title: Mental health and general wellness in the aftermath of Hurricane Ike.
abstract: Exposure to natural disasters has been linked to a range of adverse outcomes, including mental health problems (e.g., posttraumatic stress symptoms [PTSS], depression), declines in role functioning (e.g., occupational difficulties), and physical health problems (e.g., somatic complaints). However, prior research and theory suggest that the modal postdisaster response in each of these domains is resilience, defined as low levels of symptoms or problems in a given outcome over time, with minimal elevations that are limited to the time period during the disaster and its immediate aftermath. However, the extent to which disaster survivors exhibit mental health wellness (resilience across multiple mental health conditions) or general wellness (resilience across mental health, physical health, and role functioning domains) remains unexplored. The purpose of this study was to quantify mental health and general wellness, and to examine predictors of each form of wellness, in a three-wave population-based study of Hurricane Ike survivors (N = 658). Latent class growth analysis was used to determine the frequency of resilience on four outcomes (PTSS: 74.9%; depression: 57.9%; functional impairment: 45.1%; days of poor health: 52.6%), and cross-tabulations were used to determine the frequency of mental health wellness (51.2%) and general wellness (26.1%). Significant predictors of both mental health and general wellness included lower peri-event emotional reactions and higher community-level collective efficacy; loss of sentimental possessions or pets and disaster-related financial loss were negative predictors of mental health wellness, and loss of personal property was a negative predictor of general wellness. The results suggest that studies focusing on a single postdisaster outcome may have overestimated the prevalence of mental health and general wellness, and that peri-event responses, personal property loss and collective efficacy have a cross-cutting influence across multiple domains of postdisaster functioning.
authors.affiliation: Department of Epidemiology, Columbia University, Mailman School of Public Health, USA. Electronic address: srl2143@columbia.edu.
authors.forename: Sarah R
authors.initials: SR
authors.lastname: Lowe
authors.affiliation: Department of Epidemiology, Columbia University, Mailman School of Public Health, USA.
authors.forename: Spruha
authors.initials: S
authors.lastname: Joshi
authors.affiliation: United States Department of Veterans Affairs, National Center for Posttraumatic Stress Disorder, USA; Department of Psychiatry, Yale University School of Medicine, USA.
authors.forename: Robert H
authors.initials: RH
authors.lastname: Pietrzak
authors.affiliation: Department of Epidemiology, Columbia University, Mailman School of Public Health, USA.
authors.forename: Sandro
authors.initials: S
authors.lastname: Galea
authors.affiliation: Department of Epidemiology, Columbia University, Mailman School of Public Health, USA.
authors.forename: Magdalena
authors.initials: M
authors.lastname: Cerdá
mesh_terms: D000328:Adult; D055867:Cyclonic Storms; D003863:Depression / Q000209:etiology; D004190:Disasters; D005260:Female; D006304:Health Status; D006801:Humans; D008297:Male; D008603:Mental Health; D008875:Middle Aged; D055500:Resilience, Psychological; D012307:Risk Factors; D013313:Stress Disorders, Post-Traumatic / Q000209:etiology; D017741:Survivors; D013781:Texas; D055815:Young Adult
keywords: Mental health; Natural disasters; Physical health; Resilience; Role functioning; Wellness