There is a paucity of research investigating the relationship of community-level characteristics such as collective efficacy and posttraumatic stress following disasters. We examine the association of collective efficacy with probable posttraumatic stress disorder and posttraumatic stress disorder symptom severity in Florida public health workers (n = 2249) exposed to the 2004 hurricane season using a multilevel approach. Anonymous questionnaires were distributed electronically to all Florida Department of Health personnel nine months after the 2004 hurricane season. The collected data were used to assess posttraumatic stress disorder and collective efficacy measured at both the individual and zip code levels. The majority of participants were female (80.42%), and ages ranged from 20 to 78 years (median = 49 years); 73.91% were European American, 13.25% were African American, and 8.65% were Hispanic. Using multi-level analysis, our data indicate that higher community-level and individual-level collective efficacy were associated with a lower likelihood of having posttraumatic stress disorder (OR = 0.93, CI = 0.88–0.98; and OR = 0.94, CI = 0.92–0.97, respectively), even after adjusting for individual sociodemographic variables, community socioeconomic characteristic variables, individual injury/damage, and community storm damage. Higher levels of community-level collective efficacy and individual-level collective efficacy were also associated with significantly lower posttraumatic stress disorder symptom severity (b = ？0.22, p<0.01; and b = ？0.17, p<0.01, respectively), after adjusting for the same covariates. Lower rates of posttraumatic stress disorder are associated with communities with higher collective efficacy. Programs enhancing community collective efficacy may be an important part of prevention practices and possibly lead to a reduction in the rate of posttraumatic stress disorder post-disaster.
References
[1]
Akbayrak N, Oflaz F, Aslan O, Ozcan CT, Tastan S, et al. (2005) Post-traumatic stress disorder symptoms among military health professionals in Turkey. Mil Med 170: 125–129.
[2]
Benedek DM, Fullerton C, Ursano RJ (2007) First responders: mental health consequences of natural and human-made disasters for public health and public safety workers. Ann Rev Public Health 28: 55–68. doi: 10.1146/annurev.publhealth.28.021406.144037
[3]
Carson MA, Paulus LA, Lasko NB, Metzger LJ, Wolfe J, et al. (2000) Psychophysiologic assessment of posttraumatic stress disorder in Vietnam nurse veterans who witnessed injury or death. J Consult Clin Psychol 68: 890–897. doi: 10.1037//0022-006x.68.5.890
[4]
Kerasiotis B, Motta RW (2004) Assessment of PTSD symptoms in emergency room, intensive care unit, and general floor nurses. Int J Emerg Ment Health 6: 121–133.
[5]
Bai Y, Lin CC, Lin CY, Chen JY, Chue CM, et al. (2004) Survey of stress reactions among health care workers involved with the SARS outbreak. Psychiatr Serv 55: 1055–1057. doi: 10.1176/appi.ps.55.9.1055
[6]
Grieger TA, Fullerton CS, Ursano RJ, Reeves JJ (2003) Acute stress disorder, alcohol use, and perception of safety among hospital staff after the sniper attacks. Psychiatr Serv 54: 1383–1387. doi: 10.1176/appi.ps.54.10.1383
[7]
McCarroll JE, Fullerton CS, Ursano RJ, Hermsen JM (1996) Posttraumatic stress symptoms following forensic dental identification: Mt. Carmel, Waco, Texas. Am J Psychiatry 153: 778–782.
[8]
van Kamp I, van der Velden PG, Stellato RK, Roorda J, van Loon J, et al. (2006) Physical and mental health shortly after a disaster: first results from the Enschede firework disaster study. Eur J Public Health 16: 253–259. doi: 10.1093/eurpub/cki188
[9]
Sampson RJ, Raudenbush SW, Earls F (1997) Neighborhoods and violent crime: a multilevel study of collective efficacy. Science 277: 918–924. doi: 10.1126/science.277.5328.918
[10]
Gapen M, Cross D, Ortigo K, Graham A, Johnson E, et al. (2011) Perceived neighborhood disorder, community cohesion, and PTSD symptoms among low-income African Americans in an urban health setting. Am J Orthopsychiatry 81: 31–37. doi: 10.1111/j.1939-0025.2010.01069.x
[11]
Benight CC (2004) Collective efficacy following a series of natural disasters. Anxiety Stress Coping 17: 401–420. doi: 10.1080/10615800512331328768
[12]
Norris FH, Stevens SP, Pfefferbaum B, Wyche KF, Pfefferbaum RL (2008) Community resilience as a metaphor, theory, set of capacities, and strategy for disaster readiness. Am J Community Psychol 41: 127–150. doi: 10.1007/s10464-007-9156-6
[13]
Coleman J (1990) Foundations of social theory. Cambridge, MA: Harvard University Press.
