Cumulative Effects of the Gulf Oil Spill and Other Disasters on Mental Health Among Reproductive-Aged Women: The Gulf Resilience on Women's Health Study
Cumulative Effects of the Gulf Oil Spill and Other Disasters on Mental Health Among Reproductive-Aged Women: The Gulf Resilience on Women's Health Study
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DOI：
10.1037/tra0000345
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发表时间：
2018-09-01
影响因子：
6.3
通讯作者：
Lichtveld, Maureen
中科院分区：
文献类型：
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作者：
Harville, Emily W.;Shankar, Arti;Lichtveld, Maureen
目的：检验多个(最多5个)灾难对心理健康反应的影响是否为累加效应，或者较早的灾难是否对较晚的灾难产生敏感化(高)或习惯化(低)反应。方法：海湾妇女健康复原力研究访问了路易斯安那州南部1366名妇女，了解她们在卡特里娜飓风、丽塔飓风、古斯塔夫飓风、艾克飓风和墨西哥湾漏油事件中的暴露情况(以多种方式测量)，并实施了抑郁症和创伤后应激障碍(PTSD)症状的有效测量。采用多元线性回归和Logistic回归对心理健康进行建模，其中灾难暴露单独输入、组合输入和交互作用。结果：暴露在石油泄漏和飓风灾难中都与可能的抑郁和创伤后应激障碍相关，这与累积模型一致，但我们没有发现统计上的相互作用表明敏感化或习惯性。当用抑郁症和创伤后应激障碍的持续症状测量来检验结果时，它们是相似的，除了暴露在石油泄漏中和因飓风灾难而经历疾病或伤害显示出显著的交互作用(p<；0.05)，在预测创伤后应激障碍症状时，这种交互作用与致敏效应一致。这项研究的结果主要指向多重灾害对精神健康影响的累积风险，尽管有一些迹象表明，有特别严重经历的人会变得敏感。没有习惯化的证据。结论：这些发现可能会指导努力帮助那些经历了多个灾难的地区的人，这些灾难发生的顺序很近。
Objective: To test whether effects of multiple (up to 5) disasters on mental health responses were cumulative (additive effects), or whether an earlier disaster produced sensitization (higher) or habituation (lower) responses to a later one. Method: The Gulf Resilience on Women's Health study interviewed 1,366 southern Louisiana women regarding their exposure to Hurricanes Katrina, Rita, Gustav, and Ike and the Gulf oil spill (measured several ways), and administered validated measures of symptoms of depression and posttraumatic stress disorder (PTSD). Multiple linear and logistic regression with disaster exposures entered singly, combined, and as an interaction were used to model mental health. Results: Both exposure to the oil spill and hurricane disaster were associated with likely depression and PTSD, consistent with a cumulative model, but we did not find statistical interactions that would suggest sensitization or habituation. When results were examined with continuous symptom measures of depression and PTSD, they were similar, with the exception that exposure to the oil spill and experiencing illness or injury because of the hurricane disaster showed a significant interaction (p < .05) in a manner consistent with a sensitization effect when predicting PTSD symptoms. The results of this study point mainly to a cumulative risk for the mental health effects of multiple disasters, although some indication of sensitization occurred among those with particularly severe experiences. There was no evidence for habituation. Conclusions: These findings may guide efforts to assist those in regions experiencing multiple disasters that occur in close sequence.