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1. Do levels of posttraumatic growth vary by type of traumatic event experienced? An analysis of the Nurses Health Study II.

Author

Lowe, Sarah, James, Peter, Arcaya, Mariana, Vale, Mira, Rhodes, Jean, Rich-Edwards, Janet, Roberts, Andrea, and Koenen, Karestan

Subjects
Adaptation, Psychological, Bereavement, Female, Humans, Nurses, Posttraumatic Growth, Psychological, Stress Disorders, Post-Traumatic
Abstract

OBJECTIVE: Posttraumatic growth (PTG) has been documented in the aftermath of a range of traumatic events, including bereavement, physical assault, and rape. However, only a handful of studies have examined whether levels of total PTG, as well as the 5 domains of PTG (Appreciation of Life, New Possibilities, Relating to Others, Personal Strength, and Spiritual Change), vary by the type of potentially traumatic event. The current study examined variation in total PTG and PTG domains, as well as posttraumatic stress (PTS), by event type using data from a large epidemiological study. METHOD: Participants were from a substudy of the Nurses Health Study 2, an epidemiologic study of female nurses in the United States (N = 1,574). RESULTS: Controlling for demographic covariates, we found that rape was consistently associated with lower PTG, both total PTG and all five PTG domains, relative to other event types. Other findings were limited to specific PTG domains; for example, intimate partner violence (IPV) was associated with higher Personal Strength and New Possibilities. In contrast, rape and IPV were associated with higher PTS, and the serious illness or injury of someone close with lower PTS, relative to other event types. CONCLUSION: These results add to the growing literature exploring variation in PTG by event type and suggest that different events could yield markedly different patterns of PTG domains and PTS. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Published
2022

3. Understanding trajectories of underlying dimensions of posttraumatic psychopathology

Author

Sumner, Jennifer A, Rünger, Dennis, Robles, Theodore F, Lowe, Sarah R, Elashoff, David, and Shetty, Vivek

Subjects
Post-Traumatic Stress Disorder (PTSD), Mental Health, Physical Injury - Accidents and Adverse Effects, Brain Disorders, Anxiety Disorders, Behavioral and Social Science, Depression, 2.3 Psychological, social and economic factors, Aetiology, Mental health, Aged, Anxiety, Female, Humans, Longitudinal Studies, Psychopathology, Stress Disorders, Post-Traumatic, Survivors, Trauma, Posttraumatic psychopathology, Symptom dimension, Trajectory, Medical and Health Sciences, Psychology and Cognitive Sciences, Psychiatry
Abstract

BackgroundResearch suggests four modal trajectories of psychological symptoms after traumatic injury: Resilient, Chronic, Delayed Onset, Recovery. However, most studies focus on symptoms of psychiatric disorders (e.g., posttraumatic stress disorder, depression), which are limited by heterogeneity and symptom overlap. We examined trajectories of cross-cutting posttraumatic symptom dimensions following traumatic injury and predictors of trajectory membership.MethodsIn this longitudinal study of 427 predominantly Hispanic/Latino traumatic injury survivors, posttraumatic psychopathology symptoms were assessed during hospitalization and approximately one and five months post-trauma. Using latent class growth analysis, we estimated trajectories of several posttraumatic symptom dimensions: re-experiencing, avoidance, anxious arousal, numbing, dysphoric arousal, loss, and threat. We then examined sociodemographic and trauma-related characteristics (measured during hospitalization) as predictors of trajectory membership for each dimension.ResultsFour trajectories (Resilient, Chronic, Delayed Onset, Recovery) emerged for all dimensions except loss and threat, which manifested three trajectories (Resilient, Chronic, Delayed Onset). Across dimensions, membership in the Chronic (vs. Resilient) trajectory was consistently predicted by unemployment (7 of 7 dimensions), followed by older age (3/7), female sex (3/7), and assaultive trauma (2/7). For several dimensions, unemployment also distinguished between participants who presented with similar symptom levels days after trauma, but then diverged over time.LimitationsMeasures of posttraumatic symptom dimension constructs differed across assessments.ConclusionsThis study provides evidence of distinct trajectories across transdiagnostic symptom dimensions after traumatic injury. Employment status emerged as the most important predictor of trajectory membership. Research is needed to better understand the etiologies and consequences of these posttraumatic symptom dimension trajectories.

