Attitudes and perceptions towards public health safety measures during a global health crisis: Social and personal consequences.

The COVID-19 pandemic that spread throughout the globe has significantly altered our social and personal relationships. During the early phase of the pandemic, pharmaceutical interventions such as vaccine research and production were still in development, with international health agencies and governments promoting public health safety measures such as limiting mobility, school and work closures, lockdowns, economic incentives, mask-wearing, social distancing, quarantine, and hygiene to reduce the spread and flatten the curve regarding transmission and hospitalization. During the early wave (May 2020 through July 2020), we utilized a qualitative longitudinal research design coupled with weekly Zoom diary entries to investigate participant (n = 14) experiences. In doing so, we captured participant attitudes towards public health safety measures, as well as perceptions of social and interpersonal relationships during the pandemic. The main themes that emerged in our findings include feelings of safety and preparedness, personal accountability and collective responsibility, and changes to social life and relationships. While individuals have learned how to live with the pandemic, and have a new sense of normalcy, lessons learned from the impact of public health measures and social relationships have applicability moving forward post-pandemic. In particular, how to best protect against the deleterious effects of isolation during a future public health crisis.

Long-COVID stress symptoms: Mental health, anxiety, depression, or posttraumatic stress.

OBJECTIVE: Currently, there is no single profile of mental health sequela in long-coronavirus disease (COVID) patients, impacting identification, treatment, and exacerbating stigma among this population. This article highlights the rationale for mental health professionals to consider a summary of mental health symptoms in long-COVID patients. METHOD: This article provides an overview of the existing literature regarding the health and mental health impact of long COVID on patients and proposes an approach to conceptualizing mental health symptoms in individuals living with long COVID. This article summarizes the health and mental health impacts of long COVID and underscores the limitations of the current approach to measuring and screening mental health symptoms in long-COVID patients. RESULTS: Long-COVID patients have reported new and worsening mental health symptoms; most frequently reported are depression, anxiety, posttraumatic stress disorder (PTSD), and insomnia. The article concludes by proposing the notion of long-COVID stress symptoms and calls for mental health researchers to identify the unique and complex mental health profiles emerging among this patient population. CONCLUSIONS: Though some long-COVID patients survived life-threatening illnesses and may, therefore, meet the formal criteria for PTSD, many will present with posttraumatic symptomology that mimics PTSD but may not arise from life-threatening medical trauma. A better understanding of the mental health burden of long-COVID stress symptoms is essential to providing efficient and effective mental health treatment, supporting physicians treating long-COVID patients, and enhancing access to and utilization of medical services. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Mechanisms of recovery: Community perceptions of change and growth following multiple disasters.

Introduction and purpose: The geographic location of the Gulf South leaves communities in continuous threat, response, and recovery disaster cycles. Hurricane Katrina in 2005 provided an opportunity to study disaster mental health. Less than 5 years after the storm, many Hurricane Katrina survivors were impacted again by the Deepwater Horizon Gulf oil spill. Despite adversities impacting Gulf communities, over 90% of participants reported they were resilient. The purpose of this study was to improve the understanding of the mechanisms that contribute to strengths following adversity in communities affected by repeated disasters. Specifically, we focused on survivor perceptions of personal, spiritual, or community changes in efforts to describe community resilience and posttraumatic growth (PTG). Methods: Participants were recruited through a quantitative survey and community flyers. Participants represented southeastern Louisiana, in areas impacted by hurricanes and the oil spill-for a total of five focus groups and 41 participants. Focus groups began by asking each participant to provide a brief overview of their disaster survival story and three additional guiding strengths-based questions. Data were transcribed using Dragon Speech Recognition software. A total of 963 unique responses were analyzed and coded. Results: The following themes were identified: connectedness (n = 259), coping (n = 94), spirituality (n = 60), adaptability (n = 47), and self-reliance (n = 23). Participants noted a growth mindset from the disasters and also acknowledged coinciding negative experiences (n = 154) associated with community change and loss, where subthemes included change in connectedness (n = 97), crime (n = 26), and feeling like an outsider (n = 31). Discussion and implications: These findings help scholars and mental health practitioners better understand the lived experiences of PTG in a community of survivors impacted by recurring traumatic experiences. In keeping with previous literature, PTG and negative experiences associated with trauma are not mutually exclusive, but occur simultaneously. Our results offer a holistic picture of coping with cumulative or repeated traumas and suggest that connectedness, coping, and spirituality provide important buffers to negative psychosocial outcomes.

Utilizing a Matrix Approach to Analyze Qualitative Longitudinal Research: A Case Example During the COVID-19 Pandemic.

