The stability of emotional symptoms among disaster victims in a developing country

This stability of emotional distress following a major disaster in Colombia was evaluated in a 2-year follow-up of a representative subsample of 40 adult victims of the Armero disaster in Colombia. The utilization of the Self-Reporting Questionnaire indicated an increase of emotional distress from 55% to 78%. However, the mean neurotic subscale score, the most frequent neurotic symptoms, the strongest predictors of emotional distress, and the symptom-profiles of distressed victims were essentially the same.     

Marital Status Predicts Change in Distress and Well‐being in Women Newly Diagnosed With Breast Cancer and Their Peer Counselors

Abstract: We conducted a nonrandomized study matching 42 women newly diagnosed with breast cancer (sojourners) with 39 trained breast cancer survivors (navigators) who provided one‐on‐one peer counseling for 3–6 months. Because little is known about how marital status might impact participants in such an intervention, we tested whether being married/partnered buffered navigators and sojourners from distress at baseline and over time. We examined baseline and slopes over time for change in depression and trauma symptoms, and emotional well‐being. We were particularly concerned that being matched with a newly diagnosed breast cancer patient might trigger a re‐experiencing of trauma symptoms for the navigator, so we examined a re‐experiencing subscale. All participants completed baseline, 3‐, 6‐, and 12‐month assessments. Our hypotheses were tested in separate Analyses of Variance (married versus not) for the 39 sojourners and 34 navigators who provided baseline assessments, and the 29 sojourners and 24 navigators who were matched and provided at least one follow‐up. We found no significant baseline associations for navigators or sojourners. Being single/not married was associated with increasing depression symptoms over time in both navigators and sojourners compared with being married/partnered. By 12 months, these increases crossed above the clinical cut‐off for significant depression symptoms. Single status did not predict increasing trauma symptoms over time. However, being single/not married predicted a significant increase in navigators’ re‐experiencing of trauma symptoms. Over time, married sojourners increased significantly in emotional well‐being, whereas single/not married navigators did not differ from married navigators. In addition to providing ongoing training and emotional support to navigators, our findings indicate the importance of providing additional support for women who are not married or partnered.     

Parent experiences and psychosocial support needs 6 months following paediatric critical injury: A qualitative study

IntroductionParents of critically injured children can experience high levels of psychological distress post-injury, however little is known about their experiences and needs following injury. This study aimed to explore parent experiences and psychosocial support needs in the six months following child critical injury.MethodsAn interpretive qualitative design was used. Semi-structured interviews were conducted with 30 parents of 23 critically injured children. Interviews explored parent experiences and psychosocial support needs. Qualitative data were managed using NVIVO 10 and analysed thematically.ResultsFour themes were identified: integrating back into home life; adjusting mentally and emotionally to injury; coping with injury as a family; and navigating resources to meet family needs. Parents and families experienced substantial ongoing emotional impacts at 6 months following child injury. Parents were unprepared for the negative changes in their child’s psychological wellbeing and behaviour post injury, and parents’ mental health was negatively impacted, with mothers more likely to seek emotional support than fathers. Parents reported receiving no psychosocial follow-up from the hospital and limited information about community services and accessing local community resources on returning home.ConclusionsThere is a need to include all family members in discharge planning, and to use a family-centred continuity-of-care approach from the time of child injury through to post-discharge recovery. To strengthen parent and family wellbeing, a biopsychosocial holistic approach is recommended, including cognitive-behavioural and other psychological strategies to help reduce distress for parents and all family members and strengthen their coping capacity. A dedicated family support coordinator role to facilitate care over the child recovery trajectory, and development of accessible online and e-psychosocial support resources for parents and families are recommended.     

A one-year psychological follow-up of the most severely burned victims of the Bradford fire

The horrific disaster at the Valley Parade Football Stadium, Bradford, on 11 May 1985 left 53 people dead in the fire and many more seriously injured. This detailed study of five of the most seriously injured victims was started 3 weeks after the fire. Patients were interviewed and rating scales (Irritability Depression Anxiety Scale--IDA, Hamilton Depression Rating Scale--HDRS, Spielberger Anxiety Scale--STAI, Beck Depression Inventory--BDI, General Health Questionnaire--GHQ), were completed regularly, until the first anniversary of the disaster. Each victim showed some psychopathology over the study period. Depression and anxiety, the commonest reactions, were most troublesome at times of stress. While it is likely that the disaster itself predisposed the victims to these reactions, the contribution of the stressful events occurring around the time of the disaster cannot be ignored. These findings suggest that IDA, GHQ and STAI function as an effective screening triage for detecting those disaster victims who may need psychological help and support.     

