Complicated grief associated with Hurricane Katrina

Columbia University School of Social Work and Columbia University College of Physicians and Surgeons, New York, New York, USA.
Depression and Anxiety (Impact Factor: 4.29). 08/2011; 28(8):648-57. DOI: 10.1002/da.20865
Source: PubMed

ABSTRACT Although losses are important consequences of disasters, few epidemiological studies of disasters have assessed complicated grief (CG) and none assessed CG associated with losses other than death of loved one.
Data come from the baseline survey of the Hurricane Katrina Community Advisory Group, a representative sample of 3,088 residents of the areas directly affected by Hurricane Katrina. A brief screen for CG was included containing four items consistent with the proposed DSM-V criteria for a diagnosis of bereavement-related adjustment disorder.
Fifty-eight and half percent of respondents reported a significant hurricane-related loss: Most-severe losses were 29.0% tangible, 9.5% interpersonal, 8.1% intangible, 4.2% work/financial, and 3.7% death of loved one. Twenty-six point one percent respondents with significant loss had possible CG and 7.0% moderate-to-severe CG. Death of loved one was associated with the highest conditional probability of moderate-to-severe CG (18.5%, compared to 1.1-10.5% conditional probabilities for other losses), but accounted for only 16.5% of moderate-to-severe CG due to its comparatively low prevalence. Most moderate-to-severe CG was due to tangible (52.9%) or interpersonal (24.0%) losses. Significant predictors of CG were mostly unique to either bereavement (racial-ethnic minority status, social support) or other losses (prehurricane history of psychopathology, social competence.).
Nonbereavement losses accounted for the vast majority of hurricane-related possible CG despite risk of CG being much higher in response to bereavement than to other losses. This result argues for expansion of research on CG beyond bereavement and alerts clinicians to the need to address postdisaster grief associated with a wide range of losses.


Available from: Katie A Mclaughlin, Feb 06, 2015
1 Follower
  • [Show abstract] [Hide abstract]
    ABSTRACT: Background. Interventions to treat mental disorders after natural disasters are important both for humanitarian reasons and also for successful post-disaster physical reconstruction that depends on the psychological functioning of the affected population. A major difficulty in developing such interventions, however, is that large between-disaster variation exists in the prevalence of post-disaster mental disorders, making it difficult to estimate need for services in designing interventions without carrying out a post-disaster mental health needs assessment survey. One of the daunt-ing methodological challenges in implementing such surveys is that secondary stressors unique to the disaster often need to be discovered to understand the magnitude, type, and population segments most affected by post-disaster men-tal disorders. Methods. This problem is examined in the current commentary by analyzing data from the WHO World Mental Health (WMH) Surveys. We analyze the extent to which people exposed to natural disasters throughout the world also experienced secondary stressors and the extent to which the mental disorders associated with disasters were more proximally due to these secondary stressors than to the disasters themselves. Results. Lifetime exposure to natural disasters was found to be high across countries (4.4–7.5%). 10.7–11.4% of those exposed to natural disasters reported the occurrence of other related stressors (e.g. death of a loved one and destruction of property). A monotonic relationship was found between the number of additional stressors and the subsequent onset of mental disorders
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Disasters usually involves massive casualties, yet few post-disaster studies explore the prevalence of complicated grief (CG) among survivors. Complicated grief is a distinct psychological disorder, and is associated with impaired physical and psychological functions. Given such gap in the literature and the significance of this topic, this study is hoped to offer more information of complicated grief among survivors who lost their loved ones in disaster. Adopting a large scale survey, the prevalence and risk factors of CG among bereaved survivors one year after the Sichuan earthquake in China were explored.
    Journal of Affective Disorders 04/2015; 175. DOI:10.1016/j.jad.2015.01.003 · 3.71 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Superstorm Sandy made landfall in New Jersey on 29 October 2012, leaving tens of thousands homeless, businesses destroyed, and 90% of New Jersey residents without electricity. Widespread infrastructure and property damage, health-related issues, and social dislocations still remain among the challenges. We interviewed 756 people in central and coastal New Jersey to ascertain damage levels, what they would do differently next time, and what governments should do differently. To deal with future events, people thought that they should prepare, buy generators and other supplies, and evacuate sooner. Their actions dealt with preparedness, rather than recovery or resiliency. However, the subjects felt that governmental agencies also had a responsibility for emergency actions, recovery, and resiliency. Preparedness included better warnings and helping to prepare homes for the impending storm. During the storm, people thought government should have faster evacuations, communications, and provide shelter, security, and supplies. Recovery included providing gas and generators, restoring electricity, providing money, and quicker response by FEMA and insurance companies. People thought the government should ensure resiliency of their communities by allowing no beach-front homes, having better building standards, and restoring dunes. Coastal people suffered greater damage for longer, and voiced a higher sense of wanting government actions.
    Environmental Hazards 04/2014; 13(3). DOI:10.1080/17477891.2014.902801 · 0.14 Impact Factor