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Vulnerable, But Why? Post-Traumatic Stress Symptoms in Older Adults Exposed to Hurricane Sandy

Published online by Cambridge University Press:  28 March 2016

Allison R. Heid ,
Zachary Christman ,
Rachel Pruchno ,
Francine P. Cartwright  and
Maureen Wilson-Genderson
Allison R. Heid*
Affiliation:
New Jersey Institute for Successful Aging, Rowan University School of Osteopathic Medicine, Stratford, New Jersey
Zachary Christman
Affiliation:
Rowan University, Department of Geography & Environment, Glassboro, New Jersey
Rachel Pruchno
Affiliation:
New Jersey Institute for Successful Aging, Rowan University School of Osteopathic Medicine, Stratford, New Jersey
Francine P. Cartwright
Affiliation:
New Jersey Institute for Successful Aging, Rowan University School of Osteopathic Medicine, Stratford, New Jersey
Maureen Wilson-Genderson
Affiliation:
Statistical Consultant, Short Hills, New Jersey
*
Correspondence and reprint requests to Allison R. Heid, PhD, 42 East Laurel Rd, Stratford, NJ, 08084 (e-mail: [email protected]).
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Abstract

Objective

Drawing on pre-disaster, peri-disaster, and post-disaster data, this study examined factors associated with the development of post-traumatic stress disorder (PTSD) symptoms in older adults exposed to Hurricane Sandy.

Methods

We used a sample of older participants matched by gender, exposure, and geographic region (N=88, mean age=59.83 years) in which one group reported clinically significant levels of PTSD symptoms and the other did not. We conducted t-tests, chi-square tests, and exact logistic regressions to examine differences in pre-disaster characteristics and peri-disaster experiences.

Results

Older adults who experienced PTSD symptoms reported lower levels of income, positive affect, subjective health, and social support and were less likely to be working 4 to 6 years before Hurricane Sandy than were people not experiencing PTSD symptoms. Those developing PTSD symptoms reported more depressive symptoms, negative affect, functional disability, chronic health conditions, and pain before Sandy and greater distress and feelings of danger during Hurricane Sandy. Exact logistic regression revealed independent effects of preexisting chronic health conditions and feelings of distress during Hurricane Sandy in predicting PTSD group status.

Conclusions

Our findings indicated that because vulnerable adults can be identified before disaster strikes, the opportunity to mitigate disaster-related PTSD exists through identification and resource programs that target population subgroups. (Disaster Med Public Health Preparedness. 2016;10:362–370)

Keywords

PTSDHurricane Sandyolder adults
Type
Original Research
Information
Disaster Medicine and Public Health Preparedness , Volume 10 , Special Issue 3: Superstorm Sandy , June 2016 , pp. 362 - 370
Copyright
Copyright © Society for Disaster Medicine and Public Health, Inc. 2016 