Published
2021

6. A national initiative in data science for health: an evaluation of the UK Farr Institute

Author

Hemingway, H, Lyons, R, Li, Q, Buchan, I, Ainsworth, J, Pell, J, Morris, A, Barnes, Michael R, Bedford, Helen, Bennie, Marion, Blandford, Ann, Briggs, Andy, Brocklehurst, Peter, Brophy, Sinead, Brown, Gavin, Burton, Paul, Butler, Christopher, Capewell, Simon, Carpenter, James, Carroll, John, Cassell, Jackie A, Castillo, Fortunato, Catchpole, Mike, Caulfield, Mark, Colhoun, Helen, Coveney, Peter, Cunningham-Burley, Sarah, Custovic, Adnan, Deanfield, John, Denaxas, Spiros, Dennis, Michael, Dezateux, Carol, Dibben, Chris, Diggle, Peter, Dixon, Will, Dunn, Graham, Emam, Khaled El, Fone, David, Ford, David, Ford, Ian, Frank, John, Freemantle, Nick, Gabbe, Belinda, Gallacher, John, Gibson, Martin, Gilbert, Ruth, Gissler, Mika, Goble, Carol, Goldberg, Andy, Gravenor, Mike, Gunnell, David, Hannaford, Phil, Hayward, Andrew, Hickman, Matthew, Hingorani, Aroon, Holm, Soren, Holman, Cashel, John, Gareth, John, Ann, Jones, Kerina, Kalra, Dipak, Laurie, Graeme, Lewis, Shon, Lloyd, Keith, Lowe, Sarah, McCowan, Colin, Macleod, John, Martin, Richard M, Moore, Anthony, Moore, Laurence, Nazareth, Irwin, Nenadic, Goran, Paranjothy, Shantini, Parmar, Max, Pebody, Richard, Petersen, Steffen, Petersen, Irene, Pillay, Deenan, Preen, David, Pickett, Kate, Pritchard-Jones, Kathy, Przulj, Natasa, Renehan, Andrew, Roberts, Stephen, Robson, John, Rodgers, Sarah, Rossor, Martin, Russell, Ian, Shawe-Taylor, John, Sheikh, Aziz, Siebert, Stefan, Snooks, Helen, Sperrin, Matthew, Stephenson, Judith, Sullivan, Frank, Taylor, Chris, Taylor, Paul, Timmis, Adam, and Ward, Hester JT

Subjects
Information and Computing Sciences, Library and Information Studies, Health Sciences, Generic health relevance, Health sciences, Human society, Information and computing sciences
Abstract

ObjectiveTo evaluate the extent to which the inter-institutional, inter-disciplinary mobilisation of data and skills in the Farr Institute contributed to establishing the emerging field of data science for health in the UK.Design and outcome measuresWe evaluated evidence of six domains characterising a new field of science:defining central scientific challenges,demonstrating how the central challenges might be solved,creating novel interactions among groups of scientists,training new types of experts,re-organising universities,demonstrating impacts in society.We carried out citation, network and time trend analyses of publications, and a narrative review of infrastructure, methods and tools.SettingFour UK centres in London, North England, Scotland and Wales (23 university partners), 2013-2018.Results1. The Farr Institute helped define a central scientific challenge publishing a research corpus, demonstrating insights from electronic health record (EHR) and administrative data at each stage of the translational cycle in 593 papers with at least one Farr Institute author affiliation on PubMed. 2. The Farr Institute offered some demonstrations of how these scientific challenges might be solved: it established the first four ISO27001 certified trusted research environments in the UK, and approved more than 1000 research users, published on 102 unique EHR and administrative data sources, although there was no clear evidence of an increase in novel, sustained record linkages. The Farr Institute established open platforms for the EHR phenotyping algorithms and validations (>70 diseases, CALIBER). Sample sizes showed some evidence of increase but remained less than 10% of the UK population in primary care-hospital care linked studies. 3.The Farr Institute created novel interactions among researchers: the co-author publication network expanded from 944 unique co-authors (based on 67 publications in the first 30 months) to 3839 unique co-authors (545 papers in the final 30 months). 4. Training expanded substantially with 3 new masters courses, training >400 people at masters, short-course and leadership level and 48 PhD students. 5. Universities reorganised with 4/5 Centres established 27 new faculty (tenured) positions, 3 new university institutes. 6. Emerging evidence of impacts included: > 3200 citations for the 10 most cited papers and Farr research informed eight practice-changing clinical guidelines and policies relevant to the health of millions of UK citizens.ConclusionThe Farr Institute played a major role in establishing and growing the field of data science for health in the UK, with some initial evidence of benefits for health and healthcare. The Farr Institute has now expanded into Health Data Research (HDR) UK but key challenges remain including, how to network such activities internationally.

