Loss of Resources and Hurricane Experience as Predictors of Postpartum Depression Among Women in Southern Louisiana
Loss of Resources and Hurricane Experience as Predictors of Postpartum Depression Among Women in Southern Louisiana
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DOI：
10.1089/jwh.2009.1693
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发表时间：
2010-05-01
影响因子：
3.5
通讯作者：
Elkind-Hirsch, Karen
中科院分区：
文献类型：
--
作者：
Ehrlich, Matthew;Harville, Emily;Elkind-Hirsch, Karen
背景：自然灾害发生后，精神障碍往往成为一个长期的公共卫生问题。以前的研究表明，在较小规模的自然灾害条件下的心理社会资源的损失与心理distress.Methods：我们研究了抑郁症的发生6个月和12个月产后208名妇女居住在新奥尔良和巴吞鲁日，路易斯安那州，谁怀孕期间或之后立即卡特里娜飓风的登陆。基于资源保护（COR）理论，我们探讨了有形/经济和无形（心理社会）资源损失（LOR）对抑郁症结局的贡献，使用爱丁堡产后抑郁量表（EPDS）进行测量。我们还调查了个人的飓风经验抑郁症的影响，通过飓风经验评分（HES），其中包括目睹死亡，接触洪水沃茨，伤害自己或家庭成员等因素。结果：有形和无形的LOR与抑郁症的横断面和前瞻性。严重的飓风暴露（高HES）也与抑郁症有关。回归分析显示，LOR相关的抑郁症几乎完全是由无形的，而不是有形的因素。然而，与COR理论一致，无形的LOR解释了我们模型中严重飓风暴露与抑郁之间的一些关联。对于12个月时的抑郁症，甚至在6个月时控制抑郁症症状，也可以看到类似的结果。结论：这些结果表明需要采取预防措施，旨在保护心理社会资源，以减少灾难的长期影响。
Background: After a natural disaster, mental disorders often become a long-term public health concern. Previous studies under smaller-scale natural disaster conditions suggest loss of psychosocial resources is associated with psychological distress.Methods: We examined the occurrence of depression 6 and 12 months postpartum among 208 women residing in New Orleans and Baton Rouge, Louisiana, who were pregnant during or immediately after Hurricane Katrina's landfall. Based on the Conservation of Resources (COR) theory, we explored the contribution of both tangible/financial and nontangible (psychosocial) loss of resources (LOR) on the outcome of depression, measured using the Edinburgh Postnatal Depression Scale (EPDS). We also investigated the influence on depression of individuals' hurricane experience through a Hurricane Experience Score (HES) that includes such factors as witnessing death, contact with flood waters, and injury to self or family members.Results: Both tangible and nontangible LOR were associated with depression cross-sectionally and prospectively. Severe hurricane exposure (high HES) was also associated with depression. Regression analysis showed LOR-associated depression was explained almost entirely by nontangible rather than tangible factors. Consistent with COR theory, however, nontangible LOR explained some of the association between severe hurricane exposure and depression in our models. A similar result was seen prospectively for depression at 12 months, even controlling for depression symptoms at 6 months.Conclusions: These results suggest the need for preventive measures aimed at preserving psychosocial resources to reduce the long-term effects of disasters.