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References

1. US Department of Commerce National Oceanic and Atmospheric Administration. Service Assessment Hurricane/Post-Tropical Cyclone Sandy, October 22-29, 2012. http://www.nws.noaa.gov/os/assessments/pdfs/Sandy13.pdf. Published May 2013. Accessed July 14, 2015.Google Scholar
2. Brackbill, RM, Caramanica, K, Maliniak, M, et al. Nonfatal injuries 1 week after Hurricane Sandy. MMWR. 2014;63(42):950-954.Google Scholar
3. Najarian, LM, Sunday, S, Labruna, V, et al. Twenty-year follow-up of adults traumatized during childhood in Armenia. J Affect Disorders. 2011;135:51-55.CrossRefGoogle ScholarPubMed
4. Adams, RE, Boscarino, JA. Predictors of PTSD and delayed PTSD after disaster: The impact of exposure and psychosocial resources. J Nerv Ment Dis. 2006;194:485-493.Google Scholar
5. Lamet, A, Szuchman, L, Perkel, L, et al. Risk factors, resilience and psychological distress among Holocaust and non-Holocaust survivors in the post-9/11 environment. Educ Gerontol. 2009;35:32-46.Google Scholar
6. Shrira, A, Palgi, Y, Hamama-Raz, Y, et al. Previous exposure to the World Trade Center terrorist attack and posttraumatic symptoms among older adults following Hurricane Sandy. Psychiatry. 2014;77:374-385.Google Scholar
7. Caramanica, K, Brackbill, RM, Stellman, SD, et al. Posttraumatic stress disorder after Hurricane Sandy among persons exposed to the 9/11 disaster. Int J Emerg Ment Health. 2015;17:356-362.Google Scholar
8. Wen, J, Shi, Y, Li, Y, et al. Quality of life, physical diseases, and psychological impairment among survivors 3 years after Wenchuan earthquake: a population based survey. PLoS One. 2012;7(8):e4308. doi:10.1371/journal.pone.0043081.Google Scholar
9. Mapping Hurricane Sandy’s deadly toll. New York Times. http://www.nytimes.com/interactive/2012/11/17/nyregion/hurricane-sandy-map.html. Published November 17, 2012. Accessed July 14, 2015.Google Scholar
10. Eltman, F. After Sandy, many elders opt for assisted living. Philly.com. http://articles.philly.com/2013-01-08/news/36194848_1_retirement-community-lindenhurst-community-surge. Published January 2, 2013. Accessed July 14, 2015.Google Scholar
11. Acierno, R, Ruggiero, KJ, Kilpatrick, DG, et al. Risk and protective factors for psychopathology among older versus younger adults after the 2004 Florida hurricanes. Am J Geriatr Psychiat. 2006;14(12):1051-1059.Google Scholar
12. Norris, FH, Friedman, MJ, Watson, PJ, et al. 60,000 Disaster victims speak: Part I. An empirical review of the empirical literature, 1981-2001. Psychiatry. 2002;65(3):207-239.CrossRefGoogle Scholar
13. Norris, FH, Kaniasty, K, Conrad, MI, et al. Placing age differences in cultural context: a comparison of the effects of age on PTSD after disasters in the United States, Mexico, and Poland. J Clin Geropsychol. 2002;8:153-173.Google Scholar
14. Goenjian, AK, Najarian, LM, Pynoos, RS, et al. Posttraumatic stress disorder in elderly and younger adults after the 1988 earthquake in Armenia. Am J Psychiatry. 1994;151:895-901.Google Scholar
15. Ollendick, D, Hoffman, M. Assessment of psychological reactions in disaster victims. J Community Psychol. 1982;10:157-167.3.0.CO;2-8>CrossRefGoogle ScholarPubMed
16. Kohn, R, Levav, IG, Machuca, ME, et al. Prevalence, risk factors, and aging vulnerability for psychopathology following a natural disaster in a developing country. Int J Geriatr Psych. 2005;20:835-841.Google Scholar
17. Ticehurst, S, Webster, RA, Carr, VJ, et al. The psychosocial impact of an earthquake on the elderly. Int J Geriatr Psych. 1996;11:943-951.Google Scholar
18. Baltes, PB, Smith, J. New frontiers in the future of aging: from successful aging of the young old to the dilemmas of the fourth age. Gerontology. 2002;49:123-135.Google Scholar
19. Averill, PM, Beck, JG. Posttraumatic stress disorder in older adults: a conceptual review. J Anxiety Disord. 2000;14:133-156.Google Scholar
20. Bottche, M, Kuwert, P, Knaevelsrud, C. Posttraumatic stress disorder in older adults: an overview of characteristics and treatment approaches. Int J Geriatr Psych. 2012;27:230-239.Google Scholar
