Effects of Hurricane Katrina on Postpartum Mental Health

点击翻译按钮获取中文摘要

DESCRIPTION (provided by applicant): Hurricane Katrina has been described as "the worst catastrophe, or set of catastrophes" in the country's history. Natural disasters can lead to long-lasting psychopathology. New mothers are already at high risk for depression and anxiety, and also are potentially at high risk for disaster-related mental illness. Mothers who are anxious or depressed may be unable to care for themselves and their infants optimally. Child development may also be directly affected by stress during pregnancy; stress causes the release of glucocorticoids, which may determine the setpoint of the fetus' HPA axis and/or alter brain development. No previous research has specifically targeted postpartum mental health in the aftermath of a disaster. The specific hypotheses we will test are 1) women who had more severe experiences of the hurricane will be at greater risk for postpartum psychopathology than women with little direct experience of the hurricane. 2) The effect of hurricane experience will be moderated by the social support a woman receives, her baseline level of resources, and her religious faith. 3) Women who had a more severe experience of the hurricane will be more likely to smoke postpartum and less likely to breastfeed than women who did not. 4) Women who were severely exposed to the hurricane or are depressed will have higher cortisol levels, while women with PTSD will have lower cortisol levels. We propose to recruit 250 women who experienced the hurricane extensively during their pregnancies (125 evacuees now living in Baton Rouge and 125 women in New Orleans) and a comparison group of 125 Baton Rouge residents. We will interview the mothers at 2, 6, and 12 months postpartum, including information about experience during the hurricane; depression, anxiety, and post- traumatic stress disorder; health behaviors; social support; resilience; religiosity; and infant temperament. Cortisol will be measured in a subset of 75 women. With the longitudinal design, we will establish correlations and causality among the factors of disaster experience, maternal mental health, and health behavior. Our purpose is to document the effects of a major natural disaster on a population; to identify characteristics of the hurricane experience that could be modified to improve maternal and child health after disasters; to examine health behaviors affected by disaster, to allow for prevention and intervention; and to explore the effects of stress during and after pregnancy.