Article

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

ABSTRACT

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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    • "As with other types of major incidents or disasters the effects of flooding on people's health, relationships and wellbeing can be extensive (North, 2014). The aftermath of a disaster is a time when survivors can experience many psychosocial symptoms such as stress, grief, depression, and anxiety (Cohen, 2002; Reyes and Elhai., 2004; Adams et al., 2002; Norris et al., 2002; Warsini et al., 2014; Neria et al., 2008). The psychosocial impact may be exacerbated and prolonged by personal and property losses, relocation, and disruption to social support networks and daily activities (Mitchell, Witman, and Taffaro, 2008; Nikapota, 2006). "

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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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    • "While schools are a way to broadly reach all children , a recent study conducted by Rolfsnes and Idsoe (2011) found that most post-disaster mental health interventions are narrowly focused with the aim to treat children with diagnoses such as PTSD. Although these types of therapeutic interventions are appropriate for children with post-traumatic symptoms, more general psychosocial programming for children who are not exhibiting mental health symptoms may be appropriate to mitigate or prevent post-disaster mental health distress by enhancing coping skills and building protective factors after an emergency (Evans and Oehler-Stinnett 2006; Neria et al. 2008). The following case describes a broadly accessible school-based intervention, the Journey of Hope (JoH), which is geared towards preventing distress through building protective factors, enhancing social and emotional skills, and increasing positive coping among children affected by a disaster. "
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    ABSTRACT: Children are among the most vulnerable groups during and after a natural disaster experiencing a range of stressors such as fear of death or loss of a loved one, the loss of a home and community, displacement to a strange neighborhood or school, and even separation from their family. This study, conducted in Tuscaloosa, Alabama, after a series of tornadoes struck the city in 2011, examines the Journey of Hope (JoH), a psychosocial program designed to help children cope with disaster related stressors. It employed a case study approach examining the program’s impact through interviews with 5 social workers, 14 program facilitators and 30 child participants. Findings revealed that participating in the JoH helped children: articulate their feelings, process grief, regulate emotions such as anger and aggression, and gain knowledge on how to handle bullying behaviors in their school. This article builds on the literature supporting post-disaster psychosocial school-based interventions.
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