Stress Reactions in Disaster Victims Following the Bijlmermeer Plane Crash

This article examined posttraumatic stress symptoms in a sample of disaster victims following the Bijlmermeer plane crash of October, 1992, in the Netherlands. Findings indicated that six months after the disaster 26% of the respondents were suffering from posttraumatic stress disorder (PTSD). The victims' PTSD was strongly associated with material damage and loss. The discussion of the results focuses on the distinction between normal and pathological stress reactions and the implications for disaster after-care.     

Work based support,emotional exhaustion,and spillover of work stress to the family environment: A study of policewomen

This study aimed to test a path model in which work stress affects policewomen's functioning in their family environment through a component of burnout, emotional exhaustion. Work role stressors assessed were role ambiguity and role overload. Work based support from supervisors, but not colleagues, was predicted to reduce role stressors and emotional exhaustion, and improve perceptions of family functioning (cohesion and conflict). Data was collected via a mail out survey to all (1081) policewomen in an Australian state police service. Useable surveys were returned by 421 policewomen. Path analysis using LISREL 8.5 indicated a good fit to the model. Supervisor, but not coworker support reduced role stressors, which had a significant path to family cohesion and conflict, through emotional exhaustion. The findings suggest that a fruitful avenue of exploration of stress transmission to the family would be an examination of behaviours linked to emotional exhaustion. Additionally, interventions designed to reduce stress in policewomen should include supervisor training in social support. Copyright © 2005 John Wiley & Sons, Ltd.     

Chronic mustard toxicity on the testis: a historical cohort study two decades after exposure

We aimed to assess the long-term toxic effects of sulphur mustard (SM) on the testis and male fertility two decades after exposure. A historical cohort study was conducted in 2005. Sixty-four SM-exposed and 64 matched SM-unexposed casualties of the Iraq–Iran conflict were enrolled. Fecundity status, semen indices, hormonal assay results and testis histopathology were evaluated. Male factor infertility was diagnosed in 23 and 5% of married exposed and unexposed casualties, respectively ( p  <   0.01). All semen indices declined over the 15 years since 1990 among the exposed group. Furthermore, all indices with the exception of sperm motility were significantly lower in the exposed than in unexposed men. The follicle-stimulating hormone level was higher in the infertile than in fertile exposed men ( p  <   0.001). Testis histopathology of the azoospermic men showed complete absence of spermatogenesis with only Sertoli cells in the seminiferous tubules. SM can be gonadotoxic and its chronic toxicity may be permanent. Germ cells are probably the most susceptible gonadal cells to SM.     

At home parent-administered dressing changes in paediatric burns aftercare: Interviews on parents’ experiences of treatment

ObjectivePaediatric burn injuries present physical and psychosocial effects for children and their parents, including disruption to family life. Some burns services in the UK enable parents to administer dressing changes at home to reduce the number of hospital visits. To date, there is no research on parents’ experiences of administering dressing changes. The aim of this study was to describe parents’ experiences of administering dressing changes in paediatric burns aftercare.MethodsSemi-structured research interviews were conducted with a purposive sample of parents recruited from a paediatric burns centre in the UK. The interview addressed the initial offer of at-home dressing changes by clinicians; parental decision-making in relation to dressing changes; training and support received; and the experience of administering dressing changes, including practical and emotional considerations. Thematic analysis of the data was informed by the framework approach, including associative analysis using demographic and clinical characteristics.ResultsSeventeen participants were interviewed. Three themes of parents’ experiences of administering dressing changes were identified including (1) Parental Identity concerning the newly undertaken responsibility and the impact on the parental role; (2) Challenges, physical or emotional, confronted or lessened by administering dressing changes; and (3) Reassurance provided by healthcare professionals and others to support parents to adopt and maintain parent-administered dressing changes.ConclusionThe qualitative data reported here indicates that parents want to be involved in their child’s care by administering dressing changes at home, provided they receive sufficient reassurance that they are able to manage the severity of their child’s burn. Parents’ concerns about the effectiveness of their dressing changes lacks empirical basis, and this study provides preliminary data to support the development and evaluation of best practice guidance for parent-administered dressing changes in paediatric burns aftercare.     

To cut or not to cut? Personal factors influence primary care physicians’ position on elective newborn circumcision

BackgroundElective circumcision in newborns has always been a controversial issue. The purpose of this study was to determine whether personal factors play a role when physicians provide advice to parents regarding elective circumcisions in infants.MethodsQuestionnaires were sent to Family Physicians, Urologists, Obstetricians, Paediatricians and Family Medicine residents in Saskatchewan, Canada. The questionnaire contained demographic questions, questions regarding the carrying out of surgical procedures, personal and family circumcision status and factors influencing decision-making regarding elective newborn circumcisions.ResultsOf the questionnaires, 57% (572/1009) were returned. Of the 572 respondents, 65% were male, 80.4% were Family Physicians or General Practitioners and 77.1% (441/572) stated that they based their decisions regarding circumcisions on medical evidence. When asked if they were in support of circumcisions, 68.3% (125/183) of the circumcised males were in support of it and 68.8% (106/154) of the uncircumcised males were opposed to it (p<0.001).ConclusionsAlthough most respondents stated that they based their decisions on medical evidence, the circumcision status of, especially, the male respondents played a huge role in whether they were in support of circumcisions or not. Another factor that had an influence was the circumcision status of the respondents’ sons.     