Published
2020

11. Small-Scale Design Experiments as Working Space for Larger Mobile Communication Challenges

Author

Lowe, Sarah and Stuedahl, Dagny

Abstract

In this paper, a design experiment using Instagram as a cultural probe is submitted as a method for analyzing the challenges that arise when considering the implementation of social media within a distributed communication space. It outlines how small, iterative investigations can reveal deeper research questions relevant to the education of emerging design students choosing to enter the field of mobile communication design. Challenges of participatory design, media affordances in relationship to established taxonomies and sustainability are all a result of this research-driven design experiment.

Published
2014

12. Mapping concentrations of posttraumatic stress and depression trajectories following Hurricane Ike.

Author

Gruebner, Oliver, Lowe, Sarah R, Tracy, Melissa, Joshi, Spruha, Cerdá, Magdalena, Norris, Fran H, Subramanian, SV, and Galea, Sandro

Subjects
Humans, Stress Disorders, Post-Traumatic, Disasters, Adolescent, Adult, Aged, Middle Aged, Texas, Female, Male, Cyclonic Storms, Clinical Research, Behavioral and Social Science, Prevention, Climate-Related Exposures and Conditions, Depression, Brain Disorders, Mental Health, Stress Disorders, Post-Traumatic, Biochemistry and Cell Biology, Other Physical Sciences
Abstract

We investigated geographic concentration in elevated risk for a range of postdisaster trajectories of chronic posttraumatic stress symptom (PTSS) and depression symptoms in a longitudinal study (N = 561) of a Hurricane Ike affected population in Galveston and Chambers counties, TX. Using an unadjusted spatial scan statistic, we detected clusters of elevated risk of PTSS trajectories, but not depression trajectories, on Galveston Island. We then tested for predictors of membership in each trajectory of PTSS and depression (e.g., demographic variables, trauma exposure, social support), not taking the geographic nature of the data into account. After adjusting for significant predictors in the spatial scan statistic, we noted that spatial clusters of PTSS persisted and additional clusters of depression trajectories emerged. This is the first study to show that longitudinal trajectories of postdisaster mental health problems may vary depending on the geographic location and the individual- and community-level factors present at these locations. Such knowledge is crucial to identifying vulnerable regions and populations within them, to provide guidance for early responders, and to mitigate mental health consequences through early detection of mental health needs in the population. As human-made disasters increase, our approach may be useful also in other regions in comparable settings worldwide.

Published
2016

15. Long-term impact of the COVID-19 pandemic on self-management of chronic conditions among high-risk adults in the USA: protocol for the C3 observational cohort study

Author

Lovett, Rebecca, primary, Filec, Sarah, additional, Bonham, Morgan, additional, Yoshino Benavente, Julia, additional, O'Conor, Rachel, additional, Russell, Andrea, additional, Zheng, Pauline, additional, Wismer, Guisselle, additional, Yoon, Esther, additional, Weiner-Light, Sophia, additional, Vogeley, Abigail, additional, Morrissey Kwasny, Mary, additional, Lowe, Sarah, additional, Curtis, Laura M, additional, Federman, Alex, additional, Bailey, Stacy C, additional, and Wolf, Michael, additional

Published
2023
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18. Players and performances in early modern Gloucester, Tewkesbury and Bristol

