Post-traumatic stress and depression following disaster: examining the mediating role of disaster resilience.

The current study used structural equation modeling to examine the role of disaster resilience as a mediator between disaster exposure and post-traumatic stress and depressive symptoms among a sample of 625 U.S. adults who experienced a disaster event. Results found that disaster resilience mediated the relationship between disaster exposure as a predictor and depression and post-traumatic stress as dependent variables. These findings have important implications for understanding the mechanisms by which disaster resilience supports post-disaster mental health and can inform future disaster mental health interventions and practice models.

Overnight heat in sleep spaces of housed and unhoused residents: results and recommendations from a Knoxville, Tennessee, case study.

Nighttime heat is an important factor in heat-health outcomes, though nighttime heat exposure and its impacts are poorly understood. We assessed overnight heat in indoor (n = 12) and outdoor (n = 3) living spaces in Knoxville, Tennessee, using iButton Hygrochrons in August 2021. Indoor sleep spaces, all of which were air conditioned, reported a variety of overnight conditions. Indoor sleep spaces were both warmer and cooler than outdoor temperatures overnight, and some participants noted having physical health effects of overnight heat in their homes. Downtown outdoor sleep spaces, including a park and encampment, exhibited an urban heat island signal, staying warmer than other outdoor areas. Future research should focus on the intensity and length of the overnight recovery period for individuals and how that affects heat-health outcomes, especially after being exposed to daytime heat. Specifically, do homes reach a cool enough temperature for recovery, and do outdoor sleeping spaces offer a long enough and cool enough period for recovery? We provide some recommendations for such future studies, including (1) focus on purposeful sampling, (2) use deliberate sensor placement for representative results, (3) prepare for participant drop-off due to non-compliance and technological problems, and (4) strategically gather demographic information.

Examining Factors Influencing Protective Actions Among Persons with Disabilities During the December 10-11, 2021, Tornado Outbreak in the United States.

OBJECTIVE: This study examined various factors influencing protective actions among persons with disabilities exposed to the December 10-11, 2021, tornado outbreak in the US Midwest and Southeastern regions. METHODS: Survey administration occurred 5 months following the tornado outbreak and included a total of 209 persons with disabilities who lived in one of the counties impacted by tornado warnings. Structural equation modeling was used to examine the direct and indirect effects of hypothesized predictors impacting protective behavioral actions. RESULTS: Results found that persons with disabilities who had access to more tornado warning sources increased their protective actions, and tornado risk perception further mediated the relationship between warning information sources and protective actions. In addition, results found that persons with disabilities who encountered more situational barriers in their physical and social environment were found to have a decrease in protective action, and having more situational resources was found to contribute to the ability to take protective action. CONCLUSIONS: The current study's results highlight the need for policies and practices that provide additional physical and social resources for persons with disabilities to seek protection during tornado threats.

Mental Health Impacts of Tornadoes: A Systematic Review.

Tornadoes are one of the most prevalent natural hazards in the United States, yet they have been underrepresented in the disaster mental health comprehensive literature. In the current study, we systematically reviewed available scientific evidence within published research journals on tornadoes and mental health from 1994 to 2021. The electronic search strategy identified 384 potentially relevant articles. Of the 384 articles, 29 articles met the inclusion criteria, representing 27,534 participants. Four broad areas were identified: (i) Mental health impacts of tornadoes; (ii) Risk factors; (iii) Protective factors; and (iv) Mental health interventions. Overall, results showed adverse mental health symptoms (e.g., post-traumatic stress disorder, depression, anxiety) in both adult and pediatric populations. A number of risk factors were found to contribute to negative mental health, including demographics, tornado exposure, post-tornado stressors, and prior exposure to trauma. Protective factors found to contribute to positive outcomes included having access to physical, social, and psychological resources. Together, these findings can serve as an important resource for future mental health services in communities experiencing tornadoes.

Policy stress and social support: Mental health impacts for Latinx Adults in the Southeast United States.

