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Differential effect of Hurricane Sandy exposure on PTSD symptom severity: comparison of community members and responders
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  1. Adam Gonzalez1,2,
  2. Rehana Rasul2,3,4,
  3. Lucero Molina1,2,
  4. Samantha Schneider2,5,
  5. Kristin Bevilacqua2,3,
  6. Evelyn J Bromet1,
  7. Benjamin J Luft6,
  8. Emanuela Taioli2,7,
  9. Rebecca Schwartz2,5,7,8
  1. 1 Psychiatry and Behavioral Health, SUNY Stony Brook, Stony Brook, New York, USA
  2. 2 Center for Disaster Health, Trauma, and Resilience, Mount Sinai, SUNY Stony Brook, Northwell Health, New York City, New York, USA
  3. 3 Occupational Medicine, Epidemiology and Prevention, Northwell Health, Great Neck, New York, USA
  4. 4 Biostatistics, Feinstein Insitute for Medical Research at Northwell Health, Great Neck, New York, USA
  5. 5 Department of Occupational Medicine, Epidemiology and Prevention, Northwell Health, Great Neck, New York, USA
  6. 6 Medicine, SUNY Stony Brook, Stony Brook, New York, USA
  7. 7 Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York City, New York, USA
  8. 8 Occupational Medicine Epidemiology and Prevention, Zucker School of Medicine at Hofstra/Northwell, Great Neck, New York, USA
  1. Correspondence to Dr Adam Gonzalez, Psychiatry & Behavioral Health, SUNY Stony Brook, Stony Brook, NY 11794, USA; adam.gonzalez{at}stonybrook.edu

Abstract

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.

  • trauma
  • PTSD
  • disaster mental health
  • responders

https://doi.org/10.1136/oemed-2019-105957

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    Footnotes

    • 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.