Efficacy of a Therapist-Assisted Self-Help Internet-Based Intervention Targeting PTSD,Depression, and Insomnia Symptoms After a Disaster: A Randomized Controlled Trial

This study aimed at evaluating the efficacy of an online CBT intervention with limited therapist contact targeting a range of posttraumatic symptoms among evacuees from the 2016 Fort McMurray wildfires.One hundred and thirty-six residents of Fort McMurray who reported either moderate PTSD symptoms (PCL-5 ≥ 23) or mild PTSD symptoms (PCL-5 ≥ 10) with moderate depression (PHQ-9 ≥ 10) or subthreshold insomnia symptoms (ISI ≥ 8) were randomized either to a treatment (n = 69) or a waitlist condition (n = 67). Participants were on average 45 years old, and mostly identified as White (82%) and as women (76%). Primary outcomes were PTSD, depression, and insomnia symptoms. Secondary outcomes were anxiety symptoms and disability. Significant Assessment Time × Treatment Condition interactions were observed on all outcomes, indicating that access to the treatment led to a decrease in posttraumatic stress (F[1,117.04] = 12.128, p = .001; d = .519, 95% CI = .142–.895), depression (F[1,118.29] = 9.978, p = .002; d = .519, 95% CI = .141–.898) insomnia (F[1,117.60] = 4.574, p = .035; d = .512, 95% CI = .132–.892), and anxiety (F[1,119.64] = 5.465, p = .021; d = .421, 95% CI = .044–.797) symptom severity and disability (F[1,111.55] = 7.015, p = .009; d = .582, 95% CI = .200–.963). Larger effect sizes (d = 0.823–1.075) were observed in participants who completed at least half of the treatment. The RESILIENT online treatment platform was successful to provide access to specialized evidence-based mental health care after a disaster.     

Psychological reactions in Icelandic earthquake survivors

The aim of this study was to explore the psychological consequences of two earthquakes in Iceland in two probability samples of subjects--residents in the exposed area and a control group from an unexposed area. The sample was composed of 52 adults exposed to the earthquakes and 29 adults in a control group. Three months after the earthquakes, both groups were approached with questions from a survey consisting of the Harvard Trauma Questionnaire (HTQ), the Trauma Symptom Checklist (TSC), the Coping Styles Questionnaire (CSQ), the World Assumption Scale (WAS), and the Crisis Support Scale (CSS). The results revealed that 24% in the exposed group had Posttraumatic Stress Disorder (PTSD), and none in the control group had PTSD. Earthquake-related anxiety, inability to express one's thoughts and feelings, and emotional coping predicted 81% of the HTQ variance for both groups. Previous life events, low self-worth, and luck attributions, together with numbing and the feeling of being let down, predicted 56% of the symptom variance for both groups. When degree of traumatization and emotional coping were added to the model, another 30% of the variance could be explained.     

The affect heuristic,mortality salience,and risk: Domain‐specific effects of a natural disaster on risk‐benefit perception

We examine how affect and accessible thoughts following a major natural disaster influence everyday risk perception. A survey was conducted in the months following the 2004 south Asian Tsunami in a representative sample of the Swedish population (N = 733). Respondents rated their experienced affect as well as the perceived risk and benefits of various everyday decision domains. Affect influenced risk and benefit perception in a way that could be predicted from both the affect‐congruency and affect heuristic literatures (increased risk perception and stronger risk‐benefit correlations). However, in some decision domains, self‐regulation goals primed by the natural disaster predicted risk and benefit ratings. Together, these results show that affect, accessible thoughts and motivational states influence perceptions of risks and benefits.     

