optimization with compensation theory (Baltes and Baltes 1990). ...
This study assesses the relationship between age and two dimensions of subjective well-being—evaluative and emotional—among mature adults from five low-and middle-income countries. We use data from the World Health Organization’s Study on Global AGEing and Adult Health to contrast the associations of age with subjective well-being when controlling only for gender with the corresponding partial associations when including a richer set of covariates. Adjusting only for gender, we find negative associations of age with evaluative well-being, while the corresponding age gradients for emotional well-being are relatively flat. By contrast, adjusting for further socio-demographic factors results in positive associations of age with both evaluative and emotional well-being. Oaxaca-Blinder decompositions allow us to explore the roles of two factors to account for any unadjusted age differences in subjective well-being: age-group differences in individual characteristics and life circumstances, and age-specific associations of individual characteristics and life circumstances with subjective well-being. While adverse circumstances such as poor health and low income contribute to lower levels of evaluative well-being among older adults, age per se is—ceteris paribus—positively associated with subjective well-being. Even in poorer countries, older age does not need to be a time of low subjective well-being. Policies aimed at preserving income and limiting or compensating old-age disability appear to be key for maintaining subjective well-being among older adults.
... Despite a large body of research which has assessed the psychological vulnerability of older populations to extreme events, little agreement exists regarding the proportional level of psychological effects, such as post-traumatic stress disorder and depression, suffered by older adult disaster survivors. Some researchers have posited that older adults experience greater psychological distress, 25 others that there is no marked difference between older adults and the general population, 26 and still others maintain that the level of psychological stress experienced by older adults is in fact lower than average. 27 This range of outcomes has been attributed to a number of factors such as the socioeconomics of the countries affected, 28 varied definitions of older adults, 29 type of assessment, duration of time examined, and intensity of the event. ...
... In addition, there is evidence to suggest that older people may be less likely to access postdisaster services, including but not limited to psychological assistance. 25,34 This has implications for planning and in particular for communication, as it becomes necessary not only to attempt to identify and triage older patients in disaster shelters and other locations, but also to ensure that older adults are aware of the psychological services and benefits available to them. It is also important that these are presented in a manner that encourages uptake, because older adults have been shown to be less likely than their younger counterparts to complain or to ask for support. ...
In recent years, a series of large-scale, high-profile natural disasters and terrorist attacks have demonstrated the need for thorough and effective disaster preparedness. While these extreme events affect communities and societies as a whole, they also carry specific risks for particular population groups. Crises such as Hurricane Katrina and the 2011 earthquake and tsunami disaster in Japan have illustrated the risk of significant and disproportionate morbidity and mortality among older adults during disasters. Age does not necessarily equate to vulnerability, but many physical and psychological consequences of the aging process can increase the risk of adverse outcomes. As the older population grows, so too does the need to ensure that adequate, practical, and appropriate measures exist to offset the specific risks from extreme events associated with this subpopulation. Effective risk and crisis communication plays a key role in mitigating the extent to which older adults are differentially affected during extreme events. By identifying the specific issues affecting older adults, this review highlights important areas for action for practitioners and policy-makers, particularly in the realm of crisis communication. ( Disaster Med Public Health Preparedness . 2016;page 1 of 8)
... Many of our findings are consistent with previous studies, while some varied because of the earthquake intensity, the types of exposure, the sampling selection, the time elapsed since the earthquake, and the measures used. Some studies have reported that older people are vulnerable in disaster events [25,43,44]; however, this study found that older people (aged 51-68) had a high psychological health score, while the middle-aged (aged [35][36][37][38][39][40][41][42][43][44] were found to have a higher risk of poor psychological health. One possible explanation for this result is the burden perspective hypothesis which suggests that middle-aged adults have a greater burden than others [23,60]. ...
... Many of our findings are consistent with previous studies, while some varied because of the earthquake intensity, the types of exposure, the sampling selection, the time elapsed since the earthquake, and the measures used. Some studies have reported that older people are vulnerable in disaster events [25,43,44]; however, this study found that older people (aged 51-68) had a high psychological health score, while the middle-aged (aged [35][36][37][38][39][40][41][42][43][44] were found to have a higher risk of poor psychological health. One possible explanation for this result is the burden perspective hypothesis which suggests that middle-aged adults have a greater burden than others [23,60]. ...
Background
In this study, exposure refers to survivors who suffered from life-changing situations, such as personal injuries, the deaths or injury of family members, relatives or friends or the loss of or damage to personal or family property, as a result of the earthquake. The mediating effect of risk perception on the exposure and psychological health in survivors from the Longmen Shan Fault area and the moderating effect of social support on the relationship between risk perception and psychological health were both examined.
Method
A cross-sectional survey was conducted in a local Longmen Shan Fault area near the epicenter of the 2008 Wenchuan earthquake. The Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV), the standard Chinese 12-item Short Form (SF-12v2), and the Social Support Rating Scale (SSRS) were used to interview 2,080 earthquake survivors in the period one-year after the earthquake. Based on the environment and the characteristics of the Longmen Shan Fault area, a risk perception questionnaire was developed to evaluate survivor risk perception. Factor and regression analyses were conducted to determine the hypothetical relations.
Results
The analyses provided effective support for the hypothesized model. Survivor risk perception was classified into direct risk perception and indirect risk perception. Survivor direct risk perception was found to play a partial mediating role in the relationship between exposure and the two domains (Physical component summary (PCS) and the Mental component summary (MCS)) of psychological health. Survivor indirect risk perception was found to have a only partial mediating effect on the association between exposure and MCS. Social support was found to moderate the influence of risk perception on psychological health.
Conclusion
Risk communication should be considered in future post-earthquake psychological assistance programs and social support strategies could also be useful in improving psychological health.
... The relationship of age to flood-related PTSD is unclear, although one study suggested that older flood victims reported more severe PTSD symptoms than younger victims (Liu et al., 2006). Based on other disaster types, younger victims reported less PTSD symptoms and psychiatric comorbidity than older victims (Cheung, 1994;Kim-Goh et al., 1995;Lahad & Leykin, 2010;Ticehurst et al., 1996;Weine et al., 1998). However, some studies suggest that older people are more resilient than younger people regardless of trauma type (e.g. ...
... For victims in their thirties and middleaged/older victims, hopelessness was associated with both PTSD and psychiatric co-morbidity. These results echoed studies suggesting that younger victims are more resilient when faced with disaster (Cheung, 1994;Kim-Goh et al., 1995;Lahad & Leykin, 2010;Ticehurst et al., 1996;Weine et al., 1998). Resilience refers to the capacity for successful adaptation (Cicchetti & Rogosch, 1997) or recovery following disaster along with reduced distress symptoms (Garmezy, 1993). ...
Background:
In literature, the effect of age on posttraumatic stress disorder (PTSD) is inconclusive; the effect on flood-related PTSD is particularly unclear. Little is known on distorted cognitions among flood victims, although cognition distortions and PTSD have been linked among victims of other traumas.
Aims:
To investigate: (1) whether flood-related PTSD, psychiatric co-morbidity and cognitive distortions would differ according to age and (2) distinctive patterns of association between the preceding variables for different age groups.
Methods:
One hundred and fifty-four flood victims of different ages completed standardized questionnaires measuring PTSD, psychiatric co-morbidity and cognitive distortions.
Results:
Adolescents and young adults reported significantly fewer PTSD, psychiatric co-morbidity and distorted cognition symptoms than people who were older. Preoccupation with danger and hopelessness were associated with both outcomes for adolescents, people in their thirties and middle-aged/older people. For young adults, helplessness was associated with PTSD; hopelessness and preoccupation with danger with psychiatric co-morbidity.
Conclusions:
Adolescents and young adults buffered against flood-related psychological distress better than older people. Distorted cognitions related to distress outcomes differently depending on age.
... Gender is another most examined factor in disaster research. The results have shown that female survivors are more adversely affected after traumas, and are more at risk for having psychological distress (Anderson & Manuel 2005;Ba o lu, Kılıç, alcıo lu, & Livanou, 2004;Breslau, Davis, Andreski, Peterson, & Schultz, 1997;Liu et al., 2006;Montazeri et al., 2005;Norris et al., 2002;alcıo lu et al., 2003;Ticehurst, Webster, Carr, & Lewin, 1996;Tural et al., 2004). ...
... Our gender-specific result that being female predicted depression, anxiety and GSI is in the line with the results of previous studies (Anderson & Manuel 2005;Ba o lu et al., 2004;Breslau et al., 1997;Liu et al., 2006;Montazeri et al., 2005;Norris et al., 2002;alcıo lu et al., 2003;Ticehurst et al., 1996;Tural et al., 2004). However, this does not necessarily mean that women in general have a social disposition for a harmful event like earthquake. ...
... While a measure of depressed mood addresses important questions about the emotional impact of disaster and its relationship to age, previous research suggests that the emotional effects of disaster are often more specific in the form of stress-related symptoms (Nolen-Hoeksema & Morrow, 1991;Ticehurst et al., 1996). That is, the emotional response to disaster often appears in the form of symptoms specific to the disaster rather than as a change in more generic measures of mental health. ...
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.
... Bu yaklaşıma göre yaşlı yetişkinler afet sonrası psikolojik travmaya duygusal olarak daha az tepki göstermektedirler. Benzer bir bakış açısıyla aşılama teorisi, afetle ya da travmatik yaşam olayıyla doğrudan ya da dolaylı olarak ilişkili önceki deneyimlerinin, yaşlılık dönemindeki yetişkinlere benzer felaketlere karşı olgun ve işlevsel savunma mekanizmalarını kullanmaları noktasında bir aşılama sağladığını öne sürmektedir (Stephen, Webster, Carr & Lewin, 1996;Rafiey, Momtaz, Alipour, Khankeh, Ahmadi, Khoshnami & Haron, 2016). ...
