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Risk Factors for Posttraumatic Stress Symptoms Among Avalanche Survivors: A 16-Year Follow-Up
Edda Bjork Thordardottir1, Ingunn Hansdottir, Jillian C Shipherd
1*Centre of Public Health Sciences, Faculty of Medicine, and †Faculty of Psychology, School of Health Sciences, University of Iceland, Reykjavik, Iceland; ‡National Center for PTSD, Women's Health Sciences Division (116B-3), VA Boston Healthcare System; §Department of Psychiatry, Boston University School of Medicine; ∥Department of Epidemiology, Harvard School of Public Health, Boston, MA; ¶Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC; #Department of Psychology, University of Southern Denmark, Odense, Denmark; **Department of Psychology, University of Ulster, Londonderry, Northern Ireland; ††Mental Health Services, Landspitali-The National University Hospital of Iceland; and ‡‡Faculty of Medicine, School of Health Sciences, University of Iceland, Reykjavik, Iceland.
Abstract:
Few natural disaster studies have assessed factors associated with posttraumatic stress disorder (PTSD) beyond a decade after trauma. Using North's disaster model as a framework, the aim of this study was to identify factors associated with clinically significant posttraumatic stress symptoms (CS-PTSDS) in avalanche survivors (n = 399) 16 years after the disaster. Completed self-report questionnaires were received from 286 (72%) survivors. CS-PTSDS were assessed with the Posttraumatic Diagnostic Scale. Predictors of CS-PTSDS in a multivariate analysis were secondary sequelae factors of lack of social support (adjusted relative risk [RR], 2.90; 95% confidence interval [CI], 1.37-6.13) and financial hardship in the aftermath of the trauma (adjusted RR, 2.47; 95% CI, 1.16-5.26). In addition, the community factor of providing assistance in the aftermath of the avalanche (adjusted RR, 1.95; 95% CI, 1.04-3.64) was inversely associated with CS-PTSDS. Screening for these factors may be useful in identifying those most vulnerable to developing chronic PTSD after this unique type of disaster.
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