[14]
Cohen DA, Farley TA, Mason K (2003) Why is poverty unhealthy? Social and physical mediators. Soc Sci Med 57: 1631–1641. doi: 10.1016/s0277-9536(03)00015-7
[15]
Cohen DA, Finch BK, Bower A, Sastry N (2006) Collective efficacy and obesity: the potential influence of social factors on health. Soc Sci Med 62: 769–778. doi: 10.1016/j.socscimed.2005.06.033
[16]
Odgers CL, Moffitt TE, Tach LM, Sampson A, Taylor RJ, et al. (2009) The protective effects of neighborhood collective efficacy on British children growing up in deprivation: a developmental analysis. Dev Psychol 45: 942–957. doi: 10.1037/a0016162
[17]
Sapouna M (2010) Collective efficacy in the school context: does it help explain victimization and bullying among Greek primary and secondary school students? J Interpers Violence 25: 1912–1927. doi: 10.1177/0886260509354509
[18]
Xue Y, Leventhal T, Brooks-Gunn J, Earls FJ (2005) Neighborhood residence and mental health problems of 5- to 11-year-olds. Arch Gen Psychiatry 62: 554–563. doi: 10.1001/archpsyc.62.5.554
[19]
Vaeth PA, Ramisetty-Mikler S, Caetano R (2010) Depression among couples in the United States in the context of intimate partner violence. J Interpers Violence 25: 771–790. doi: 10.1177/0886260509336957
[20]
Hembree C, Galea S, Ahern J, Tracy M, Markham Piper T, et al. (2005) The urban built environment and overdose mortality in New York City neighborhoods. Health Place 11: 147–156. doi: 10.1016/j.healthplace.2004.02.005
[21]
Acierno R, Ruggiero KJ, Galea S, Resnick HS, Koenen K, et al. (2007) Psychological sequelae resulting from the 2004 Florida hurricanes: implications for postdisaster intervention. Am J Public Health 97 Suppl 1: S103–108. doi: 10.2105/ajph.2006.087007
[22]
National Oceanic and Atmospheric Administration NWS, National Hurricane Center (2005) Atlantic Hurricane Season. Available: http://www.nhc.noaa.gov/2004atlan.shtml. Accessed 2009 February 16.
[23]
FEMA (2010) FEMA's Public Assistance Program - Building The Road To Recovery. Available: http://www.fema.gov/news/newsrelease.fem？a?id=24863. Accessed 2010 October 5.
[24]
Weathers FW, Ford J (1996) Psychometric review of PTSD Checklist (PCL-C, PCL-S, PCL-M, PCL- PR). In: Stamm BH, editor. Measurement of stress, trauma, and adaptation. Lutherville, MD: Sidran Press. pp.250–251.
[25]
Lang AJ, Laffaye C, Satz LE, Dresselhaus TR, Stein MB (2003) Sensitivity and specificity of the PTSD checklist in detecting PTSD in female veterans in primary care. J Trauma Stress 16: 257–264. doi: 10.1023/a:1023796007788
[26]
Walker EA, Newman E, Dobie DJ, Ciechanowski P, Katon W (2002) Validation of the PTSD checklist in an HMO sample of women. Gen Hosp Psychiatry 24: 375–380. doi: 10.1016/s0163-8343(02)00203-7
[27]
SAS Institute Inc. (2006) SAS/STAT Software, Version 9.2 for Windows. Cary, NC: SAS Inst. Inc.
