title: The role of anger and ongoing stressors in mental health following a natural disaster.
abstract: OBJECTIVE
  Research has established the mental health sequelae following disaster, with studies now focused on understanding factors that mediate these outcomes. This study focused on anger, alcohol, subsequent life stressors and traumatic events as mediators in the development of mental health disorders following the 2009 Black Saturday Bushfires, Australia's worst natural disaster in over 100 years.
  
  
  METHODS
  This study examined data from 1017 (M = 404, F = 613) adult residents across 25 communities differentially affected by the fires and participating in the Beyond Bushfires research study. Data included measures of fire exposure, posttraumatic stress disorder, depression, alcohol abuse, anger and subsequent major life stressors and traumatic events. Structural equation modeling assessed the influence of factors mediating the effects of fire exposure on mental health outcomes.
  
  
  RESULTS
  Three mediation models were tested. The final model recorded excellent fit and observed a direct relationship between disaster exposure and mental health outcomes (b = .192, p < .001) and mediating relationships via Anger (b = .102, p < .001) and Major Life Stressors (b = .128, p < .001). Each gender was compared with multiple group analyses and while the mediation relationships were still significant for both genders, the direct relationship between exposure and outcome was no longer significant for men (p = .069), but remained significant (b = .234, p < .001) for women.
  
  
  CONCLUSIONS
  Importantly, anger and major life stressors mediate the relationship between disaster exposure and development of mental health problems. The findings have significant implications for the assessment of anger post disaster, the provision of targeted anger-focused interventions and delivery of government and community assistance and support in addressing ongoing stressors in the post-disaster context to minimize subsequent mental health consequences.
authors.affiliation: Australian Centre for Posttraumatic Mental Health and Department of Psychiatry, University of Melbourne, Carlton, Australia dforbes@unimelb.edu.au.
authors.forename: David
authors.initials: D
authors.lastname: Forbes
authors.affiliation: Australian Centre for Posttraumatic Mental Health and Department of Psychiatry, University of Melbourne, Carlton, Australia.
authors.forename: Nathan
authors.initials: N
authors.lastname: Alkemade
authors.affiliation: Jack Brockhoff Child Health and Wellbeing Program, Melbourne School of Population and Global Health, University of Melbourne, Carlton, Australia.
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Waters
authors.affiliation: Jack Brockhoff Child Health and Wellbeing Program, Melbourne School of Population and Global Health, University of Melbourne, Carlton, Australia.
authors.forename: Lisa
authors.initials: L
authors.lastname: Gibbs
authors.affiliation: Melbourne School of Psychological Sciences, University of Melbourne, Parkville, Australia.
authors.forename: Colin
authors.initials: C
authors.lastname: Gallagher
authors.affiliation: Melbourne School of Psychological Sciences, University of Melbourne, Parkville, Australia.
authors.forename: Phillipa
authors.initials: P
authors.lastname: Pattison
authors.affiliation: Centre for Transformative Innovation, Swinburne University of Technology, Hawthorn, Australia.
authors.forename: Dean
authors.initials: D
authors.lastname: Lusher
authors.affiliation: Southgate Institute for Health, Society and Equity, and School of Medicine, Flinders University, Adelaide, Australia.
authors.forename: Colin
authors.initials: C
authors.lastname: MacDougall
authors.affiliation: Department of Social Work, University of Melbourne, Carlton, Australia.
authors.forename: Louise
authors.initials: L
authors.lastname: Harms
authors.affiliation: Jack Brockhoff Child Health and Wellbeing Program, Melbourne School of Population and Global Health, University of Melbourne, Carlton, Australia.
authors.forename: Karen
authors.initials: K
authors.lastname: Block
authors.affiliation: Jack Brockhoff Child Health and Wellbeing Program, Melbourne School of Population and Global Health, University of Melbourne, Carlton, Australia.
authors.forename: Elyse
authors.initials: E
authors.lastname: Snowdon
authors.affiliation: Department of Social Work, University of Melbourne, Carlton, Australia.
authors.forename: Connie
authors.initials: C
authors.lastname: Kellet
authors.affiliation: Prevention and Population Health Branch, Department of Health, Melbourne, Australia.
authors.forename: Vikki
authors.initials: V
authors.lastname: Sinnott
authors.affiliation: Health and Human Services Emergency Management, Department of Human Services, Melbourne, Australia.
authors.forename: Greg
authors.initials: G
authors.lastname: Ireton
authors.affiliation: Emergency Services, Australian Red Cross, Carlton, Australia.
authors.forename: John
authors.initials: J
authors.lastname: Richardson
authors.affiliation: School of Psychology, University of New South Wales, Sydney, Australia.
authors.forename: Richard A
authors.initials: RA
authors.lastname: Bryant
mesh_terms: D000786:Anger; D004190:Disasters; D005260:Female; D005390:Fires; D006801:Humans; D008016:Life Change Events; D008297:Male; D008603:Mental Health; D008875:Middle Aged; D012307:Risk Factors; D013315:Stress, Psychological / Q000523:psychology*; D014739:Victoria
keywords: anger; disasters; life change events; mental health; sex