ÖZ Depremler, günümüzde dünya çapında en çok ölüme, ciddi yaralanmaya ve uzuv kaybına neden olan doğal afetlerdir. Depremler, etkileri toplumlar için yüksek ekonomik kayıplara ve maliyetlere neden olan, kaçınılmaz, zamansız ama yıkıcı etkileri olan en önemli doğa olaylarından biri olarak insanlığı etkilemeye devam etmektedir. Geçmişte yaşanan depremlerin tarihsel etkilerinin görülebildiği ülkemiz, yakın gelecekte deprem olgusuyla yeniden yüzleşmek zorunda kalmış, toplumumuz bugün depremler nedeniyle travmalar yaşamaya devam etmekte ve gelecekte birlikte yaşamayı öğrenmek zorundadır. Deprem, başta deprem bölgesi olmak üzere toplumun hemen hemen tamamını olumsuz etkilemekle birlikte, yol açtığı sosyoekonomik sorunlar ve ruh sağlığı sorunları ile özellikle savunmasız bireyleri, özellikle engelliler, çocuklar ve yaşlılar gibi toplum gruplarını daha şiddetli ve olumsuz etkilemektedir. Yaşlı nüfusun hızla arttığı ülkemizde yaşlılık nedeni ile kırılgan bu ileri yaştaki toplumsal grubun depreme bağlı ruh sağlığı sorunları ayrıcalıklı bir şekilde ele alınmalıdır. Anahtar Kelimeler: Doğal afet, Yaşlı, Deprem ve Yaşlı, Yaşlılar ve Psikososyal Sorunlar ABTRACT Earthquakes are natural disasters that cause the most deaths, serious injuries and loss of limbs worldwide today. Earthquakes continue to affect humanity as one of the most important natural events with unavoidable, untimely but devastating effects, the effects of which cause high economic losses and costs for societies. Our country, where the historical effects of earthquakes in the past can be seen, had to face the earthquake phenomenon again in the near future, our society continues to experience traumas due to earthquakes today and has to learn to live together in the future. While the earthquake negatively affects almost all of the society, especially in the earthquake zone, it affects especially vulnerable individuals, especially social groups such as the disabled, children and the elderly, with the socioeconomic problems and mental health problems it causes, more severely and negatively. In our country, where the elderly population is rapidly increasing, the mental health problems of this elderly social group, who are fragile due to old age, should be handled in a privileged way. Keywords: Natural disaster, Elderly, Earthquake and Elderly, Elderly and Psychosocial Problems
... Les personnes âgées se retrouveraient aussi plus souvent seules dans leur domicile au moment d'un sinistre, ce qui augmente les risques de conséquences néfastes des désastres chez cette population. Les aînés auraient aussi tendance à moins se plaindre que les individus plus jeunes (Kaniasty, Norris & Murrel, 1990;Tanida, 1996), ils sous-utiliseraient les ressources formelles d'aide et demanderaient généralement moins le soutien de leurs proches et des organismes communautaires (Bolin & Klenow, 1982-1983Kaniasty, Norris & Murrel, 1990;Ticehurst et al., 1996). Bolin et Klenow (1982-1983 estiment aussi que les personnes âgées souffriraient plus que les autres adultes des pertes subies en raison de la valeur sentimentale accordée à ce qui a été détruit ou perdu, et qu'elles auraient plus de difficulté à se rétablir économiquement. ...
Au cours des derniers mois, partout dans le monde, y compris au Québec, des événements catastrophiques, comme des inondations, des accidents ferroviaires, des incendies dans des résidences pour aînés ont malheureusement affecté bon nombre de personnes âgées de 65 ans ou plus. Certaines de ces personnes ont subi de graves blessures, d’autres ont eu peur de mourir et malheureusement plusieurs d’entre elles ont été incapables de se déplacer rapidement pour faire face aux dangers, trouvant ainsi la mort dans des conditions atroces. Le but de cet article est de présenter les faits saillants d’une recension des écrits scientifiques portant sur les facteurs qui fragilisent les personnes âgées en cas de désastre et ceux qui les protègent pendant et après une catastrophe. À ce sujet, les études consultées ont généralement permis de constater qu’en cas de désastre, les personnes âgées de 65 ans ou plus sont plus à risque que les adultes plus jeunes de mourir, de subir des blessures, de ne pas recevoir suffisamment d’aide et de soutien des autorités publiques ou des organismes non gouvernementales (ONG) et de développer des problèmes de santé post-désastre. Il sera aussi possible de constater que trois points de vue différents s’affrontent lorsque l’on parle de la question des conséquences des désastres sur la santé des personnes âgées. C’est ainsi que certains chercheurs estiment que les aînés représentent une population particulièrement à risque de développer des problèmes de santé physique ou psychologique à la suite de leur exposition à un événement traumatisant, tandis que d’autres considèrent, par contre, que les aînés, et particulièrement ceux âgés de plus de 65 ans, s’en sortent mieux que les adultes plus jeunes. Certaines autres études ont, pour leur part, démontré que les personnes âgées ne sont pas plus affectées que les victimes plus jeunes et que la vulnérabilité et la résilience des victimes d’un désastre ne sont pas des éléments nécessairement reliés à l’âge. Cet article permettra aussi de présenter certaines données de recherches qualitatives et quantitatives réalisées au Québec portant sur les effets à moyen et à long terme des sinistres sur la santé physique et psychologique des personnes âgées. Dans ces diverses études portant sur les impacts d’une grave inondation et d’une tempête de verglas sur la santé des aînés et sur leur processus de rétablissement, Maltais et ses collaborateurs ont ainsi pu identifier les principales difficultés que vivent ces personnes pendant et après leur exposition à ce type de désastre ainsi que les répercussions de ce genre d’événement sur leur santé et leurs conditions de vie.
... The higher the score, the more symptoms of post-traumatic stress the respondent shows. A score higher than 25 on this scale indicates a high level of manifestations of post-traumatic stress [20]. The scale's alpha coefficient in this study is 0.93. ...
Background
Three and a half years after a technological disaster, the train derailment in Lac-Mégantic (Quebec, Canada) in 2013, a study was conducted with adolescents to determine their mental health condition.
Method
Data were collected from 538 young people using a self-administered questionnaire distributed at their secondary school. One question specifically concerned the presence or absence of suicidal ideations. This article compares the characteristics of high school students who had had suicidal ideations during the 12 months preceding the survey (n = 172), with other adolescents in the same age group who had not had such ideations (n = 366).
Results
This study revealed that close to a third of respondents (32%) said that they had had suicidal ideations during the year preceding the data collection. They differed from the other respondents due to sociodemographic, psychological, educational, familial and social factors. The characteristics related to adolescents’ mental health are mainly associated with the presence of suicidal ideations.
Conclusion
Suicidal ideations in adolescents are a public health concern and may appear in non-negligible numbers after a disaster. This article indicates the importance after such an event of acting on all the social determinants of health in order to protect young people at risk of developing suicidal ideations and promote their recovery.
... Scoring ranges from 0 to 75 points. Moderate risk post-traumatic stress disorder is represented by scores between 26 and 43; with high risk above 44 (Ticehurst et al., 1996). The alpha coefficient is .92 ...
On July 6, 2013, a train with 72 crude oil tank cars derailed in the heart of Lac-Mégantic, a small municipality of 6,000 inhabitants located in Québec (Canada). This tragedy killed 47 people. Technological disasters are rarely studied in bereavement research, and train derailments even less. The goal of this article is to increase our understanding of the bereavement consequences of technological disasters. Specifically, we aim to identify the factors that lead to the experience complicated grief and distinguish from the protective factors. A representative population-based survey was conducted among 268 bereaved people, three and a half years after the train accident. Of these, 71 people (26.5%) experienced complicated grief. People with complicated grief (CG) differ significantly from those without CG in terms of psychological health, perception of physical health, alcohol use and medication, as well as social and professional relationships. Hierarchical logistic regression analysis identified four predictive factors for CG: level of exposure to the disaster, having a negative perception of the event, as well as having a paid job and low-income increase the risk of CG. The importance of having health and social practitioners pay attention to these factors of CG are discussed along with future directions for research.
... However, old age may not always result in lower levels of subjective well-being, as suggested by several theories such as the socio-emotional selectivity theory (Carstensen 1995;Carstensen et al. 1999), the emotional maturity theory (Kato et al. 1996;Ticehurst et al. 1996), or the selective optimization with compensation theory (Baltes and Baltes 1990) as well as corresponding empirical work on this topic (Blanchflower and Oswald 2008;Stone et al. 2010;Carstensen et al. 2011;Dolan et al. 2017;Kieny et al. 2020). By contrast with the double jeopardy hypothesis, the age as leveler hypothesis argues that gender inequalities may be decreasing in old age, as all individuals suffer from the physical effects of age (Markides and Black 1996). ...
Using data from the World Health Organization’s Study on Global AGEing and Adult Health (SAGE), we evaluate the relationship between gender and several measures of subjective well-being among older adults in developing countries. Furthermore, we contrast the partial associations of gender with these well-being measures when controlling only for age (age-adjusted analyses) with the corresponding partial associations when including individual characteristics and life circumstances as controls (multivariable-adjusted analyses). While age-adjusted analyses reveal that older women have lower levels of evaluative well-being than older men, multivariable-adjusted analyses show that - given similar life circumstances - they have equal or slightly higher evaluative well-being. This suggests that the gender gap in evaluative well-being may be explained by less favorable life circumstances of older women. Age-adjusted results also show that older women tend to have lower levels of emotional well-being. However, we find no reversal, but merely an attenuation of these gender differences in emotional well-being when controlling for additional individual characteristics and life circumstances. Finally, we perform Oaxaca-Blinder decompositions to disaggregate the gender gaps in well-being into explained parts - attributable to gender differences in individual characteristics and life circumstances - and unexplained parts - related to gender differences in the association between life circumstances and subjective well-being. These results further corroborate our findings that women tend to be disadvantaged in terms of both evaluative and emotional well-being, and that this disadvantage is mostly driven by observable factors related to the explained part of the decomposition, such as gender differences in socio-economic status and health.
... Earthquakes, as a natural disaster, not only causes deaths, physical disease, damage to infrastructure, and economic loss, they also have long-lasting mental health effects on individuals involved. A study highlighted that older people had higher levels of post-traumatic stress symptoms after an earthquake (Ticehurst, Webster, Carr, et al., 1996). As per the Government of Nepal (2018), half of the people reported physiological stress on the day of the earthquake in Nepal, and far more women had psychosocial problems than men. ...
