title: Posttraumatic stress symptoms, intrusive thoughts, loss, and immune function after Hurricane Andrew.
abstract: OBJECTIVE
  To examine the impact of and relationship between exposure to Hurricane Andrew, a severe stressor, posttraumatic stress symptoms and immune measures.
  
  
  METHODS
  Blood draws and questionnaires were taken from community volunteer subjects living in the damaged neighborhoods between 1 and 4 months after the Hurricane.
  
  
  RESULTS
  The sample exhibited high levels of posttraumatic stress symptoms by questionnaire (33% overall; 76% with at least one symptom cluster), and 44% scored in the high impact range on the Impact of Events (IES) scale. A substantial proportion of variance in posttraumatic stress symptoms could be accounted for by four hurricane experience variables (damage, loss, life threat, and injury), with perceived loss being the highest correlate. Of the five immune measures studied Natural Killer Cell Cytotoxicity (NKCC) was the only measure that was meaningfully related (negatively) to both damage and psychological variables (loss, intrusive thoughts, and posttraumatic stress disorder (PTSD). White blood cell counts (WBCs) were significantly positively related with the degree of loss and PTSD experienced. Both NKCC (lower) and WBC were significantly related to retrospective self-reported increase of somatic symptoms after the hurricane. Overall, the community sample was significantly lower in NKCC, CD4 and CD8 number, and higher in NK cell number compared to laboratory controls. Finally, evidence was found for new onset of sleep problems as a mediator of the posttraumatic symptom-NKCC relationship.
  
  
  CONCLUSIONS
  Several immune measures differed from controls after Hurricane Andrew. Negative (intrusive) thoughts and PTSD were related to lower NKCC. Loss was a key correlate of both posttraumatic symptoms and immune (NKCC, WBC) measures.
authors.affiliation: Department of Psychology, University of Miami, Coral Gables, Florida 33124, USA.
authors.forename: G
authors.initials: G
authors.lastname: Ironson
authors.forename: C
authors.initials: C
authors.lastname: Wynings
authors.forename: N
authors.initials: N
authors.lastname: Schneiderman
authors.forename: A
authors.initials: A
authors.lastname: Baum
authors.forename: M
authors.initials: M
authors.lastname: Rodriguez
authors.forename: D
authors.initials: D
authors.lastname: Greenwood
authors.forename: C
authors.initials: C
authors.lastname: Benight
authors.forename: M
authors.initials: M
authors.lastname: Antoni
authors.forename: A
authors.initials: A
authors.lastname: LaPerriere
authors.forename: H S
authors.initials: HS
authors.lastname: Huang
authors.forename: N
authors.initials: N
authors.lastname: Klimas
authors.forename: M A
authors.initials: MA
authors.lastname: Fletcher
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001708:Biopterins / Q000031:analogs & derivatives / Q000097:blood; D003602:Cytotoxicity, Immunologic / Q000276:immunology; D004190:Disasters; D005260:Female; D005431:Florida; D005790:General Adaptation Syndrome / Q000276:immunology; D006117:Grief; D006801:Humans; D007694:Killer Cells, Natural / Q000276:immunology; D008016:Life Change Events; D018655:Lymphocyte Count; D008297:Male; D011939:Mental Recall / Q000502:physiology*; D008875:Middle Aged; D019798:Neopterin; D010552:Personality Assessment; D011602:Psychophysiologic Disorders / Q000175:diagnosis / Q000276:immunology / Q000523:psychology; D013313:Stress Disorders, Post-Traumatic / Q000175:diagnosis / Q000276:immunology* / Q000523:psychology; D016176:T-Lymphocyte Subsets / Q000276:immunology; D013601:T-Lymphocytes / Q000276:immunology*; D013850:Thinking / Q000502:physiology*
chemical_list: D001708:Biopterins; D019798:Neopterin