Impact of coping styles on post-traumatic stress disorder and depressive symptoms among pregnant women exposed to Hurricane Katrina

Objective: Experiencing natural disasters such as hurricanes is associated with post-traumatic stress disorder (PTSD) and depression.We examined the role played by perceived stress and coping styles in explaining and modifying this association among pregnant women exposed to Hurricane Katrina.Design: The study comprised 192 women (133 from New Orleans and 59 from Baton Rouge) who were pregnant during Hurricane Katrina or became pregnant immediately after the hurricane. Women were interviewed regarding their hurricane experience, perceived stress, and mental health outcomes. Coping styles was assessed using the Brief COPE, PTSD symptoms using the Post-Traumatic Checklist, and depressive symptoms using the Edinburgh Depression Scale. Multivariable regression models were run to determine the effects of coping styles on mental health and the interactions among coping styles, hurricane experience, and perceived stress on mental health.Results: Apart from the positive reframing and humor coping styles, all coping styles correlated positively with PTSD or depression (p 0.05). The instrumental support, denial, venting, and behavioral disengagement coping styles were significantly associated with worsened PTSD symptoms among those who reported higher perceived stress (p 0.05). Use of a humor coping style seemed to reduce the effect of perceived stress on depressive symptoms (p = 0.02 for interaction) while use of instrumental support (p = 0.04) and behavioral disengagement (p 0.01) were both associated with more symptoms of depression among those who perceived more stress. There were no strong interactions between coping style and hurricane experience.Conclusion: Coping styles are potential moderators of the effects of stress on mental health of pregnant women.