The purpose of this study is to understand the linkages between natural disasters and their impact on the mental health of people as well as associated resilience mechanisms in India. Natural disasters affect not only the physical environment but also the economy, social life, and well-being of the population. In addition to the loss of precious lives and economic losses, disasters affect the natural growth and mental health of the affected populations to a great extent. It is extremely challenging to quantify the true scale of damage caused by a disaster because physical damage is visible, but hidden impacts could be much more severe and have catastrophic effects on the socioeconomic growth of the affected families and areas. Against this background and with the limited available evidence, this study has tried to understand how disasters lead to poor mental health among the affected populations around the globe and tried to conceptualize this in the Indian context. Our review documents the different pathways for disasters to adversely affect mental health, particularly among vulnerable populations. The review also highlights how an increased frequency of disasters with climate change can lead to a post-traumatic stress disorder, adjustment disorder, and depression. Changes in climate and global warming may require populations to migrate, which can lead to acculturation stress. It can also lead to increased rates of physical illnesses, which secondarily would be associated with psychological distress. This research is an initial step in bringing this important issue forward in the context of Sustainable Development Goals and outlining that better policies need to be designed for prevention, services, and psychological counseling of mental health problems due to disasters. This study also suggests for more longitudinal research to understand the development of disaster-related mental health problems and to develop adequate mitigation strategies.
... Plus le score est élevé, plus les répondants manifestent des symptômes de stress post-traumatique. Un score supérieur à 25 à cette échelle indique des risques modérés ou élevés de présenter des manifestations de stress post-traumatique (Ticehurst, Webster, Carr et Lewin, 1996). Dans le cadre de cette étude, le coefficient alpha de Cronbach de cet instrument de mesure est de 0,92. ...
En 2013, à Lac-Mégantic (Québec, Canada), un déraillement de train a entrainé d’importantes pertes humaines et matérielles. Cet article dresse le portrait psychosocial de jeunes âgés de 10 à 13 ans et documente les impacts de cette catastrophe sur divers aspects de leur vie. Cette étude a été réalisée auprès de 144 élèves du troisième cycle du primaire (5e et 6e années) par l’intermédiaire d’un questionnaire autoadministré en classe dans deux écoles situées à Lac-Mégantic et dans deux autres situées dans des municipalités à proximité. Cette étude a été réalisée à la suite d’une demande formulée par les organismes du milieu constatant le peu d’informations disponibles sur l’état de santé des jeunes de la communauté de Lac-Mégantic exposés au déraillement du train. Elle démontre que, 3 ans et demi après la tragédie, l’exposition à cette catastrophe technologique a des conséquences sur l’état de santé psychologique des enfants, notamment la présence de manifestations de stress post-traumatique et un faible niveau d’estime de soi. Des proportions plus élevées de jeunes exposés que de non exposés considèrent aussi que des problèmes de stress, d’anxiété ou de comportements ont perturbé leur vie familiale et scolaire. Cet article démontre l’importance d’apporter une attention particulière aux enfants pendant et après leur exposition à une catastrophe technologique afin de limiter les effets néfastes d’un tel évènement sur leur santé à court et à plus long terme. Il s’agit d’une contribution originale étant donné que la majorité des études portant sur les conséquences des catastrophes technologiques abordent le vécu des adultes demeurant aux États-Unis ou en Europe. De plus, les études permettant de documenter les conséquences des désastres sur la santé des jeunes ont surtout été réalisées à la suite de catastrophes naturelles dans d’autres pays que le Canada.
Mots-clés :
catastrophe technologique, enfants, santé psychologique, stress post-traumatique, résilience
... The higher the score, the more post-traumatic stress symptoms respondents show. A score greater than 25 indicates the presence of PTSD (Ticehurst, Webster, Carr, & Lewin, 1996). This data was used as a dichotomous variable. ...
In July 2013, the derailment of a train caused the death of 47 people and the destruction of Lac-Mégantic’s downtown area (Canada). Three years after this event, a population survey was conducted among a representative sample of 800 adults, including 282 men. Several significant differences were observed among respondents of a survey based on their level of exposure to this tragedy, including their physical (changes in physical health) and psychological health (post-traumatic stress disorder, mood and anxiety disorders, psychological distress, signs of depression, consultation of social workers and psychologists) as well as their use of prescribed (anxiolytics and antidepressants) and nonprescribed drugs. Such results can be explained by the nature, magnitude, and cause of the event.
... Answers (never = 0; rarely = 1; sometimes = 3; or often = 5) were used to compute a composite score ranging from zero to 75 with scores between 26 and 43, and scores higher than 43, suggestive of moderate and severe posttraumatic stress symptoms (PSS), respectively. 29 The alpha coefficient of this instrument was 0.82 and the test-re-test fidelity coefficient was 0.89. 27 This tool had already been used in other studies and surveys and showed good validity. ...
Introduction
In July 2013, a train carrying 72 cars of crude oil derailed in the town of Lac-Mégantic (Eastern Townships, Quebec, Canada). This disaster provoked a major conflagration, explosions, 47 deaths, the destruction of 44 buildings, the evacuation of one-third of the local population, and an unparalleled oil spill. Notwithstanding the environmental impact, many citizens of this town and in surrounding areas have suffered and continue to suffer substantial losses as a direct consequence of this catastrophe.
Problem
To tailor public health interventions and to meet the psychosocial needs of the community, the Public Health Department of Eastern Townships has undertaken repeated surveys to monitor health and well-being over time. This study focuses on negative psychosocial outcomes one and two years after the tragedy.
Methods
Two cross-sectional surveys (2014 and 2015) were conducted among large random samples of adults in Lac-Mégantic and surrounding areas (2014: n = 811; 2015: n = 800), and elsewhere in the region (2014: n = 7,926; 2015: n = 800). A wide range of psychosocial outcomes was assessed (ie, daily stress, main source of stress, sense of insecurity, psychological distress, excessive drinking, anxiety or mood disorders, psychosocial services use, anxiolytic drug use, gambling habits, and posttraumatic stress symptoms [PSS]). Exposure to the tragedy was assessed using residential location (ie, six-digit postal code) and intensity of exposure (ie, intense, moderate, or low exposure; from nine items capturing human, material, or subjective losses). Relationships between such exposures and adverse psychosocial outcomes were examined using chi-squares and t-tests. Distribution of outcomes was also examined over time.
Results
One year after the disaster, an important proportion of participants reported human, material, and subjective losses (64%, 23%, and 54%, respectively), whereas 17% of people experienced intense exposure. Participants from Lac-Mégantic, particularly those intensely exposed, were much more likely to report psychological distress, depressive episode, anxiety disorders, and anxiolytic drug use, relative to less-exposed ones. In 2015, 67% of the Lac-Mégantic participants (76% of intensely exposed) reported moderate to severe PSS. Surprisingly, the use of psychosocial services in Lac-Mégantic declined by 41% from 2014 to 2015.
Conclusion
The psychosocial burden in the aftermath of the Lac-Mégantic tragedy is substantial and persistent. Public health organizations responding to large-scaling disasters should monitor long-term psychosocial consequences and advocate for community-based psychosocial support in order to help citizens in their recovery process.
... The higher the score, the more PTSD symptoms respondents show. A score above 25 indicates a moderate or high-level risk to present PTSD (Ticehurst, Webster, Carr, & Lewin, 1996). In this study, the alpha coefficient is .92 ...
In July 2013, a train derailment caused the death of 47 people and destroyed the downtown area
in the city of Lac-Mégantic (Quebec, Canada). This tragedy had several impacts on this small community. Method:
Three years after this disaster, we used a representative population-based survey conducted among 800 adults
(including 265 seniors aged 65 or above) to assess the physical and mental health of seniors. Results: Several
differences were observed in seniors’ physical and mental health based on their level of exposure to the tragedy.
Nearly half of seniors highly exposed to the train derailment (41.7%) believe that their health has deteriorated
in the past 3 years. The majority of seniors highly exposed to the train derailment (68.7%) also show symptoms
of posttraumatic stress disorders. Seniors highly or moderately exposed to the tragedy were also more likely to
have found positive changes in their personal and social life as compared with nonexposed seniors. Discussion:
A technological disaster such as a train derailment still had negative impacts on seniors’ physical and mental health
3 years later. Conclusion: Public health authorities must tailor prevention and promotion programs to restore
health and well-being in this population.
... The higher the score, the more PTSD symptoms respondents show. A score above 25 indicates a moderate or high-level risk to present PTSD (Ticehurst, Webster, Carr, & Lewin, 1996). In this study, the alpha coefficient is .92 ...
Introduction: In July 2013, a train derailment caused the death of 47 people and destroyed the downtown area in the city of Lac-Mégantic (Quebec, Canada). This tragedy had several impacts on this small community. Method: Three years after this disaster, we used a representative population-based survey conducted among 800 adults (including 265 seniors aged 65 or above) to assess the physical and mental health of seniors. Results: Several differences were observed in seniors’ physical and mental health based on their level of exposure to the tragedy. Nearly half of seniors highly exposed to the train derailment (41.7%) believe that their health has deteriorated in the past 3 years. The majority of seniors highly exposed to the train derailment (68.7%) also show symptoms of posttraumatic stress disorders. Seniors highly or moderately exposed to the tragedy were also more likely to have found positive changes in their personal and social life as compared with nonexposed seniors. Discussion: A technological disaster such as a train derailment still had negative impacts on seniors’ physical and mental health 3 years later. Conclusion: Public health authorities must tailor prevention and promotion programs to restore health and well-being in this population.
... Kovats and Kristie, 27 for their part, have examined the factors leading to increased risk of death during heat waves for people 65 years or older, noting that factors such as living alone, social isolation, inadequate air conditioning systems, and other housing characteristics, including living on the upper floors of apartment buildings, are all significant. In addition, Ticehurst, Webster, Carr, and Lewin, 28 in a study comparing the psychosocial consequences of an earthquake INQUIRY in Australia on people in 2 age groups (below 65 years and 65 years or older), found that seniors reported a greater inci- dence of symptoms associated with posttraumatic stress dis- order (PTSD). Other studies have shown that, in addition, seniors face particular disruptions that unsettle their daily routines, beliefs, and values, as well as their personal and social relationships. ...
The article aims to describe the medium-term impacts of a major earthquake event (Chile, February 27, 2010) on 26 seniors. The authors adopted a qualitative study approach. Data obtained using the Impact of Event Scale–Revised (IES-R) show the presence of manifestations of posttraumatic stress in the majority of respondents. In addition, data collected in interviews demonstrated a progressive deterioration of the health of respondents over a period of 4 years following the disaster. Seniors are particularly vulnerable to the effects of material loss, emotional stress, and postdisaster health complications. These impacts are exacerbated by low economic status. Furthermore, broader research is necessary involving elderly living in poverty who have survived natural disasters and others without such experiences, in order to better identify and differentiate between health complications associated with exposure to disaster events and those linked more strictly with natural aging processes.
