Disasters, Diagnosis, and Distress: Multiple Perspectives, Populations, and Methodologies

A special issue of Behavioral Sciences (ISSN 2076-328X). This special issue belongs to the section "Health Psychology".

Deadline for manuscript submissions: closed (31 December 2020) | Viewed by 25029

Special Issue Editors


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Guest Editor
Psychiatry and Surgery/Division of Emergency Medicine, The University of Texas Southwestern Medical Center, 6363 Forest Park Rd., Dallas, TX 75390-8828,USA
Interests: psychiatric aspects of medical illnesses; psychiatric effects of disasters, terrorism, and other trauma; psychiatric epidemiology, substance abuse, and service use among the homeless population; psychoeducation; somatoform and dissociative disorders
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Guest Editor
College of Social and Behavioral Sciences, Walden University, Minneapolis, MN, USA
Interests: homelessness; mental health and addiction services; evidence based practice and education; HIV/HCV; disaster mental health; geospatial research; social media

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Guest Editor
School of Nursing, The University of Alabama at Birmingham, USA
Interests: patient education; health literacy; homelessness; hepatitis C; disaster

Special Issue Information

Dear Colleagues,

This Special Issue focuses on disaster mental health, an important topic in today’s world in which disasters are increasing in both numbers and magnitude. A succession of different disasters in the last several decades have exposed the limitations of traditional ways of approaching disaster interventions and research, requiring unique considerations and innovative approaches. The articles in this Special Issue respond to these challenges by featuring studies examining many disaster types, populations of survivors and first responders, and different research methods including quantitative, qualitative, and mixed methods. The authors’ expertise in psychiatric nosology, broad experience with mixed methods in disaster research, and extensive, longstanding, and pioneering research on disasters of all types provide a unique perspective and approach to this subject. A featured article on the recent COVID-19 pandemic brings together the collective experience of this team of investigators to anticipate oncoming issues inherent in this worldwide disaster that are becoming increasingly apparent as this disaster continues to unfold.

Prof. Dr. Carol North
Prof. David Pollio
Prof. E. Whitney Pollio
Guest Editors

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Keywords

  • disaster mental health
  • terrorism
  • pandemic
  • qualitative and mixed methods research
  • psychiatric nosology
  • posttraumatic stress disorder
  • major depressive disorder
  • disaster survivors
  • first responders
  • post-disaster workplace response

Published Papers (9 papers)

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Editorial

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8 pages, 198 KiB  
Editorial
Disasters, Diagnosis, and Distress: Multiple Perspectives, Populations, and Methodologies
by Carol S. North, David E. Pollio and Elizabeth Whitney Pollio
Behav. Sci. 2022, 12(5), 152; https://doi.org/10.3390/bs12050152 - 18 May 2022
Viewed by 1534
Abstract
Disaster mental health is a consequential topic in today’s world in which disasters are increasing in both numbers and magnitude and inflicting deep psychological wounds across wide populations [...] Full article

