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Post-Hurricane Distress Scale (PHDS): A Novel Tool for First Responders and Disaster Researchers

Published online by Cambridge University Press:  05 March 2019

Yonatan Carl ,
Ediricardo Rodríguez Ortiz ,
Moisés Cintrón ,
Andy Vega Open the ORCID record for Andy Vega [Opens in a new window] ,
Cristina Font Open the ORCID record for Cristina Font [Opens in a new window] ,
Marina Stukova ,
Andrew Blundell ,
Ashley N. Gutierréz  and
Raúl Ferrer Burgos
Yonatan Carl*
Affiliation:
San Juan Bautista School of Medicine, Caguas, Puerto Rico
Ediricardo Rodríguez Ortiz
Affiliation:
San Juan Bautista School of Medicine, Caguas, Puerto Rico
Moisés Cintrón
Affiliation:
San Juan Bautista School of Medicine, Caguas, Puerto Rico
Andy Vega
Affiliation:
San Juan Bautista School of Medicine, Caguas, Puerto Rico
Cristina Font
Affiliation:
San Juan Bautista School of Medicine, Caguas, Puerto Rico
Marina Stukova
Affiliation:
San Juan Bautista School of Medicine, Caguas, Puerto Rico
Andrew Blundell
Affiliation:
San Juan Bautista School of Medicine, Caguas, Puerto Rico
Ashley N. Gutierréz
Affiliation:
San Juan Bautista School of Medicine, Caguas, Puerto Rico
Raúl Ferrer Burgos
Affiliation:
San Juan Bautista School of Medicine, Caguas, Puerto Rico
*
Correspondence and reprint requests to Mr Yonatan Carl, San Juan Bautista School of Medicine, Salida 21, Carr. 12, Urb. Turabo Gardens, Caguas, Puerto Rico 00726 (e-mail: yonatanc@sanjuanbautista.edu).
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Abstract

Objective

The aim of this study was the construction and validation of a novel research instrument to quantify the degree of post-hurricane trauma and distress in an affected population. The Post-Hurricane Distress Scale (PHDS) has quantitative measures of both acute and prolonged distress, attributable to meteorological and hydrological disasters.

Methods

A careful evaluation of existing questionnaires, as well as extensive canvasing of the post-Maria population of Puerto Rico, availed the construction of the PHDS. The PHDS consists of 20 items, organized into 4 subscales. The PHDS was pre-validated (n=79), revised, and then distributed to a broad sampling of the post-Hurricane Maria Puerto Rican population (n=597). Validation, including factor analysis, analyses of concurrent validity, discriminant validity, and internal reliability, was performed.

Results

After comparing various scales, factor loading profiles, concurrent validities, and models of fit, we show that the PHDS is best scored as a single 0–6 distress scale. When compared with the Traumatic Exposure Severity Scale, the PHDS shows superior concurrent validity, more accurately predicting scores for the Peritraumatic Distress Inventory, Impact of Event Scale – Revised, and Generalized Anxiety Disorder 7 Scale. The PHDS shows good internal reliability and discriminant validity.

Conclusions

The PHDS represents a novel, useful instrument for disaster first-responders and researchers. The prompt identification of high-risk populations is possible using this instrument. (Disaster Med Public Health Preparedness. 2019;13:82-89)

Keywords

disastersemergency respondershurricaneposttraumaticstress disorderspsychological stress
Type
Original Research
Information
Disaster Medicine and Public Health Preparedness , Volume 13 , Special Issue 1: Serial Hurricanes , February 2019 , pp. 82 - 89
Copyright
Copyright © 2019 Society for Disaster Medicine and Public Health, Inc. 

