Risk Factors for Posttraumatic Stress Disorder in Haitian Students

Gretel Silvestre, Pascale Anacréon, Michèle Théodore, Emmanuel Silvestre, Eugenia Garcia-Dubus

John Jay College of Criminal Justice, New York, USA.
Pontificia Universidad Católica Madre y Maestra, Santiago, Dominican Republic.

DOI: 10.4236/psych.2014.58096                

Abstract

The aim of this study was to assess the prevalence of posttraumatic stress disorder (PTSD) in undergraduate students after the Haiti earthquake on January 12, 2010, as well as to identify the risk factors involved in the development of PTSD symptoms in this sample. Evaluations concerning depression, anxiety, risk and protective factors, and PTSD symptoms were conducted in 246 Haitian undergraduate students enrolled in a Dominican private university. Results indicate a prevalence of 36% for PTSD 2 years after the earthquake, with a high prevalence also of depression (31.7%) and anxiety (21.1%). Some of the risk factors identified are being female, a history of psychiatric treatment, and the amount of personal and material losses. The instauration of crisis management and follow-up protocols after traumatic events was deemed to be needed. Further research is necessary to study the long-term effects of this tragedy, not only in undergraduate students, but also in the working class Haitian immigrants living in the Dominican Republic.

Keywords

Epidemiology, Ethiology-Risk and Protective Factors, Earthquake, PTSD, Haiti

Conflicts of Interest

The authors declare no conflicts of interest.