Author

Lowe, Sarah Elizabeth

Subjects
942, PN2000 Dramatic representation. The Theater, PR621 Drama
Abstract

This thesis is an analysis of the responses in the early modern period of civic and church authorities to local and visiting groups of players in Gloucester, Tewkesbury and Bristol. It is also an examination of the venues in which these groups performed. Reactions to these groups varied, and this study explores how these, both positive and negative, were affected by economic, legal and cultural factors. The thesis proceeds chronologically, and is thus divided into twenty-year intervals in order to draw the most effective comparisons between the three urban centres over a number of decades. The first period under examination, the 1560s, records the early reaction of the three settlements to the phenomenon of the Elizabethan travelling company. The relationship between the regional authorities and the patrons comes to the fore in the second period, the 1580s, as the dominance of the ambitious Earl of Leicester grew in the region. Legislation decreeing the withdrawal of mayoral control over itinerant troupes at the close of the sixteenth century, the third period, released civic officials from previous obligations and this influenced the level and character of their hospitality towards the ‘noble’ companies. Although evidence is scarce, the records of Gloucester, Tewkesbury and Bristol contain clues to an attitude towards these entertainers during the reign of James I, the final period under scrutiny. The study is based on the extant economic records for the region, as these contain much fruitful information. This thesis consciously places itself in dialogue with the internationally acclaimed REED Project, and draws on the information collated by the editors of the volumes for Bristol and Gloucestershire. A parallel examination of the entries into municipal records of the three towns, and the areas around them, in conjunction with genealogical and topographical evidence, has allowed for an interpretation of the data in a wide regional context, revealing that although each town tolerated players in their municipal spaces, with the officials personally entertaining the companies on some occasions, the reception of the companies varied significantly from town to town and across the historic period.

Published
2008

27. A Life‐Course Model of Trauma Exposure and Mental Health Among Low‐Income Survivors of Hurricane Katrina

Author

Massachusetts Institute of Technology. Department of Urban Studies and Planning, Lowe, Sarah R, Raker, Ethan J, Arcaya, Mariana C, Zacher, Meghan L, Waters, Mary C, Rhodes, Jean E, Massachusetts Institute of Technology. Department of Urban Studies and Planning, Lowe, Sarah R, Raker, Ethan J, Arcaya, Mariana C, Zacher, Meghan L, Waters, Mary C, and Rhodes, Jean E

Abstract

© 2020 International Society for Traumatic Stress Studies Prior research has provided robust evidence that exposure to potentially traumatic events (PTEs) during a disaster is predictive of adverse postdisaster mental health outcomes, including posttraumatic stress symptoms (PTSS) and nonspecific psychological distress (PD). However, few studies have explored the role of exposure to other PTEs over the life-course in shaping postdisaster mental health. Based on the broader literature on trauma exposure and mental health, we hypothesized a path analytic model linking predisaster PTEs to long-term postdisaster PTSS and PD via predisaster PD, short-term postdisaster symptoms, and disaster-related and postdisaster PTEs. We tested this model using data from the Resilience in Survivors of Katrina study, a longitudinal study of low-income, primarily non-Hispanic Black mothers exposed to Hurricane Katrina and assessed before the disaster and at time points 1, 4, and 12 years thereafter. The models evidenced a good fit with the data, RMSEA <.01–.04, CFIs >.99. In addition, 44.1%–67.4% of the effect of predisaster PTEs on long-term postdisaster symptoms was indirect. Descriptive differences were observed across models that included PTSS versus PD, as well as models that included all pre- and postdisaster PTEs versus only those that involved assaultive violence. The results suggest the importance of incorporating disaster preparedness in clinical work with trauma survivors and the value in attending to other lifetime PTEs when working in postdisaster contexts.

Published
2022

28. Mitigating Health Disparities After Natural Disasters: Lessons From The RISK Project: Study examines mitigating health disparities after natural disasters.

Author

Massachusetts Institute of Technology. Department of Urban Studies and Planning, Raker, Ethan J, Arcaya, Mariana C, Lowe, Sarah R, Zacher, Meghan, Rhodes, Jean, Waters, Mary C, Massachusetts Institute of Technology. Department of Urban Studies and Planning, Raker, Ethan J, Arcaya, Mariana C, Lowe, Sarah R, Zacher, Meghan, Rhodes, Jean, and Waters, Mary C

Abstract

© 2020, Project HOPE. All rights reserved. Climate change exacerbates the severity of natural disasters, which disproportionately affect vulnerable populations. Mitigating disasters’ health consequences is critical to promoting health equity, but few studies have isolated the short-and long-term effects of disasters on vulnerable groups. We filled this gap by conducting a fifteen-year (2003– 2018) prospective study of low-income, predominantly Black parents who experienced Hurricane Katrina: the Resilience in Survivors of Katrina (RISK) Project. Here we describe this project and synthesize lessons from work that has resulted from it. Our findings can guide policy makers, service providers, and health officials in disaster planning and response. We synthesize them into an organizational schema of five priorities: Primary efforts should be aimed at preventing exposure to trauma through investments in climate resilience and by eliminating impediments to evacuation, health care policies should promote uninterrupted and expanded access to care, social services should integrate and strive to reduce the administrative burden on survivors, programs should aid survivors in forging or strengthening connections to their communities, and policy makers should fund targeted long-term services for highly affected survivors.