The flooding of Hat Yai: predictors of adverse emotional responses to a natural disaster

Background: A severe flood occurred in Hat Yai following a torrential downpour of rain in November 2000, killing at least 32 people, injuring about 1700, and causing severe damage to property. We have assessed the effect of this disaster on the mental health of the community and investigated predictors of adverse emotional responses. Method: A cross‐sectional survey using a structured questionnaire was carried out and Thai versions of the General Health Questionnaire (GHQ) and Impact of Event Scale (IES) were administered. Data on 590 respondents residing in four areas of the city and its environs were obtained. Results: Two hundred and thirty‐three (40 per cent) respondents had a positive GHQ score suggesting a mental health problem. There were significant associations between a positive GHQ and the subjects' perception of the severity of loss, the ability to collect possessions, and showing a ‘negative’ response to the flood. High IES scores were associated with indices of the severity of loss, lower socio‐economic status and minority religion. Conclusions: Natural disasters, such as floods, have a major impact on the mental health of a community. The impact is related to the perception of severity and loss, and is greater in lower socio‐economic and minority religious sub‐groups. Copyright © 2004 John Wiley & Sons, Ltd.     

Psychologic effects of vasectomy in voluntarily childless men.

Forty-four childless men and 51 vasectomized parents were compared as to their childhood backgrounds, marital satisfaction, social/emotional adjustment, physical and emotional problems attributed to the vasectomy, and attitudes toward vasectomy as a means of birth control. The findings suggested that for young married men, firmly committed to childlessness and in agreement with their wives regarding the necessity of the operation, vasectomy appears to be as physically and psychologically safe as in married parents for at least a two-year period. There were differences in the childfree men and fathers in styles of adjustment, with the childfree reporting themselves to be more independent, mobile, and less tied to tradition; these differences were seen as being more related to choosing a childfree life style than to the choice of vasectomy as a contraceptive method.     

Family Functioning,Marital Satisfaction and Social Support in Hemodialysis Patients and their Spouses

A growing number of studies have demonstrated the importance of marital quality among patients undergoing medical procedures. The aim of the study was to expand the literature by examining the relationships between stress, social support and family and marriage life among hemodialysis patients. A total of 114 participants, including 38 patients and their spouses and 38 healthy controls, completed a survey package assessing social support, stress, family functioning and marital satisfaction and quality. We found that hemodialysis patients and spouses were less flexible in family adaptability compared with the healthy controls. Patients and spouses had more stress and instrumental social support compared with healthy people. Stress was negatively associated with marital satisfaction. Instrumental support was not associated with family or marital outcomes. The association between marital quality and support outside of family was positive in healthy individuals but was negative in patients and their spouses. Family adaptability was positively associated with support within family as perceived by patients and positively associated with emotional support as perceived by spouses. In conclusion, findings suggest that social support may promote adjustment depending on the source and type. Future research should pay more attention to the types and sources of social support in studying married couples. Copyright © 2014 John Wiley & Sons, Ltd.     

The impact of disaster support work

Limited available evidence suggests that disaster support work may have negative effects. This study attempts to examine the impact of disaster-related stress on helpers offering psychological support to victims of two major disasters, and to identify potential moderating factors. Sixty-seven social workers were surveyed, measures being taken of psychological symptomatology and wellbeing, personality variables, social support, life events, and various aspects of disaster support work. Comparison with normative data suggested that subjects were experiencing significant levels of stress. Two major sources of disaster-related stress were identified: role-related difficulties and contact with clients' distress. Approximately one third of the variance in helper response could be explained by variables reflecting coping style, prior life events and the aforementioned aspects of disaster support work. Follow-up data at 12 months demonstrated persisting high levels of stress.     

Smaller genitals at school age in boys whose mothers were exposed to non-persistent pesticides in early pregnancy

