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?

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.

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Acknowledgments

We thank Dr. Qixuan Chen and Dr. Linda Muthen for advice on the estimation of the applied statistical models. This research was supported by the National Center for Disaster Mental Health Research (NIMH Grant 5 P60 MH082598) and individual grants to MC (DA030449–01) and KCK (MH093612–01 and MH078928–04). The National Institute of Mental Health and the National Institute on Drug Abuse had no further role in study design; in the collection, analysis and interpretation of data; in the writing of the report; and in the decision to submit the paper for publication.

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The authors declare that they have no conflict of interest.

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Correspondence to M. Cerdá.

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Cerdá, M., Bordelois, P.M., Galea, S. et al. 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?. Soc Psychiatry Psychiatr Epidemiol 48, 385–395 (2013). https://doi.org/10.1007/s00127-012-0560-3

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Keywords

  • Posttraumatic stress disorder
  • Disasters
  • Functional impairment
  • Traumatic events
  • Daily stressors