The role of event relevance and congruence to social groups in flashbulb memory formation

ABSTRACT

Flashbulb memories are vivid, confidently held, long-lasting memories for the personal circumstances of learning about an important event. Importance is determined, in part, by social group membership. Events that are relevant to one’s social group, and furthermore, are congruent with the prior beliefs of that group, should be more likely to be retained as flashbulb memories. The Fukushima nuclear disaster was relevant to ongoing political conversations in both Germany and the Netherlands, but, while the disaster was congruent with German beliefs about the dangers of nuclear energy, it was incongruent with Dutch support for nuclear power. Danish participants would not have found the disaster to be particularly relevant. Partially consistent with this prediction, across two samples (N?=?265 and N?=?518), German participants were most likely to have flashbulb memories for the Fukushima disaster. Furthermore, event features thought to be related to flashbulb memory formation (e.g. ratings of importance and consequentiality) also differed as a function of nationality. Spontaneously generated flashbulb memories for events other than Fukushima also suggested that participants reported events that were relevant to national identity (e.g. the Munich attacks for Germans, the Utøya massacre for Danes, and Malaysian Airlines flight MH-17 for Dutch participants).     

A Cross-Cultural Study of Depression in the Aftermath of a Natural Disaster

This study evaluated the extent and severity of depressive symptoms among adults (n=1015) in Armenia one year after the 1988 earthquake, using an Armenian translation of the Beck Depression Inventory (BDI-Arm). Earthquake surivivors had higher levels of depression than did their non-earthquake counterparts. For both the quake and non-quake regions, women were found to have higher scores on the BDI-Arm than men, and persons between the ages of 31–55 reported significantly higher depressive ratings than individuals who were 17–30. Interactions between the quake and non-quake areas and gender indicated that women in both areas reported significantly more depressive symptoms than men. The psychometric properties of the BDI-Arm compared favorably to those defined by North American studies.     

My Disaster Recovery: a pilot randomized controlled trial of an Internet intervention

Abstract

This pilot study tested the efficacy of the My Disaster Recovery (MDR) website to decrease negative affect and increase coping self-efficacy. Fifty-six survivors of Hurricane Ike were recruited from a larger study being conducted at the University of Texas Medical Branch at the first anniversary of the storm. Restricted randomization was used to assign participants to the MDR website, an information-only website, or a usual care condition. Group×time interactions indicated that MDR reduced participant worry more than the other conditions. A similar trend was also identified for depression. Both websites were accessed a small to moderate amount and participants reported mixed satisfaction for both websites. Although the effect sizes for worry and depression were in the moderate to large range, small sample size and timing of the intervention qualify the findings. These preliminary findings encourage further evaluation of MDR with a larger, demographically diverse sample and indicate that the MDR website might be helpful in reducing worry and depression.     

Religious Care in Coping with Terrorism

Abstract

Spiritual care has taken an important role in the aftermath of 9/11. The shattering of numerous basic assumptions by this attack has created many spiritual and existential questions. In this article, we explore different aspects of spiritual care after major disasters and the different roles that clergy can fulfill. As the field of spiritual trauma care is in a rudimentary stage, best practices for spiritual care need to be developed. In the second part of the article, different elements of the training for spiritual caregivers are described. In order to assure appropriate caregiving, guidelines for training of clergy need to be developed.     

Volunteers in Disaster Response

Abstract

Terrorism directed against the United States abroad and at home during the 1990s, in conjunction with the ongoing terrorist threat and use of weapons of mass destruction, and mass casualty disasters demanded a reexamination of national security and disaster response. Strategies to confront current threats and meet population needs include increasing collaboration and cooperation among federal, state, and county agencies and voluntary organizations. The American Red Cross has implemented training to familiarize participants with terrorist threats and the characteristics of chemical, biological, radiological, nuclear, and explosive weapons and has introduced technological changes to speed up service delivery at disasters.     

Preliminary Development of a Measure to Assess Children's Trauma Attributions

ABSTRACT

The Trauma Attribution Checklist (TAC) is a brief self-report measure of children's trauma-related attributions. A preliminary study with school-aged children, 12 months after exposure to a series of tornadoes, demonstrated significant correlations between TAC items and the Reaction Index, a measure of posttraumatic distress. Children with higher posttraumatic distress scores made more attributions of responsibility for negative tornado-related events, were more concerned with making attributions, had higher expectations of a tornado recurrence, and were more hypervigilant than children with less severe symptoms. Regression analyses indicated that items addressing expectations of recurrence and hypervigilance explained 53.3% of the variance in posttraumatic distress, with having made an attribution of responsibility for a tornado-related event accounting for an additional 5.6% of the variance.