21. Neria, Y, Nandi, A, Galea, S. Post-traumatic stress disorder following disasters: a systematic review. Psychol Med. 2008;38:467-480.CrossRefGoogle ScholarPubMed
22. Wright, BK, Kelsall, HL, Sim, MR, et al. Support mechanisms and vulnerabilities in relation to PTSD in veterans of the Gulf War, Iraq War, and Afghanistan deployments: a systematic review. J Trauma Stress. 2013;26(3):310-318.Google Scholar
23. Shalev, AY, Freedman, S. PTSD following terrorist attacks: a prospective evaluation. Am J Psychiatry. 2005;162(6):1188-1191.Google Scholar
24. Pietrzak, RH, Southwick, SM, Tracy, M, et al. Posttraumatic stress disorder, depression, and perceived needs for psychological care in older persons affected by Hurricane Ike. J Affect Disorders. 2012;138:96-103.Google Scholar
25. Pietrzak, RH, Van Ness, PH, Fried, TR, et al. Trajectories of posttraumatic stress symptomatology in older persons affected by a large-magnitude disaster. J Psychiatr Res. 2013;47:520-526.Google Scholar
26. Kun, P, Tong, X, Liu, Y, et al. What are the determinants of post-traumatic stress disorder: age, gender, ethnicity or other? Evidence from 2008 Wenchuan earthquake. Public Health. 2013;127:644-652.CrossRefGoogle ScholarPubMed
27. Xu, J, Wu, Z. One-year follow-up analysis of cognitive and psychological consequences among survivors of the Wenchuan earthquake. Int J Psychol. 2011;46(2):144-152.CrossRefGoogle ScholarPubMed
28. Kessler, RC, Galea, S, Gruber, MJ, et al. Trends in mental illness and suicidality after Hurricane Katrina. Mol Psychiatr. 2008;13(4):374-384.Google Scholar
29. Xu, J, Song, X. Posttraumatic stress disorder among survivors of the Wenchuan earthquake 1 year after: prevalence and risk factors. Compr Psychiatry. 2011;52(4):431-437.CrossRefGoogle ScholarPubMed
30. Freedy, JR, Saladin, ME, Kilpatrick, DG, et al. Understanding acute psychological distress following natural disaster. J Trauma Stress. 1994;7:257-273.Google Scholar
31. Preville, M, Lamoureux-Lamarche, C, Vasiliadis, H-M, et al. The 6-month prevalence of posttraumatic stress syndrome (PTSD) among older adults: validity and reliability of the PTSD scale. Can J Psychiat. 2014;59:548-555.Google Scholar
32. Tolin, DF, Foa, EB. Sex differences in trauma and posttraumatic stress disorder: A quantitative review of 25 years of research. Psychol Bull. 2006;132:959-992.Google Scholar
33. Zhou, X, Kang, L, Sun, X, et al. Prevalence and risk factors of post-traumatic stress disorder among adult survivors six months after the Wenchuan earthquake. Compr Psychiatry. 2013;54:493-499.Google Scholar
34. Acierno, RE, Resnick, HS, Kilpatrick, DG, et al. PTSD symptoms in widowed women with lifetime trauma experiences. J Loss Trauma. 2004;9:35-43.Google Scholar
35. Byers, AL, Covinsky, KE, Neylan, TC, et al. Chronicity of posttraumatic stress disorder and risk of disability in older persons. JAMA Psychiatry. 2014;71:540-546.Google Scholar
36. Pietrzak, RH, Goldstein, RB, Southwick, SM, et al. Physical health conditions associated with posttraumatic stress disorder in US older adults: results from wave 2 of the National Epidemiologic Survey on Alcohol and Related Conditions. J Am Geriatr Soc. 2012;60:296-303.Google Scholar
37. Lancaster, SL, Melka, SE, Rodriguez, BF. emotional predictors of PTSD symptoms. Psychol Trauma. 2011;3:313-317.Google Scholar
38. Pietrzak, RH, Goldstein, RB, Southwick, SM, et al. Psychiatric comorbidity of full and partial posttraumatic stress disorder among older adults in the United States: results from wave 2 of the National Epidemiologic Survey on Alcohol and Related Conditions. Am J Geriatr Psychiat. 2012;20:380-390.Google Scholar
39. Keane, TM, Kaloupek, DG. Comorbid psychiatric disorders in PTSD: Implications for research. Ann N Y Acad Sci. 1997;821:24-34.Google Scholar
40. O’Connor, M, Nickerson, A, Aderka, IM, et al. The temporal relationship between change in symptoms of prolonged grief and posttraumatic stress following old age spousal bereavement. Depress Anxiety. 2014;32:335-340.Google Scholar
41. Watanabe, C, Okumura, J, Chiu, T, et al. Social support and depressive symptoms among displaced older adults following the 1999 Taiwan earthquake. J Trauma Stress. 2004;17(1):63-67.Google Scholar
