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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.

Objective: This study explored predisposing, illness-related, and enabling factors as predictors of mental health service use among disaster survivors with perceived need for services.Methods: Participants (N=658) were part of a three-wave, population-based study of Hurricane Ike survivors. At each wave, participants were asked whether they perceived having a need for mental health services, for example, information about stress reactions and medication for emotional problems. Those with perceived need were asked about use of eight services, such as a psychiatrist or physician, to address needs. Generalized estimating equations examined predisposing, illness-related, and enabling factors as predictors of service use among participants with perceived need (N=304).Results: More general stressors (predisposing factor) and insurance coverage (enabling factor) predicted service use among participants with perceived need.Conclusions: The results suggest that expanded access to services that do not require insurance coverage could better address survivors' mental health needs after a disaster. [ABSTRACT FROM AUTHOR]

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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. [ABSTRACT FROM AUTHOR]

The federal Crisis Counseling Program (CCP) funds states' delivery of mental health services after disasters. These services are provided by social workers, other mental health professionals, and paraprofessionals from the local community. The present study examined whether CCP grant recipients that reported more tailoring of their interventions to the needs of diverse community segments achieved greater community penetration. The study reviewed archival records from 36 crisis counseling projects ending between 1996 and 2001. Numbers of clients and client ethnicity were determined through service logs. Tailoring of services was determined by content coding of projects' reports. Community demographics were determined from census data. Fifty-six percent of the projects reported using three or more tailoring strategies, suggesting a "precompetence" or greater stage of cultural competence. The proportion of members of racial or ethnic minority groups among program clients closely matched the proportion in grantees' communities. Projects that reported more types of tailored activities reached more clients and served more members of minority groups. These findings confirm that adapting crisis counseling services to diverse local needs is associated with greater community penetration of mental health services. [ABSTRACT FROM AUTHOR]

Communities have the potential to function effectively and adapt successfully in the aftermath of disasters. Drawing upon literatures in several disciplines, we present a theory of resilience that encompasses contemporary understandings of stress, adaptation, wellness, and resource dynamics. Community resilience is a process linking a network of adaptive capacities (resources with dynamic attributes) to adaptation after a disturbance or adversity. Community adaptation is manifest in population wellness, defined as high and non-disparate levels of mental and behavioral health, functioning, and quality of life. Community resilience emerges from four primary sets of adaptive capacities—Economic Development, Social Capital, Information and Communication, and Community Competence—that together provide a strategy for disaster readiness. To build collective resilience, communities must reduce risk and resource inequities, engage local people in mitigation, create organizational linkages, boost and protect social supports, and plan for not having a plan, which requires flexibility, decision-making skills, and trusted sources of information that function in the face of unknowns. [ABSTRACT FROM AUTHOR]

In this article, we present and illustrate cognitive-behavioral therapy for postdisaster distress. The treatment is for individuals who show more than normal transient stress after disaster and functions as an intermediate step between traditional crisis counseling and longer-term mental health treatments. Thus, it is one part of a larger mental health disaster response and is designed to be implemented no sooner than 60 days post disaster. A clinical case demonstrates its process and technique in a community practice setting. © 2006 Wiley Periodicals, Inc. J Clin Psychol: In Session. [ABSTRACT FROM AUTHOR]

Analyses were conducted to estimate lifetime and current prevalence of major depressive disorder (MDD) for four representative cities of Mexico, to identify variables that influence the probability of MDD, and to further describe depression in Mexican culture. A multistage probability sampling design was used to draw a sample of 2,509 adults in four different regions of Mexico. MDD was assessed according to DSM-IV criteria by using the Composite International Diagnostic Interview collected by trained lay interviewers. The prevalence of MDD in these four cities averaged 12.8% for lifetime and 6.1% for the previous 12 months. MDD was highly comorbid with other mental disorders. Women were more likely to have lifetime MDD than were men. Being divorced, separated, or widowed (compared to married or never married) and having experienced childhood trauma were related to higher lifetime prevalence but not to current prevalence. In addition, age and education level were related to current 12-month MDD. Data on the profile of MDD in urban Mexico are provided. This research expands our understanding of MDD across cultures. Depression and Anxiety 23:158–167, 2006. © 2006 Wiley-Liss, Inc. [ABSTRACT FROM AUTHOR]

The article presents abstracts of political and social science research. They include "The Political Costs of Failure in the Katrina and Rita Disasters," "President Bush and Hurricane Katrina: A Presidential Leadership Study," "Metaphors Matter: Disaster Myths, Media Frames, and Their Consequences in Hurricane Katrina," "Weathering the Storm: The Impact of Hurricanes on Physical and Mental Health," and "Planning for Postdisaster Resiliency."

