Post-traumatic stress disorder following disasters: Systematic review

Department of Epidemiology, Mailman School of Public Health, Columbia University Medical Center, New York, NY 10032, USA.
Psychological Medicine (Impact Factor: 5.94). 05/2008; 38(4):467-80. DOI: 10.1017/S0033291707001353
Source: PubMed


Disasters are traumatic events that may result in a wide range of mental and physical health consequences. Post-traumatic stress disorder (PTSD) is probably the most commonly studied post-disaster psychiatric disorder. This review aimed to systematically assess the evidence about PTSD following exposure to disasters. MethodA systematic search was performed. Eligible studies for this review included reports based on the DSM criteria of PTSD symptoms. The time-frame for inclusion of reports in this review is from 1980 (when PTSD was first introduced in DSM-III) and February 2007 when the literature search for this examination was terminated.
We identified 284 reports of PTSD following disasters published in peer-reviewed journals since 1980. We categorized them according to the following classification: (1) human-made disasters (n=90), (2) technological disasters (n=65), and (3) natural disasters (n=116). Since some studies reported on findings from mixed samples (e.g. survivors of flooding and chemical contamination) we grouped these studies together (n=13).
The body of research conducted after disasters in the past three decades suggests that the burden of PTSD among persons exposed to disasters is substantial. Post-disaster PTSD is associated with a range of correlates including sociodemographic and background factors, event exposure characteristics, social support factors and personality traits. Relatively few studies have employed longitudinal assessments enabling documentation of the course of PTSD. Methodological limitations and future directions for research in this field are discussed.

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    • "Studies covering a range of disasters (natural, human-caused, and technological) and communities (both developed and developing) have reported high levels of post-traumatic stress disorder (PTSD), depressive disorders, and substance abuse or dependency among survivors (reviews include those by: McNally, 2003; Nemeroff, Bremner, Foa, Mayberg, North, & Stein, 2006; Neria, Nandi, & Galea, 2008; Norris, Friedman, Watson, Byrne, Diaz, & Kaniasty, 2002). There is also a considerable literature about adverse psychological impacts on those who respond to disasters: police, fire and other rescue workers; emergency and other medical personnel; relief and aid workers; and others involved in postdisaster recovery endeavours (see, for example: Alexander & Klein, 2009; Argentero & Setti, 2011; Bills et al., 2008; Centers For Disease Control, 2006; Cukor et al., 2011; Fullerton, Ursano, & Wang, 2006; Galea, Nandi, & Vlahov, 2005; Neria et al., 2008; North et al. 2002; Ozen & Sir, 2004; Palm, Polusny, & Follette, 2004). This literature also implies that many researchers have been involved in collecting data from survivors, responders, and relief and recovery workers in the aftermath of disasters. "
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    ABSTRACT: ABSTRACT Background: There are numerous reports that those involved in disaster response and recovery are at-risk of developing post-traumatic stress disorder, acute stress reaction, or secondary traumatic stress. There are few reports of research concerning the experiences of post-disaster field research interviewers. During the period 2009—2014, post-bushfire research interviews were conducted with residents affected by seven major bushfire events in four Australian states. This report describes findings from follow-up surveys of those who conducted five of these post-bushfire research interview studies. The aim was to investigate (a) the nature of their experiences; and (b) their perceptions of the adequacy of the training and preparation for the work. Method: Sixty-five post-bushfire research interviewers were contacted and invited to take part in an interview or complete a survey questionnaire about their post-bushfire research experiences. Thirty-three researchers (51%) provided 38 responses: one researcher described experiences on each of three deployments, three researchers described their experiences on each of two deployments. Results: Of the 38 responses, 9 (24%) described no stress symptoms associated with the interviews; 26 (68%) described little to mild levels of stress symptoms; 3 (8%) reported moderate levels of stress symptoms. Twenty three researchers (64%) reported that their experiences overall were positive. Reports about training and preparation were mostly positive. Conclusions: Interviewing residents affected by future disaster events will be psychologically impactful for many who conduct post-disaster field research. For the majority, the experience will probably have some distressing elements, but will be viewed positively overall. A small percentage will experience moderate levels of secondary stress, especially if the event involved multiple fatalities, but this will be relatively transient. The approach to training and preparation used for the post-bushfire field interviews is probably adequate, but needs to be evaluated more rigorously.
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    • "A investigação epidemiológica sobre a exposição a experiências potencialmente traumáticas em adultos tem verificado que estas são comuns em todo o mundo (Galea, Nandi & Vlahov, 2005), incluindo acidentes e desastres de causa humana e natural e estando associada à incidência de PTSD (Neria, Nandi & Galea, 2007). "
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    • "enough to adequately test the present hypotheses , it would be helpful for future studies to involve much larger and more diverse samples . This sort of diversity is important because individuals may respond quite differently to these sorts of events ( e . g . , men and women have been found to respond differently to potentially traumatic events ; Neria et al . , 2008 ) ."
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    ABSTRACT: Among civilians exposed to war trauma, the development of acute anxiety symptoms has been found to be positively associated with the severity of the traumatic exposure but negatively associated with intrapersonal resilience (optimism, hope, and self-esteem). No study to date has examined whether intrapersonal resilience plays a moderating role in the development of acute anxiety among individuals as they are exposed to trauma. This “natural laboratory” study examined the putative role of intrapersonal resilience in moderating the association between exposure-severity and the development of symptoms of posttraumatic stress disorder (PTSD) as assessed in vivo (i.e., under life-threatening conditions during exposure to war). A nonclinical community sample of 251 adults was assessed during real-time exposure to missile and rocket fire during an eruption of violence in the Middle East during July and August 2014. The results indicate that the severity of PTSD symptoms was positively associated with severity of exposure to trauma. However, this association was moderated by individual differences in intrapersonal resilience. More specifically, individuals with low levels of intrapersonal resilience reported more PTSD symptoms than those with high levels of intrapersonal resilience in the geographic regions in which individuals were exposed to low and high levels of rocket and missile fire. The findings of this study provide further evidence that intrapersonal resilience may significantly mitigate the development of PTSD symptoms among civilians exposed to potentially traumatic events
    Self and Identity 10/2014; 14(1). DOI:10.1080/15298868.2014.966143 · 1.42 Impact Factor
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