42. Phifer, JF. Psychological distress and somatic symptoms after natural disaster: differential vulnerability among older adults. Psychol Aging. 1990;5(3):412-420.CrossRefGoogle ScholarPubMed
43. Seplaki, CL, Goldman, N, Weinstein, M, et al. Before and after the 1999 Chi-Chi earthquake: traumatic events and depressive symptoms in an older population. Soc Sci Med. 2006;62(12):3121-3132.Google Scholar
44. Pruchno, RA, Wilson-Genderson, M, Cartwright, F. A two-factor model of successful aging. J Gerontol Psychol Sci. 2010;65B(6):671-679.Google Scholar
45. Foa, EB, Riggs, DS, Dancu, CV, et al. Reliability and validity of a brief instrument for assessing posttraumatic stress. J Trauma Stress. 1993;6:459-473.Google Scholar
46. Sin, GL, Adbin, E, Lee, J. The PSS-SR as a screening tool for PTSD in frist-episode psychosis patients. Early Interv Psychiatry. 2012;6:191-194.Google Scholar
47. Coffey, SF, Gudmundsdottir, B, Beck, G, et al. Screening for PTSD in motor vehicle accident survivors using the PSS-SR and IES. J Trauma Stress. 2006;19(119):128.Google Scholar
48. Andresen, EM, Malmgren, JA, Carter, WB, et al. Screening for depression in well older adults: evaluation of a short form of the CES-D (Center for Epidemiologic Studies Depression Scale). Am J Prev Med. 1994;10(1):77-84.Google Scholar
49. Lawton, MP, Kleban, MH, Dean, J, et al. The factorial generality of brief positive and negative affect measures. J Gerontol Psychol Sci. 1992;47(4):P228-P237.Google Scholar
50. National Center for Health Statistics. National Health Interview Survey. 2004. ftp://ftp.cdc.gov/pub/Health_Statistics/NCHS/Survey_Questionnaires/NHIS/2004/english/. Accessed July 14, 2015.Google Scholar
51. Cartwright, FP, Pruchno, R, Heid, AR, et al. Exposure to Hurricane Sandy, neighborhood social capital, and PTSD symptoms in older adults. Poster presented at : ASPR/CDC/NIEHS Hurricane Sandy Conference: Translating Research into Practice; August 2015; New York, NY.Google Scholar
52. Heid, AR, Pruchno, R, Cartwright, FP, et al. Exposure to Hurricane Sandy, neighborhood collective efficacy, and posttraumatic stress symptoms in older adults. Aging Mental Health. 2016. doi: 10.1080/13607863.2016.1154016.Google Scholar
53. LeardMann, CA, Smith, TC, Smith, B, et al. Baseline self-reported functional health and vulnerability to post-traumatic stress disorder after combat deployment: Prospective US military cohort study. BMJ. 2009;338:b1273.Google Scholar
54. Logan-Greene, P, Green, S, Nurius, PS, et al. Distinct contributions of adverse childhood experiences and resilience resources: a cohort analysis of adult physical and mental health. Soc Work Health Care. 2014;53:776-797.Google Scholar
55. McFarlane, J, Symes, L, Frazier, L, et al. Connecting the dots of heart disease, poor mental health, and abuse to understand gender disparities and promote women’s health: a prospective cohort analysis. Health Care Women Int. 2010;31:313-326.Google Scholar
56. Smith, TC, Ryan, MA, Wingard, DL, et al. New onset and persistent symptoms of post-traumatic stress disorder self-reported after deployment and combat exposures: Prospective population based US military cohort study. BMJ. 2008;336:366-371.Google Scholar
57. Gargano, LM, Caramanica, K, Sisco, S, et al. Exposure to the World Trade Center disaster and 9/11-related post-traumatic stress disorder and household disaster preparedness. Disaster Med Public Health Prep. 2015;9(6):625-633. doi:10.1017/dmp.2015.71.Google Scholar
58. Tang, CS. Positive and negative postdisaster psychological adjustment among adult survivors of the southeast Asian earthquake-tsunami. J Psychosom Res. 2006;61:699-795.Google Scholar
59. Boals, A, Hayslip, B, Knowles, LR, et al. Perceiving a negative event as central to one’s identity partially mediates age differences in posttraumatic stress disorder symptoms. J Aging Health. 2012;24(459):474.Google Scholar
60. La Greca, AM, Lai, BS, Joormann, J, et al. Children’s risk and resilience following a natural disaster: genetic vulnerability, posttraumatic stress, and depression. J Affect Disorders. 2013;151:860-867.Google Scholar