Seven years after the bombing of the Murrah Federal Building in Oklahoma City, 34 individuals affiliated with various organizations were interviewed about their experiences in providing disaster mental health services to victims and the community. Their perspectives elucidated the importance of preparedness, training and education, local control, interagency cooperation, and psychosocial support for providers. Significant conflicts emerged among providers about credentials, referrals, the quality of services provided, and the appropriateness, in this context, of basing services solely on a crisis counseling model. The lack of ongoing needs assessment or evaluation data further fueled the debates. On the basis of the findings, the authors outline several recommendations for planning mental health responses to future terrorist attacks. [ABSTRACT FROM AUTHOR]

Examines the effects of disasters on mental health. Symptoms of distress; Elements of cognitive-behavioral interventions; Risks factors for poor mental health outcomes.

This article provides a brief overview of the field of disaster research, summarizing what is known at present about the prevalence of disasters, the range of stressors and outcomes experienced, and sample-, event-, and individual-level risk factors for poor health and mental health outcomes. Prior research does not suggest that an urban context either enhances or reduces risk for individual survivors. It is argued, however, that the influence of extraindividual exposure, ethnic diversity, and support deterioration may be especially salient for understanding urban disasters. Investigators of urban disasters are especially well situated to expand knowledge of ecological and collective aspects of disaster response and recovery. [ABSTRACT FROM AUTHOR]

A probability sample of 1,429 adults aged 55 and older was interviewed in their homes three times at six-month intervals. Measures of symptoms, social support, and education were obtained before measures of life-event stress. A LISREL analysis of three waves and two intervals of data yielded a goodness of fit of .989 between the data and the model. For both intervals, increases in stress led to increases in symptoms, which supported the Dohrenwend hypothesis of a normative stress reaction. This reaction typically did not persist beyond six months unless there was high stress over both intervals. Contrary to Dohrenwend's resource mediation hypothesis, social support and education did not influence either the reaction to or the recovery from stress. Symptoms were very stable over the one-year period. Overall, the results depict older adults as quite consistent and resilient. Because life events were correlated over time and were predicted by person characteristics, they should not be considered as independent of person factors. [ABSTRACT FROM AUTHOR]

The article examines the mediating roles of various domains of chronic stress such as marital, parental, filial, financial, occupational, ecological, and physical. More specifically, the study attempts to explore the mechanism through which acute disaster stress such as injury, life threat, property damage or loss may produce lasting psychological distress such as depression, anxiety, somatization, and hostility. In the views of the authors, the stress-distress relation is reciprocal in nature, with distress causing stress, as well as the reverse. The results provide strong support for the hypothesis that chronic stress mediates the long-term effects of acute disaster stress on psychological distress. The main effects of loss, though limited in strength, were completely explained by victims' higher financial, marital, filial, and physical stress. The findings suggest that injury has the strongest and most pervasive effects. Overall, threat and injury has more adverse or lasting consequences than material loss.

Estimates of the natural distribution of environmental demands on older adults are provided here. Frequencies of occurrence over a one-year period for 54 life events relevant to older adults are reported for a sample of 1102 men and 1758 women representative of the population aged 55 and older in Kentucky. Estimates of the absolute number of noninstitutionalized Kentucky older adults who would experience selected events in a year are thus made possible. In addition, older adult judgments as to the desirability or undesirability of each event are also reported. These data could be used, with some qualifications, to establish normative weights or desirability classifications for these events for older adults. The following selected classes of events are evaluated in terms of their impact, based on the desirability ratings and previous research: health, death, family conflict, and rewards. Program implications suggested by considering both the prevalence and impact data are: (a) mental health interventions should be closely tied to physical health events; (b) death of spouse would be an event important for prevention programs; (c) other forms of marital disruption would be too in- frequent to justify programs; (d) retirement would appear to have too little impact to justify adjustment programs; and (e) the very desirable impact of reward events found here would justify programs promoting these events for older adults. [ABSTRACT FROM AUTHOR]

A "QOL-Contribution" model for resource allocation decisions is proposed that integrates concepts and values from community psychology, need assessment, and quality of life (QOL) studies. QOL is taken as the criterion for establishing the goodness-of-fit between a population and its environment. It is assumed that the characteristics of a given human group interact with the resources and the stressors of its environment, with its level of QOL as the result. The utility and the implications of the model for resource decisions are demonstrated with data from a statewide need assessment. In this application, different life domains, and different program targets within life domains, are prioritized according to their relative contributions to QOL. The findings for mental health and employment illustrate the specificity of the model's application. The model is then restated as the general task, and a unifying theme, for community psychology. [ABSTRACT FROM AUTHOR]

A short screening instrument for detecting the occurrence and impact of traumatic events is presented. It is proposed that a relevant event population for assessing exposure to traumatic events comprises ‘violent encounters with nature, technology, or humankind’ and that loss, scope, threat, blame, familiarity, and post-traumatic stress are the dimensions of the experience that are most critical to assess. It is estimated that 8% of the U.S. adult population will experience one or more of the selected events within a year's time. Potential uses and contributions of the instrument are discussed. [ABSTRACT FROM AUTHOR]