... Older survivors who are affected by natural disasters have a higher risk of developing depressive symptoms than those in other age groups, as has been shown in previous studies (39)(40)(41). Our finding further supports the hypothesis that relocation after a natural disaster is associated with the development of depressive symptoms, and that furthermore the type of accommodation matters. ...
The 2011 Great East Japan Earthquake and Tsunami resulted in widespread property destruction and over 250,000 displaced residents. We sought to examine whether the type of housing arrangement available to the affected victims was associated with a differential incidence of depressive symptoms. In this prospective cohort study comprising participants (65 years or older) from Iwanuma as a part of the Japan Gerontological Evaluation Study, we had information about the residents' mental health both pre-dating the disaster in 2010 as well as 2.5 years afterward. The geriatric depression scale was used. The type of accommodation after the disaster was divided into five categories: no move, prefabricated housing (temporary housing), existing private accommodation (temporary apartment), newly established housing, and other. Poisson regression analysis was adopted with and without multiple imputation. Among the 2,242 participants, 16.2% reported depressive symptoms at follow-up. The adjusted rate ratio for depressive symptoms in those moving into prefabricated housing than those who did not was 2.07 (95% confidence interval: 1.45, 2.94). Moving into existing private accommodation or other types of accommodation was not associated. The relationship between the living environment and long-term mental health should be considered for disaster recovery planning.
... This is in agreement with the findings of earlier Chinese and Western studies (Hauffa et al., 2011). Older people are more likely to experience certain types of negative events, especially the sudden death of a family member, and may also be more vulnerable to PTSD compared to those who experience the same trauma at younger ages (Ticehurst et al., 1996). Loss of loved ones may lead to less social support which increases the likelihood of developing PTSD (Van Zelst et al., 2003). ...
Object
There have been significantly fewer community-based, epidemiological studies focusing on PTSD and its socio-demographic correlates among the Chinese than Western populations.
Method
The multistage household cluster random sampling method was used to select participants from18 districts and counties in Beijing; a total of 16,032 participants were assessed; face-to-face interviews and data collection was conducted using the semi-structured clinical interview for DSM-IV-TR Axis I Disorders-Patient Edition (SCID-I/P).
Result
The lifetime PTSD prevalence was 0.3%. Older age, low educational level, low personal monthly income, urban living, unemployment and being a farmer were all significantly associated with an increased risk of PTSD. Multivariate analysis showed that farmers and the unemployed were significantly associated with a higher risk for PTSD.
Conclusions
The prevalence rates of PTSD in Beijing were low compared with that of Western countries. Farming occupation and unemployment were independent risk factors for PTSD.
... A possible reason for older adults experiencing higher levels of PTSD symptomatology may be due to the elderly needing more assistance and finding it more difficult to obtain what they lost. Younger individuals were found to be less depressed before and after the 1994 Northridge earthquake (Carr et al., 1997), whereas a study of responses to the 1989 Newcastle earthquake found that adults older than 65 were more likely to have PTSD, despite reporting less severity of exposure to the actual trauma (Ticehurst et al., 1996). Other studies have indicated younger adults (Epstein et al., 1998;Palinkas et al., 1993) are more at risk for distress. ...
Encyclopedia of Mental Health, Second Edition, tackles the subject of mental health, arguably one of the biggest issues facing modern society. The book presents a comprehensive overview of the many genetic, neurological, social, and psychological factors that affect mental health, also describing the impact of mental health on the individual and society, and illustrating the factors that aid positive mental health. The book contains 245 peer-reviewed articles written by more than 250 expert authors and provides essential material on assessment, theories of personality, specific disorders, therapies, forensic issues, ethics, and cross-cultural and sociological aspects. Both professionals and libraries will find this timely work indispensable. * Provides fully up-to-date descriptions of the neurological, social, genetic, and psychological factors that affect the individual and society* Contains more than 240 articles written by domain experts in the field* Written in an accessible style using terms that an educated layperson can understand* Of interest to public as well as research libraries with coverage of many important topics, including marital health, divorce, couples therapy, fathers, child custody, day care and day care providers, extended families, and family therapy
... A possible reason for older adults experiencing higher levels of PTSD symptomatology may be due to the elderly needing more assistance and finding it more difficult to obtain what they lost. Younger individuals were found to be less depressed before and after the 1994 Northridge earthquake (Carr et al., 1997), whereas a study of responses to the 1989 Newcastle earthquake found that adults older than 65 were more likely to have PTSD, despite reporting less severity of exposure to the actual trauma (Ticehurst et al., 1996). Other studies have indicated younger adults (Epstein et al., 1998;Palinkas et al., 1993) are more at risk for distress. ...
Many individuals experience natural disasters including earthquakes, tornadoes, hurricanes, tsunamis, and wildfires; residents of developing nations experience greater/more severe risk. While many individuals display resilience post-disaster, deleterious physical and mental health problems are also common and correlate with disaster characteristics, demographic indicators, socioeconomic status, and pre-disaster mental health. Post-disaster responses have been examined less frequently among children; detrimental effects may persist for decades. Longitudinal assessments post-disaster are relatively uncommon, although critical for understanding long-term adaptation. Logistical difficulties generate challenges for disaster research and marked variability in methodologies has hindered cross-study comparisons. Improved designs may enhance current knowledge, improving outreach services.
... Some research indicates that older people facing disasters experience lower rates of psychopathology than do younger people, [11][12][13] whereas other studies have documented comparable 14,15 or increased rates. 13,16,17 Older adults are potentially vulnerable during disasters given the innate developmental challenges of aging. ...
Objective:
Drawing on pre-disaster, peri-disaster, and post-disaster data, this study examined factors associated with the development of post-traumatic stress disorder (PTSD) symptoms in older adults exposed to Hurricane Sandy.
Methods:
We used a sample of older participants matched by gender, exposure, and geographic region (N=88, mean age=59.83 years) in which one group reported clinically significant levels of PTSD symptoms and the other did not. We conducted t-tests, chi-square tests, and exact logistic regressions to examine differences in pre-disaster characteristics and peri-disaster experiences.
Results:
Older adults who experienced PTSD symptoms reported lower levels of income, positive affect, subjective health, and social support and were less likely to be working 4 to 6 years before Hurricane Sandy than were people not experiencing PTSD symptoms. Those developing PTSD symptoms reported more depressive symptoms, negative affect, functional disability, chronic health conditions, and pain before Sandy and greater distress and feelings of danger during Hurricane Sandy. Exact logistic regression revealed independent effects of preexisting chronic health conditions and feelings of distress during Hurricane Sandy in predicting PTSD group status.
Conclusions:
Our findings indicated that because vulnerable adults can be identified before disaster strikes, the opportunity to mitigate disaster-related PTSD exists through identification and resource programs that target population subgroups. (Disaster Med Public Health Preparedness. 2016;page 1 of 9).
... 'Vulnerability' is defined in terms of the capacity of a person or group to anticipate, cope with, resist and recover from the impact of a natural hazard (Blaikie et al 1994). Certain groups within communities (eg the elderly, disabled, children, women, ethnic minorities and those on low incomes) may be more vulnerable than others to the effects of flooding Thompson 1995;Curle and Wiliams 1996;Ticehurst et al 1996;Flynn and Nelson 1998;Fordham 1998;Morrow 1999;Tapsell and Tunstall 2001). Consequently, these groups may suffer greater effects from a flood and may need special consideration by the authorities during the response and recovery periods. ...
In Europe, floods are the most common natural disaster. The adverse human health consequences of flooding are complex and far-reaching. The main health effects include drowning, injuries and, perhaps most importantly with floods in Europe, an increased incidence of common mental health disorders. Anxiety and depression may last for months and possibly even years after the flood event and so the true health burden is rarely appreciated. The effect of floods increasing the risk of communicable diseases appears relatively infrequent in Europe. The vulnerability of a person or group to a natural hazard is defined in terms of their capacity to anticipate, cope, resist and recover from the impact of the disaster. Determining vulnerability is a major challenge. What little research literature there is on this subject indicates that certain groups within communities (eg the elderly, disabled, children, women, ethnic minorities and those on low incomes) may be more vulnerable to the effects of flooding than others. However, there is a need for more good-quality epidemiological data before vulnerability indices could be used operationally to minimise the effects of flooding. With better information available, the emphasis in disaster management could shift from post-disaster improvisation to pre-disaster planning. A comprehensive, risk-based emergency management programme of preparedness, response and recovery has the potential to reduce the adverse health effects of floods, but there is currently inadequate evidence of the effectiveness of such schemes.
... 23,25 Lastly, the exposure hypothesis proposes that older adults are at greatest risk of mental health outcomes because of a lower likelihood of receiving advanced warnings, a reluctance to evacuate, a reduced ability to seek assistance, disruption to accustomed patterns of life, and a sense of deprivation resulting from their personal, physical, and social losses post disaster. [26][27][28] In addition, they may be in worse health before the disaster. ...
Background
Older people are increasingly “in harm's way” following human-induced disasters (HID). There is debate in the literature as to the relative impact of disasters on their psychological health compared with other age groups. Natural Disasters and HID are thought to affect survivors differentially, and this may extend to older adults as a group. In the absence of existing systematic reviews, we aimed to synthesis the available evidence and conduct meta-analyses of the effects of HID on the psychological health of older versus younger adults.
Methods
A meta-analysis was conducted on papers identified through a systematic review. The primary outcomes measured were post-traumatic stress disorder (PTSD), depression, anxiety disorders, adjustment disorder, and psychological distress.
Results
We identified eleven papers from 10 studies on HID (n= 26, 753 ), of which eight had sufficient data for a random-effects meta-analysis. Older adults were 2.85 times less likely to experience PTSD symptoms following HID (95% CI= 1.42-5.70) when compared to younger adults. There was no statistically significant difference in terms of anxiety and depressive symptoms.
Conclusion
Health and emergency services need to be increasingly prepared to meet the psychological needs of older people, given the global rise in the numbers of older adults affected by disasters of all kinds. Preliminary evidence suggests that, that old age may be a protective factor for the development of post-traumatic stress disorder in the wake of HID.
Keywords:
Mental Health, Post Traumatic Stress Disorder, Older Persons, Human-induced Disaster, Meta-analysis
... 23,25 Lastly, the exposure hypothesis proposes that older adults are at greatest risk of mental health outcomes because of a lower likelihood of receiving advanced warnings, a reluctance to evacuate, a reduced ability to seek assistance, disruption to accustomed patterns of life, and a sense of deprivation resulting from their personal, physical, and social losses post disaster. [26][27][28] In addition, they may be in worse health before the disaster. ...
