Social capital and chronic post-traumatic stress disorder among survivors of the 2007 earthquake in Pisco, Peru
This study aimed to evaluate the association between chronic Post-Traumatic Stress Disorder (PTSD) and both structural and cognitive social capital in adult survivors of the 2007 earthquake in Pisco, Peru. Cognitive social capital measures trust, sense of belonging and interpersonal relationships in the community and structural social capital measures group membership, support from community groups and individuals, and involvement in citizenship activities. We conducted a population-based cross-sectional study in five counties in Pisco, selecting 1012 adults through complex, multi-stage random sampling. All participants completed socio-demographic questions and validated Spanish-language versions of the Adapted Social Capital Assessment Tool (SASCAT) and the civilian PTSD checklist (PCL-C). After performing descriptive and bivariate analyses, we carried out prevalence ratio (PR) regression. The overall prevalence of chronic PTSD was 15.9% (95% CI: 12.3, 19.8), much higher than anticipated based on existing evidence. Cognitive social capital was found to be negatively associated with chronic PTSD, while no significant association was found for structural social capital. Specifically, those with high cognitive social capital had an almost two times lower prevalence of chronic PTSD (PR = 1.83, 95% CI: 1.50, 2.22) compared with those with low cognitive social capital. No independent association between structural social capital and chronic PTSD was found (PR = 1.44, 95% CI: 0.70, 2.97). In conclusion, cognitive social capital, but not structural social capital, has a protective influence on the occurrence of chronic PTSD in survivors of natural disasters. These results may have public health implications. For example, pre- and post-disaster community-based interventions that catalyze and foster dimensions of cognitive social capital may aid in ameliorating the effect of earthquakes and other natural disasters on populations with high vulnerability to such events and poor access to mental health and other support services.
Available from: Paolo Stratta
- "There is now agreement that PTSD represents the most frequent mental disorder occurring after exposure to mass trauma, particularly earthquakes (Maj et al., 1989; Armenian et al., 2002; Lai et al., 2004; Wang et al., 2011; Ehring et al., 2011; Zhang et al., 2011; Carmassi et al., 2014b). PTSD prevalence rates ranging between 10.3% and 49.6% have, in fact, been reported in the general population exposed to such events (Armenian et al., 2000; Bödvarsdottir and Elklit, 2004; Kun et al., 2009; Wang et al., 2009; Cairo et al., 2010; Dell'Osso et al., 2011b; Carmassi et al., 2013), besides the tendency to a chronic and highly debilitating course and an elevated risk of complications such as suicide (Chou et al., 2007; Stratta et al., 2012; Flores et al., 2014; Cénat and Derivois, 2014). Consisting results were reported by some of us regarding Italian survivors to the earthquake (Richter Magnitude 6.3) that struck the town of L'Aquila (Italy) on April 6th 2009, causing 309 victims, more than 1600 wounded and 66,000 displaced (Dell'Osso et al., 2011a, 2011b, 2012a, 2012b; Carmassi et al., 2014a). "
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Considerable comorbidity rates between Post-traumatic Stress Disorder (PTSD) and eating disorders have been recently reported, as well as increased obesity and underweight conditions. The aim of the present study was to investigate the possible associations between DSM-5 PTSD, gender and impaired eating habits in a sample of 512 Italian earthquake survivors evaluated by the Trauma and Loss Spectrum-Self Report (TALS-SR) and the Mood Spectrum-Self Report (MOODS-SR). Alterations in eating behaviors were assessed by means of four MOODS-SR items: n=150 (…there was no food that appealed to you or tasted good to you?), n=151 (…you constantly craved sweets or carbohydrates?), n=152 (…your appetite or weight decreased?), n=153 (…your appetite or weight increased?). In a Decision Tree procedure subjects with PTSD with respect to those without and, in the No-PTSD subgroup, females with respect to males, had a significantly higher ratio of at least one MOODS-SR eating behavior item (MOODS-SR EB). In the No-PTSD subgroup only, subjects with at least one MOODS-SR EB presented a significantly higher mean TALS-SR symptomatological domains total score with respect to those without MOODS-SR EB. In conclusion, alterations in eating behaviors were associated with PTSD after the L׳Aquila earthquake; among survivors without PTSD significant a correlation emerged between MOODS-SR EB and PTSD symptoms.
Psychiatry Research 01/2015; 225(1-2):64-69. DOI:10.1016/j.psychres.2014.10.008 · 2.47 Impact Factor
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ABSTRACT: Poor mental health is a concern in the US and world-wide. In this study we examine the effects of socioeconomic and environmental variables on the number of days of poor mental health reported across US counties. The results suggest that educational attainment, employment opportunities including self-employment, and social capital have important benefits in terms of community mental health. Other socio-demographic variables also tend to have predicted effects, as does the amount of sunshine in January, which is our control for Seasonal Affective Disorder. The general conclusion of the study is that living in a non-metro county and adjacent to a metro core, is associated with greater happiness. Mental health days also increase considerably due to natural disasters and they are affected by regional climate variability. For policymakers concerned about reducing the average number of poor mental health days across the nation, our results suggest that reducing poverty is a more powerful strategy than reducing income inequality.
Social Indicators Research 10/2014; 124(2). DOI:10.1007/s11205-014-0792-6 · 1.40 Impact Factor
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ABSTRACT: The long-term psychiatric consequences of exposure to war and/or mass conflict continue to be of great concern and particularly in Cambodia. The current cross-sectional study examined the relationship between history of trauma and current psychiatric and functional morbidity in 3200 randomly selected adults aged 18-60 in Cambodia. Structured interviews were conducted from November 2011 until May 2012 in two predominantly rural regions purposively selected for differing duration of exposure to the Khmer Rouge occupation. Information was also collected regarding ongoing daily stressors and intimate partner violence. Despite high prevalence rates of conflict/war-related trauma, current rates of psychiatric disorders (depression, post-traumatic stress disorder) were relatively low, suggesting that the effects of trauma and extreme hardship in civilian populations may be modified by contextual factors and/or the passage of time. Poor to fair physical health was, however, reported by nearly 60% of the sample. Daily stressors were more important for current morbidity levels than history of trauma, especially in the region with shorter Khmer Rouge occupation. The results suggest that a focus exclusively on past trauma may overlook the contribution of adverse daily life circumstances towards current levels of well-being in civilian populations affected by war and/or mass conflict.
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Social Science & Medicine 10/2014; 123C:133-140. DOI:10.1016/j.socscimed.2014.10.049 · 2.89 Impact Factor
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