Published
2022

34. Differentiating PTSD from anxiety and depression: Lessons from the ICD-11 PTSD diagnostic criteria

Author

Barbano, Anna C., van der Mei, Willem F., deRoon-Cassini, Terri A., Grauer, Ettie, Lowe, Sarah Ryan, Matsuoka, Yutaka J., O'Donnell, Meaghan, Olff, Miranda, Qi, Wei, Ratanatharathorn, Andrew, Schnyder, Ulrich, Seedat, Soraya, Kessler, Ronald C., Koenen, Karestan C., Shalev, Arieh Y., Bryant, Richard, Delahanty, Douglas, Goslings, Carel, Luitse, Jan, Moergeli, Hanspeter, Mouthaan, Joanne, Nishi, Daisuke, Sijbrandij, Marit, Suliman, Sharain, van Zuiden, Mirjam, Adult Psychiatry, ANS - Mood, Anxiety, Psychosis, Stress & Sleep, APH - Global Health, APH - Mental Health, University of Zurich, Barbano, Anna C, and Clinical Psychology

Subjects
Adult, Male, Nosology, 610 Medicine & health, nosology, Anxiety, behavioral disciplines and activities, Article, DSM-5, Diagnosis, Differential, Stress Disorders, Post-Traumatic, 2738 Psychiatry and Mental Health, 03 medical and health sciences, 0302 clinical medicine, anxiety disorders, SDG 3 - Good Health and Well-being, International Classification of Diseases, mental disorders, medicine, Humans, Survivors, Israel, Depression (differential diagnoses), Aged, Depressive Disorder, Depression, business.industry, 3203 Clinical Psychology, Odds ratio, Middle Aged, medicine.disease, Comorbidity, 030227 psychiatry, Diagnostic and Statistical Manual of Mental Disorders, Psychiatry and Mental health, Clinical Psychology, comorbidity, 10057 Klinik für Konsiliarpsychiatrie und Psychosomatik, Mood, posttraumatic stress disorder, Female, medicine.symptom, business, depressive disorders, 030217 neurology & neurosurgery, Anxiety disorder, Clinical psychology
Abstract

Objective: Posttraumatic stress disorder (PTSD) is frequently associated with depression and anxiety, but the nature of the relationship is unclear. By removing mood and anxiety diagnostic criteria, the 11th edition of the International Classification of Diseases (ICD-11) aims to delineate a distinct PTSD phenotype. We examined the effect of implementing ICD-11 criteria on rates of codiagnosed depression and anxiety in survivors with recent PTSD. Method: Participants were 1,061 survivors of traumatic injury admitted to acute care centers in Israel. ICD-10 and ICD-11 diagnostic rules were applied to the Clinician-Administered PTSD Scale for DSM-IV. Co-occurring disorders were identified using the Structured Clinical Interview for DSM-IV (SCID). Depression severity was measured by the Beck Depression Inventory-II (BDI-II). Assessments were performed 0–60 (“wave 1”) and 90–240 (“wave 2”) days after trauma exposure. Results: Participants identified by ICD-11 PTSD criteria were equally or more likely than those identified by the ICD-10 alone to meet depression or anxiety disorder diagnostic criteria (for wave 1: depressive disorders, OR [odds ratio] = 1.98, 95% CI [confidence interval] = [1.36, 2.87]; anxiety disorders, OR = 1.04, 95% CI = [0.67, 1.64]; for wave 2: depressive disorders, OR = 1.70, 95% CI = [1.00, 2.91]; anxiety disorders, OR = 1.04, 95% CI = [0.54, 2.01]). ICD-11 PTSD was associated with higher BDI scores (M = 23.15 vs. 17.93, P

Published
2019

35. Impact of Media-based Negative and Positive Age Stereotypes on Older Individuals’ Mental Health during the COVID-19 Pandemic

Author

Levy, Becca R, Chang, E-Shien, Lowe, Sarah, Provolo, Natalia, and Slade, Martin D

Subjects
Ageism, Research Report, Aged, 80 and over, Stereotyping, Mental Health, AcademicSubjects/SCI02100, Humans, COVID-19, AcademicSubjects/SOC02600, anxiety, media, Pandemics, age stereotypes, Aged
Abstract