Background:
Older people are increasingly "in harm's way" following human-induced disasters (HIDs). There is debate in the literature as to the relative impact of disasters on their psychological health compared with other age groups. Natural disasters and HIDs are thought to affect survivors differentially, and this may extend to older adults as a group. In the absence of existing systematic reviews, we aimed to synthesize the available evidence and conduct meta-analyses of the effects of HIDs on the psychological health of older versus younger adults.
Methods:
A meta-analysis was conducted on papers identified through a systematic review. The primary outcomes measured were post-traumatic stress disorder (PTSD), depression, anxiety disorders, adjustment disorder, and psychological distress.
Results:
We identified 11 papers from 10 studies on HIDs (N = 26,753), of which 8 had sufficient data for a random-effects meta-analysis. Older adults were 2.85 times less likely to experience PTSD symptoms following HID (95% CI: 1.42-5.70) when compared with younger adults. There was no statistically significant difference in terms of anxiety and depressive symptoms.
Conclusion:
Health and emergency services need to be increasingly prepared to meet the psychological needs of older people, given the global rise in the numbers of older adults affected by disasters of all kinds. Preliminary evidence suggests that old age may be a protective factor for the development of PTSD in the wake of HID.
... Eerdere onderzoeken naar PTSS, die wel verschillen lieten zien, waren veelal niet gebaseerd op vergelijking met gegevens voor de ramp en met gegevens in een controlegroep. [31][32][33][34] De verschillen tussen slachtoffers en controlepersonen vóór de ramp hadden betrekking op LOK en gastro-intestinale morbiditeit, met iets hogere prevalenties bij de slachtoffergroepen. Verschillen in sociaal-economische status en etniciteit droegen mogelijk bij aan verschillen in gezondheidsproblemen voordat de vuurwerkramp plaatsvond, aangezien beide groepen slachtoffers, maar vooral de verhuisde, een wat lagere sociaal-economische status hadden dan de controlegroep. ...
... By focusing on and venting emotions, patients in fact dwell on their distress (maintaining or possibly increasing it), find it difficult to move beyond it and distract themselves from active coping and thereby impede adjustment and affect health-related quality of life. This is why older people who use escape avoidance coping, a form of emotion-focused coping, tend to be associated with negative outcomes [68][69][70][71][72]. The Chronic Illness Coping model also advocates a similar idea by claiming that trauma symptoms resulting from multiple adversities can impact on health outcome and this path is mediated via maladaptive or impaired coping strategies. ...
This study explored (1) the incidence of posttraumatic stress disorder (PTSD) resulting from past trauma among older patients with COPD and (2) whether PTSD and COPD severity would relate to psychiatric co-morbidity and health-related quality of life. Eighty-five older patients completed the Hospital Anxiety and Depression Scale, the Chronic Respiratory Questionnaire, the Posttraumatic Stress Diagnostic Scale and the Medical Outcomes Short Form 12. The results showed that 55, 39 and 6 % had no, partial and full-PTSD respectively. Partial least squares showed that PTSD was significantly correlated with COPD severity which in turn was significantly correlated with health-related quality of life and psychiatric co-morbidity. Mediational analysis showed that the emotional symptoms of COPD mediated between PTSD and the mental health functioning of health-related quality of life and between PTSD and depression. To conclude, PTSD from past trauma was related to the severity of COPD for older patients. In particular, it impacted on the elevated emotional arousal of COPD severity. In turn, COPD severity impacted on older patients' general psychological well-being and depression.
... Sin embargo, no todo el impacto es explicado por estas cuatro variables incluidas en el modelo. La parte no explicada podría estar relacionada con: variables geográficas y económicas tales como el costo de la reconstrucción de los hogares, el grado de destrucción de la ciudad o barrio en donde la persona reside; variables psicosociales como el grado de vulnerabilidad de las personas que sufrieron la catástrofe; y también con la variable tiempo, es decir con el efecto distinto que pueden tener estas variables a medida que transcurre el tiempo después de una catástrofe (Groome y Soureti, 2004;Khan, Masood, Mukhtar, Sana y Chaudhry, 2010;Kar, 2009;Kar et al., 2007;Önder et al., 2006;Ticehurst, Webster, Carr y Lewin, 1996). A su vez, desde el punto de vista de la salud mental, tampoco se controló el número de síntomas de TEPT que presenta la población. ...
El 27 de febrero de 2010 la zona central de Chile sufrió un terremoto como pocos en la historia mundial. Este estudio cuantifica el impacto de este evento mediante la creación de un indicador de impacto de terremotos en las personas (IITP). Para esto, se midieron en 264 participantes las siguientes variables: daño físico de la vivienda, coste de los enseres perdidos, distancia del domicilio al epicentro y cantidad de síntomas de pánico. Luego, se realizan dos análisis factoriales: exploratorio (AFE) para extraer un factor común (impacto) y cuantificarlo; y confirmatorio (AFC) para conocer el ajuste del modelo. Posteriormente, mediante un análisis de regresión lineal múltiple se obtienen los coeficientes que permiten definir el IITP. Los resultados evidencian el adecuado ajuste del modelo (CMIN=1.374, RMSEA=.038, NFI=.921 y CFI=.974) además del buen funcionamiento del IITP. Se confirma que el impacto fue mayor en las zonas costeras afectadas por el terremoto y el tsunami. Finalmente se expone la utilidad de esta nueva herramienta que permite cuantificar el impacto de un evento catastrófico como éste mediante 16 preguntas.
... Pour chacun des quinze items, le répondant doit indiquer la fréquence des symp-tomes durant la dernière semaine. Ticehurst et al. (1996) soulignent qu'un score supérieur à 25 à l'IES dénote un niveau élevé de manifestations post-traumatiques. La version française de l'IES utilisée dans la présente étude a déjà fait l'objet d'une analyse factorielle en composantes principales auprès de sinistrés et les résultats suggèrent la pertinence de référer à un seul facteur (Maltais et al, 2000). ...
Social support, coping and psychological health after a flood
Two years after serious flooding, a study was conducted involving 177 disaster victims. This article presents the results of analyses aiming to identify the principal factors associated with post-disaster psychological problems by examining mediating or moderating influences of social support and adjustment strategies in the stressor-health link. The results show, within the variables studied, that there are very few significant differences between men and women; however, women did receive more help for evacuation, cleaning, and rebuilding. The results also demonstrate that exposure to the stressor is the greatest contributor in explaining manifestations of post-traumatic stress, while variables like social support and adjustment strategies are more likely to explain the existence of depression symptoms and psychological stress. The analyses also allow conclusions to be drawn about mediating and moderating effects of adjustment strategies in the stressor-health link. In other respects, the observed effects involving social support variables are direct.
Afetlerin sayısı ve yıkıcılığı her geçen gün artmaktadır. Afetlere karşı dirençli olunması için afet yönetim süreçlerinin bütünleşik olarak ele alınması gerekmektedir. Dünyada ve ülkemizde yaşanan çok sayıdaki afet ve acil durumun meydana getirdiği zararların azaltılmasında afet ve acil durumlar öncesinde hazırlık ve zarar azaltma çalışmalarının katkısı yüksektir. Risk yönetimi alışmalarının etkin yürütülmesi dirençliliğin artmasına katkı sağlamaktadır. Bu nedenle yeni oluşturulan ulusal ve uluslararası eylem planlarında risk yönetimi süreçleri olan hazırlık ve zarar azaltma çalışmalarına geçmişe oranla daha çok önem verilmektedir (UNISDR, 2005, 2015).
Afetler toplumların bazı kesimlerini daha çok etkilemektedir. Yaşlılar, çocuklar, engelliler, kadınlar, göçmenler afetten daha çok etkilenen kesimin önemli kısmını oluşturmaktadır. Bahsedilen bu grupların afetlerden daha çok etkilenmesinin nedenleri arasında diğer bireylerden farklı olarak bazı özel ihtiyaçlara gereksinim duymaları, dışlanma nedeniyle yoksullaşma ve afet yönetim süreçlerinde dikkate alınmamaları sayılabilir. Bütünleşik afet yönetiminin tüm süreçlerini dikkate alan ve bu süreçleri toplumun
tüm kesimleri için kapsayıcı olarak uygulayan toplumlar afetlere karşı daha dirençli hale gelmektedir.
Kitabın özelinde değerlendirilen yaşlı bireyler yaşlanan dünya nüfusu nedeniyle her alanda olduğu gibi afet yönetimi alanında da daha çok odaklanılan gruplar arasında yer almaktadır. Yaşlı bireyler; hareket kısıtlılıkları, kronik hastalıklar, engellilik durumları nedeniyle gündelik yaşamlarında desteğe ihtiyaç duyabilmektedirler. Afet durumlarında ise bu destek ağlarının kaybı yeni engelliliklerin ortaya çıkması, kronik hastalıklarının takibinde meydana gelen aksamalar, yoksullaşma, dışlanma gibi nedenlerle
dezavantajlı konuma düşebilmektedirler. Ancak yaşlı bireylerin afet yönetimi süreçlerine dâhil edilmesi ile bu bireyler dezavantajlı değil dirençli bireyler olarak afet yönetim süreçlerine destek sağlayabilmektedirler. Yaşlı bireylerin var olan bilgi birikimleri ve
deneyimleri afet yönetimi açısından önem taşımaktadır.
Kitabın bu bölümünde yaşlı bireyler açısından afetlerin yönetimine yönelik yapılan araştırmaların kavramsal çerçevesi, yaşlı bireylerin afetlerde karşılaştıkları zorluklar, bu zorluklara yönelik öneriler ile yaşlı bireyler açısından afetlerin yönetimi konuları yer alacaktır.