Endocrine disrupting chemicals are believed to play a role in the development of the testicular dysgenesis syndrome. Many pesticides are known to have endocrine disrupting abilities. In a previous study, sons of women who were occupationally exposed to non-persistent pesticides in early pregnancy showed signs of impaired reproductive function (reduced genital size and altered serum hormone concentrations) at three months of age. To assess the possible long-term effects of prenatal pesticide exposure, the boys were re-examined at 6-11 years. The 94 boys (59 exposed, 35 unexposed) underwent genital examinations including ultrasound of testicular volumes, puberty staging (Tanner), anthropometry, and blood sampling. Only a few of the boys had reached puberty (n = 3). Among prepubescent boys, testicular volume and penile length (age- and weight-adjusted) were reduced if mothers were exposed to pesticides. The effects were associated with the maternal exposure levels, so that high-exposed boys had smaller genitals than medium-exposed boys, who had smaller genitals than those who were unexposed. Boys of mothers in the high exposure group (n = 23) had 24.7% smaller testes (95% CI: -62.2; -10.1) and 9.4% shorter penile length (95% CI: -16.8; -1.1) compared with the unexposed. The testicular volume and penile length at school age could be tracked to measures from the same boys made at 3 months, e.g. those that had small testes at school age also had small testes at 3 months. Pituitary and testicular hormone serum concentrations did not differ between exposed and unexposed boys. Eight prenatally exposed boys had genital malformations (no unexposed). These boys had smaller testis, shorter penile length and lower inhibin B concentrations than prepubertal boys without genital malformations. The findings support the results obtained at three months of age and indicate that prenatal pesticide exposure has long-term effects on reproductive function in boys.     

Social support and psychological symptomatology following a natural disaster

The effects of perceived availability of social support on psychological symptomatology following a natural disaster were studied in a sample of victims of a major flood in Roanoke, Virginia. Ninety-six subjects were administered questionnaires that measured self-reported levels of depression, anxiety, and somatization 1 week after the disaster and four additional times within 6 months after the disaster. A questionnaire mailed 3 months after the disaster assessed perceived availability of social support. Results indicated that subjects experienced severe distress immediately following the disaster, that this distress decreased sharply 6 weeks after the flood, and decreased more gradually in the following months. Perceived availability of social support was not related to distress immediately following the disaster nor 5 months afterwards. Social support and symptomatology were significantly correlated during the intermediate period.     

International Tourists’ Reactions to a Natural Disaster: Experiences of the 2015 Earthquake in Nepal Among Israeli Travelers

There is a scarcity of research exploring the experiences of foreign travelers exposed to natural disasters while abroad. This qualitative study explored the experiences of the 2015 earthquake in Nepal among international travelers immediately following the earthquake. In‐depth interviews were conducted with 21 Israeli backpackers who were traveling in Nepal at the time of the earthquake. Thematic analysis revealed 4 themes: emotional turmoil, quick recovery, springing into action, and connection to the army. Findings suggest that foreign travelers initially respond with emotional turmoil to the disaster. Then they actively search for ways to effectively cope with the situation by problem solving, creating a community of action and support, and searching their own history for similar circumstances that can provide a sense of competence or clear directions for coping. Implications and limitations of the study, as well as suggestions for future research are discussed.     

Posttraumatic stress in aging World War II survivors after a fireworks disaster: a controlled prospective study

Little is known about the effects of cumulative trauma and whether traumatized individuals are more vulnerable. In 2000, a fireworks disaster created the possibility to examine this issue among World War II survivors who were part of an ongoing longitudinal study. Between 1998 and 2000 posttraumatic stress increased in disaster exposed respondents as opposed to the control group. War-related reexperiencing and avoidance also increased. The strongest increase occurred in disaster-exposed respondents who had low levels of wartime stress and a slight decrease occurred in those who had high wartime exposure. This unique controlled observation suggests that disasters do increase the levels of posttraumatic stress, and that reactivation of previous traumatic events generally occurs. However, the vulnerability hypothesis was not supported.     

Mediating effects of intrapersonal and social support on mental health 1 and 3 years after a natural disaster

Knowledge regarding social support has increased expotentially in the last decade; however, it remains unclear how support prevents or relieves stress and whether persons experiencing different kinds of stress need different kinds of support. This paper explores these issues. First, some of the stressful encounters reported by disaster victims are identified. Next, alternative schools of thought regarding how social support is conceptualized and measured is discussed. Finally, a longitudinal disaster study conducted by the author in which two rival hypotheses (self-efficacy and social support) were tested in mediating the relationship between stress and health is reported. Recommendations for future study are suggested in light of current methodological issues and study findings.     

Sexual assault history and social support: six general population studies

We evaluated the association of sexual assault history with later social support, operationalized as network size, marital status, presence of a partner, frequency of network contacts, and emotional support from friends and family, from spouse, and from partner. Data came from six independent general population surveys (pooled N = 9,865) whose results were summarized using meta-analysis. People who had been sexually assaulted were less likely than others to be married (OR = 0.75, 95% CI = 0.65, 0.87) or to report at least weekly contact with friends and relatives (OR = 0.48, 95% CI = 0.31, 0.75), and reported less emotional support from friends and family (OR = 0.72, 95% CI = 0.58, 0.89) and spouse (OR = 0.67, 95% CI = 0.54, 0.82). Results were consistent across studies, genders, and ethnic groups. Circumstances of sexual assault were sometimes related to social support.