Social Psychiatry and Psychiatric Epidemiology

, Volume 48, Issue 3, pp 385–395

The course of posttraumatic stress symptoms and functional impairment following a disaster: what is the lasting influence of acute versus ongoing traumatic events and stressors?

  • M. Cerdá
  • P. M. Bordelois
  • S. Galea
  • F. Norris
  • M. Tracy
  • K. C. Koenen
Original Paper

DOI: 10.1007/s00127-012-0560-3

Cite this article as:
Cerdá, M., Bordelois, P.M., Galea, S. et al. Soc Psychiatry Psychiatr Epidemiol (2013) 48: 385. doi:10.1007/s00127-012-0560-3

Abstract

Purpose

Ongoing traumatic events and stressors, rather than acute sources of trauma, may shape long-term post-disaster mental health. The purpose of this study was to compare the influence of acute hurricane-related exposures and ongoing post-hurricane exposures on the short- and long-term course of posttraumatic stress symptoms (PTSS) and functional impairment (FI).

Methods

A random sample of adults (n = 658) in Galveston and Chambers Counties, Texas, was selected 2–6 months after Hurricane Ike and interviewed 3 times over 18 months. Hurricane-related exposures included traumatic events such as death of a family member due to the hurricane and stressors such as loss/damage to personal property due to the hurricane. Post-hurricane exposures included traumatic events such as sexual assault and stressors such as divorce or serious financial problems.

Results

Experiencing an acute hurricane-related traumatic event or stressor was associated with initial post-hurricane PTSS [RR = 1.92 (95 % CI = 1.13–3.26) and RR = 1.62 (1.36–1.94), respectively] and FI [RR = 1.76; (1.05–2.97) and RR = 1.74 (1.46–2.08)], respectively, and acute hurricane-related stressors were associated with a higher rate of increase in FI over time [RR = 1.09; (1.01–1.19)]. In contrast, ongoing post-hurricane daily stressors were not associated within initial PTSS and FI, but were associated with PTSS and FI at the second and third interviews.

Conclusions

While immediate postdisaster interventions may influence short-term mental health, investment in the prevention of ongoing stressors may be instrumental to manage long-term mental health status.

Keywords

Posttraumatic stress disorder Disasters Functional impairment Traumatic events Daily stressors 

Copyright information

© Springer-Verlag 2012

Authors and Affiliations

  • M. Cerdá
    • 1
    • 2
  • P. M. Bordelois
    • 1
  • S. Galea
    • 1
    • 2
  • F. Norris
    • 2
    • 3
    • 4
  • M. Tracy
    • 1
    • 2
    • 5
  • K. C. Koenen
    • 1
  1. 1.Department of EpidemiologyColumbia University, University Mailman School of Public HealthNew YorkUSA
  2. 2.National Center for Disaster Mental Health ResearchWhite River JunctionUSA
  3. 3.National Center for PTSDVA Medical CenterWhite River JunctionUSA
  4. 4.Department of PsychiatryDartmouth Medical School, Dartmouth UniversityHanoverUSA
  5. 5.Department of EpidemiologySchool of Public Health University of MichiganAnn ArborUSA

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