Objectives During the COVID-19 pandemic, stigmatization of older persons has increased in traditional and social media. It was unknown whether this negative messaging could be detrimental to the mental health of older individuals, and whether the relatively uncommon positive messaging about older individuals could benefit their mental health. Method To address these gaps, we designed age-stereotype interventions based on actual news stories that appeared during the pandemic, and divided them into negative and positive versions of what we term personified (i.e., person-based) and enumerative (i.e., number-based) age-stereotype messaging. The negative versions of the two types of messaging reflected the age stereotype of decline whereas the positive versions of the two types of messaging reflected the age stereotype of resilience. Results As expected, the exposure of older individuals to the negative-age-stereotype-messaging interventions led to significantly worse mental health (more anxiety and less peacefulness), compared to a neutral condition; in contrast, the positive-age-stereotype-messaging interventions led to significantly better mental health (less anxiety and more peacefulness), compared to a neutral condition. The findings were equally strong for the personified and enumerative conditions. Also as expected, the interventions, which were self-irrelevant to the younger participants, did not significantly impact their mental health. Discussion This is the first-known study to experimentally demonstrate that institutional ageism, and statistics that reflect stereotypes about older individuals, can impact mental health. The results demonstrate the need for media messaging aimed at empowering older individuals during the pandemic and beyond.

Published
2021

37. Space-time dependence of emotions on Twitter after a natural disaster

Author

Garske, Sonja I, Elayan, Suzanne; https://orcid.org/0000-0003-2071-0926, Sykora, Martin, Edry, Tamar, Grabenhenrich, Linus B, Galea, Sandro, Lowe, Sarah R, Gruebner, Oliver; https://orcid.org/0000-0001-9783-4770, Garske, Sonja I, Elayan, Suzanne; https://orcid.org/0000-0003-2071-0926, Sykora, Martin, Edry, Tamar, Grabenhenrich, Linus B, Galea, Sandro, Lowe, Sarah R, and Gruebner, Oliver; https://orcid.org/0000-0001-9783-4770

Abstract

Natural disasters can have significant consequences for population mental health. Using a digital spatial epidemiologic approach, this study documents emotional changes over space and time in the context of a large-scale disaster. Our aims were to (a) explore the spatial distribution of negative emotional expressions of Twitter users before, during, and after Superstorm Sandy in New York City (NYC) in 2012 and (b) examine potential correlations between socioeconomic status and infrastructural damage with negative emotional expressions across NYC census tracts over time. A total of 984,311 geo-referenced tweets with negative basic emotions (anger, disgust, fear, sadness, shame) were collected and assigned to the census tracts within NYC boroughs between 8 October and 18 November 2012. Global and local univariate and bivariate Moran’s I statistics were used to analyze the data. We found local spatial clusters of all negative emotions over all disaster periods. Socioeconomic status and infrastructural damage were predominantly correlated with disgust, fear, and shame post-disaster. We identified spatial clusters of emotional reactions during and in the aftermath of a large-scale disaster that could help provide guidance about where immediate and long-term relief measures are needed the most, if transferred to similar events and on comparable data worldwide.

Published
2021

40. Evaluating a screener to quantify PTSD risk using emergency care information: a proof of concept study

Author

van der Mei, Willem F; https://orcid.org/0000-0002-6396-3790, Barbano, Anna C, Ratanatharathorn, Andrew, Bryant, Richard A, Delahanty, Douglas L, deRoon-Cassini, Terri A, Lai, Betty S, Lowe, Sarah R, Matsuoka, Yutaka J, Olff, Miranda, Qi, Wei, Schnyder, Ulrich, Seedat, Soraya, Kessler, Ronald C, Koenen, Karestan C, Shalev, Arieh Y, van der Mei, Willem F; https://orcid.org/0000-0002-6396-3790, Barbano, Anna C, Ratanatharathorn, Andrew, Bryant, Richard A, Delahanty, Douglas L, deRoon-Cassini, Terri A, Lai, Betty S, Lowe, Sarah R, Matsuoka, Yutaka J, Olff, Miranda, Qi, Wei, Schnyder, Ulrich, Seedat, Soraya, Kessler, Ronald C, Koenen, Karestan C, and Shalev, Arieh Y

