Sarah R Lowe

• PhD
• Professor (Assistant) at Yale University

People with disabilities (PWD) have reported higher major depression (MD) and generalized anxiety disorder (GAD) symptoms during the COVID-19 pandemic than others in the general population, with social isolation and disability stigma as key predictors of heightened symptomatology. However, the nature and predictors of PWD’s MD and GAD symptom traje...

The health impact of floods has not been well characterized. This study evaluated long-term associations between cause-specific mortality rates and county-level monthly flood days (excluding coastal floods caused by tropical storms) in the post-flood year in the contiguous U.S., using a triply robust approach incorporating propensity score, counter...

As climate change intensifies, hurricanes and weather-related disasters have been increasingly frequent and severe, impacting regions like the U.S. Gulf Coast with repeated hurricanes. While acute and short-term health impacts are well-described, impacts on longer-term and chronic conditions such as hypertension remain underexplored. This study exa...

Mental health problems appear common among Pacific Islander adolescents. The lack of culturally adapted mental health screening instruments is a barrier to establishing prevalence estimates needed to inform resource allocation and health system budgeting. Following the Gjersing et al. (2010) guidelines, we adapted five clinical mental health screen...

This study examined the relationship between the theme of interdependence in the narratives of American adults with disabilities during the first three years of the COVID-19 pandemic and psychological well-being. In contrast to independence, interdependence has emerged as a focus of research about people with disabilities in both the humanistic dis...

Despite reports of mental health concerns among adolescents in American Samoa, little is known about the current mental health burden. Furthermore, previous literature has identified mental illness-related stigma as a significant global barrier to mental health care access and treatment. By gathering various perspectives from adult stakeholders and...

Sexual consent has been a major focus of campus campaigns to reduce sexual violence (SV). However, these campaigns often educate students about consent with little attention to the complex ways consent can be experienced, expressed, and interpreted by others. Further, little research has focused on the consent feelings and communication cues of stu...

Background: The COVID-19 pandemic has caused psychological problems among nurses worldwide. However, their willingness to seek professional help is relatively low, due to perceived barriers that have remained unknown. Aims: This study analysed the potential barriers and influencing factors of psychological help-seeking among nurses participating in...

Trauma survivors’ experiences of perceived posttraumatic growth (PTG) are thought to be dynamic, with levels varying over time. Although a small body of literature has examined PTG trajectories, key limitations include the lack of preevent data and little consideration of the nondisaster-related resources and stressors experienced by survivors foll...

Introduction: A strong link has been found between parental posttraumatic stress (PTS) symptoms and child psychopathology, including secondary PTS symptoms. However, research is scarce on the association between parental PTS symptoms and child secondary posttraumatic growth (PTG). The current study aimed to investigate associations between parental...

Racism-related stress is a root cause of racial and ethnic disparities in mental health outcomes. An individual may be exposed to racism directly or vicariously by hearing about or observing people of the same racial and/or ethnic group experience racism. Although the healthcare setting is a venue by which healthcare workers experience both direct...

Introduction COVID-19 is an unprecedented public health threat in modern times, especially for older adults or those with chronic illness. Beyond the threat of infection, the pandemic may also have longer-term impacts on mental and physical health. The COVID-19 & Chronic Conditions (‘C3’) study offers a unique opportunity to assess psychosocial and...

Mental health challenges appear common among adolescents in American Samoa. There is a community-identified need to better understand the health burden and identify opportunities to strengthen the mental health system to better meet adolescent mental health needs. The goal of this qualitative study was to gather community stakeholders' perceptions...

Little is known about the combined impact of the COVID-19 pandemic and other major disasters on mental health. Hurricane Harvey hit the Gulf Coast in 2017, resulting in substantial costs, significant levels of displacement, and approximately 100 deaths, and was followed in 2020 by the COVID-19 pandemic. We randomly sampled 1167 Houstonians from 88...

Purpose/Objective: The COVID-19 pandemic has exacerbated existing health inequities for people with disabilities (PWD), including disparities in mental health needs and service use. The present study investigated prospective predisposing, enabling, and illness-related correlates of mental health service need and use among PWD during the COVID-19 pa...

Following exposure to traumatic life events, most individuals are psychologically resilient, and experience minimal-to-no symptoms of posttraumatic stress, major depressive, or generalized anxiety disorders. To date, however, most research has focused on factors associated with adverse post-trauma mental health outcomes rather than understanding th...

Background: Weather-related disasters, including hurricanes, are becoming more frequent and severe due to climate change. Vulnerable populations, such as people with low income and racial and ethnic minorities, are particularly prone to increased levels of physical harm and psychiatric adversity from weather-related events. Objectives: We aimed to...

