Psychological Medicine
Volume 38, Issue 4, 2008, Pages 499-510

Risk factors for physical symptoms after a disaster: A longitudinal study (Article)

Van Den Berg B.* , Grievink L. , Van Der Velden P.G. , Yzermans C.J. , Stellato R.K. , Lebret E. , Brunekreef B.
  • a National Institute for Public Health and the Environment (RIVM), Bilthoven, Netherlands, Institute for Risk Assessment Sciences (IRAS), Utrecht University, Utrecht, Netherlands, National Institute for Public Health and the Environment (RIVM), PO Box 1 (postbox 10), 3720 BA Bilthoven, Netherlands
  • b National Institute for Public Health and the Environment (RIVM), Bilthoven, Netherlands
  • c Institute for Psychotrauma (IvP), Zaltbommel, Netherlands
  • d Netherlands Institute for Health Services Research (NIVEL), Utrecht, Netherlands
  • e Centre for Biostatistics, Utrecht University, Utrecht, Netherlands
  • f National Institute for Public Health and the Environment (RIVM), Bilthoven, Netherlands
  • g Institute for Risk Assessment Sciences (IRAS), Utrecht University, Utrecht, Netherlands, Julius Centre, Utrecht University, Utrecht, Netherlands

Abstract

Background. Although symptoms such as fatigue, headache and pain in bones and muscles are common after disasters, risk factors for these symptoms among disaster survivors have rarely been studied. We examined predisposing, precipitating and perpetuating factors for these physical symptoms among survivors of a man-made disaster. In addition, we examined whether risk factors for physical symptoms differ between survivors and controls. Method. Survivors completed a questionnaire 3 weeks (n=1567), 18 months and 4 years after the disaster. Symptoms and risk factors were measured using validated questionnaires. A comparison group was included at waves 2 and 3 (n=821). Random coefficient analysis (RCA) was used to study risk factors for symptoms. Results. Female gender [beta (β)=1.0, 95% confidence interval (CI) 0.6-1.4], immigrant status (β=1.0, 95% CI 0.6-1.4) and pre-disaster psychological problems (β=0.8, 95% CI 0.1-1.4) were predisposing factors for symptoms. Although disaster-related factors were predictors, the relationship between symptoms and disaster-related factors was not very strong and the magnitude of this association was reduced when perpetuating factors were added. Intrusions and avoidance, depression, anxiety and sleeping problems were important perpetuating factors for physical symptoms among survivors and mediated the association between traumatic stress and physical symptoms. Risk factors for symptoms were comparable between survivors and controls. Conclusions. The results indicate that health-care workers should be alert for physical symptoms among female survivors, immigrant survivors and individuals with a high level of psychological problems both before and after a disaster. © 2007 Cambridge University Press.

Author Keywords

Psychological problems Longitudinal studies physical symptoms risk factors Disaster

Index Keywords

Netherlands immigrant depression anxiety disorder regression analysis Follow-Up Studies human Longitudinal Studies survivor Survivors controlled study Adaptation, Psychological Depressive Disorder Anxiety Disorders disaster Explosions physical disease Cross-Sectional Studies Humans avoidance behavior sleep disorder male Emigrants and Immigrants female risk factor Risk Factors questionnaire Article health care Questionnaires major clinical study adult Sex Factors Stress Disorders, Post-Traumatic Sleep Disorders Somatoform Disorders
Link
https://www.scopus.com/inward/record.uri?eid=2-s2.0-40449119418&doi=10.1017%2fS003329170700133X&partnerID=40&md5=df85fde3d9377e22ecfa2dcf795f0e79
DOI: 10.1017/S003329170700133X
ISSN: 00332917
Cited by: 22
Original Language: English