References

[1]	American Psychiatric Association (2000). Diagnostic and Statistical Manual of Mental Disorders (4th ed.). Washington DC: American Psychiatric Association. http://dx.doi.org/10.1176/appi.books.9780890423349
[2]	American Psychological Association (2006). APA’s Response to International and National Disasters and Crises: Addressing Diverse Needs. American Psychologist, 61, 513-521. http://dx.doi.org/10.1037/0003-066X.61.5.513
[3]	Armenian, H. K., Morikawa, M., Melkonian, A. K., Hovanesian, A. P., Haroutunian, N., Saigh, P. A. et al. (2000). Loss as a Determinant of PTSD in a Cohort of Adult Survivors of the 1988 Earthquake in Armenia: Implications for Policy. Acta Psychiatrica Scandinavica, 102, 58-64. http://dx.doi.org/10.1034/j.1600-0447.2000.102001058.x
[4]	Ballenger, J. C., Davidson, J. R. T., Lecrubier, Y., Nutt, D. J., Marshall, R. D., Nemeroff, C. B. et al. (2004). Consensus Statement Update on Posttraumatic Stress Disorder from the International Consensus Group on Depressions and Anxiety. The Journal of Clinical Psychiatry, 65, 55-62.
[5]	Beck, A. T. (2006). Depression: Causes and treatment. Philadelphia: University of Pennsylvania Press.
[6]	Beck, A. T., & Steer, R. A. (1993). Beck Anxiety Inventory Manual. San Antonio, TX: The Psychological Corporation Harcourt Brace & Company.
[7]	Beck, A. T., Epstein, N., Brown, G., & Steer, R. A. (1988). An Inventory for Measuring Clinical Anxiety: Psychometric Properties. Journal of Consulting and Clinical Psychology, 56, 893-897. http://dx.doi.org/10.1037/0022-006X.56.6.893
[8]	Beck, A. T., Ward, C. H., Mendelson, M., Mock, J., & Erbaugh, J. (1961). An Inventory for Measuring Depression. Archives of General Psychiatry, 4, 561-571. http://dx.doi.org/10.1001/archpsyc.1961.01710120031004
[9]	Brewin, C. R., Andrews, B., & Valentine, J. D. (2000). Meta-Analysis of Risk Factors for Posttraumatic Stress Disorder in Trauma-Exposed Adults. Journal of Consulting and Clinical Psychology, 68, 748-766. http://dx.doi.org/10.1037/0022-006X.68.5.748
[10]	Brown, C., Ripp, J., & Kazura, J. (2012). Perspectives on Haiti Two Years after the Earthquake. The American Journal of Tropical Medicine and Hygiene, 86, 5-6. http://dx.doi.org/10.4269/ajtmh.2012.11-0684a
[11]	Campbell, D. G., Felker, B. L., Liu, C. F., Yano, E. M., Kirchner, J. E., Chan, D. et al. (2007). Prevalence of Depression-PTSD Comorbidity: Implications for Clinical Practice Guidelines and Primary Care-Based Interventions. Journal of General Internal Medicine, 22, 711-718. http://dx.doi.org/10.1007/s11606-006-0101-4
[12]	Chen, C. C., Yeh, T. L., Yang, Y. K., Chen, S. J., Lee, I. H., Fu, L. S. et al. (2001). Psychiatric Morbidity and Post-Traumatic Symptoms among Survivors in the Early Stage Following the 1999 Earthquake in Taiwan. Psychiatry Research, 105, 13-22. http://dx.doi.org/10.1016/S0165-1781(01)00334-1
[13]	Chou, F. H., Wu, H. C., Chou, P., Su, C. Y., Tsai, K. Y., Chao, S. S. et al. (2007). Epidemiologic Psychiatric Studies on Post-Disaster Impact among Chi-Chi Earthquake Survivors in Yu-Chi, Taiwan. Psychiatry and Clinical Neurosciences, 61, 370-378. http://dx.doi.org/10.1111/j.1440-1819.2007.01688.x
[14]	Choul, F. H., Chou, P., Lin, C., Su, T. T., Ou-Yang, W. C., Chien, I. C. et al. (2004). The Relationship between Quality of Life and Psychiatric Impairment for a Taiwanese Community Post-Earthquake. Quality of Life Research: An International Journal of Quality of Life Aspects of Treatment, Care and Rehabilitation, 13, 1089-1097. http://dx.doi.org/10.1023/B:QURE.0000031337.73269.64
[15]	Cohen, J. (1992). A Power Primer. Psychological Bulletin, 112, 155-159. http://dx.doi.org/10.1037/0033-2909.112.1.155
[16]	Cohen, S., Kamarck, T., & Mermelstein, R. (1983). A Global Measure of Perceived Stress. Journal of Health and Social Behavior, 24, 385-396. http://dx.doi.org/10.2307/2136404
[17]	Eren-KoCak, E., KiliC, C., Aydin, I., & Hizli, F. G. (2009). Memory and Prefrontal Functions in Earthquake Survivors: Differences between Current and Past Post-Traumatic Stress Disorder Patients. Acta Psychiatrica Scandinavica, 119, 35-44. http://dx.doi.org/10.1111/j.1600-0447.2008.01281.x
[18]	Farhood, L. F., & Noureddine, S. N. (2003). PTSD, Depression, and Health Status in Lebanese Civilians Exposed to a Church Explosion. International Journal of Psychiatry in Medicine, 33, 39-53. http://dx.doi.org/10.2190/309D-7HQX-D4J4-T6TR