Bu araştırmanın amacı, 06 Şubat 2023 günü Kahramanmaraş merkezli yıkıcı depremlerin toplumsal etkilerini incelemektir. Araştırmada depremzedelerin deprem anındaki deneyimleri, yaşanan hasar ve kayıplar, kurtarma ve yardım faaliyetleri ile deprem sonrasında yaşadıkları psiko-sosyal sorunların boyutları, onların perspektifinden anlaşılmaya çalışılmıştır. Ayrıca depremzedelerin yaşadıkları afete atfettikleri anlam da ortaya konulmaya çalışılmıştır. Araştırma, yıkıcı depremlerden üç hafta sonra, katılımcı gözlem ve esnek nitel görüşme yöntemi kullanılarak gerçekleştirilmiştir. Depremzedelerin hassasiyetleri dikkate alınarak, görüşmeler doğal akışı içinde yapılmış ve depremzedelerin sözlerini kesmemeye özen gösterilmiştir. Deprem sonrasında bölgede güçlü bir pro-sosyal davranışın (toplumsal dayanışmanın) geliştiği gözlenmiştir. İlk günlerde az da olsa anti-sosyal davranışlar (yağma ve suç) örnekleri görülmüş, ancak kısa süre-de kontrol altına alınmıştır. Görüşme yapılan depremzedelerin büyük bir bölümünde uykusuzluk, kaygı, korku, sinirlilik, konsantrasyon sorunları, unutkanlık, anlamsızlık ve gelecek kaygısı gibi psikolojik belirtiler gözlenmiştir. Kadınlar, çocuklar ve yoksullar diğer gruplara kıyasla depremden
daha olumsuz etkilenmişlerdir.
Ayrıca yaşanan depreme atfedilen anlam, kişinin eğitim, gelir ve dini
bağlılık düzeyine göre değişmektedir. Görüşme yapılan katılımcıların bir
bölümü depremin yıkıcı etkilerini tabiat kuralları, denetimsizlik, çürük
binalar gibi nedenlerle açıklarken, daha büyük bir bölümü de depremi günahkârlıkların bir sonucu veya Tanrının bir cezası olduğunu düşünmüşlerdir.
Deprem bölgesinde, depremin neden olduğu stres ve kaynakların
sınırlı olması ve aynı deprem çadırı alanlarının paylaşılmasının etkisiyle, göçmen karşıtlığı yoğun bir şekilde gözlemlenmiştir.
Anahtar Kelimeler: Kahramanmaraş depremleri, psiko-sosyal
sorunlar, pro-sosyal davranış, anti-sosyal davranış ve anlam atfetme.
Objective
With natural hazards increasing in frequency and severity and global population aging, preparedness efforts must evolve to address older adults’ risks in disasters. This study elucidates potential contributors to the elevated older adult mortality risk following Hurricane Maria in Puerto Rico through an examination of community stakeholder preparedness, response, and recovery experiences.
Methods
In April 2018, qualitative interviews (n = 22) were conducted with stakeholders in 7 Puerto Rican municipalities. Interview transcripts were deductively and inductively coded and analyzed to identify salient topics and themes representing participant response patterns.
Results
The hurricane’s detrimental impact on older adult health emerged as a prominent finding. Through 6 months post-hurricane, many older adults experienced unmet needs that contributed to declining physical and emotional health, inadequate non-communicable disease management, social isolation, financial strain, and excess morbidity and mortality. These needs were predominantly consequences of lengthy public service gaps, unsafe living conditions, interrupted health care, and the incongruence between preparedness and event severity.
Conclusions
In a landscape of increasing natural hazard frequency and magnitude, a pattern of older adult risk has become increasingly clear. Study findings compel practitioners to engage in natural hazard preparedness planning, research, and policy-making that considers the multiple facets of older adult well-being.
But de l’étude
En 2013, un déraillement de train à Lac-Mégantic (Québec, Canada) a occasionné d’importantes pertes humaines et matérielles. Cette étude documente les conséquences de l’exposition à cette catastrophe sur le fonctionnement psychosocial d’adolescents.
Méthode
Trois ans et demi après la tragédie, 689 élèves, âgés de 12 à 18 ans, ont complété, tous en même temps, un questionnaire autoadministré au sein de leur école.
Résultats
L’étude souligne que les jeunes adolescents exposés au désastre étaient significativement plus nombreux à constater une diminution de la qualité de vie dans leur communauté (12,9 %), à présenter une estime de soi et un niveau de résilience plus faibles, ainsi qu’à éprouver des problèmes psychologiques, dont des manifestations de stress post-traumatique (15,6 %) et des pensées suicidaires (38,9 %), au cours de l’année précédant l’enquête. Les adolescents exposés étaient aussi significativement plus nombreux à déclarer des difficultés, tant personnelles, familiales que scolaires, en raison de leur consommation d’alcool.
Conclusion
L’étude souligne que, plus de trois ans après un déraillement de train, les adolescents qui avaient été exposés à cette catastrophe, comparativement à leurs pairs non exposés, étaient davantage affectés dans plusieurs aspects leur vie personnelle, familiale, scolaire et communautaire. Les résultats mettent de l’avant l’importance d’agir auprès des adolescents victimes d’une catastrophe.
https://www.sciencedirect.com/science/article/pii/S0222961721001148?dgcid=author
Objectives
The aim of this study was to examine social network characteristics and social support (emotional and instrumental support) and to determine how those factors differed between relocating older adults and nonrelocating older adults who were affected by the 2015 flood in South Carolina.
Methods
Twenty-five community-dwelling elderly (CDE) were interviewed between December 2015 and May 2016 to learn about their experiences in the immediate aftermath of the flood. Ego-centric network data were collected with a focus on social network members and the types of flood-related support that these network members provided.
Results
Ten of 25 CDE relocated because of the flood. All CDE were more likely to receive social support from female network members and family members than from other acquaintances. Relocating CDE received significantly less emotional support in comparison to nonrelocating CDE. The odds of receiving instrumental support were higher, but nonsignificant, among relocating CDE in comparison to nonrelocating CDE.
Conclusions
The findings around the support provision are concerning particularly because of the additional psychological burden that relocation can place on flood-affected, older adults. Recommendations for public health preparedness strategies are provided in addition to future research directions for examining the well-being of flood-affected, older adults.
The psychosocial impact concept improves the understanding of the effects of disasters on people and communities. However, its definition is not clear. This work explores consistencies between studies (k = 21) that refer to the psychosocial impact of disasters by way of a meta-analytic synthesis. This synthesis indicates that people are more prone to illness when they are exposed to a disaster, and less when they are protected (OR = 2.737). Please check the change conveys the intended meaning or amend Nevertheless, there are no differences in healthy responses, regardless of how protected or exposed they are (OR = 1.053). Finally, a model is proposed to explain four types of psychosocial impact: resilient, traumatic, sensitive, witness.
Pre-existing longitudinal studies of people affected by disasters provide opportunities to examine the effects of these events on health. Data used in the current investigation were provided by participants in the New Zealand Health, Work and Retirement longitudinal surveys conducted in 2010, 2012 and 2014 (n = 428; aged 50–83), who lived in the Canterbury region of New Zealand during the 2010–2011 earthquakes. Latent profile growth analyses were used to identify groups of respondents who had similar pre–post-disaster physical and mental health profiles. These groups were compared in terms of demographic factors, personal impact of the earthquakes assessed in 2012 and the overall negative–positive impact of the earthquake assessed in 2014. There was little evidence of change in health status overtime. Groups did not differ in their experiences of threat or disruption, however those in poorest health reported greatest distress and a more negative overall impact of the earthquake. Although results suggest little impact of disasters on health of surviving older adults, pre-disaster vulnerabilities were associated with distress. Social workers and agencies responsible for disaster response can play a key role in pre-disaster planning and assessment of vulnerabilities of older adults to enhance potential for positive outcomes post-disaster.
The psychosocial impact concept improves the understanding of the effects of disasters on people and communities. However, its definition is not clear. This work explores consistencies between studies (k = 21) that refer to the psychosocial impact of disasters by way of a meta-analytic synthesis. This synthesis indicates that people are more prone to illness when they are exposed to a disaster, and less when they are protected (OR = 2.737). Please check the change conveys the intended meaning or amend Nevertheless, there are no differences in healthy responses, regardless of how protected or exposed they are (OR = 1.053). Finally, a model is proposed to explain four types of psychosocial impact: resilient, traumatic, sensitive, witness.
Background
Despite the growing interest in the study of disasters, there is limited research addressing the elderly population that lead to prejudiced beliefs that older adults are more vulnerable to disasters than younger adults. This study aimed to compare positive mental health between elderly and young earthquake survivors.
Method
Data for this study, consisting of 324 earthquake survivors, were obtained from a population-based cross-sectional survey conducted in Iran, 2015. The long-term effect of earthquake was assessed using the Mental Health Continuum-Short Form questionnaire. A one-way multivariate analysis of covariance (MANCOVA) using SPSS (version 22) was used in data analysis.
Results
Older adults scored significantly a higher level of overall positive mental health (mean [M]=34.31, standard deviation [SD]=10.52) than younger age group (M=27.48, SD=10.56, t=−4.41; P<0.001). Results of MANCOVA revealed a statistically significant difference between older and young adults on the combined positive mental health subscales (F(3,317)=6.95; P<0.001), after controlling for marital status, sex, and employment status.
Conclusion
The present findings showing a higher level of positive mental health among elderly earthquake survivors compared with their younger counterparts in the wake of natural disasters suggest that advancing age per se does not contribute to increasing vulnerability.
Aim:
The present study examines the associations among social support, coping strategies and relocation adjustment outcomes, including community cohesion, residential satisfaction and depressive symptoms, for older persons in Taiwan displaced by Typhoon Morakot.
Methods:
This study enrolled 372 adults aged 60 years or older who were relocated to permanent houses after Typhoon Morakot destroyed their homes on 8 August 2009. A path analysis simultaneously examined the hypothesized links among social support, coping strategies and relocation adjustment outcomes.
Results:
The relationships between coping strategies and relocation outcomes varied. Problem-focused and support-seeking coping were positively related to perceived community cohesion, whereas emotion-focused coping was associated with a high number of depressive symptoms. Social support was positively related to residential satisfaction. Additionally, social support was also indirectly related to increased community cohesion and residential satisfaction through its positive relationship with support-seeking and problem-focused coping.
Conclusions:
More interventions should be implemented to enhance support within informal networks and a sense of belonging to the new resident community, thereby promoting more active coping strategies, enhancing the effectiveness of coping efforts and maximizing positive adjustment outcomes.
