title: Risk Factors for Posttraumatic Stress Symptoms Among Avalanche Survivors: A 16-Year Follow-Up.
abstract: Few natural disaster studies have assessed factors associated with posttraumatic stress disorder (PTSD) beyond a decade after trauma. Using North's disaster model as a framework, the aim of this study was to identify factors associated with clinically significant posttraumatic stress symptoms (CS-PTSDS) in avalanche survivors (n = 399) 16 years after the disaster. Completed self-report questionnaires were received from 286 (72%) survivors. CS-PTSDS were assessed with the Posttraumatic Diagnostic Scale. Predictors of CS-PTSDS in a multivariate analysis were secondary sequelae factors of lack of social support (adjusted relative risk [RR], 2.90; 95% confidence interval [CI], 1.37-6.13) and financial hardship in the aftermath of the trauma (adjusted RR, 2.47; 95% CI, 1.16-5.26). In addition, the community factor of providing assistance in the aftermath of the avalanche (adjusted RR, 1.95; 95% CI, 1.04-3.64) was inversely associated with CS-PTSDS. Screening for these factors may be useful in identifying those most vulnerable to developing chronic PTSD after this unique type of disaster.
authors.affiliation: *Centre of Public Health Sciences, Faculty of Medicine, and †Faculty of Psychology, School of Health Sciences, University of Iceland, Reykjavik, Iceland; ‡National Center for PTSD, Women's Health Sciences Division (116B-3), VA Boston Healthcare System; §Department of Psychiatry, Boston University School of Medicine; ∥Department of Epidemiology, Harvard School of Public Health, Boston, MA; ¶Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC; #Department of Psychology, University of Southern Denmark, Odense, Denmark; **Department of Psychology, University of Ulster, Londonderry, Northern Ireland; ††Mental Health Services, Landspitali-The National University Hospital of Iceland; and ‡‡Faculty of Medicine, School of Health Sciences, University of Iceland, Reykjavik, Iceland.
authors.forename: Edda Bjork
authors.initials: EB
authors.lastname: Thordardottir
authors.forename: Ingunn
authors.initials: I
authors.lastname: Hansdottir
authors.forename: Jillian C
authors.initials: JC
authors.lastname: Shipherd
authors.forename: Unnur Anna
authors.initials: UA
authors.lastname: Valdimarsdottir
authors.forename: Heidi
authors.initials: H
authors.lastname: Resnick
authors.forename: Ask
authors.initials: A
authors.lastname: Elklit
authors.forename: Ragnhildur
authors.initials: R
authors.lastname: Gudmundsdottir
authors.forename: Berglind
authors.initials: B
authors.lastname: Gudmundsdottir
mesh_terms: D000293:Adolescent; D000328:Adult; D055875:Avalanches; D002908:Chronic Disease; D003430:Cross-Sectional Studies; D004190:Disasters; D005500:Follow-Up Studies; D006801:Humans; D007055:Iceland; D008016:Life Change Events; D008403:Mass Screening / Q000706:statistics & numerical data; D012307:Risk Factors; D012944:Social Support; D013313:Stress Disorders, Post-Traumatic / Q000175:diagnosis* / Q000453:epidemiology*; D017741:Survivors / Q000523:psychology* / Q000706:statistics & numerical data*; D055815:Young Adult