Article

Velden PG, Yzermans CJ, Kleber RJ, Gersons BP. Correlates of mental health services utilization 18 months and almost 4 years postdisaster among adults with mental health problems

Institute for Psychotrauma (IvP), Zaltbommel, The Netherlands.
Journal of Traumatic Stress (Impact Factor: 2.72). 12/2007; 20(6):1029-39. DOI: 10.1002/jts.20273
Source: PubMed

ABSTRACT

The authors assess the correlates of mental health services utilization (MHS) after a disaster among adults with mental health problems. Data of a three-wave longitudinal study among adult survivors of a fireworks disaster (T1: 2-3 weeks, T2: 18 months, T3: almost 4 years postdisaster) were linked with their electronic medical records (N = 649). Multivariate logistic regression analyses showed that triple comorbidity of PTSD and high levels of anxiety and depression symptoms were positively associated with self-reported MHS utilization at T2 (n = 270) and T3 (n = 216). Private insurance, predisaster psychological problems, and relocation were associated with MHS utilization at T2 while female gender, being single, and migrant status was associated with MHS utilization at T3. Receiving treatment at T2 was positively associated with receiving treatment at T3, as opposed to medium optimism at T2.

    • "Many victims with severe and ongoing symptomatology or mental disorders do not or wait to seek treatment (Van der Velden et al., 2007; Rodrigues and Kohn, 2008). In this perspective and because of relatively low costs, online self-screening for posttraumatic stress symptoms is becoming popular (Donker et al., 2009; Winwood et al., 2009; Vetter et al., 2011). "
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    ABSTRACT: Social organizational stressors are well-known predictors of mental health disturbances (MHD). However, to what extent these stressors predict post-disaster MHD among employed victims hardly received scientific attention and is clearly understudied. For this purpose we examined to what extent these stressors independently predict MHD 1.5 years post-disaster over and above well-known risk factors such as disaster exposure, initial MHD and lack of general social support, life-events in the past 12 months and demographics (N=423). Exposure, social organizational stressors and support were significantly associated with almost all examined mental health disturbances on a bi-variate level. Multivariate logistic regression analyses showed that these stressors, i.e. problems with colleagues, independently predicted anxiety (Adj. OR=5.93), depression (Adj. OR=4.21), hostility (Adj. OR=2.85) and having two or more mental health disturbances (Adj. OR=3.39) in contrast to disaster exposure. Disaster exposure independently predicted symptoms of PTSD symptoms (Adj. OR=2.47) and agoraphobia (Adj. OR=2.15) in contrast to social organizational stressors. Importantly, levels of disaster exposure were not associated nor correlated with (levels of) social organizational stressors. Findings suggest that post-disaster mental health care programs aimed at employed affected residents, should target social organizational stressors besides disaster-related stressors and lack of general social support. © 2014 Elsevier Ireland Ltd. All rights reserved.
    No preview · Article · May 2014 · Psychiatry Research
    • "Many victims with severe and ongoing symptomatology or mental disorders do not or wait to seek treatment (Van der Velden et al., 2007; Rodrigues and Kohn, 2008). In this perspective and because of relatively low costs, online self-screening for posttraumatic stress symptoms is becoming popular (Donker et al., 2009; Winwood et al., 2009; Vetter et al., 2011). "
    [Show abstract] [Hide abstract]
    ABSTRACT: Social organizational stressors are well-known predictors of mental health disturbances (MHD). However, to what extent these stressors predict post-disaster MHD among employed victims hardly received scientific attention and is clearly understudied. For this purpose we examined to what extent these stressors independently predict MHD 1.5 years post-disaster over and above well-known risk factors such as disaster exposure, initial MHD and lack of general social support, life-events in the past 12 months and demographics (N=423). Exposure, social organizational stressors and support were significantly associated with almost all examined mental health disturbances on a bi-variate level. Multivariate logistic regression analyses showed that these stressors, i.e. problems with colleagues, independently predicted anxiety (Adj. OR=5.93), depression (Adj. OR=4.21), hostility (Adj. OR=2.85) and having two or more mental health disturbances (Adj. OR=3.39) in contrast to disaster exposure. Disaster exposure independently predicted symptoms of PTSD symptoms (Adj. OR=2.47) and agoraphobia (Adj. OR=2.15) in contrast to social organizational stressors. Importantly, levels of disaster exposure were not associated nor correlated with (levels of) social organizational stressors. Findings suggest that post-disaster mental health care programs aimed at employed affected residents, should target social organizational stressors besides disaster-related stressors and lack of general social support.
    No preview · Article · Jan 2014
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    • "This indicates that, as in other disaster studies, that the associations between risk factors and post-event mental health problems may be affected by MHS use. Although we examined MHS use in our study sample [34-36], unfortunately our data does not enable further analyses on the effects of MHS use on the mental health of the respondents. Despite this, since our analyses - i.e. contrasting predictive values of separate items versus a sum score of items- are conducted within the same sample, comparison of outcomes are not inflated because of MHS use (i.e. is constant). "
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    ABSTRACT: Background Disaster experiences have been associated with higher prevalence rates of (mental) health problems. The objective of this study was to examine the independent relation between a series of single disaster experiences versus the independent predictive value of a accumulation of disaster experiences, i.e. a sum score of experiences and symptoms of distress and post-traumatic stress disorder (PTSD). Methods Survivors of a fireworks disaster participated in a longitudinal study and completed a questionnaire three weeks (wave 1), eighteen months (wave 2) and four years post-disaster (wave 3). Ten years post-disaster (wave 4) the respondents consisted of native Dutch survivors only. Main outcome measures were general distress and symptoms of PTSD. Results Degree of disaster exposure (sum score) and some disaster-related experiences (such as house destroyed, injured, confusion) were related to distress at waves 2 and 3. This relation was mediated by distress at an earlier point in time. None of the individual disaster-related experiences was independently related to symptoms of distress. The association between the degree of disaster exposure and symptoms of PTSD at waves 2 and 3 was still statistically significant after controlling for symptoms of distress and PTSD at earlier point in time. The variable ‘house destroyed’ was the only factor that was independently related to symptoms of PTSD at wave 2. Ten years after the disaster, disaster exposure was mediated by symptoms of PTSD at waves 2 and 3. Disaster exposure was not independently related to symptoms of PTSD ten years post-disaster. Conclusions Until 4 years after the disaster, degree of exposure (a sum score) was a risk factor for PTSD symptoms while none of the individual disaster experiences could be identified as an independent risk factor. Ten years post-disaster, disaster exposure was no longer an independent risk factor for symptoms of PTSD. Since symptoms of PTSD and distress at earlier waves perpetuate the symptoms at later waves, health care workers should aim their resources at those who still have symptoms after one and a half year post-disaster, to prevent health problems at medium and long-term.
    Full-text · Article · Sep 2012 · BMC Psychiatry
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