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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. [ABSTRACT FROM AUTHOR]

Exposure to disasters is associated with a range of posttraumatic stress symptom (PTSS) trajectories. However, few studies have tracked PTSS for more than a decade postdisaster, and none to our knowledge has explored the role of predisaster resources and vulnerabilities in shaping the likelihood of trajectory membership. The current study included participants from the Resilience in Survivors of Katrina Study (N = 885). Participants were originally part of a community college intervention study and were assessed prior to the hurricane (6–21 months predisaster), and approximately 1 year, 4 years, and 12 years postdisaster. Latent class growth analysis identified PTSS trajectories. Perceived social support, probable mental illness, and physical health conditions or problems–all assessed predisaster–were examined as predictors of trajectory membership at the univariate level and in multivariable models without and with adjustment for disaster exposure. Three PTSS trajectories were detected: Moderate-Decreasing (69.3%), High-Decreasing (23.1%), and High-Stable (7.6%). In the multivariable predictive model without adjustment for disaster exposure, probable predisaster mental illness was significantly associated with greater odds of the High-Decreasing and High-Stable trajectories, and physical health conditions or problems with greater odds of the High-Decreasing trajectory, relative to the Moderate-Decreasing trajectory. However, when disaster exposure was adjusted, only the association between predisaster mental illness and the odds of the High-Stable trajectory remained statistically significant. Lower predisaster perceived social support was significantly associated with membership in the High-Decreasing trajectory, relative to the Moderate-Decreasing, at the univariate level, but not in either multivariable model. Whereas predisaster mental illness confers risk for chronic postdisaster PTSS, other impacts of predisaster resources and vulnerabilities on elevated PTSS trajectories do not go beyond those of disaster exposure. The results support disaster preparedness efforts targeting those with mental and physical health conditions, and postdisaster mental health services addressing preexisting vulnerabilities in addition to disaster-related PTSS. [ABSTRACT FROM AUTHOR]

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Abstract: Background: There is considerable variation in psychological reactions to natural disasters, with responses ranging from relatively mild and transitory symptoms to severe and persistent posttraumatic stress (PTS). Some survivors also report post-traumatic growth (PTG), or positive psychological changes due to the experience and processing of the disaster and its aftermath. Gene–environment interaction (GxE) studies could offer new insight into the factors underlying variability in post-disaster psychological responses. However, few studies have explored GxE in a disaster context. Methods: We examined whether ten common variants in seven genes (BDNF, CACNA1C, CRHR1, FKBP5, OXTR, RGS2, SLC6A4) modified associations between Hurricane Katrina exposure and PTS and PTG. Data were from a prospective study of 205 low-income non-Hispanic Black parents residing in New Orleans prior to and following Hurricane Katrina. Results: We found a significant association (after correction) between RGS2 (rs4606; p=0.0044) and PTG, which was mainly driven by a cross-over GxE (p=0.006), rather than a main genetic effect (p=0.071). The G (minor allele) was associated with lower PTG scores for low levels of Hurricane exposure and higher PTG scores for moderate and high levels of exposure. We also found a nominally significant association between variation in FKBP5 (rs1306780, p=0.0113) and PTG, though this result did not survive correction for multiple testing. Limitations: Although the inclusion of low-income non-Hispanic Black parents allowed us to examine GxE among a highly vulnerable group, our findings may not generalize to other populations or groups experiencing other natural disasters. Moreover, not all participants invited to participate in the genetic study provided saliva. Conclusions: To our knowledge, this is the first study to identify GxE in the context of post-traumatic growth. Future studies are needed to clarify the role of GxE in PTS and PTG and post-disaster psychological responses, especially among vulnerable populations. [Copyright &y& Elsevier]

In August 2005, Hurricane Katrina caused unprecedented damage, widespread population displacement, and exposed Gulf Coast residents to traumatic events. The hurricane's adverse impact on survivors' mental health was apparent shortly after the storm and persisted, but no study has examined the long-term effects now that more than a decade has transpired. Using new data from a panel study of low-income mothers interviewed once before Hurricane Katrina and now three times after, we document changes in mental health, and estimate the sociodemographic and hurricane-related factors associated with long-term trajectories of mental health. We find that post-traumatic stress symptoms (PTSS) declined at each of the three post-Katrina follow-ups, but 12 years after the hurricane, one in six still had symptoms indicative of probable post-traumatic stress disorder. The rate of non-specific psychological distress (PD) remained consistently higher in all three follow-ups, compared to the pre-disaster period. In full covariate-adjusted models, no sociodemographic variables predicted long-run combinations of PTSS and PD. However, 12 years later, exposure to hurricane-related traumatic events and pre-disaster PD significantly predicted co-occurring PTSS and PD. Hurricane-related housing damage predicted PTSS in earlier follow-ups, but no longer predicted PTSS in the long-term. Furthermore, hurricane-related traumatic events significantly differentiated the risk of having persistent PTSS, relative to recovering from PTSS. The results suggest that there is still a non-negligible group of survivors with continued need for recovery resources and that exposure to traumatic events is a primary predictor of adverse mental health more than a decade post-disaster. • Hurricane-related traumas predict persistent post-traumatic stress symptoms (PTSS). • Twelve years after Katrina, PTSS remains in one in six sampled low-income mothers. • Hurricane-related traumas predict comorbid psychological distress (PD) and PTSS. • Pre-disaster PD increases the likelihood of adverse mental health in the long term. [ABSTRACT FROM AUTHOR]