[19]	Fawzi, M. C., Betancourt, T. S., Marcelin, L., Klopner, M., Munir, K., Muriel, A. C. et al. (2009). Depression and Post-Traumatic Stress Disorder among Haitian Immigrant Students: Implications for Access to Mental Health Services and Educational Programming. BMC Public Health, 22, 482-492. http://dx.doi.org/10.1186/1471-2458-9-482
[20]	Foa, E. B., & Tolin, D. F. (2000). Comparison of the PTSD Symptom Scale-Interview Version and the Clinician-Administered PTSD Scale. Journal of Traumatic Stress, 13, 181-191. http://dx.doi.org/10.1023/A:1007781909213
[21]	Galea, S., Tracy, M., Norris, F., & Coffey, S. F. (2008). Financial and Social Circumstances and the Incidence and Course of PTSD in Mississippi during the First Two Years after Hurricane Katrina. Journal of Traumatic Stress, 21, 357-368. http://dx.doi.org/10.1002/jts.20355
[22]	Lau, J. T., Yu, X., Zhang, J., Mak, W. W., Choi, K. C., Lui, W. W. et al. (2010). Psychological Distress among Adolescents in Chengdu, Sichuan at 1 Month after the 2008 Sichuan Earthquake. Journal of Urban Health, 87, 504-523. http://dx.doi.org/10.1007/s11524-010-9447-3
[23]	Liu, Z. Y., Yang, Y. F., Ye, Y. L., Zeng, Z. Q., Xiang, Y. J., & Yuan P. (2010). One-Year Follow-Up Study of Post-Traumatic Stress Disorder among Adolescents Following the Wenchuan Earthquake in China. BioScience Trends, 4, 96-102.
[24]	McMillen, C., North, C., Mosley, M., & Smith, E. (2002). Untangling the Psychiatric Comorbidity of Posttraumatic Stress Disorder in a Sample of Flood Survivors. Comprehensive Psychiatry, 43, 478-485.
[25]	McMillen, J. C., North, C. S., & Smith, E. M. (2000). What Parts of PTSD Are Normal: Intrusion, Avoidance, or Arousal? Data from the Northridge, California, Earthquake. Journal of Traumatic Stress, 13, 57-75. http://dx.doi.org/10.1023/A:1007768830246
[26]	McNally, R. J. (2008). Panic and Posttraumatic Stress Disorder: Implications for Culture, Risk, and Treatment. Cognitive Behaviour Therapy, 37, 131-134. http://dx.doi.org/10.1080/16506070801969120
[27]	Onder, E., Tural, U., Aker, T., KiliC, C., & Erdogan, S. (2006). Prevalence of Psychiatric Disorders Three Years after the 1999 Earthquake in Turkey: Marmara Earthquake Survey (MES). Social Psychiatry and Psychiatric Epidemiology, 41, 868-874. http://dx.doi.org/10.1007/s00127-006-0107-6
[28]	Pan American Health Organization (2009). Health Situation Analysis and Trends Summary. http://www.haitiresiliencesystem.org/node/105
[29]	Parvaresh, N., & Bahramnezhad, A. (2009). Post-Traumatic Stress Disorder in Bam-Survived Students Who Immigrated to Kerman, Four Months after the Earthquake. Archives of Iranian Medicine, 12, 244-249.
[30]	Perez Benitez, C. I., Vicente, B., Zlotnick, C., Kohn, R., Johnson, J., Valdivia, S. et al. (2009). Estudio Epidemiologico de Sucesos Traumaticos, Trastorno de Estres Post-traumatico y otros Trastornos Psiquiatricos en una Muestra Representativa de Chile. Salud Mental, 31, 145-153.
[31]	Salcioglu, E., Basoglu, M., & Livanou, M. (2007). Post-Traumatic Stress Disorder and Comorbid Depression among Survivors of the 1999 Earthquake in Turkey. Disasters, 31, 115-129. http://dx.doi.org/10.1111/j.1467-7717.2007.01000.x
[32]	Schnurr, P. P., Lunney, C. A., & Sengupta, A. (2004). Risk Factors for the Development Versus Maintenance of Posttraumatic Stress Disorder. Journal of Traumatic Stress, 17, 85-95. http://dx.doi.org/10.1023/B:JOTS.0000022614.21794.f4
[33]	Silvestre, G., Anacreon, P., Theodore M., & Silvestre, E. (2011). Prevalencia de trastorno de estres post traumatico en estudiantes haitianos un ano tras el terremoto de enero 12 del 2010. Unpublished.
[34]	Tural, U., Coskun, B., Onder, E., CorapCioglu, A., Yildiz, M., Kesepara, C. et al. (2004). Psychological Consequences of the 1999 Earthquake in Turkey. Journal of Traumatic Stress, 17, 451-459. http://dx.doi.org/10.1007/s10960-004-5793-9
[35]	Yehuda, R., McFarlane, A. C., & Shalev, A. Y. (1998). Predicting the Development of Posttraumatic Stress Disorder from the Acute Response to a Traumatic Event. Biological Psychiatry, 44, 1305-1313. http://dx.doi.org/10.1016/S0006-3223(98)00276-5
[36]	Yuste, M. (2010). Un fuerte terremoto reduce a escombros la capital de Haiti [A Strong Earthquake Reduces to Rubble Haiti’s Capital] El Pais. http://internacional.elpais.com/internacional/ 2010/01/12/actualidad/1263250811_850215.html
[37]	Zhang, Y., & Ho, S. M. (2011). Risk Factors of Posttraumatic Stress Disorder among Survivors after the 512 Wenchuan Earthquake in China. PLoS ONE, 6, Article ID: e22371. http://dx.doi.org/10.1371/journal.pone.0022371