Research

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18 pages, 310 KiB  
Article
The Association between Child and Parent Psychiatric Disorders in Families Exposed to Flood and/or Dioxin
by Min Hyung Lee, Betty Pfefferbaum, Robert Portley, Vinay Kotamarti, Fatih Canan and Carol S. North
Behav. Sci. 2021, 11(4), 46; https://doi.org/10.3390/bs11040046 - 1 Apr 2021
Cited by 4 | Viewed by 2185
Abstract
Associations of disaster mental health sequelae between children and their parents have been demonstrated, but not using full diagnostic assessment. This study examined children and their parents after a series of disasters in 1982 to investigate associations of their psychiatric outcomes. Members of [...] Read more.
Associations of disaster mental health sequelae between children and their parents have been demonstrated, but not using full diagnostic assessment. This study examined children and their parents after a series of disasters in 1982 to investigate associations of their psychiatric outcomes. Members of 169 families exposed to floods and/or dioxin or no disaster were assessed in 1986–1987 with structured diagnostic interviews. This vintage dataset collected several decades ago provides new information to this field because of the methodological rigor that is unparalleled in this literature. Disaster-related PTSD and incident postdisaster disorders in children were associated, respectively with disaster-related PTSD and incident postdisaster disorders in the chief caregiver and mother. More flood-only than dioxin-only exposed parents reported great harm by the disaster, but neither children nor parents in these two groups differed in incident psychiatric disorders. Although this study did not determine the direction of causal influences, its findings suggest that clinicians working with disaster-exposed families should work with children and adult members together, as their mental health outcomes may be intertwined. Full article
12 pages, 274 KiB  
Article
Associations between News Media Coverage of the 11 September Attacks and Depression in Employees of New York City Area Businesses
by Betty Pfefferbaum, Jayme M. Palka and Carol S. North
Behav. Sci. 2021, 11(3), 29; https://doi.org/10.3390/bs11030029 - 27 Feb 2021
Cited by 3 | Viewed by 2346
Abstract
Research has examined the association between contact with media coverage of mass trauma events and various psychological outcomes, including depression. Disaster-related depression research is complicated by the relatively high prevalence of the major depressive disorder in general populations even without trauma exposure. The [...] Read more.
Research has examined the association between contact with media coverage of mass trauma events and various psychological outcomes, including depression. Disaster-related depression research is complicated by the relatively high prevalence of the major depressive disorder in general populations even without trauma exposure. The extant research is inconclusive regarding associations between disaster media contact and depression outcomes, in part, because most studies have not distinguished diagnostic and symptomatic outcomes, differentiated postdisaster incidence from prevalence, or considered disaster trauma exposures. This study examined these associations in a volunteer sample of 254 employees of New York City businesses after the 11 September 2001, terrorist attacks. Structured interviews and questionnaires were administered 35 months after the attacks. Poisson and logistic regression analyses revealed that post-9/11 news contact significantly predicted the number of postdisaster persistent/recurrent and incident depressive symptoms in the full sample and in the indirect and unexposed groups. The findings suggest that clinical and public health approaches should be particularly alert to potential adverse postdisaster depression outcomes related to media consumption in disaster trauma-unexposed or indirectly-exposed groups. Full article
9 pages, 482 KiB  
Article
Problems and Needs Persist for Oklahoma City Bombing Survivors Many Years Later
by Phebe Tucker, Betty Pfefferbaum, Kevin Watson, Landon Hester and Christopher Czapla
Behav. Sci. 2021, 11(2), 19; https://doi.org/10.3390/bs11020019 - 29 Jan 2021
Cited by 3 | Viewed by 2857
Abstract
Background: This study assesses long-term physical and emotional symptoms and unmet needs in direct survivors of the 1995 Oklahoma City terrorist bombing 18 ½ years after the event. Methods: A telephone questionnaire assessed psychiatric symptoms, health problems and co** strategies in 138 terrorism [...] Read more.
Background: This study assesses long-term physical and emotional symptoms and unmet needs in direct survivors of the 1995 Oklahoma City terrorist bombing 18 ½ years after the event. Methods: A telephone questionnaire assessed psychiatric symptoms, health problems and co** strategies in 138 terrorism survivors (of whom 80% were physically injured) from a state registry of directly exposed persons, and 171 non-exposed community controls. Structured survey questions measured psychiatric symptoms, posttraumatic growth, general health problems and health care utilization. Open-ended questions explored survivors’ most important terrorism-related problems and needs. Quantitative and qualitative data analysis methods were undertaken. Results: Survivors reported similar rates of major health problems and general health care utilization, more anxiety and depression symptoms, and more ancillary health care use than controls on structured assessments. Survivors also reported posttraumatic growth, using several positive co** skills. Open-ended questions identified survivors’ specific continuing bombing-related problems, and needs which were not disclosed on the questionnaire; these included many lasting physical injuries, health problems (especially hearing difficulties), specific posttraumatic stress disorder (PTSD) symptoms, other emotional symptoms, work and financial problems, interpersonal issues, and desires to help others. Conclusions: Results suggest that extended recovery services are needed long after terrorism exposure, and that open-ended assessment is useful to identify those requiring services. Full article
