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White River Junction, VT, United States

Schumacher J.A.,University of Mississippi Medical Center | Coffey S.F.,University of Mississippi Medical Center | Norris F.H.,National Center for Disaster Mental Health Research | Tracy M.,University of Michigan | And 2 more authors.
Violence and Victims | Year: 2010

This study sought to establish the prevalence and correlates of intimate partner violence (IPV) victimization in the 6 months before and after Hurricane Katrina. Participants were 445 married or cohabiting persons who were living in the 23 southernmost counties of Mississippi at the time of Hurricane Katrina. Data for this study were collected as part of a larger, population-based, representative study. The percentage of women reporting psychological victimization increased from 33.6% prior to Hurricane Katrina to 45.2% following Hurricane Katrina (p <.001). The percentage of men reporting psychological victimization increased from 36.7% to 43.1% (p =.01). Reports of physical victimization increased from 4.2% to 8.3% for women (p =.01) but were unchanged for men. Significant predictors of post-Katrina victimization included pre-Katrina victimization, age, educational attainment, marital status, and hurricane-related stressors. Reports of IPV were associated with greater risk of post-Katrina depression and posttraumatic stress disorder. Data from the first population-based study to document IPV following a large-scale natural disaster suggest that IPV may be an important but often overlooked public health concern following disasters. © 2010 Springer Publishing Company. Source

Pfefferbaum R.L.,Phoenix Community College | Pfefferbaum R.L.,The University of Oklahoma Health Sciences Center | Neas B.R.,The University of Oklahoma Health Sciences Center | Pfefferbaum B.,The University of Oklahoma Health Sciences Center | And 3 more authors.
International Journal of Emergency Mental Health | Year: 2013

While building community resilience to disasters is becoming an important strategy in emergency management, this is a new field of research with few available instruments for assessing community resilience. This article describes the development of the Communities Advancing Resilience Toolkit (CART) survey instrument. CART is a community intervention designed to enhance community resilience to disasters, in part, by engaging communities in measuring it. The survey instrument, originally based on community capacity and related literature and on key informant input, was refined through a series of four field tests. Community organizations worked with researchers in a participatory action process that provided access to samples and helped to guide the research. Exploratory factor analysis performed after each field test led to the identification of four interrelated constructs (also called domains) which represent the foundation for CART: Connection and Caring, Resources, Transformative Potential, and Disaster Management. This model was confirmed using confirmatory factor analysis on two community samples. The CART survey can provide data for organizations and communities interested in assessing a community's resilience to disasters. Baseline data, preferably collected pre disaster, can be compared to data collected post disaster and/or post intervention. © 2013 Chevron. Source

Pietrzak R.H.,Yale University | Pietrzak R.H.,National Center for Disaster Mental Health Research | Galea S.,National Center for Disaster Mental Health Research | Galea S.,Columbia University | And 4 more authors.
Journal of Affective Disorders | Year: 2013

Background: Little is known about the specificity of the interaction of serotonin transporter 5-HTTLPR genotype x trauma exposure in relation to contemporary structural models of PTSD symptomatology, which suggest that 4- or 5-factor models provide a better representation of the phenotypic expression of this disorder. Methods: One hundred forty-nine respondents of a representative sample of adults affected by Hurricane Ike were interviewed 2-5 months after this 2008 disaster. Results: After adjustment for age, sex, and ancestral proportion scores, the interaction of 5-HTTPLR genotype x trauma exposure was significantly associated with both severity (β=.40, p<.001) and probable diagnosis (Wald=4.55, p=.033; odds ratio=3.81, 95% CI=1.11-13.03) of Ike-related PTSD. Respondents with the low-expression variant of the 5-HTTPLR polymorphism (S allele carriers) who were highly exposed to Hurricane Ike reported significantly greater severity of PTSD symptoms and were more likely to screen positive for PTSD than respondents homozygous for the L allele who were highly exposed to Hurricane Ike. Confirmatory factor analyses revealed that a 5-factor model of intercorrelated re-experiencing, avoidance, numbing, dysphoric arousal, and anxious arousal symptoms provided the best structural representation of PTSD symptomatology. The 5-HTTPLR genotype x exposure interaction was significant only for anxious arousal (β=.44, p<.001) and re-experiencing (β=.35, p<.001) symptoms, but not avoidance, numbing, or dysphoric arousal symptoms (all βs≤.20, all ps>.13). Limitations: The small sample size and employment of self-report measures may limit generalizability of these findings. Conclusions: Results of this pilot study suggest that the low-expression variant of the 5-HTTLPR polymorphism modifies risk for PTSD, but that this effect may be specific to anxious arousal and re-experiencing symptoms. Source