[28]
Littell RC (2006) SAS for mixed models. Cary, NC: SAS Institute Inc.
[29]
Wang J, Xie H, Fisher JH (2009) Multilevel models: applications using SAS. Beijing China: Higher Education Press.
[30]
Raudenbush SW, Bryk AS (2002) Hierarchial linear models: applications and data analysis methods (2nd edition). Newbury ParkCA: Sage Publications, Inc. 485 p.
[31]
Larsen K, Petersen JH, Budtz-Jorgensen E, Endahl L (2000) Interpreting parameters in the logistic regression model with random effects. Biometrics 56: 909–914. doi: 10.1111/j.0006-341x.2000.00909.x
[32]
Aiken LS, West SG (1991) Multiple regression: Testing and interpreting interactions. Newbury Park, London: Sage Publications, Inc. 224 p.
[33]
Cieslak R, Anderson V, Bock J, Moore BA, Peterson AL, et al. (2013) Secondary traumatic stress among mental health providers working with the military: prevalence and its work- and exposure-related correlates. J Nerv Ment Dis 201: 917–925. doi: 10.1097/nmd.0000000000000034
[34]
Shah SA (2010) Mental health emergencies and Post-Traumatic Stress Disorder. In: Kapur GB, Smith JP, editors. Emergency public health: preparedness and response. Boston, MA: Jones and Bartlett Publishers, pp.493–516.
[35]
Bills CB, Levy NA, Sharma V, Charney DS, Herbert R, et al. (2008) Mental health of workers and volunteers responding to events of 9/11: review of the literature. Mt Sinai J Med 75: 115–127. doi: 10.1002/msj.20026
[36]
Bryant RA, Harvey AG (1996) Posttraumatic stress reactions in volunteer firefighters. J Trauma Stress 9: 51–62. doi: 10.1007/bf02116833
[37]
Fullerton CS, Ursano RJ, Wang L (2004) Acute stress disorder, posttraumatic stress disorder, and depression in disaster or rescue workers. Am J Psychiatry 161: 1370–1376. doi: 10.1176/appi.ajp.161.8.1370
[38]
Hobfoll SE, Tracy M, Galea S (2006) The impact of resource loss and traumatic growth on probable PTSD and depression following terrorist attacks. J Trauma Stress 19: 867–878. doi: 10.1002/jts.20166
[39]
Breslau N, Kessler RC, Chilcoat HD, Schultz LR, Davis GC, et al. (1998) Trauma and posttraumatic stress disorder in the community: the 1996 Detroit Area Survey of Trauma. Arch Gen Psychiatry 55: 626–632. doi: 10.1001/archpsyc.55.7.626
[40]
Hobfoll SE, Watson P, Bell CC, Bryant RA, Brymer MJ, et al. (2007) Five elements of immediate and mid-term mass trauma intervention: empirical evidence. Psychiatry 70: 283–315. doi: 10.1521/psyc.2007.70.4.283
[41]
Fontana A (1997) Rosenheck (1997) Effectiveness and cost of the inpatient treatment of posttraumatic stress disorder: comparison of three models of treatment. Am J Psychiatry 154: 758–765.
[42]
Jack K, Glied S (2002) The public costs of mental health response: lessons from the New York City post-9/11 needs assessment. J Urban Health 79: 332–339. doi: 10.1093/jurban/79.3.332
[43]
Siegel CE, Laska E, Meisner M (2004) Estimating capacity requirements for mental health services after a disaster has occurred: a call for new data. Am J Public Health 94: 582–585. doi: 10.2105/ajph.94.4.582
[44]
Tanieliean TL, Jaycox LHeditors (2008) Invisible wounds of war: Psychological and cognitive injuries, their consequences, and services to assist recovery. Santa MonicaCA: RAND Corporation. 64 p.
[45]
Schoenbaum M, Butler B, Kataoka S, Norquist G, Springgate B, et al. (2009) Promoting mental health recovery after hurricanes Katrina and Rita: what can be done at what cost. Arch Gen Psychiatry 66: 906–914. doi: 10.1001/archgenpsychiatry.2009.77