INTRODUCTION There is a large body of empirical evidence illustrating that disasters can have considerable mental health effects for a significant proportion of survivors, ranging from temporary stress reactions to more persistent and severe psychopathology (Norris, Friedman, & Watson, 2002). Although there is still some ongoing debate regarding risk and protective factors for mental health vulnerability in the face of disasters, some evidence suggests that those at greater risk are children, women, people of low socioeconomic status, individuals with physical and mental disabilities, ethnic minorities, first responders, the uninsured, residents of rural areas, and subgroups of older adults (Johnson et al., 2006; Johnson & Langlieb, 2005; Mokdad et al., 2005; Norris et al., 2002). Advances in public health, biomedicine, and socioeconomic and living conditions have all contributed to making older adults one of the fastest growing segments of the population in the United States and other industrialized countries (He, Sengupta, Velkoff, & DeBarros, 2005). Among those 65 years of age and older, women far outnumber men, and there is increasing heterogeneity in race and ethnicity (He et al., 2005). Since female gender and ethnic minority status are two potential risk factors for vulnerability in the event of a disaster, this may compound concern for those among the older adult population. There are numerous views regarding why older adults are or are not expected to be differentially vulnerable to the effects of disasters.
This study examines the effects of economic loss on the life satisfaction and mental health of Wenchuan earthquake survivors. Economic loss is measured by earthquake impacts on the income and houses of the survivors. The correlation analysis shows that earthquake impact on income is significantly correlated with life satisfaction and depression. The regression analyses indicate that earthquake impact on income is indirectly associated with life satisfaction and depression through its effect on financial strain. The research highlights the importance of coping strategies in maintaining a balance between economic status and living demands for disaster survivors.
© 2015 The Author(s). Disasters © Overseas Development Institute, 2015.
The aim of the current study was to systematically assess the psychological effects of the Persian Gulf War on a nonclinical group of elderly Israeli civilians with and without a Holocaust background.
Sixty-one elderly Holocaust survivors and 131 elderly civilians without a Holocaust background completed questionnaires in their homes. Measures included sense of safety, symptoms of psychological distress, and levels of state and trait anxiety.
Findings indicate that Holocaust survivors perceived higher levels of danger and reported more symptoms of acute distress than comparison subjects. In addition, they displayed higher levels of both state and trait anxiety.
Findings do not support the notion that prior experience with extreme stress has an inoculating effect that leads to greater resilience in dealing with other forms of stress. On the contrary, Holocaust experience was found to render the elderly more vulnerable rather than less. These findings of greater vulnerability among Holocaust survivors are of particular significance since they stem from a nonclinical group.
The Mississippi Scale for Combat-Related Posttraumatic Stress Disorder is a 35-item self-report scale derived from Diagnostic and Statistical Manual of Mental Disorders criteria for the disorder. This article describes a series of three studies designed to explore the psychometric properties of the scale. Study 1 used 362 Vietnam veterans seeking help at Vet Centers (Operation Outreach) to confirm the internal consistency of the instrument and provide an assessment of its factor structure. Study 2 demonstrated the high test—retest reliability of the instrument over a period of 1 week. Study 3 indicated that the test’s sensitivity was .93, specificity was .89, and overall hit rate was .90 when it was used to differentiate between a posttraumatic stress disorder (PTSD) group and two non-PTSD comparison groups. The utility of the test when it is administered within the context of a multiaxial approach to assess military-related PTSD is discussed.
This paper addresses two issues: (a) the utility of applying the social support-stress-coping paradigm to the study of substance abuse, and (b) refinements needed in conceptualization of the coping aspect of the model. A brief review of the more recent theoretical and methodological treatments of social support is followed by an examination of two limitations of current perspectives. The first limitation considered is the failure of previous work to address the behavioral components of the hypothesized connection between social support and stress reduction, and the second is the lack of “bidirectionality” in social support models. Data from a study of heroin addicted women is used to illustrate how refinements in the coping aspect of the model, in particular, may help clarify the role of social support in stress reduction. Findings included the indication that, for heroin addicted women, the absence of social support is associated with the use of non-social, potentially dysfunctional coping strategies. A similar pattern did not exist for men.
The long-term outcome of a civilian disaster is examined in an elderly population assessed originally for medicolegal purposes. Thirty-one elderly inhabitants of the village of Lockerbie, who had survived the Lockerbie air disaster, were assessed 1 year after the event. Nineteen of the sample were available for reexamination 2 years later. Although there was a significant reduction in the incidence of PTSD and significant improvement across a range of anxiety-based symptoms, 15.7% of the subjects continued to fulfil diagnostic criteria (DSM-III-R) for PTSD. In these subjects, there was a persistence of other anxiety-related symptoms and of major depression (DSM-III-R). This is the only longitudinal assessment of PTSD in elderly subjects and it shows that, as with younger subjects, PTSD tends to persist for at least 2 years after the traumatic event and, for a substantial minority, has still not remitted within 3 years of the traumatic event.
Validated the General Health Questionnaire (GHQ) among 300 urban Spanish adults (aged 65+ yrs). The following results were obtained: sensitivity 75%, specificity 80%, test efficiency 77%, and wrongly classified ratio 22.86%. These results and the application advantages of the GHQ-28 (briefness, simplicity, self-administration) make it a valid instrument to be used in the 1st of 2 phases in screening surveys among the geriatric population. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
Thirty-one elderly people were examined in Lockerbie and compared with 24 younger survivors of the disaster which took place in December 1988. Examination took place within one year of the disaster, but was timed to avoid the anniversary period. All subjects were in Lockerbie at the time the aeroplane exploded in mid-air. Examinations were conducted for purposes of medico-legal assessment. The elderly had similar responses to the younger disaster victims, the majority of whom met DSM-III-R criteria for PTSD. The elderly, however, had a very high incidence of coexisting major depression, unlike the younger population. Loss or injury to friends and the witnessing of human remains was positively correlated with a diagnosis of post-traumatic stress disorder in the elderly but not in the younger subjects. Neither material nor personal loss, nor the witnessing of human remains, was associated with a diagnosis of depression in the elderly, although significant material loss was associated with depression in the younger patients.
Thirty former World War II Far East prisoners of war were assessed with a structured clinical interview for PTSD based on DSM-III-R criteria and the results compared with the self-report measures. Thirty per cent of the subjects fulfilled a DSM-III-R diagnosis of PTSD and 90% complained of at least one post traumatic intrusive or avoidant symptom. The Mississippi scale was the most accurate measure of PTSD severity (r = 0.81) and the MMPI-PTSD subscale was the most efficient dichotomous measure of PTSD (sensitivity = 0.89 and specificity = 0.62). The avoidance subscale of the impact of event scale did not discriminate avoidant symptoms from those of intrusion. Self-report scales for chronic PTSD used in the elderly should be interpreted with caution and require further evaluation of their validity.
A review of the research literature is provided regarding vulnerability and psychological resource characteristics of the victim that mediate between disaster and psychopathology. Common generalizations about the effect of vulnerability variables such as age, gender, and previous level of functioning are seldom supported. Coping styles appear promising predictive variables. Attitude variables deserve further attention. More complex designs are suggested to determine interaction effects between disaster and victim variables.
Some age-related effects of the 1974 Brisbane floods are examined. The impact of the floods on health increased in those over 35 years of age probably because they were more likely to be householders. Women under 65 years of age had more psychiatric symptoms than men, but this sex difference disappeared in those over 65 years, perhaps because the working man is not constantly confronted with the damage to his home in the way that others are. The possibility that people over 75 years living in flood-affected suburbs experienced increased morbidity even though not themselves flooded cannot be excluded.
Clinical, field, and experimental studies of response to potentially stressful life events give concordant findings: there is a general human tendency to undergo episodes of intrusive thinking and periods of avoidance. A scale of current subjective distress, related to a specific event, was based on a list of items composed of commonly reported experiences of intrusion and avoidance. Responses of 66 persons admitted to an outpatient clinic for the treatment of stress response syndromes indicated that the scale had a useful degree of significance and homogeneity. Empirical clusters supported the concept of subscores for intrusions and avoidance responses.
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.
In the 12 months following the Brisbane flood of 1974, 234 flooded families (695 persons) and 163 non-flooded families (507 persons) were interviewed to ascertain changes in health status. We found that the number of visits to general practitioners, hospitals and specialists were all significantly increased for flooded persons in the year following the flood. Persistent psychological symptoms, which included irritability, nervous tension and depressed mood, predominated in those seeking medical care, and the consumption of sleeping tablets and psychotropic drugs rose. Increased psychological symptoms were significantly more common in female than in male flood victims and significantly more common in both sexes than increased physical complaints. There was no increase in mortality after the flood. The incidence of psychiatric symptoms was directly related to dissatisfaction with help received.
A screening questionnaire was distributed to 5,000 adult members of the community six months after the 1989 Newcastle earthquake, with a response rate of 63 per cent (n = 3,007). The mean age of respondents was 46.7 years and 58 per cent were female. Subjects' earthquake experiences were rated in terms of weighted indices of exposure to threat and disruption. Psychological morbidity was measured using the General Health Questionnaire and the Impact of Event Scale. Subjects were asked to indicate which of a range of general and disaster-related support services they had used in dealing with the stressful effects of the earthquake. It was estimated that 21.3 per cent of the adult population used general and/or disaster-related support services. Users of these services reported greater exposure to threat and/or disruption and had higher levels of psychological distress than nonusers. However, a high level of use of general services and reliance on medical services were related more to psychological morbidity than degree of exposure to earthquake-related events. Overall, the Newcastle community's needs for assistance in the aftermath of the earthquake were effectively absorbed by the existing support services and the resources marshalled to supplement those services. Individuals and organisations mobilised following natural disasters need to be strengthened by enhancing the capacity of support service workers to identify and manage psychological distress in their clients.
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.
In a prospective study of 81 independently living elderly persons, information on coping strategy in response to a stressful life event was used in a canonical analysis to examine the relationship between coping factors and health status measures. A canonical correlation of .53 (28% of variance) indicated that those who responded to stressful life events with self-blame, wishful thinking, and avoidance tended to be more symptomatic 4 months later. In a regression analysis, avoidant coping significantly contributed to the prediction of psychological disturbance at the time of the second interview (R2 = .22, p less than .05). Coping strategy, however, did not significantly contribute to the prediction of physical health status during the interval examined. These results are generally consistent with the notion that coping strategies modulate the influence of life events on health and well-being but underscore the possibility that such relationships may differ depending on whether physical or psychological health status is being predicted.
The use of the 30-item GHQ as a screening instrument in a community population aged 70 years and older was examined. An acceptable sensitivity (70%) and specificity (84%) was obtained. As in the younger age groups, the GHQ was not good at detecting chronic, generalised anxiety disorders. The GHQ is best used in combination with the MMSE to screen out cases of dementia in an elderly population.