Background: Gender discrimination among healthcare workers (HCWs) negatively impacts their mental health and career development; however, few studies have explored how experiences of gender discrimination change during times of health system strain. Methods: This survey-based study assesses the associations between gender discrimination and four st...

Residential greenness may support mental health among disaster-affected populations; however, changes in residential greenness may disrupt survivors’ sense of place. We obtained one pre- and three post-disaster psychological distress scores (Kessler [K]-6) from a cohort (n = 229) of low-income mothers who survived Hurricane Katrina in New Orleans,...

Women are at heightened risk for chronic stress-related psychological sequelae (SRPS), including major depressive disorder (MDD), generalized anxiety disorder (GAD), and posttraumatic stress disorder (PTSD) in response to potentially traumatic events, including the COVID-19 pandemic. However, few studies have examined pre- and peri-event stressors...

This study examines how peri- and post-disaster factors influence long-run perceptions of disaster recovery in marginalized populations. We paired survey (N = 533) and in-depth interview (N = 87) data from the Resilience in Survivors of Katrina (RISK) Project—a fifteen-year (2003–2018) panel study of low-income mothers affected by Hurricane Katrina...

Background Gender discrimination among women healthcare workers (HCWs) negatively impacts job satisfaction, mental health, and career development; however, few studies have explored how experiences of gender discrimination change during times of health system strain. Thus, we conducted a survey study to characterize gender discrimination during a t...

While the COVID-19 pandemic is known to have caused widespread mental health challenges, it remains unknown how the prevalence, presentation, and predictors of mental health adversity during the pandemic compare to other mass crises. We shed light on this question using longitudinal survey data (2003-2021) from 424 low-income mothers who were affec...

Introduction Family-level psychosocial factors appear to play a critical role in mediating the intergenerational transmission of trauma; however, no review article has quantitatively synthesized causal mechanisms across a diversity of trauma types. This study aims to systematically consolidate the epidemiological research on family-level psychosoci...

Vicarious racism occurs when hearing about or observing people of the same racial and/or ethnic group experience racism. Healthcare workers may face unique experiences of vicarious racism through witnessing or hearing about racism that their patients and colleagues face. However, there are no validated measures of vicarious racism for the healthcar...

This study examines narrative identity among a large, diverse American sample of people with disabilities (PWDs) during the "second wave" of the Covid-19 pandemic (October-December, 2020). The study relied on abductive analyses, combining a purely inductive phase of inquiry followed by two rounds of investigation that filtered inductive insights th...

Background: We aimed to estimate the association between urbanicity and the onset of posttraumatic stress disorder (PTSD) and to investigate heterogeneity therein according to age and socioeconomic position (SEP). Methods: We analysed administrative data from the Korean National Health Insurance Database for patients with PTSD from 2004-2018 (N=...

Weather-related disasters are increasing in both frequency and severity, which in turn increases the likelihood for the development of adverse mental health outcomes (Augustinavicius et al., 2021; CRED & UNDRR, 2015; NOAA National Centers for Environmental Information, 2020). Religion and spirituality are an accessible form of coping that many peop...

Background For individuals in treatment for substance use, supportive social networks are essential to protect against a return to use. Objective This study aimed to explore the impact of the swift and severe isolation brought on by the COVID-19 pandemic, specifically for individuals in treatment for substance use disorder, by exploring the relati...

The aim of this study was to investigate whether two emotion regulation strategies, expressive suppression or cognitive reappraisal, mediated the development of posttraumatic stress disorder (PTSD), major depression (MD), and generalized anxiety disorder (GAD) in first responders (FR) who experienced occupational stressors, using cross-sectional da...

Potentially traumatic events (PTEs), such as natural disasters, sexual assault, and child abuse, are frequent occurrences throughout the world and take a tremendous psychological toll on individuals and communities. In this chapter, we present the global public health burden posed by PTE exposure. To accomplish this goal, we review the global preva...

Whether and how university students exchange sex for financial compensation in the USA is critically understudied. The purpose of this secondary analysis was to determine whether undergraduate and graduate students at a large public university report exchanging sex for financial or other compensation, and identify factors (e.g., demographics, child...

BACKGROUND For individuals in treatment for substance use, supportive social networks are essential to protect against a return to use. OBJECTIVE This study aimed to explore the impact of the swift and severe isolation brought on by the COVID-19 pandemic, specifically for individuals in treatment for substance use disorder, by exploring the relati...