Abstract

Background: Previous work has indicated that post-traumatic stress disorder (PTSD) symptoms, measured by the Clinician-Administered PTSD Scale (CAPS) within 60 days of trauma exposure, can reliably produce likelihood estimates of chronic PTSD among trauma survivors admitted to acute care centers. Administering the CAPS is burdensome, requires skilled professionals, and relies on symptoms that are not fully expressed upon acute care admission. Predicting chronic PTSD from peritraumatic responses, which are obtainable upon acute care admission, has yielded conflicting results, hence the rationale for a stepwise screening-and-prediction practice. This work explores the ability of peritraumatic responses to produce risk likelihood estimates of early CAPS-based PTSD symptoms indicative of chronic PTSD risk. It specifically evaluates the Peritraumatic Dissociative Experiences Questionnaire (PDEQ) as a risk-likelihood estimator. Methods: We used individual participant data (IPD) from five acute care studies that used both the PDEQ and the CAPS (n = 647). Logistic regression calculated the probability of having CAPS scores ≥ 40 between 30 and 60 days after trauma exposure across the range of initial PDEQ scores, and evaluated the added contribution of age, sex, trauma type, and prior trauma exposure. Brier scores, area under the receiver-operating characteristic curve (AUC), and the mean slope of the calibration line evaluated the accuracy and precision of the predicted probabilities. Results: Twenty percent of the sample had CAPS ≥ 40. PDEQ severity significantly predicted having CAPS ≥ 40 symptoms (p < 0.001). Incremental PDEQ scores produced a reliable estimator of CAPS ≥ 40 likelihood. An individual risk estimation tool incorporating PDEQ and other significant risk indicators is provided. Conclusion: Peritraumatic reactions, measured here by the PDEQ, can reliably quantify the likelihood of acute PTSD symptoms predictive of chronic PTSD and requiring clinical attention.

Published
2020

50. Cumulative Disaster Exposure and Mental and Physical Health Symptoms Among a Large Sample of Residents of the U.S. Gulf Coast Residents

Author

Lowe, Sarah R., McGrath, John A., Young, Megan N., Kwok, Richard K., Engel, Lawrence S., Galea, Sandro, and Sandler, Dale P.

Subjects
Adult, Male, Psychiatric Status Rating Scales, Depressive Disorder, Major, Cyclonic Storms, Health Status, Middle Aged, Anxiety Disorders, Texas, Article, Southeastern United States, Stress Disorders, Post-Traumatic, Humans, Female, Petroleum Pollution, Disaster Victims
Abstract

