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Assessing the relationship between psychosocial stressors and psychiatric resilience among Chilean disaster survivors.
Fernandez, Cristina A; Choi, Karmel W; Marshall, Brandon D L; Vicente, Benjamin; Saldivia, Sandra; Kohn, Robert; Koenen, Karestan C; Arheart, Kristopher L; Buka, Stephen L.
Afiliação
  • Fernandez CA; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA; and Department of Epidemiology, Brown School of Public Health, Providence, RI, USA.
  • Choi KW; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA.
  • Marshall BDL; Department of Epidemiology, Brown School of Public Health, Providence, RI, USA.
  • Vicente B; Departamento de Psiquiatría y Salud Mental, Universidad de Concepción, Concepción, Chile.
  • Saldivia S; Departamento de Psiquiatría y Salud Mental, Universidad de Concepción, Concepción, Chile.
  • Kohn R; Department of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University, ProvidenceRI, USA.
  • Koenen KC; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA.
  • Arheart KL; Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, FL, USA.
  • Buka SL; Department of Epidemiology, Brown School of Public Health, Providence, RI, USA.
Br J Psychiatry ; 217(5): 630-637, 2020 11.
Article em En | MEDLINE | ID: mdl-32522300
BACKGROUND: According to the stress inoculation hypothesis, successfully navigating life stressors may improve one's ability to cope with subsequent stressors, thereby increasing psychiatric resilience. AIMS: Among individuals with no baseline history of post-traumatic stress disorder (PTSD) and/or major depressive disorder (MDD), to determine whether a history of a stressful life event protected participants against the development of PTSD and/or MDD after a natural disaster. METHOD: Analyses utilised data from a multiwave, prospective cohort study of adult Chilean primary care attendees (years 2003-2011; n = 1160). At baseline, participants completed the Composite International Diagnostic Interview (CIDI), a comprehensive psychiatric diagnostic instrument, and the List of Threatening Experiences, a 12-item questionnaire that measures major stressful life events. During the study (2010), the sixth most powerful earthquake on record struck Chile. One year later (2011), the CIDI was re-administered to assess post-disaster PTSD and/or MDD. RESULTS: Marginal structural logistic regressions indicated that for every one-unit increase in the number of pre-disaster stressors, the odds of developing post-disaster PTSD or MDD increased (OR = 1.21, 95% CI 1.08-1.37, and OR = 1.16, 95% CI 1.06-1.27 respectively). When categorising pre-disaster stressors, individuals with four or more stressors (compared with no stressors) had higher odds of developing post-disaster PTSD (OR = 2.77, 95% CI 1.52-5.04), and a dose-response relationship between pre-disaster stressors and post-disaster MDD was found. CONCLUSIONS: In contrast to the stress inoculation hypothesis, results indicated that experiencing multiple stressors increased the vulnerability to developing PTSD and/or MDD after a natural disaster. Increased knowledge regarding the individual variations of these disorders is essential to inform targeted mental health interventions after a natural disaster, especially in under-studied populations.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Transtornos de Estresse Pós-Traumáticos / Sobreviventes / Transtorno Depressivo Maior / Desastres / Resiliência Psicológica Tipo de estudo: Etiology_studies / Observational_studies / Qualitative_research / Risk_factors_studies Limite: Adult / Female / Humans / Male / Middle aged País/Região como assunto: America do sul / Chile Idioma: En Revista: Br J Psychiatry Ano de publicação: 2020 Tipo de documento: Article País de afiliação: Estados Unidos País de publicação: Reino Unido

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Transtornos de Estresse Pós-Traumáticos / Sobreviventes / Transtorno Depressivo Maior / Desastres / Resiliência Psicológica Tipo de estudo: Etiology_studies / Observational_studies / Qualitative_research / Risk_factors_studies Limite: Adult / Female / Humans / Male / Middle aged País/Região como assunto: America do sul / Chile Idioma: En Revista: Br J Psychiatry Ano de publicação: 2020 Tipo de documento: Article País de afiliação: Estados Unidos País de publicação: Reino Unido