Objectives To evaluate whether the association between Hurricane Sandy exposures and post-traumatic stress disorder (PTSD) symptom severity was greater for exposed community members compared with responders.
Methods Data were analysed from three existing studies with similar methodologies (N=1648): two community studies, Leaders in Gathering Hope Together (n=531) and Project Restoration (n=763); and the Sandy/World Trade Center Responders Study (n=354). Sandy-related PTSD symptoms were measured using the PTSD checklist-specific traumatic event and dichotomised as elevated (>30) versus low/no (<30) PTSD symptoms. Sandy exposures were measured with a summed checklist. Multivariable logistic regression was performed to evaluate the differential effect of exposures on PTSD by responder status, adjusting for demographics and time elapsed since Sandy.
Results Responders were somewhat older (50.5 years (SD=8.3) vs 45.8 years (SD=20.0)), more likely to identify as white (92.4% vs 48.1%) and were male (90.7% vs 38.4%). Responders were less likely to have elevated PTSD symptoms than community members (8.6% vs 31.1%; adjusted OR=0.28, 95% CI 0.17 to 0.46). While exposure was significantly related to elevated PTSD status, the effects were similar for responders and community members.
Conclusions Responders appear to be more resilient to PTSD symptoms post-Sandy than community members. Understanding the mechanisms that foster such resilience can inform interventions aimed at populations that are more vulnerable to experiencing PTSD after natural disasters.
- disaster mental health
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Correction notice This article has been corrected since it published Online First.
Contributors AG led the Sandy/WTC Responders study and co-led the development of the research questions for the current study. He also contributed to the writing of the introduction, methods and discussion sections and edited the final manuscript. RR led the data analytic plan and statistical analyses. She also contributed to the writing of the methods and results section, and editing of the final manuscript. LM contributed to writing the introduction section and provided edits to the final manuscript. SS contributed to writing the methods and discussions sections and edited the final manuscript. KB contributed to writing the discussion section and edited the final manuscript. EJB contributed to the design of the Sandy/WTC Responders study and edited the final manuscript. BJL contributed to the design of the Sandy/WTC Responders study and edited the final manuscript. ET led the Project Leaders in Gathering Hope Together study and edited the final manuscript. RS led the Project Restoration study and co-led the development of the research questions for the current study. She edited the final manuscript. She contributed to the writing of the methods and discussion sections and edited the final manuscript.
Funding This study was funded by the Department of Health and Human Services Office of the Assistant Secretary for Preparedness and Response #EP-HIT-14-0020) and the Centers for Disease Control and Prevention (#U01-TP000573-01).
Competing interests None declared.
Patient consent for publication Not required.
Provenance and peer review Not commissioned; externally peer reviewed.
Data availability statement Data are available upon reasonable request.
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