A large body of research has linked disaster exposure to adverse mental and physical health outcomes. Few studies, however, have explored the cumulative impact of exposure to multiple disasters. Participants (N = 8,366) from the National Institute of Environmental Health Sciences Gulf Long-Term Follow-Up Study were classified as having been exposed to both, either, or neither Hurricane Katrina and the Deepwater Horizon oil spill (DHOS). Participants also reported on a range of mental and physical health symptoms. Logistic regression models found that participants who were exposed to both disasters had significantly higher odds of probable generalized anxiety disorder, odds ratio (OR) = 1.72, 95% CI [1.52, 1.96]; major depression, OR = 1.53, 95% CI [1.32, 1.77]; and posttraumatic stress disorder, OR = 2.51, 95% CI [2.03, 3.10], than participants who were exposed to only one disaster, ps.001. Additionally, a linear regression model found that participants who were exposed to both disasters had significantly more physical health symptoms at the time of the spill than those who were exposed to only one disaster, B = 0.99, SE = .20, p.001. The results indicate that cumulative disaster exposure confers enhanced risk for adverse mental and physical health outcomes. The findings demonstrate that screening for prior exposure among disaster-affected individuals might identify those at greatest risk for adverse health outcomes.Spanish Abstracts by Asociación Chilena de Estrés Traumático (ACET) Exposición Acumulativa a Desastres y Síntomas de Salud Mentales y Físicos entre una Amplia Muestra de Residentes del Golfo de México EXPOSICION ACUMULATIVA AL DESASTRE Y SINTOMAS DE SALUD Un vasta serie de investigaciones ha vinculado la exposición a desastres con resultados adversos en la salud mental y física. Sin embargo, escasos estudios han explorado el impacto acumulativo de la exposición a múltiples desastres Los participantes (N = 8,366) del Estudio de Seguimiento a Largo Plazo del Golfo del Instituto Nacional de Ciencias de la Salud Ambiental fueron clasificados como expuesto a ambos, ya sea al Huracán Katrina o al derrame de petróleo de Deepwater Horizon (DHOS en sus siglas en inglés). Los participantes también informaron un rango de síntomas de salud mental y física. Modelos de regresión logística encontraron que los participantes que estuvieron expuestos a ambos desastres tuvieron probabilidades significativamente más altas de presentar trastorno de ansiedad generalizada, proporción de probabilidades (OR) = 1.72, IC 95% [1.52, 1.96]; depresión mayor, OR = 1,53, IC del 95% [1,32, 1,77]; y trastorno de estrés postraumático, OR = 2.51, IC 95% [2.03, 3.10], comparado con los participantes que estuvieron expuestos a un sólo desastre, ps.001. Adicionalmente, un modelo de regresión lineal encontró que los participantes que fueron expuestos a ambos desastres tuvieron significativamente más síntomas de salud física en el momento del derrame que aquellos que estuvieron expuestos a un sólo desastre, B = 0.99, SE = .20, p.001. Los resultados indican que la exposición acumulativa al desastre confiere mayor riesgo de resultados adversos para la salud mental y física. Los hallazgos demuestran que la detección de la exposición previa entre individuos afectados por un desastre podría identificar aquellos con mayor riesgo para presentar resultados adversos para la salud.Traditional and Simplified Chinese Abstracts by the Asian Society for Traumatic Stress Studies (AsianSTSS) 簡體及繁體中文撮要由亞洲創傷心理研究學會翻譯 Cumulative Disaster Exposure and Mental and Physical Health Symptoms among a Large Sample of Gulf Coast Residents Traditional Chinese 標題: 美國墨西哥灣沿岸地區住客組成的大型樣本的累積災難經歷、心理和生理症狀 撮要: 過往大量研究發現, 災難經歷跟不良的心理和生理健康問題有關。然而, 少有研究探索多重的災難經歷的累積影響。樣本來自國家環境醫學研究所墨西哥灣長期跟進研究(N = 8,366)。我們把樣本分為經歷了颶風卡特里娜以及墨西哥灣漏油事故(DHOS)兩者、兩者其一、或兩者均無經歷的組別。參與者亦報告廣泛的心理和生理健康症狀。邏輯迴歸模型反映, 相比只經歷了一種災難的參與者(ps.001), 經歷了兩種災難的參與者有顯著較大機會為有可能患廣泛性焦慮症(勝算比(OR) = 1.72, 95% CI [1.52, 1.96])、重度抑鬱症(OR = 1.53, 95% CI [1.32, 1.77])、和創傷後壓力症(OR = 2.51, 95% CI [2.03, 3.10])。此外, 線性迴歸模型反映, 在漏油事故發生時, 相比只經歷了一種災難的參與者, 經歷了兩種災難的參與者顯著地有較多生理症狀(B = 0.99, SE = .20, p.001)。結果顯示, 累積的災難經歷會提升有不良的心理和生理問題的風險, 亦反映對受災難影響人士進行過往經歷的篩查, 可能有助找出有較大風險患健康問題的人士。 Simplified Chinese 标题: 美国墨西哥湾沿岸地区住客组成的大型样本的累积灾难经历、心理和生理症状 撮要: 过往大量研究发现, 灾难经历跟不良的心理和生理健康问题有关。然而, 少有研究探索多重的灾难经历的累积影响。样本来自国家环境医学研究所墨西哥湾长期跟进研究(N = 8,366)。我们把样本分为经历了飓风卡特里娜以及墨西哥湾漏油事故(DHOS)两者、两者其一、或两者均无经历的组别。参与者亦报告广泛的心理和生理健康症状。逻辑回归模型反映, 相比只经历了一种灾难的参与者(ps.001), 经历了两种灾难的参与者有显著较大机会为有可能患广泛性焦虑症(胜算比(OR) = 1.72, 95% CI [1.52, 1.96])、重度抑郁症(OR = 1.53, 95% CI [1.32, 1.77])、和创伤后压力症(OR = 2.51, 95% CI [2.03, 3.10])。此外, 线性回归模型反映, 在漏油事故发生时, 相比只经历了一种灾难的参与者, 经历了两种灾难的参与者显著地有较多生理症状(B = 0.99, SE = .20, p.001)。结果显示, 累积的灾难经历会提升有不良的心理和生理问题的风险, 亦反映对受灾难影响人士进行过往经历的筛查, 可能有助找出有较大风险患健康问题的人士。.

Published
2019

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