Qualitative Longitudinal Research (QLR) is an evolving methodology used in understanding the rich and in-depth experiences of individuals over time. QLR is particularly conducive to pandemic or disaster-related studies, where unique and rapidly changing environments warrant fuller descriptions of the human condition. Despite QLR's usefulness, there are a limited number of articles that detail the methodology and analysis, especially in the social sciences, and specifically social work literature. As researchers adjust their focus to incorporate the impact of the COVID-19 global pandemic, there is a growing need in understanding the progression and adaptation of the pandemic on individuals' lives. This article provides a process and strategy for implementing QLR and analyzing data in online diary entries. In the provided case example, we explore a phenomenological QLR conducted with graduate level students during the COVID-19 pandemic (Saltzman et al., 2021), and outline a matrix framework for QLR analysis. This paper provides an innovative way in which to engage in qualitative data collection and analysis for social science research.

COVID-19 Mental Health Disparities.

Communities of color in the United States have been disproportionately impacted by the COVID-19 pandemic. Studies exploring the mental health implications of these disparities have only just begun to emerge. The purpose of this study is to better understand mental health concerns and test whether social determinants of health and COVID-19-related experiences influence these concerns. In April 2020, we launched a community-based survey for adults across the United States. A total of 341 respondents completed the survey, which included questions about demographics, depression, social isolation, work environment, and preexisting mental health conditions. We generated matched controls by adding county data from the Robert Wood Johnson Foundation to our survey. Chi square, Pearson product-moment correlation, point biserial correlation, and logistic regression were estimated. Our analysis revealed that respondents who identified as Latinx, Latin@, or Hispanic were 10 times more likely to meet the threshold score for depression. Similarly, individuals with prior mental health conditions and those who expressed feelings of social isolation due to COVID-19 were 3 times more likely to meet the threshold score for depression. These results confirm our hypothesis that communities of color will likely experience disproportionate mental health impacts of COVID-19-specifically, the mental health sequela that emerge from exposure, cumulative burden, and social isolation. We discuss the implications for expanding access and quality of health and mental health services to address current inequities.

Perceptions of Resilience and Physical Health Symptom Improvement Following Post Disaster Integrated Health Services.

OBJECTIVE: Theorists and researchers have linked resilience with a host of positive psychological and physical health outcomes. This paper examines perceptions of resilience and physical health symptoms in a sample of individuals exposed to multiple community disasters following involvement in integrated mental health services. METHODS: A multiwave naturalistic design was used to follow 762 adult clinic patients (72% female; 28% minority status), ages 18-92 years (mean age=40 years), who were evaluated for resilience and physical health symptoms prior to receiving services and at 1, 3, and 6 months' follow-up. RESULTS: Data indicated increases in perceptions of resilience and decreased physical health symptoms reported over time. Results also indicated that resilience predicted physical health symptoms, such that resilience and physical health symptoms were negatively associated (ie, improved resilience was associated with decreases in physical health symptoms). These effects were primarily observed for those individuals with previous exposure to natural disasters. CONCLUSIONS: Findings provide correlational evidence for behavioral health treatment provided as part of a stepped-care, collaborative model in reducing physical health symptoms and increasing resilience post-disaster. Controlled trials are warranted. (Disaster Med Public Health Preparedness. 2019;13:223-229).

Effects of Stress Related to the Gulf Oil Spill on Child and Adolescent Mental Health.

OBJECTIVE: To examine the interactive effects of stress related to the Gulf oil spill on mental health of children and adolescents on the Gulf Coast who were also affected by previous hurricanes. METHODS: A prospective design, with n = 1,577 youth (aged 3-18 years), evaluated pre-oil spill and again post-oil spill for posttraumatic stress disorder (PTSD) symptoms, previous hurricane exposure, and amount of oil spill stress. RESULTS: Stressors related to the spill were common and were associated with PTSD symptoms. Moreover, there was an interactive effect such that those with high preexisting PTSD symptoms, high previous hurricane exposure, and high oil spill stress had the most elevated post-oil spill PTSD symptoms. CONCLUSIONS: This study provides initial evidence linking stress related to the Gulf oil spill to youth mental health symptoms. The effects of the oil spill on youth mental health were most evident among those with cumulative risk.

Trajectories of post-traumatic stress disorder symptoms among youth exposed to both natural and technological disasters.