Using a prospective design with five follow-up intervals, the study addressed questions regarding the timing of onset, duration,
course, and nature of psychological reactions to natural disaster. As participants in a statewide panel study, more than 200
older adults were interviewed both before and after two distinct floods occurred in southeastern Kentucky in 1981 and 1984.
Exposure to these incidents, which differed in overall intensity, was assessed at both the individual and community levels.
Personal loss was associated with short-term increases in negative affect, limited to one year postflood. Longer-term effects
were more dependent on the level of community destruction. Exposure to high levels of community destruction was related to
decreased positive affect up to two years postdisaster, whereas exposure to high levels of both community destruction and
personal loss was predictive of increased negative affect for two years.
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.
This study examined the longitudinal course, over a 25-month period, of posttraumatic morbidity in a group of 469 firefighters exposed to a bushfire disaster. The patterns of posttraumatic morbidity were defined by the General Health Questionnaire. Contrary to expectation, an acute pattern of morbidity was less common than the delayed-onset or chronic forms. Predisaster variables were found to be as important in the onset and course of the disorder as were the firefighters' losses or extent of exposure to the disaster. These data suggest that exposure to an extreme trauma is necessary but not sufficient to explain the onset and pattern of posttraumatic morbidity.
The failure of researchers to consider the temporal dimensions of the stress process may be at least partially responsible for the disappointing empirical findings from research on stress and health. We argue that careful consideration must be given to the time lag between the occurrence of a stressor and initial symptom development, as well as the length of time that is required for symptoms to abate. Using a synthetic cohort design, we examine the length of time needed for symptoms to dissipate following a natural disaster (Hurricane Alicia). Findings from a random community survey of older adults suggest that the major effects of the storm diminish in about 16 months. Significant gender differences were found in this adjustment process. The implications of these findings for stress research are discussed.
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.
The nature of individual coping responses to stressful life events was explored in a representative adult community sample. Two approaches to the classification of coping strategies were operationalized. Using these measures, small but significant gender and contextual differences in coping were identified. Mood and symptom levels were related to coping responses and to quantitative and qualitative measures of social resources. Measures of coping and social resources attenuated the relationship between undesirable life events and personal functioning.
SYNOPSIS
A stratified random sample of 3007 Australian adults completed a screening questionnaire 6 months after the 1989 Newcastle earthquake. Information was obtained on initial earthquake experiences and reactions, use of specific services, social support, coping strategies and psychological morbidity. This questionnaire was the first phase of the Quake Impact Study, a longitudinal project investigating the psychosocial impact of the earthquake. Two weighted indices of exposure were developed: a threat index, which measured exposure to injury or the possibility of injury; and a disruption index, which measured experiences of property damage, displacement and other losses. Levels of exposure to threat and disruption events were significant predictors of morbidity on both the General Health Questionnaire and Impact of Event Scale, as were coping style and gender. Effects of exposure to threat and disruption were largely additive, with higher exposure being associated with greater use of support services, higher perceived stressfulness and more severe psychological morbidity. Use of avoidance as a coping strategy, female gender, lower social support and being older were also associated with higher post-disaster psychological distress. It was estimated that 14·8% of the population was exposed to high levels of threat or disruption, of whom approximately 25% experienced moderate to severe psychological distress as a direct result of the disaster. It was further estimated that 18·3% of those exposed to high levels of threat were at risk of developing post-traumatic stress disorder, representing approximately 2% of the city's adult population.
408 elderly primary care attenders were screened using the Geriatric Depression Scale (GDS) and the 30-item General Health Questionnaire (GHQ). 36% were identified as 'cases' on the GDS and 32% on the GHQ. The 'cases' and a random sample of 'non-cases' were interviewed using the Geriatric Mental State Examination (GMS), the Bedford College Life Events and Difficulties Interview (LEDS), the National Adult Reading Test (NART), and systematic inquiry concerning physical health. Sensitivity and specificity of the GDS were 85% and 68%, and of the GHQ 77% and 67%. General practitioner identification of cases showed a sensitivity of 78% and a specificity of 60% against the GMS. Depression was significantly associated with life events, chronic difficulties, poor physical health and current lack of a confiding relationship. Subjective complaints of depression were associated with low premorbid intelligence and lifelong lack of a confiding relationship. The availability of a confiding relationship appears to have a protective effect against depressive illness associated with life events and chronic difficulties.
This study was undertaken 1 1/2 years after the 1988 earthquake in Armenia to assess the frequency and severity of posttraumatic stress reactions among elderly and younger adult victims and to assess the relation of exposure, age, sex, and death of a family member to these reactions.
One hundred seventy-nine subjects of both sexes were evaluated with the Posttraumatic Stress Disorder (PTSD) Reaction Index. A subgroup of 60 individuals were also assessed for PTSD with the DSM-III-R criteria.
There was a strong association between the presence of severe symptoms on the index and a DSM-III-R diagnosis of PTSD. Elderly and younger adult victims in cities closer to the epicenter (higher exposure) had significantly higher index scores than elderly and adult victims in more distant locations. In comparison with previous studies of natural disasters, much greater rates of chronic severe posttraumatic stress reactions were found among the highly exposed individuals. Although there was no difference in total mean score on the Posttraumatic Stress Disorder Reaction Index, a significant difference in symptom profile was found between the elderly and younger adults; the elderly scored higher on arousal symptoms and lower on intrusive symptoms. There was a positive correlation between loss of family members and severity of posttraumatic stress reaction.
These findings indicate that after a major natural disaster with subsequent multiple adversities, a substantial proportion of the adult population may experience severe and chronic posttraumatic stress reactions. The risk factors identified in this study may prove useful in screening exposed individuals for appropriate treatment.
The Defense Style Questionnaire has proven of interest as the first questionnaire to reliably describe defense styles. The 72-item DSM-III-R-labeled Defense Style Questionnaire was administered to 388 controls and 324 patients. Eight statistical and two a priori criteria were used in choosing two items to represent each of the 20 defenses. A new 40-item Defense Style Questionnaire is published together with normative and reliability data on a normal population, patients with anxiety disorders, and child-abusing parents. The scores are unaffected by the sex of the respondent, but the endorsement of immature defense styles decreases with age.
Synopsis
This paper describes the construction, refinement and implementation of a self-administered measure of personal hopefulness, the Hunter Opinions and Personal Expectations Scale (HOPES). Initial state and trait versions of the HOPES instrument were utilized in three separate studies, comprising a medical student sample ( N = 211), an adolescent male sample ( N = 280) and a psychiatric hospital staff sample ( N = 318). A revised 20-item, two factor, trait version of the scale was then utilized in a prospective, longitudinal investigation ( N = 753) of the psychosocial sequelae of the earthquake which struck Newcastle (Australia) in December, 1989. Data from all four studies provide strong support for the HOPES instrument's construct, concurrent and predictive validity. Global personal hopefulness (GPH) was shown to be an enduring characteristic of individuals, with a test–retest correlation of r = +0·71 (over 64 weeks). The association between GPH and trait anxiety ( r = −0·64) raised the possibility of redefining anxiety as hope under threat. The hope subscale (HS) and the despair subscale (DS) were moderately negatively correlated ( r = −0·32), suggesting that hope and despair are not simply polar opposites. There were no gender differences in GPH scores, however, there were relatively clear age effects, with those aged 70 years and over reporting the lowest levels of personal hopefulness. GPH was negatively correlated with post-earthquake scores on the General Health Questionnaire ( r = −0·33), the Impact of Event Scale ( r = −0·33), the Beck Depression Inventory ( r = −0·54) and the global symptom index from the SCL-90-R ( r = −0·43). Overall, the contribution made by personal hopefulness to post-earthquake morbidity was equal to the contributions made by initial exposure to disruption and threat experiences.
This paper examines the contributions of dispositional and non-dispositional factors to post-disaster psychological morbidity. Data reported are from the 845 participants in the longitudinal component of the Quake Impact Study.
The phase 1 survey was used to construct dimensional indices of threat and disruption exposure. Subsequently, a range of dispositional characteristics were measured, including neuroticism, personal hopefulness and defence style. The main morbidity measures were the General Health Questionnaire (GHQ-12) and Impact of Event Scale (IES).
Dispositional characteristics were the best predictors of psychological morbidity throughout the 2 years post-disaster, contributing substantially more to the variance in morbidity (12-39%) than did initial exposure (5-12%), but the extent of their contribution was greater for general (GHQ-12) than for post-traumatic (IES) morbidity. Among the non-dispositional factors, avoidance coping contributed equally to general and post-traumatic morbidity (pr = 0.24). Life events since the earthquake (pr = 0.18), poor social relationships (pr = -0.25) and ongoing earthquake-related disruptions (pr = 0.22) also contributed to general morbidity, while only the latter contributed significantly to post-traumatic morbidity (pr = 0.15).
Medium-term post-earthquake morbidity appears to be a function of multiple factors whose contributions vary depending on the type of morbidity experienced and include trait vulnerability, the nature and degree of initial exposure, avoidance coping and the nature and severity of subsequent events.
A sample of 1089 Australian adults was selected for the longitudinal component of the Quake Impact Study, a 2-year, four-phase investigation of the psychosocial effects of the 1989 Newcastle earthquake. Of these, 845 (78%) completed a survey 6 months post-disaster as well as one or more of the three follow-up surveys.
The phase 1 survey was used to construct dimensional indices of self-reported exposure to threat the disruption and also to classify subjects by their membership of five 'at risk' groups (the injured; the displaced; owners of damaged small businesses; helpers in threat and non-threat situations). Psychological morbidity was assessed at each phase using the 12-item General Health Questionnaire (GHQ-12) and the Impact of Event Scale (IES).
Psychological morbidity declined over time but tended to stabilize at about 12 months post-disaster for general morbidity (GHQ-12) and at about 18 months for trauma-related (IES) morbidity. Initial exposure to threat and/or disruption were significant predictors of psychological morbidity throughout the study and had superior predictive power to membership of the targeted 'at risk' groups. The degree of ongoing disruption and other life events since the earthquake were also significant predictors of morbidity. The injured reported the highest levels of distress, but there was a relative absence of morbidity among the helpers.
Future disaster research should carefully assess the threat and disruption experiences of the survivors at the time of the event and monitor ongoing disruptions in the aftermath in order to target interventions more effectively.
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