Dataset Information

Predisaster predictors of posttraumatic stress symptom trajectories: An analysis of low-income women in the aftermath of Hurricane Katrina.

ABSTRACT: 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 participants from the Resilience in Survivors of Katrina Study (N = 885). Participants were originally part of a community college intervention study and were assessed prior to the hurricane (6-21 months predisaster), and approximately 1 year, 4 years, and 12 years postdisaster. Latent class growth analysis identified PTSS trajectories. Perceived social support, probable mental illness, and physical health conditions or problems-all assessed predisaster-were examined as predictors of trajectory membership at the univariate level and in multivariable models without and with adjustment for disaster exposure. Three PTSS trajectories were detected: Moderate-Decreasing (69.3%), High-Decreasing (23.1%), and High-Stable (7.6%). In the multivariable predictive model without adjustment for disaster exposure, probable predisaster mental illness was significantly associated with greater odds of the High-Decreasing and High-Stable trajectories, and physical health conditions or problems with greater odds of the High-Decreasing trajectory, relative to the Moderate-Decreasing trajectory. However, when disaster exposure was adjusted, only the association between predisaster mental illness and the odds of the High-Stable trajectory remained statistically significant. Lower predisaster perceived social support was significantly associated with membership in the High-Decreasing trajectory, relative to the Moderate-Decreasing, at the univariate level, but not in either multivariable model. Whereas predisaster mental illness confers risk for chronic postdisaster PTSS, other impacts of predisaster resources and vulnerabilities on elevated PTSS trajectories do not go beyond those of disaster exposure. The results support disaster preparedness efforts targeting those with mental and physical health conditions, and postdisaster mental health services addressing preexisting vulnerabilities in addition to disaster-related PTSS.

SUBMITTER: Lowe SR

PROVIDER: S-EPMC7577433 | biostudies-literature | 2020

REPOSITORIES: biostudies-literature

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Predisaster predictors of posttraumatic stress symptom trajectories: An analysis of low-income women in the aftermath of Hurricane Katrina.

Lowe Sarah R SR Raker Ethan J EJ Waters Mary C MC Rhodes Jean E JE

PloS one 20201021 10

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 participants from the Resilience in Survivors of Katrina Study (N = 885). Participants were originally part of a community college intervention study ...[more]

PMID: 33085670

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Project description:BackgroundThe aim of the study was to identify trajectories of perinatal depressive symptoms and their predictors among women living in a low-resource setting in South Africa, and who present with a risk of depression during pregnancy.MethodsThis is a secondary analysis of a randomised controlled trial among 384 women living in Khayelitsha, a low income setting in South Africa, recruited at their first antenatal visit if they scored 13 or above on the Edinburgh Postnatal Depression Scale, were at least 18 years of age, less than 29 weeks pregnant and spoke isiXhosa. Participants were followed up at 8 months gestation, 3 and 12 months postpartum. Latent trajectories of depressive symptoms were identified using growth mixture modelling, based on the Hamilton Depression Rating Scale (HDRS). There were no differences in HDRS scores between the control and intervention arms, so all participants were assessed together. Health, social and economic predictors of trajectories were investigated to identify high-risk groups with greater or more chronic depressive symptoms, using univariate logistic regression.ResultsTwo trajectories were identified: antenatal only (91.4%), with moderate to severe symptoms at baseline which later subside; and antenatal and postnatal (8.6%), with severe depressive symptoms during pregnancy and later in the postpartum period, which subside temporarily to moderate levels at 3 months postpartum. Predictors for the antenatal and postnatal trajectory include severe food insecurity, intimate partner violence, lower social support, greater functional impairment, problematic drinking and suicide risk.ConclusionsA small proportion of women who are at risk for depression antenatally remain at risk throughout the perinatal period, and can be differentiated from those who show a natural remission. Identification and referral strategies should be developed with these findings in mind, especially given the limited mental health resources in low-income settings.

Project description:There is considerable variation in psychological reactions to natural disasters, with responses ranging from relatively mild and transitory symptoms to severe and persistent posttraumatic stress (PTS). Some survivors also report post-traumatic growth (PTG), or positive psychological changes due to the experience and processing of the disaster and its aftermath. Gene-environment interaction (GxE) studies could offer new insight into the factors underlying variability in post-disaster psychological responses. However, few studies have explored GxE in a disaster context.We examined whether ten common variants in seven genes (BDNF, CACNA1C, CRHR1, FKBP5, OXTR, RGS2, SLC6A4) modified associations between Hurricane Katrina exposure and PTS and PTG. Data were from a prospective study of 205 low-income non-Hispanic Black parents residing in New Orleans prior to and following Hurricane Katrina.We found a significant association (after correction) between RGS2 (rs4606; p=0.0044) and PTG, which was mainly driven by a cross-over GxE (p=0.006), rather than a main genetic effect (p=0.071). The G (minor allele) was associated with lower PTG scores for low levels of Hurricane exposure and higher PTG scores for moderate and high levels of exposure. We also found a nominally significant association between variation in FKBP5 (rs1306780, p=0.0113) and PTG, though this result did not survive correction for multiple testing.Although the inclusion of low-income non-Hispanic Black parents allowed us to examine GxE among a highly vulnerable group, our findings may not generalize to other populations or groups experiencing other natural disasters. Moreover, not all participants invited to participate in the genetic study provided saliva.To our knowledge, this is the first study to identify GxE in the context of post-traumatic growth. Future studies are needed to clarify the role of GxE in PTS and PTG and post-disaster psychological responses, especially among vulnerable populations.

Dataset Information

Predisaster predictors of posttraumatic stress symptom trajectories: An analysis of low-income women in the aftermath of Hurricane Katrina.

Publications

Predisaster predictors of posttraumatic stress symptom trajectories: An analysis of low-income women in the aftermath of Hurricane Katrina.

Similar Datasets

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