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Community characteristics, such as perceived collective efficacy, a measure of community strength, can affect mental health outcomes following disasters. We examined the association of perceived collective efficacy with posttraumatic stress disorder (PTSD) and frequent mental distress (14 or more mentally unhealthy days in the past month) following exposure to the 2004 and 2005 hurricane seasons.
Participants were 1486 Florida Department of Health workers who completed anonymous questionnaires that were distributed electronically 9 months after the 2005 hurricane season. Participant ages ranged from 20 to 79 years (mean, 48; SD, 10.7), and the majority were female (79%), white (75%), and currently married (64%). Fifty percent had a BA/BS degree or higher.
In 2 separate logistic regression models, each adjusted for individual sociodemographics, community socioeconomic characteristics, individual injury/damage, and community storm damage, lower perceived collective efficacy was significantly associated with a greater likelihood of having PTSD (OR, 0.93; 95% CI, 0.90-0.96), and lower collective efficacy was significantly associated with frequent mental distress (OR, 0.94; 95% CI, 0.92-0.96).
Programs enhancing community collective efficacy may be a significant part of prevention practices and possibly lead to a reduction in the rate of PTSD and persistent distress postdisaster. (Disaster Med Public Health Preparedness. 2019;13:44–52).
This study examined the relationship of sniper-related television viewing (TV) and perceived safety to posttraumatic stress (PTS) and depressive symptoms during the Washington, DC sniper attacks.
Participants were 1238 Washington, DC area residents assessed using an internet survey including the Impact of Event Scale-Revised, Patient Health Questionnaire-9, hours of TV, and perceived safety.
Almost 40% (n = 459) of participants watched at least 2 hours of sniper-related TV daily. TV viewing was associated with lower total perceived safety. After adjusting for demographics, more TV viewing and decreased perceived safety were related to increased PTS and depressive symptoms. TV viewing modified the effect of safety on PTS and depressive symptoms. Among participants with low and high perceived safety, hours of TV were positively associated with PTS; however, the effect was stronger among those with low perceived safety. The relationship of TV to increased depressive symptoms was identified only in participants who reported low perceived safety.
The influence of media exposure and perceived safety have implications for intervention by community leaders and mental health care providers. Recommendations include limiting media exposure during a terrorist event, particularly among those who perceive that their safety is at risk, and targeting safety in communication strategies. (Disaster Med Public Health Preparedness. 2019;13:570-576)
A series of sniper attacks in the Washington, DC, area left 10 people dead and 3 wounded. We developed and tested a model that examined the unique and interdependent relationships of sniper-related television viewing, prior life-threatening events, and parental status to identification with attack victims.
Participants were 1238 residents of the DC area (aged 18-90 years, mean=41.7 years; 51% female; 68% white) who completed an online survey that assessed identification with sniper attack victims, amount of television viewing, and prior life-threatening events. Identification was measured by using a previously developed scale that assessed to what extent participants identified victims as similar to themselves, a friend, or a family member.
The relationship of television viewing to identification was examined by using multivariate linear regression analyses. In univariate analyses, female gender, having children, higher levels of television viewing, and past life-threatening events were independently related to greater identification. After adjustment for demographics and life-threatening events, sniper-related television viewing continued to be associated with identification (B=0.61, P≤0.001, ∆R2=0.07). Examination of the interactions of television viewing by parental status and television viewing by life-threatening event revealed significant relationships.
Attention to events preceding and during a terrorist event could help in the recognition of those at particular risk for increased identification with attack victims. These findings also have implications for recommendations for media exposure during an event. (Disaster Med Public Health Preparedness. 2018; 12: 337–344)
For over 3 weeks in October 2002, a series of sniper attacks in the Washington, DC, area left 10 people dead and 3 wounded. This study examined the relationship of distress associated with routine activities and perceived safety to psychological and behavioral responses.
Participants were 1238 residents of the Washington, DC, metropolitan area (aged 18 to 90 years, mean=41.7 years) who completed an Internet survey including the Impact of Event Scale-Revised, Patient Health Questionnaire-9, and items pertaining to distress related to routine activities, perceived safety, and alcohol use. Data were collected at one time point approximately 3 weeks after the first sniper shooting and before apprehension of the suspects. Relationships of distress and perceived safety to post-traumatic stress, depressive symptoms, and increased alcohol use were examined by using linear and logistic regression analyses.
Approximately 8% of the participants met the symptom criteria for probable post-traumatic stress disorder, 22% reported mild to severe depression, and 4% reported increased alcohol use during the attacks. Distress related to routine activities and perceived safety were associated with increased post-traumatic stress and depressive symptoms and alcohol use.
Distress and perceived safety are associated with specific routine activities and both contribute to psychological and behavioral responses during a terrorist attack. These findings have implications for targeted information dissemination and risk communication by community leaders. (Disaster Med Public Health Preparedness. 2015;9:509–515)
Examinations of the demands on public health workers after disaster exposure have been limited. Workers provide emergency care while simultaneously risking injury, damage to personal property, and threats to their own and their family's safety. We examined the disaster management experiences of 4323 Florida Department of Health workers 9 months after their response to 4 hurricanes and 1 tropical storm during a 7-week period in August and September of 2004.
Participants completed a self-report questionnaire focused on work performance, mental and physical health, daily functioning, sleep disturbance, physiological arousal, and injury and work demand at the time of the hurricanes, and answered open-ended questions that described their experiences in more detail.
A qualitative analysis conducted from the write-in data yielded 4 domains: (1) work/life balance; (2) training for disaster response role; (3) workplace support; and (4) recovery.
Study findings highlighted a number of concerns that are important to public health workers who provide emergency care after a disaster and, in particular, multiple disasters such as during the 2004 hurricane season. The findings also yielded important recommendations for emergency public health preparedness. (Disaster Med Public Health Preparedness. 2013;0:1–7)
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