BACKGROUND: Latinx, and especially Mexican and Central American, adults in the United States (U.S.) have been detrimentally impacted by policies under the Trump administration that instilled continual stress associated with immigration enforcement. Both native- and foreign-born adults are affected when either they or loved ones are deported, resulting in family disruption. Though research has established a connection between Trump-era exclusionary immigration policies and mental health status of Latinx community members, data are notably lacking for Mexicans and Central Americans in the southeastern U.S., where enforcement activity is particularly high. METHODS: To inform service provision and policymaking, the current study was designed to investigate stress associated with policies under the Trump administration on two mental health outcomes (depression and anxiety) among Mexican and Central American adults in the southeastern U.S. Additionally, the mediating effect of social support on the relationship was examined. A sample of 264 Mexican and Central American adults in the southeast was surveyed via an online platform. Using structural equation modeling (SEM), we employed a two-step procedure to first test a measurement model to ensure that the latent variables were explained by the indicators. In the next step, we estimated a structural model for hypothesized direct and indirect relationships between Trump-era policy stress, social support, and two outcome variables: depression and anxiety. RESULTS: Findings suggest that Trump-era policy stress significantly and positively predicted depression and anxiety symptoms. In addition, policy stress predicted lower levels of social support, which in turn, predicted more symptoms of both depression and anxiety. CONCLUSION: Findings can inform service provision and policymaking for a vulnerable community that underutilizes mental health services.

Effects of COVID-19, Discrimination, and Social Support on Latinx Adult Mental Health.

We investigated the role of COVID-19 exposure and discrimination on depressive and posttraumatic stress symptoms among Latinx adults residing in the southeastern United States. Survey data were collected from 264 Latinx adults. Using structural equation modeling (SEM) procedures, we estimated a structural model for hypothesized direct and indirect relationships between the risk factors of COVID-19 exposure and discrimination, social support, and two mental health conditions: depression and posttraumatic stress. COVID-19 exposure and discrimination each had a significant and positive relationship with both depression and posttraumatic stress. Social support was found to have a significant and inverse relationship with depression and posttraumatic stress, as well as to mediate the relationship between discrimination and both mental health symptoms. Implications for service provision and program design are presented. Future studies should examine variation between southeastern states and consider the influence of documentation status among an immigrant-only sample.

The Mental Health Impacts of Successive Disasters: Examining the Roles of Individual and Community Resilience Following a Tornado and COVID-19.

Prior research has found that exposure to natural hazards and infectious disease are associated with adverse mental health outcomes. Less studied are the ways that individual-level and community-level resilience can protect against problematic mental health outcomes following exposure to successive disaster events. In the current study, we examine the role of individual and community resilience on mental health outcomes among 412 adults in Nashville, Tennessee exposed to an EF-3 tornado followed by the COVID-19 pandemic. Results found the cumulative impact of exposure to the tornado and COVID-19 was related to higher levels of PTS and depression symptoms. Individual resilience had a protective, inverse relationship with PTS and depression symptoms and mediated the relationship between community resilience and adverse mental health outcomes. Findings support the development of a multi-system disaster resilience framework that links individual resilience capacities to broader community resilience capacities to activate and sustain healthy adaptation following exposure to successive disasters.

Identifying Risk and Resilience Factors Impacting Mental Health among Black and Latinx Adults following Nocturnal Tornadoes in the U.S. Southeast.

Prior research has found that Black and Latinx communities in the U.S. face significant disparities that impact both preparedness for severe weather events and the support received after a disaster has occurred. In the current study, we examined key risk and protective factors that impacted mental health among 221 Black and Latinx adult respondents exposed to the 2-3 March 2020 nocturnal tornado outbreak in the U.S. state of Tennessee. Key factors that adversely affected mental health among participants were encountering barriers for receiving tornado warning alerts and tornado-related exposure. Key factors that served a protective mechanism against adverse mental health included having access to physical resources, supportive relationships, and adaptive coping skills. These findings may assist National Weather Service (NWS) personnel, emergency managers, and mental health providers with the development of policies and practices to address barriers and promote protective strategies for future nocturnal tornado events.

The Disaster Adaptation and Resilience Scale: development and validation of an individual-level protection measure.

Given the increasing threat of disasters in the United States and elsewhere around the world, well-tested assessment tools that operationalise specific protective factors associated with adaptation and resilience to such events are needed. Consequently, the authors proposed, developed, and validated the Disaster Adaptation and Resilience Scale (DARS) to measure five domains found to support adaptive responses in individuals exposed to disasters: physical resources; social resources; problem-solving; distress regulation; and optimism. The development and validation processes of DARS occurred across two studies: the first comprised construct development, item generation, and expert review, whereas the second involved a full validation evaluation of the psychometric properties of the scale in a sample of adults exposed to a disaster in the US (N=625). The results revealed that DARS had psychometric properties that support its use among adults experiencing a disaster. A discussion is presented on how the scale can be employed in both research and practice.