Pietrzak R.H.,Yale University | Pietrzak R.H.,National Center for Disaster Mental Health Research | Van Ness P.H.,Yale University | Fried T.R.,Yale University | And 4 more authors.
International Psychogeriatrics | Year: 2012

Background: Little research has examined the diagnostic utility and factor structure of commonly used posttraumatic stress disorder (PTSD) assessment instruments in older persons. Methods: A total of 206 adults aged 60 or older (mean age = 69 years; range = 60-92), who resided in the Galveston Bay area when Hurricane Ike struck in September 2008, completed a computer-assisted telephone interview two-five months after this disaster. Using the PTSD Checklist (PCL), PTSD symptoms were assessed related both to this disaster and to participants' worst lifetime traumatic event. Total PCL scores were compared to PCL-based, Diagnostic and Statistical Manual of Mental Disorders, 4th edition (DSM-IV)-derived probable diagnoses of PTSD to determine optimal cut scores. Confirmatory factor analyses (CFAs) were conducted to evaluate PTSD symptom structure. Results: Receiver operating characteristic analyses indicated that a PCL score of 39 achieved optimal sensitivity and specificity in assessing a PCL-based, algorithm-derived DSM-IV diagnosis of worst event-related PTSD; and that a score of 37 optimally assessed probable Ike-related PTSD. CFAs revealed that a recently proposed five-factor model - comprised of re-experiencing, avoidance, numbing, dysphoric arousal, and anxious arousal factors-provided a better fitting representation of both worst event- and disaster-related PTSD symptoms than alternative models. Current Ike-related anxious arousal symptoms demonstrated a significantly stronger association with current generalized anxiety than depressive symptoms, thereby supporting the construct validity of this five-factor model of PTSD symptomatology. Conclusions: A PCL score of 37 to 39 may help identify probable PTSD in older persons. The expression of PTSD symptoms in older adults may be best characterized by a recently proposed five-factor model with distinct dysphoric arousal and anxious arousal clusters. © Copyright International Psychogeriatric Association 2012. Source

Norris F.H.,National Center for Disaster Mental Health Research | Sherrieb K.,National Center for Disaster Mental Health Research | Galea S.,National United University
Rehabilitation Psychology | Year: 2010

Objective: To explore the extent to which disasters may be a source of injury and disability in community populations, we examined the prevalence and short-term consequences of disaster-related illness and injury for distress, disability, and perceived needs for care. Design: A random population survey was conducted 2-6 months after Hurricane Ike struck Galveston Bay on September 13, 2008. Participants: The sample was composed of 658 adults representative of Galveston and Chambers Counties, Texas. Results: The prevalences of personal injury (4%) and household illness (16%) indicated that approximately 7,700 adults in the two-county area were injured, and another 31,500 adults experienced household-level illness. Risk for injury/illness increased with area damage and decreased with evacuation. In bivariate tests, injury or illness or both were related to all outcome measures. In multivariate analyses that controlled for co-occurring stressors representing trauma, loss, adversities, and community effects, injury or illness or both were associated with global stress, posttraumatic stress, dysfunction, days of disability, and perceived needs for care, but not with depression or anxiety. Conclusions: The associations of injury with distress and disability suggest that community programs should reach out to injured persons for early mental health and functional assessments and, where indicated, intervene in ways that reduce further disability and need for complex rehabilitative services. The results also point to the potential effectiveness of evacuation incentives with regard to the prevention of disaster-related injury and disability. © 2010 American Psychological Association. Source

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