Background Posttraumatic stress disorder (PTSD) symptoms have been shown to increase the likelihood of substance use in the general population. First responders (e.g., EMTs, paramedics, and firefighters) are routinely exposed to potentially traumatic events (PTEs) as part of their regular duties, increasing their risk for a range of adverse mental...

Objectives: During the COVID-19 pandemic, stigmatization of older persons increased in traditional and social media. It was unknown whether this negative messaging could be detrimental to the mental health of older individuals, and whether the relatively uncommon positive messaging about older individuals could benefit their mental health. Method:...

Natural disasters adversely impact children's mental health, with increased parent or child exposure and subsequent parental distress predicting poorer outcomes. It remains unknown, however, whether the psychological consequences of disasters for children persist long-term, and if so, why and for whom. We therefore examined the effects of mothers'...

Extensive evidence suggests low-income mothers depend upon their families and friends for emotional, practical, and economic support in times of need. This is the first study to examine the operation of low-income mothers’ informal support networks and the impact of such networks on maternal well-being during the COVID-19 pandemic. We interviewed l...

A growing body of research has documented the phenomenon of climate change anxiety (CCA), defined broadly as negative cognitive, emotional, and behavioral responses associated with concerns about climate change. A recently validated scale of CCA indicated two subscales: cognitive emotional impairment and functional impairment (Clayton & Karazsia, 2...

Understanding how individuals conceptualize and communicate sexual consent is critical to sexual health and has important implications for the prevention of sexual assault. This study used a data-driven (vs. a theoretical) approach to understand how students’ internal feelings of willingness (i.e., internal consent) and behavioral communication of...

Ambient particulate matter pollution has been linked to impaired cognitive performance, but the effect of ambient ozone exposure on cognitive function remains largely unknown. We examined the association of long-term ozone exposure with the risk of cognitive impairment among a national representative cohort of 9,544 Chinese older adults (aged 65 ye...

Purpose/objective: Emerging research has highlighted sources of magnified stress and trauma for people with disabilities during the COVID-19 pandemic, as compared to others in the general population. However, little research has examined the mental health impact of the pandemic on people with disabilities in relation to disability-related stigma,...

Prior research suggests that meaning-making and forgiveness are associated with lower post-traumatic stress symptoms (PTSS) following exposure to trauma. Few studies have examined these factors in the aftermath of natural disasters. This study therefore aimed to investigate the relationship between meaning-making and forgiveness, and their associat...

During the COVID-19 pandemic, stigmatization of older persons has increased in traditional and social media. It was unknown whether this negative messaging could be detrimental to the mental health of older individuals, and whether the relatively uncommon positive messaging about older individuals could benefit their mental health. To address these...

Rape myths are cultural beliefs that invalidate, blame, and stigmatize rape survivors, thereby perpetuating sexual violence. Few studies have explored associations between rape myth acceptance (RMA) and mental health outcomes, but evidence suggests that RMA can buffer the mental health impact of some forms of sexual assault. The current study exami...

Background: Racial and ethnic diversity of healthcare workers have benefits on team functioning and patient care. However, a significant barrier to retaining diverse providers is discrimination. Objective: To assess the predictors, perpetrators, and narratives of racial discrimination among healthcare workers. Design: Survey study. Participan...

It is estimated that 116 million children were born worldwide in the first nine months of the COVID-19 pandemic. Given the critical importance of early life for neurodevelopment, and evidence suggesting that prenatal maternal stress and early childhood adversity negatively impacts neurodevelopment, it is alarming that many pregnant women and new mo...

Racial and gender discrimination are risk factors for adverse mental health outcomes in the general population; however, the effects of discrimination on the mental health of healthcare workers needs to be further explored, especially in relation to competing stressors. Thus, we administered a survey to healthcare workers to investigate the associa...

This study examined how well the Posttraumatic Growth Inventory (PTGI; Tedeschi & Calhoun, 1996) corresponds with self-reported pre- to posttrauma changes in related constructs, including sense of purpose in life, religiosity, and social support. Participants were 328 low-income mothers (85.2% non-Hispanic Black) who survived Hurricane Katrina and...

The COVID-19 pandemic has had devastating consequences for health, social, and economic domains, but what has received far less focus is the effect on people’s relationship to vital ecological supports, including access to greenspace. We assessed patterns of greenspace use in relation to individual and environmental factors and their relationship w...

Natural disasters can have significant consequences for population mental health. Using a digital spatial epidemiologic approach, this study documents emotional changes over space and time in the context of a large-scale disaster. Our aims were to a) explore the spatial distribution of negative emotional expressions of Twitter users before, during,...

