International Society for Traumatic Stress Studies

Methodological Advances in Studying Traumatic Responses Following Hurricanes

09/11/2019
by Rebecca R Thompson, PhD, and Dana Rose Gafin, PhD
Natural hazards share many defining characteristics that make the study of psychological responses to them exceedingly difficult. The specific site and timing of these events are often unpredictable and seemingly random. As a result, there are several notable gaps in the research on individuals’ psychological and behavioral responses to disasters (Garfin & Silver, 2016). In order to assess the extent of key gaps in the literature, our research team conducted a systematic review of the literature on evacuation from natural disasters (Thompson, Garfin, & Silver, 2017). This review covered 83 peer-reviewed articles published before March 2016 that examined evacuation surrounding a variety of natural hazards, including hurricanes/cyclones, floods/mudslides, firestorms, volcano eruptions and tsunamis in both U.S. and international samples. This review identified only two studies that included longitudinal, prospective assessments of evacuation behavior; all other studies were cross-sectional. Additionally, reports of the amount of time between the target disaster event and the data collection period varied widely: between four-to-eight days and seven years post-disaster. Often this information was not reported. Our review highlighted a dearth of methodologically rigorous, longitudinal studies of evacuation behavior. We concluded that the extant knowledge is exceedingly limited with respect to how pre-storm thoughts, feelings and behaviors are associated with post-storm behavioral and psychological outcomes.
 
In order to assess some of these research gaps, since the 2017 Atlantic hurricane season, our interdisciplinary research team has followed a panel of individuals in Texas and Florida who are at repeated risk of exposure to hurricanes. Our team consists of social psychologists (Drs. Roxane Cohen Silver & Rebecca R. Thompson), health psychologists (Drs. E. Alison Holman & Dana Rose Garfin) and decision scientists (Drs. Gabrielle Wong-Parodi & Dr. Baruch Fischhoff). Thus far, we have completed three waves of data collection. Our first wave was fielded over the 60 hours leading up to Hurricane Irma’s landfall on the southern coast of Florida, between 6 p.m. EST, September 8, 2017, and 3 p.m. EST on September 11, 2017 (N=2,774 in Texas & Florida). Participants from the GfK (now Ipsos) KnowledgePanel were recruited to complete online surveys relating to their experiences with Hurricanes Irma and Harvey (which made landfall in Texas approximately two weeks prior as a Category 4 hurricane) on their computer or smartphone. Approximately one month later our panel completed a second wave of data collection that assessed their psychological responses to these storms (N=2564 in Texas and Florida). One year later, this panel completed a third follow-up survey with questions regarding their adjustment following the recent Hurricane Michael, which made landfall on the northern coast of Florida on October 10 as a Category 5 hurricane (N=1879 in Texas & Florida). Each of the three surveys attained a participation rate of 70% or higher, despite the compressed timeline and approaching hurricane in the first survey. Importantly, these samples were representative of the demographics of their respective states.
 
By leveraging a pre-existing panel, we were able to evade many of the methodological challenges that often plague post-disaster research—data may be collected quickly, with little disruption to the lives of participants and with the ability to make population-based inferences. By designing a survey that was adaptable to both computer and mobile devices, participants could complete the survey as they were preparing for the hurricane and, in some cases, while evacuating. Having an interdisciplinary team in place with draft questions and an IRB protocol allowed us to mobilize quickly in response to Hurricane Irma’s increasing threat. Our study demonstrated that it is feasible to assess individuals in the hours and days immediately prior to a hurricane, while they are making critical decisions such as whether to evacuate or not. Thus, the design of this study uniquely positions us to examine how pre-storm psychological and cognitive factors are associated with behavior that occurs before, during and after a disaster.
 
The first paper to be published from this study (Thompson, Holman, & Silver, 2019) assessed the impact of pre-Hurricane Irma forecasted posttraumatic stress responses (PTS) and hurricane-related media exposure on post-storm psychological adjustment (i.e., PTS, general distress, functional impairment and worry about future events). Structural equation modeling analyses revealed that both forecasted PTS and media exposure directly predicted post-storm adjustment, controlling for demographics, prior mental health status, perceived evacuation zone status and direct hurricane exposure. Additionally, media exposure to the hurricane partially mediated the relationship between forecasted PTS responses and psychological adjustment one month after landfall. These findings demonstrate the importance of considering individuals’ pre-event psychological functioning when studying their responses to collective traumas. Our forthcoming manuscripts (currently in preparation) will continue to explore predictors of evacuation behavior, disaster-related decision processes, post-disaster distress and the trajectory of resilience over time.
 
Funding for the referenced research was provided by National Science Foundation grants BCS-1760764 and BCS-1902925 to Drs. Roxane Cohen Silver & E. Alison Holman.
 

About the Authors:

 
Rebecca R Thompson, PhD, is a postdoctoral scholar in the Department of Psychological Science at the University of California, Irvine. Her research focuses on the psychosocial predictors of risk and resilience following exposure to negative life events, especially indirect media exposure to collective traumas.
 
Dana Rose Gafin, PhD, is an assistant professor in the Sue & Bill Gross School of Nursing at the University of California, Irvine. Her program of research investigates how traumatic and stressful events, broadly defined, influence health across the lifespan. She has examined the epidemiology of trauma through a series of studies that examined how individuals respond to large-scale negative events including terrorist attacks and natural disasters. She is currently principal investigator of an NIH-funded award examining the efficacy of a mindfulness-based intervention to address PTSD in trauma-exposed women.
 

References

 
Garfin, D. R., & Silver, R. C. (2016). Responses to natural disasters. In H. S. Friedman (Ed.), Encyclopedia of mental health (2nd ed., Vol. 4, pp. 35–46). Waltham, MA: Academic Press.
 
Thompson, R. R., Garfin, D. R., & Silver, R. C. (2017). Evacuation from natural disasters: A systematic review of the literature. Risk Analysis37, 812–839. https://doi.org/10.1111/risa.12654
 
Thompson, R. R., Holman, E. A., & Silver, R. C. (2019). Media coverage, forecasted posttraumatic stress symptoms, and psychological responses before and after an approaching hurricane. JAMA Network Open2(1), e186228. https://doi.org/10.1001/jamanetworkopen.2018.6228
 

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