Risk factors for physical symptoms after a disaster: a longitudinal study

B van der Berg, Linda Grievink, P.G. van der Velden, C.J. Yzermans, R Stellato, E. Lebret, B. Brunekreef

Research output: Contribution to journalArticleScientificpeer-review

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 (beta)=1.0, 95% confidence interval (CI) 0.6-1.4], immigrant status (beta=1.0, 95% CI 0.6-1.4) and pre-disaster psychological problems (beta=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.
Original languageEnglish
Pages (from-to)499-510
Number of pages11
JournalPsychological Medicine
Publication statusPublished - 2008

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Disasters
Survivors
Confidence Intervals
Precipitating Factors
Depression
Delivery of Health Care
Muscles

Cite this

van der Berg, B., Grievink, L., van der Velden, P. G., Yzermans, C. J., Stellato, R., Lebret, E., & Brunekreef, B. (2008). Risk factors for physical symptoms after a disaster: a longitudinal study. Psychological Medicine, 499-510.
van der Berg, B ; Grievink, Linda ; van der Velden, P.G. ; Yzermans, C.J. ; Stellato, R ; Lebret, E. ; Brunekreef, B. / Risk factors for physical symptoms after a disaster: a longitudinal study. In: Psychological Medicine. 2008 ; pp. 499-510.
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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 (beta)=1.0, 95{\%} confidence interval (CI) 0.6-1.4], immigrant status (beta=1.0, 95{\%} CI 0.6-1.4) and pre-disaster psychological problems (beta=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.",
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van der Berg, B, Grievink, L, van der Velden, PG, Yzermans, CJ, Stellato, R, Lebret, E & Brunekreef, B 2008, 'Risk factors for physical symptoms after a disaster: a longitudinal study', Psychological Medicine, pp. 499-510.

Risk factors for physical symptoms after a disaster: a longitudinal study. / van der Berg, B; Grievink, Linda; van der Velden, P.G.; Yzermans, C.J.; Stellato, R; Lebret, E.; Brunekreef, B.

In: Psychological Medicine, 2008, p. 499-510.

Research output: Contribution to journalArticleScientificpeer-review

TY - JOUR

T1 - Risk factors for physical symptoms after a disaster: a longitudinal study

AU - van der Berg, B

AU - Grievink, Linda

AU - van der Velden, P.G.

AU - Yzermans, C.J.

AU - Stellato, R

AU - Lebret, E.

AU - Brunekreef, B.

PY - 2008

Y1 - 2008

N2 - 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 (beta)=1.0, 95% confidence interval (CI) 0.6-1.4], immigrant status (beta=1.0, 95% CI 0.6-1.4) and pre-disaster psychological problems (beta=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.

AB - 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 (beta)=1.0, 95% confidence interval (CI) 0.6-1.4], immigrant status (beta=1.0, 95% CI 0.6-1.4) and pre-disaster psychological problems (beta=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.

M3 - Article

SP - 499

EP - 510

JO - Psychological Medicine

JF - Psychological Medicine

SN - 0033-2917

ER -

van der Berg B, Grievink L, van der Velden PG, Yzermans CJ, Stellato R, Lebret E et al. Risk factors for physical symptoms after a disaster: a longitudinal study. Psychological Medicine. 2008;499-510.