The COVID-19 pandemic has had devastating consequences for health, social, and economic domains, but what has received far less focus is the effect on people’s relationship to vital ecological supports, including access to greenspace. We assessed patterns of greenspace use in relation to individual and environmental factors and their relationship w...

Objectives During the COVID-19 pandemic, stigmatization of older persons has increased in traditional and social media. It was unknown whether this negative messaging could be detrimental to the mental health of older individuals, and whether the relatively uncommon positive messaging about older individuals could benefit their mental health. Meth...

Objectives: During the COVID-19 pandemic, stigmatization of older persons increased in traditional and social media. It was unknown whether this negative messaging could be detrimental to the mental health of older individuals, and whether the relatively uncommon positive messaging about older individuals could benefit their mental health. Method:...

Introduction: Psychosocial factors within the family appear to play a critical role in mediating the intergenerational transmission of trauma; however, there has yet to be a review article that quantitatively synthesizes causal mechanisms across a diversity of trauma-types. This study aims to systematically consolidate the epidemiological research...

In the United States, Muslims have increasingly been the targets of discrimination. While prior research suggests that increased perceived discrimination is associated with elevated depression and anxiety symptoms in this population, no existing studies have explored whether this relationship is mediated by acculturative stress, and few have examin...

Research has documented a strong association between perceived social support, posttraumatic stress symptoms (PTSS), and psychological distress (PD) among people exposed to natural disasters. However, the direction of associations between these factors remains unclear. This study examined possible mediational relationships among perceived social su...

Importance Disaster exposure is associated with the development of posttraumatic stress (PTS) symptoms in youths. However, little is known about how to predict which youths will develop chronic PTS symptoms after disaster exposure. Objective To evaluate PTS symptom trajectories among youths after 4 major US hurricanes and assess factors associated...

Background Healthcare workers are at increased risk of adverse mental health outcomes during the COVID-19 pandemic. Studies are warranted that examine socio-ecological factors associated with these outcomes to inform interventions that support healthcare workers during future disease outbreaks. Methods We conducted an online cross-sectional study...

Exposure to air pollution has been associated with increased risk for a range of adverse mental health conditions. Less is known about whether air pollution is also associated with increases in the utilization of mental health services, especially outpatient mental health service utilization. This study aimed to examine the association between the...

Background Research suggests four modal trajectories of psychological symptoms after traumatic injury: Resilient, Chronic, Delayed Onset, Recovery. However, most studies focus on symptoms of psychiatric disorders (e.g., posttraumatic stress disorder, depression), which are limited by heterogeneity and symptom overlap. We examined trajectories of cr...

Muslim Americans increasingly have been targets of discrimination. Previous research has provided preliminary evidence that higher perceived discrimination is associated with higher symptoms of discrimination-related posttraumatic stress disorder (PTSD) symptoms and higher discrimination-related posttraumatic growth (PTG). Further research in other...

The Social Communication Questionnaire (SCQ) is a 40-item instrument designed to screen children at risk for Autism Spectrum Disorder (ASD). Both Lifetime and Current forms of the scale are available. Although these forms are manageable for many respondents, their use may result in substantial respondent and administrative burden, particularly amon...

Climate change exacerbates the severity of natural disasters, which disproportionately affect vulnerable populations. Mitigating disasters' health consequences is critical to promoting health equity, but few studies have isolated the short- and long-term effects of disasters on vulnerable groups. We filled this gap by conducting a fifteen-year (200...

Objectives. To examine how physical health symptoms developed and resolved in response to Hurricane Katrina. Methods. We used data from a 2003 to 2018 study of young, low-income mothers who were living in New Orleans, Louisiana, when Hurricane Katrina struck in 2005 (n = 276). We fit logistic regressions to model the odds of first reporting or “dev...

The COVID-19 pandemic puts health workers at increased risk of adverse mental health outcomes. However, no studies have assessed health workers’ experiences using qualitative methods during the COVID-19 outbreak in the United States to identify novel factors that could relate to their mental health. In May 2020, we distributed an online survey to h...

Exposure to disasters is associated with a range of posttraumatic stress symptom (PTSS) trajectories. However, few studies have tracked PTSS for more than a decade postdisaster, and none to our knowledge has explored the role of predisaster resources and vulnerabilities in shaping the likelihood of trajectory membership. The current study included...

Background Graduate school environments are recognized for contributing to elevated stress levels among student populations. Purpose: The objective was to test whether a behavioral intervention, delivered through an online course on behavior change, is effective in preventing declining mental health. Methods: Data were collected via a quasi-experim...

