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The prevalence of mental disorders among Black, Latino, and Asian adults is lower than among Whites. Factors that explain these differences are largely unknown. We examined whether racial/ethnic differences in exposure to traumatic events (TEs) or vulnerability to trauma-related psychopathology explained the lower rates of psychopathology among racial/ethnic minorities.
We estimated the prevalence of TE exposure and associations with onset of DSM-IV depression, anxiety and substance disorders and with lifetime post-traumatic stress disorder (PTSD) in the Collaborative Psychiatric Epidemiology Surveys, a national sample (N = 13 775) with substantial proportions of Black (35.9%), Latino (18.9%), and Asian Americans (14.9%).
TE exposure varied across racial/ethnic groups. Asians were most likely to experience organized violence – particularly being a refugee – but had the lowest exposure to all other TEs. Blacks had the greatest exposure to participation in organized violence, sexual violence, and other TEs, Latinos had the highest exposure to physical violence, and Whites were most likely to experience accidents/injuries. Racial/ethnic minorities had lower odds ratios of depression, anxiety, and substance disorder onset relative to Whites. Neither variation in TE exposure nor vulnerability to psychopathology following TEs across racial/ethnic groups explained these differences. Vulnerability to PTSD did vary across groups, however, such that Asians were less likely and Blacks more likely to develop PTSD following TEs than Whites.
Lower prevalence of mental disorders among racial/ethnic minorities does not appear to reflect reduced vulnerability to TEs, with the exception of PTSD among Asians. This highlights the importance of investigating other potential mechanisms underlying racial/ethnic differences in psychopathology.
This chapter summarizes the complex ways in which people experience disasters. These experiences are organized into categories of traumatic stressors, loss, ongoing adversities, and community effects and meanings. The chapter explores the most acutely severe and personally traumatic aspects of disaster exposure: loss of life and traumatic bereavement; threat to life, injury, and fear; and witnessing of horror. Damage to home and property, often accompanied by financial loss, may be the prototypical stressor associated with natural disasters. The acutely stressful experiences of trauma and loss are followed by a host of challenges associated with poor housing conditions, rebuilding, and other stressors in the postdisaster environment. Postdisaster stressors are typically captured in disaster research by measures of stressful life events or chronic stress. Development and validation of quantitative measures that encompass both universal and culture-specific responses to trauma could help address current cross-cultural and transnational assessment challenges.
A large number of firefighters retired after 11 September 2001. These retirees were confronted with multiple challenges, including grief, trauma- related physical injuries and psychological distress, difficulties related to the transition of their roles, and deterioration of social support.
The Fire Department of NewYork (FDNY) Counseling Service Unit's “Stay Connected” Program designed and implemented after 11 September 2001 is described in this report. This unique program was designed to usea combination of peer outreach and professional counseling to address the mental health needs of retiring firefighters and their families.
Descriptive information about the intervention program was gathered through semi-structured interviews with Counseling Service Unit staff. Client satisfaction surveys were collected during three six-week periods.
Quantitative data indicate that clients rated their overall satisfaction with the clerical and counseling staff a perfect 4 out of 4. The report of their overall satisfaction with the services also was nearly at ceiling (3.99 out 4).The perceived helpfulness of the services in resolving the problems experienced by the clients increased significantly over time.Qualitative data indicate that peer involvement and intensive community outreach, i.e., social events, wellness activities, and classes, were integral to the success of the intervention.
This project provided valuable lessons about how to develop and implement a “culturally competent”intervention program for public safety workers retiring after a disaster. Creative, proactive, non-traditional outreach efforts and leveraging peers for credibility and support were particularly important.
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