Stress, Trauma, and Resilience in African-American Hurricane Katrina Survivors: Stress Exposures and Perceived Stress Endurance as Associated with Long-Term Depression, Post-Traumatic Stress, and Cortisol Levels.

摘要

Hurricane Katrina was one of the most impactful natural disasters to occur in the United States. Individuals living in New Orleans at the time of this disaster are likely to have experienced drastic changes in multiple domains of their lives. The overarching goals of this study were to: (1) develop a reliable scale to measure a belief system (perceived stress endurance) that may be protective to the health of African-Americans who face adversity and (2) determine whether stressors and traumas associated with exposure to Hurricane Katrina have led to health problems in African-American survivors over 4 years post-disaster and whether perceived stress endurance protects some individuals from these long-term health difficulties. Through an iterative and hypothesis-driven process using undergraduate participants, we developed a psychometrically solid scale to measure the perceived stress endurance construct. Next, a community sample of 215 African-American male and female Hurricane Katrina survivors completed self-report questionnaires covering demographic information, hurricane stressor exposure, hurricane trauma exposure, current chronic stress burden, perceived stress endurance, coping, affect, depression, and post-traumatic stress. A sub-sample of seventy-six participants collected samples of their own saliva to be assayed for cortisol. Prevalence rates for Post-Traumatic Stress Disorder and Major Depression exceeded 20% in this sample. Higher levels of hurricane trauma and chronic stress were associated with depression and post-traumatic stress, higher levels of hurricane trauma was associated with hypocortisolism, and higher levels of hurricane stress and trauma were associated with poor self-rated health. Perceived stress endurance buffered the effects of hurricane stress on depressive symptoms and Major Depression risk. Although perceived stress endurance did not moderate the effects of hurricane trauma on post-traumatic stress, higher levels of perceived stress endurance were directly associated with lower levels of post-traumatic stress. The associations of perceived stress endurance with these mental health outcomes were mediated through relatively less avoidant coping and negative emotions. With respect to cortisol, more hurricane trauma and hurricane stress were associated with hypocortisolism. More hurricane stress was associated with perceptions of poorer health. More hurricane traumas combined with less perceived stress endurance was associated with poorest self-rated health. The validity of self-rated health was demonstrated through its' association with number of health events experienced since Hurricane Katrina.