This cross‐sectional study aimed to address whether occupational stressors are associated with adverse mental health outcomes in first responders via lower social support. A total of 895 first responders including emergency medical technicians, paramedics, and firefighters from 50 US States and the Virgin Islands (mean = 37.32, standard deviation =...

Prior research has provided robust evidence that exposure to potentially traumatic events (PTEs) during a disaster is predictive of adverse postdisaster mental health outcomes, including posttraumatic stress symptoms (PTSS) and nonspecific psychological distress (PD). However, few studies have explored the role of exposure to other PTEs over the li...

An amendment to this paper has been published and can be accessed via the original article.

Exposure to disasters has a range of adverse mental-health consequences. This Commentary argues that to understand variation in post-disaster mental health, we must look beyond the disaster itself to other sources of vulnerability throughout the life course, as well as the developmental stage at which the disaster was experienced.

Beyond their immediate effects on mortality, disasters have widespread, indirect impacts on mental and physical well-being by exposing survivors to stress and potential trauma. Identifying the disaster-related stressors that predict health adversity will help officials prepare for the coronavirus disease 2019 (COVID-19) pandemic. Using data from a...

Background Epidemiologic studies have shown that persons suffering from psychotic disorders are at increased risk of violent behavior. Several factors have been shown to predict violent behavior among persons with psychosis. However, prior research is limited in that these factors have not been explored simultaneously within the same study. Method...

Objective: Posttraumatic growth (PTG) has been documented in the aftermath of a range of traumatic events, including bereavement, physical assault, and rape. However, only a handful of studies have examined whether levels of total PTG, as well as the 5 domains of PTG (Appreciation of Life, New Possibilities, Relating to Others, Personal Strength,...

Abstract Background Previous work has indicated that post-traumatic stress disorder (PTSD) symptoms, measured by the Clinician-Administered PTSD Scale (CAPS) within 60 days of trauma exposure, can reliably produce likelihood estimates of chronic PTSD among trauma survivors admitted to acute care centers. Administering the CAPS is burdensome, requir...

Background Research exploring the longitudinal course of posttraumatic stress disorder (PTSD) symptoms has documented four modal trajectories (low, remitting, high, and delayed), with proportions varying across studies. Heterogeneity could be due to differences in trauma types and patient demographic characteristics. Methods This analysis pooled d...

Purpose of Review As interest in the mental health consequences of environmental disasters increases, this review aimed to summarize peer-reviewed studies published in 2018 on posttraumatic stress disorder (PTSD) and depression symptoms after such events. Recent Findings Notable trends in the past year of research included studies focusing on vuln...

Evidence suggests that Social Anxiety Disorder (SAD) is less responsive to cognitive behavioral treatment (CBT) compared to other anxiety disorders. Therefore, exploring what might facilitate clinical benefit is essential. Social threat cognitions, characterized by exaggerated perceptions of negative evaluation by others, may be one important avenu...

In August 2005, Hurricane Katrina caused unprecedented damage, widespread population displacement, and exposed Gulf Coast residents to traumatic events. The hurricane's adverse impact on survivors' mental health was apparent shortly after the storm and persisted, but no study has examined the long-term effects now that more than a decade has transp...

Prior research has found that Muslim Americans' discrimination experiences are associated with increased risk of mental health problems. However, few studies have included Muslim American college students or identified moderators of this relationship. Among a sample of Muslim American college students (N = 141), the current study found that perceiv...

The present longitudinal study examined the relationship between patterns of cigarette smoking and alcohol use during adolescence and illicit drug abuse (DA) and prescription drug abuse (PDA) in early adulthood. The sample consisted of 984 predominantly minority young adults (57% women) who completed (a) six annual surveys as adolescents attending...

Muslim Americans have been increasingly the targets of discrimination. Whereas prior research suggests that higher perceived discrimination is associated with more severe symptoms of posttraumatic stress disorder (PTSD) in various minority groups, only 1 prior study has explored this topic among Muslim Americans. The current study included 145 Musl...

Sexual assault, often defined as nonconsensual sex, is a problem among college students. Universities have made efforts to increase student awareness about sexual consent, which varies along two dimensions: internal feelings of wantedness and external expressions of consent. However, interventions focus on increasing knowledge of the external expre...

A large body of research has linked disaster exposure to adverse mental and physical health outcomes. Few studies, however, have explored the cumulative impact of exposure to multiple disasters. Participants (N = 8,366) from the National Institute of Environmental Health Sciences Gulf Long-Term Follow-Up Study were classified as having been exposed...