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11 pages, 265 KiB  
Article
Factors Associated with Symptoms of Depression and Psychological Distress during the COVID-19 Pandemic
by Yuqi Guo, Omar T. Sims, Weidi Qin and Fan Yang
Behav. Sci. 2021, 11(2), 13; https://doi.org/10.3390/bs11020013 - 21 Jan 2021
Cited by 16 | Viewed by 3500
Abstract
The objective of this study was to examine factors associated with symptoms of depression and psychological distress during the COVID-19 pandemic in China. Convenience sampling and snowball sampling were used to recruit a sample of adults in China (n = 2130) from [...] Read more.
The objective of this study was to examine factors associated with symptoms of depression and psychological distress during the COVID-19 pandemic in China. Convenience sampling and snowball sampling were used to recruit a sample of adults in China (n = 2130) from 14 February 2020 to 3 March 2020 to complete an online survey. Linear regression was used to examine the predictors of symptoms of depression and psychological distress. Living in a non-urban area and the number of confirmed cases in their city of residence were positively associated with symptoms of depression. Female gender, not being married, practicing social distancing, the amount of time spent daily on social media searching for and reading information on COVID-19, the number of confirmed cases of COVID-19 in their city of residence, and having confirmed or suspected cases of COVID-19 in personal networks were positively associated with psychological distress. Social distancing is a widely used public health approach for population-wide virus-containment of COVID-19. However, reductions in population-wide psychological well-being are inadvertent consequences of social distancing. There is an emerging need to negate factors that increase adverse mental health vulnerabilities during the COVID-19 pandemic. Full article
10 pages, 235 KiB  
Article
The Symptom Structure of Postdisaster Major Depression: Convergence of Evidence from 11 Disaster Studies Using Consistent Methods
by Carol S. North and David Baron
Behav. Sci. 2021, 11(1), 8; https://doi.org/10.3390/bs11010008 - 13 Jan 2021
Cited by 3 | Viewed by 2295
Abstract
Agreement has not been achieved across symptom factor studies of major depressive disorder, and no studies have identified characteristic postdisaster depressive symptom structures. This study examined the symptom structure of major depression across two databases of 1181 survivors of 11 disasters studied using [...] Read more.
Agreement has not been achieved across symptom factor studies of major depressive disorder, and no studies have identified characteristic postdisaster depressive symptom structures. This study examined the symptom structure of major depression across two databases of 1181 survivors of 11 disasters studied using consistent research methods and full diagnostic assessment, addressing limitations of prior self-report symptom-scale studies. The sample included 808 directly-exposed survivors of 10 disasters assessed 1–6 months post disaster and 373 employees of 8 organizations affected by the September 11, 2001 terrorist attacks assessed nearly 3 years after the attacks. Consistent symptom patterns identifying postdisaster major depression were not found across the 2 databases, and database factor analyses suggested a cohesive grou** of depression symptoms. In conclusion, this study did not find symptom clusters identifying postdisaster major depression to guide the construction and validation of screeners for this disorder. A full diagnostic assessment for identification of postdisaster major depressive disorder remains necessary. Full article
10 pages, 225 KiB  
Article
Outcomes and Correlates of Major Depression in 11 Disaster Studies Using Consistent Methods
by Carol S. North and David Baron
Behav. Sci. 2021, 11(1), 4; https://doi.org/10.3390/bs11010004 - 1 Jan 2021
Cited by 3 | Viewed by 1982
Abstract
This study investigated psychosocial functioning and employment status in association with postdisaster major depression and its course in survivors of 11 different disasters in a sample of 808 directly-exposed survivors of 10 disasters and 373 survivors of the 11 September 2001 (9/11), terrorist [...] Read more.
This study investigated psychosocial functioning and employment status in association with postdisaster major depression and its course in survivors of 11 different disasters in a sample of 808 directly-exposed survivors of 10 disasters and 373 survivors of the 11 September 2001 (9/11), terrorist attacks on New York City’s World Trade Center (total n = 1181). Participants were assessed between 1987 and 2007 with structured diagnostic interviews in a prospective longitudinal design. Consistent research methods allowed merging of the disaster databases for analysis using multivariate modeling. Postdisaster major depression in the study cohort from the 9/11 disaster was more than twice as prevalent as in the other disasters, possibly reflecting the greater psychosocial/interpersonal loss and bereavement experienced by 9/11 disaster survivors. At follow up, employment was associated with remission of postdisaster major depression, non-development of PTSD, and co** via family or friends. Functioning problems were associated with disaster injuries, but not with persistent major depression. This study is unprecedented in its large sample of survivors across the full range of disaster typology studied using consistent methods and full structured interview diagnostic assessment. These findings may help guide future interventions to address postdisaster depression. Full article

