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2 - Epidemiology of disaster mental health

from Part II - Foundations of disaster psychiatry

Published online by Cambridge University Press:  09 August 2009

By
Carol S. North
Edited by
Robert J. Ursano ,
Carol S. Fullerton ,
Lars Weisaeth  and
Beverley Raphael
Carol S. North
Affiliation:
Professor of Psychiatry UT Southwestern Medical Center Department of Psychiatry USA
Robert J. Ursano
Affiliation:
Uniformed Services University of the Health Sciences, Maryland
Carol S. Fullerton
Affiliation:
Uniformed Services University of the Health Sciences, Maryland
Lars Weisaeth
Affiliation:
Universitetet i Oslo
Beverley Raphael
Affiliation:
University of Western Sydney
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Summary

Introduction

Psychiatric epidemiology provides a broad foundation for general understanding of the mental health effects of extreme trauma and secondarily helps to inform the field of mental health response to less extreme stress. Disaster mental health has considerable relevance in today's world, with disasters and terrorism increasingly occupying concerns of communities internationally.

The study of the mental health effects of traumatic events suffers from inherent methodological limitations. Studies of personal traumatic events endemic to community settings (such as motor vehicle accidents, gunshot wounds, and violent assault) suffer from confounding resulting from the nonrandom nature of their occurrence.

Pre-existing characteristics of individuals may be associated with risk for exposure to traumatic events (Breslau et al., 1998), such as drug abuse, other psychopathology, high novelty-seeking and low harm-avoidance characteristics of personality, and low socioeconomic status (Breslau et al., 1991). Risk for exposure to traumatic events in community settings is thus confounded with the mental health consequences of them. Studies of trauma in community settings may therefore be unable to determine what part of post-trauma effects is due to the traumatic experience, and what is pre-existing in individuals predisposed to such exposure. Because pre-existing characteristics of individuals exposed to trauma in individual incidents in communities determine their status after the event, findings from studies of other kinds of traumatic events may not apply to populations affected by disasters.

Keywords

community supportdisaster typologyepidemiologic researchmental health effectsPTSDpsychiatric illnesspostdisaster settings
Type
Chapter
Information
Textbook of Disaster Psychiatry , pp. 29 - 47
Publisher: Cambridge University Press
Print publication year: 2007

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