Longitudinal study of changing psychological outcomes following the Victorian Black Saturday bushfires
Longitudinal study of changing psychological outcomes following the Victorian Black Saturday bushfires
复制标题
DOI：
10.1177/0004867417714337
复制
发表时间：
2018-06-01
影响因子：
4.6
通讯作者：
Forbes, David
中科院分区：
文献类型：
--
作者：
Bryant, Richard A.;Gibbs, Lisa;Forbes, David
目的：绘制受影响社区的心理结果的变化流行和预测因子5年后的黑色星期六火灾在维多利亚。方法：在高，中等和非受影响的社区在维多利亚，澳大利亚的纵向队列研究的后续评估。参与者包括1017名受访者（第一波），他们在2011年12月至2013年1月期间通过电话和网络访问，735名（76.1%）合资格的参与者在2014年7月至11月期间进行了重新测试（第二波）。调查包括与火灾有关的和随后的压力事件的措施，可能的创伤后应激障碍，严重抑郁发作，酒精使用和严重的痛苦。与火灾有关的创伤后应激障碍的发病率有所下降（8.7%对12.1%），一般创伤后应激障碍（14.7%对18.2%），重性抑郁发作（9.0%对10.9%）和严重精神疾病（5.4%对7.8%）。弹性率随着时间的推移而增加（81.8%对77.1%），问题酒精使用在第一波（22.1%）和第二波（21.4%）中仍然很高。火灾相关创伤后应激障碍后期发展的最可靠预测因素（比值比：2.11; 95%置信区间：[1.22，3.65]），一般创伤后应激障碍（比值比：3.15; 95%置信区间：[1.98，5.02]），重度抑郁发作（比值比：2.86; 95%置信区间：[1.74，4.70]），严重精神疾病（比值比：2.67; 95%置信区间：[0.57，1.72]）或恢复力下降（比值比：2.01; 95%可信区间：[1.32，3.05]）是近期生活压力源的程度。结论：虽然心理健康问题的发生率随着时间的推移而降低，但仍高于全国水平。研究结果表明，决策者需要认识到，灾害的心理健康后果可能会在事件发生后持续多年，并需要将资源分配给那些由于重大损失和持续的生活压力而面临最大风险的人。
Objectives: To map the changing prevalence and predictors of psychological outcomes in affected communities 5 years following the Black Saturday bushfires in Victoria.Method: Follow-up assessment of longitudinal cohort study in high, medium and non-affected communities in Victoria, Australia. Participants included 1017 respondents (Wave 1) interviewed via telephone and web-based survey between December 2011 and January 2013, and 735 (76.1%) eligible participants were retested between July and November 2014 (Wave 2). The survey included measures of fire-related and subsequent stressful events, probable posttraumatic stress disorder, major depressive episode, alcohol use and severe distress.Results: There were reduced rates of fire-related posttraumatic stress disorder (8.7% vs 12.1%), general posttraumatic stress disorder (14.7% vs 18.2%), major depressive episode (9.0% vs 10.9%) and serious mental illness (5.4% vs 7.8%). Rates of resilience increased over time (81.8% vs 77.1%), and problem alcohol use remained high across Wave 1 (22.1%) and Wave 2 (21.4%). The most robust predictor of later development of fire-related posttraumatic stress disorder (odds ratio: 2.11; 95% confidence interval: [1.22, 3.65]), general posttraumatic stress disorder (odds ratio: 3.15; 95% confidence interval: [1.98, 5.02]), major depressive episode (odds ratio: 2.86; 95% confidence interval: [1.74, 4.70]), serious mental illness (odds ratio: 2.67; 95% confidence interval: [0.57, 1.72]) or diminished resilience (odds ratio: 2.01; 95% confidence interval: [1.32, 3.05]) was extent of recent life stressors.Conclusion: Although rates of mental health problems diminished over time, they remained higher than national levels. Findings suggest that policy-makers need to recognize that the mental health consequences of disasters can persist for many years after the event and need to allocate resources towards those who are most at risk as a result of substantive losses and ongoing life stressors.