Review

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16 pages, 621 KiB  
Review
A Critical Review of Effective Child Mass Trauma Interventions: What We Know and Do Not Know from the Evidence
by Betty Pfefferbaum, Pascal Nitiéma and Elana Newman
Behav. Sci. 2021, 11(2), 25; https://doi.org/10.3390/bs11020025 - 11 Feb 2021
Cited by 5 | Viewed by 2613
Abstract
Over the last 20 years, numerous interventions have been developed and evaluated for use with children exposed to mass trauma with six publications reporting meta-analyses of randomized controlled trials of child mass trauma interventions using inactive controls to examine intervention effects on posttraumatic [...] Read more.
Over the last 20 years, numerous interventions have been developed and evaluated for use with children exposed to mass trauma with six publications reporting meta-analyses of randomized controlled trials of child mass trauma interventions using inactive controls to examine intervention effects on posttraumatic stress, depression, anxiety, and functional impairment. The current report reviews the results of these meta-analytic studies to examine the status of the evidence for child mass trauma mental health interventions and to evaluate potential moderators of intervention effect and implications for practice. The meta-analyses reviewed for the current report revealed a small to medium overall effect of interventions on posttraumatic stress, a non-statistically significant to small overall effect on depression, a non-statistically significant overall effect on anxiety, and a small overall effect on functional impairment. The subgroup analyses suggest that interventions should be matched to the populations being served and to the context. Additional research is needed to tailor future interventions to further address outcomes other than posttraumatic stress including depression, anxiety, and functional impairment. Full article
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Other

14 pages, 274 KiB  
Perspective
A Nosological Exploration of PTSD and Trauma in Disaster Mental Health and Implications for the COVID-19 Pandemic
by Carol S. North, Alina M. Surís and David E. Pollio
Behav. Sci. 2021, 11(1), 7; https://doi.org/10.3390/bs11010007 - 8 Jan 2021
Cited by 32 | Viewed by 4940
Abstract
The coronavirus disease of 2019 (COVID-19) pandemic rapidly spread around the world, resulting in massive medical morbidity and mortality and substantial mental health consequences. Post-traumatic stress disorder (PTSD) is an important psychiatric disorder associated with disasters, and many published scientific articles have reported [...] Read more.
The coronavirus disease of 2019 (COVID-19) pandemic rapidly spread around the world, resulting in massive medical morbidity and mortality and substantial mental health consequences. Post-traumatic stress disorder (PTSD) is an important psychiatric disorder associated with disasters, and many published scientific articles have reported post-traumatic stress syndromes in populations studied for COVID-19 mental health outcomes. American diagnostic criteria for PTSD have evolved across editions of the manual, and the current definition excludes naturally occurring medical illness (such as viral illness) as a qualifying trauma, ruling out this viral pandemic as the basis for a diagnosis of PTSD. This article provides an in-depth nosological consideration of the diagnosis of PTSD and critically examines three essential elements (trauma, exposure, and symptomatic response) of this diagnosis, specifically applying these concepts to the mental health outcomes of the COVID-19 pandemic. The current criteria for PTSD are unsatisfying for guiding the response to mental health consequences associated with this pandemic, and suggestions are made for addressing the conceptual diagnostic problems and designing research to resolve diagnostic uncertainties empirically. Options might be to revise the diagnostic criteria or consider categorization of COVID-19-related psychiatric syndromes as non-traumatic stressor-related syndromes or other psychiatric disorders. Full article
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