BACKGROUND: Theorists and researchers have demonstrated multiple trajectories of symptoms following disasters (Ecology and Society, 13, 2008, 9), highlighting the importance of obtaining more knowledge about exposed youth who demonstrate resilience as well as those who suffer chronic difficulties. This paper examines trajectories of post-traumatic stress disorder (PTSD) symptoms following exposure to hurricanes and the Deepwater Horizon Oil Spill to increase understanding of resilience and chronic reactions to both natural and technological disasters. METHODS: A multiwave longitudinal design was used to follow N = 4,619 youth who were evaluated for PTSD symptoms, hurricane exposure, and oil spill exposure/stress at four time points over a period of 4 years. Trajectories were identified with cluster analyses and multilevel modeling. RESULTS: Individual trajectories were statistically identified consistent with theory. The largest group exhibited stable-low symptoms (52%), a second group showed steep declines following initial symptoms (21%), a third group exhibited increasing symptoms (18%), and a fourth group showed stable-high symptoms (9%). Both hurricane exposure and oil spill stress predicted trajectories and overall levels of PTSD symptoms. CONCLUSIONS: Results identified an effect of oil spill stress and hurricane exposure on symptom levels and trajectories of exposed youth. Results provide prospective data to support theories of multiple symptom trajectories following disasters and reinforce the importance of research that utilizes a developmental perspective to consider the long-term effects of disasters in youth. Findings highlight the importance of identifying symptoms and predictors of resilience as well as factors that contribute to resilience.

The effect of long-term relocation on child and adolescent survivors of Hurricane Katrina.

The current study is designed to increase knowledge of the effects of relocation and its association with longer-term psychological symptoms following disaster. Following clinical observations and in discussions held with school officials expressing concerns about relocated students, it was hypothesized that students who relocated to a different city following Hurricane Katrina in 2005 would have more symptoms of posttraumatic stress compared to students who returned to New Orleans. The effect of Hurricane Katrina relocation was assessed on a sample of child and adolescent survivors in 5th through 12th grades (N = 795). Students with Orleans Parish zip codes prior to Hurricane Katrina were categorized into relocation groupings: (a) relocated to Baton Rouge, (b) returned to prior zip code, and (c) moved to a different zip code within Orleans Parish. Overall results revealed more trauma symptoms for relocated students. Results also revealed that younger relocated students had fewer symptoms compared to older students. The opposite was found for students who returned to their same zip code, with older students having fewer symptoms. This study supports the need for school-based services not only in disaster areas, but also in schools where survivors tend to migrate.

Assessment of psychiatric symptoms at a level I trauma center surgery follow-up clinic: a preliminary report.

At Level I trauma centers, psychiatric consultation is readily available to inpatient surgical services. This study sought to characterize the psychiatric symptoms present in the surgical follow-up clinic. Patients aged 18 years and older were assessed over one month for symptoms of posttraumatic stress disorder (PTSD) with the Short PTSD Rating Interview (SPRINT), depression with the Patient Health Questionnaire (PHQ-9), alcohol abuse with the Alcohol Use Disorder Identification Test (AUDIT), and the presence of violence using the MacArthur Community Violence Instrument (MCVIa [victimization] MCVIb [perpetration]). Twenty-five individuals participated. Using the SPRINT, 13 (52.0%) met the cutoff for PTSD. For PHQ-9 depression, 11 (44%) were in the moderate to severe range. For AUDIT, five (20.0%) likely had an alcohol problem. Using the MCVI, 15 (60.0%) reported victimization and 12 (48.0%) reported perpetration. Elevated levels of psychiatric symptoms were found in the trauma surgery follow-up clinic. Psychiatric care embedded in this setting may be warranted.

Deepwater horizon oil spill: mental health effects on residents in heavily affected areas.

BACKGROUND: Mental health issues are a significant concern after disasters such as the Deepwater Horizon oil spill in the Gulf of Mexico in 2010. This study was designed to assess the mental health effects on residents of areas of southeastern Louisiana affected by the oil spill. METHODS: Telephone and face-to-face interviews were conducted with residents (N = 452) assessing concerns and direct impact. RESULTS: The results show that the greatest effect on mental health related to the extent of disruption to participants' lives, work, family, and social engagement, with increased symptoms of anxiety, depression, and posttraumatic stress. Given the location of the oil spill affecting communities that had been devastated by Hurricane Katrina, results also revealed that losses from Hurricane Katrina were highly associated with negative mental health outcomes. Conversely, the ability to rebound after adversity and place satisfaction were highly associated with better mental health outcomes. CONCLUSIONS: Enhanced understanding of mental health effects after the Deepwater Horizon oil spill will help in determining directions for much-needed mental health services after the disaster and in contributing to the knowledge of complex traumatization and the ability to rebound after adversity.