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References

REFERENCES

1. Davis, TE 3rd, Grills-Taquechel, AE, Ollendick, TH. The psychological impact from Hurricane Katrina: effects of displacement and trauma exposure on university students. Behav Ther. 2010;41(3):340-349.Google Scholar
2. Ford, ES, Mokdad, AH, Link, MW, et al. Chronic disease in health emergencies: in the eye of the hurricane. Prev Chronic Dis. 2006;3(2):A46.Google Scholar
3. Gleser, GC, Green, BL, Winget, CN. Prolonged psychosocial effects of disaster: a study of Buffalo Creek. New York: Academic Press; 1981.Google Scholar
4. Kishore, V, Theall, KP, Robinson, W, et al. Resource loss, coping, alcohol use, and posttraumatic stress symptoms among survivors of Hurricane Katrina: a cross-sectional study. Am J Disaster Med. 2008;3(6):345-357.Google Scholar
5. Parker, G, Lie, D, Siskind, DJ, et al. Mental health implications for older adults after natural disasters – a systematic review and meta-analysis. Int Psychogeriatr. 2016;28(1):11-20.Google Scholar
6. Schnurr, PP, Green, BL. Trauma and health: physical health consequences of exposure to extreme stress. 1st ed. Washington, DC: American Psychological Association; 2004.Google Scholar
7. Chan, CS, Rhodes, JE. Measuring exposure in Hurricane Katrina: a meta-analysis and an integrative data analysis. PLoS One. 2014;9(4):e92899.Google Scholar
8. Green, BL. Evaluating the effects of disasters. J Consult Clin Psychol. 1991;3(4):538-546.Google Scholar
9. Kaniasty, K, Norris, FH. Longitudinal linkages between perceived social support and posttraumatic stress symptoms: sequential roles of social causation and social selection. J Trauma Stress. 2008;21(3):274-281.Google Scholar
10. Norris, FH, Friedman, MJ, Watson, PJ, et al. 60,000 disaster victims speak: part I. An empirical review of the empirical literature, 1981–2001. Psychiatry. 2002;65(3):207-239.Google Scholar
11. Norris, FH, Sherrieb, K, Galea, S. Prevalence and consequences of disaster-related illness and injury from Hurricane Ike. Rehabil Psychol. 2010;55(3):221-230.Google Scholar
12. Chastang, F, Rioux, P, Dupont, I, et al. Suicide attempts and job insecurity: a complex association. Eur Psychiatry. 1998;13(7):359-364.Google Scholar
13. Reuther, ET, Davis, TE 3rd, Matthews, RA, et al. Fear of anxiety as a partial mediator of the relation between trauma severity and PTSD symptoms. J Trauma Stress. 2010;23(4):519-522.Google Scholar
14. Beck, JG, Grant, DM, Read, JP, et al. The impact of event scale-revised: psychometric properties in a sample of motor vehicle accident survivors. J Anxiety Disord. 2008;22(2):187-198.Google Scholar
15. Elal, G, Slade, P. Traumatic Exposure Severity Scale (TESS): a measure of exposure to major disasters. J Trauma Stress. 2005;18(3):213-220.Google Scholar
16. Cepeda, A, Valdez, A, Kaplan, C, Hill, LE. Patterns of substance use among Hurricane Katrina evacuees in Houston, Texas. Disasters. 2010;34(2):426-446.Google Scholar
17. LaJoie, AS, Sprang, G, McKinney, WP. Long-term effects of Hurricane Katrina on the psychological well-being of evacuees. Disasters. 2010;34(4):1031-1044.Google Scholar
18. Wadsworth, ME, Santiago, CD, Einhorn, L. Coping with displacement from Hurricane Katrina: predictors of one-year post-traumatic stress and depression symptom trajectories. Anxiety Stress Coping. 2009;22(4):413-432.Google Scholar
19. Heptulla, R, Hashim, R, Johnson, DN, et al. Evaluating emergency preparedness and impact of Hurricane Sandy in pediatric patients with diabetes. Disaster Mil Med. 2016;2:2.Google Scholar
20. Joyette, AR, Nurse, LA, Pulwarty, RS. Disaster risk insurance and catastrophe models in risk-prone small Caribbean islands. Disasters. 2015;39(3):467-492.Google Scholar
21. Staff, J. A guide to hurricanes. Sci Am. https://www.scientificamerican.com/report/hurricane-guide/. Published Sept 5, 2008. Accessed October 21, 2018.Google Scholar
22. Hernandez-Suarez, DF, Rodriguez-Ruiz, C, Malave-Sanchez, M, et al. Adapt and evolve: how our internal medicine residency changed in Hurricane Maria. P R Health Sci J. 2018;37(1):3-4.Google Scholar
23. Kishore, N, Marques, D, Mahmud, A, et al. Mortality in Puerto Rico after Hurricane Maria. N Engl J Med. 2018;379(2):162-170.Google Scholar
24. Staff: The National Center for Health Statistics. A reference guide for certification of deaths in the event of a natural, human-induced, or chemical/radiological disaster. Hyattsville, MD :The National Center for Health Statistics; 2017.Google Scholar
25. Robert, L, Spitzer, JBWW, Kroenke, K. Patient health questionnaire screeners. https://www.phqscreeners.com/select-screener/31. Accessed January 3, 2018.Google Scholar
26. Brunet, A, Weiss, DS, Metzler, TJ, et al. The Peritraumatic Distress Inventory: a proposed measure of PTSD criterion A2. Am J Psychiatry. 2001;158(9):1480-1485.Google Scholar
27. Morina, N, Ehring, T, Priebe, S. Diagnostic utility of the impact of event scale-revised in two samples of survivors of war. PLoS One. 2013;8(12):e83916.Google Scholar
28. Thomas, E, Saumier, D, Brunet, A. Peritraumatic distress and the course of posttraumatic stress disorder symptoms: a meta-analysis. Can J Psychiatry. 2012;57(2):122-129.Google Scholar
29. Spitzer, RL, Kroenke, K, Williams, JB, Lowe, B. A brief measure for assessing generalized anxiety disorder: the GAD-7. Arch Intern Med. 2006;166(10):1092-1097.Google Scholar
30. Akaike, H. A new look at the statistical model identification. IEEE Trans Automat Contr. 1974;AC-19 (6):716-723.Google Scholar
31. Norris, M, Lecavalier, L. Evaluating the use of exploratory factor analysis in developmental disability psychological research. J Autism Dev Disord. 2010;40(1):8-20.Google Scholar
32. Reise, SP, Waller, NG, Comrey, AL. Factor analysis and scale revision. Psychol Assess. 2000;12(3):287-297.Google Scholar
33. Tran, Q-N, Arabnia, H. Emerging trends in computational biology, bioinformatics, and systems biology: algorithms and software tools. Waltham, MA: Morgan Kaufman (Elsevier); 2015.Google Scholar
34. Cahill, SP, Pontoski, K. Post-traumatic stress disorder and acute stress disorder I: their nature and assessment considerations. Psychiatry (Edgmont). 2005;2(4):14-25.Google Scholar
35. Keane, TM, Marshall, AD, Taft, CT. Posttraumatic stress disorder: etiology, epidemiology, and treatment outcome. Annu Rev Clin Psychol. 2006;2:161-197.Google Scholar
36. Ranasinghe, S, Ramesh, S, Jacobsen, KH. Hygiene and mental health among middle school students in India and 11 other countries. J Infect Public Health. 2016;9(4):429-435.Google Scholar
37. Libby, AM, Ghushchyan, V, McQueen, RB, Campbell, JD. Economic grand rounds: psychological distress and depression associated with job loss and gain: the social costs of job instability. Psychiatr Serv. 2010;61(12):1178-1180.Google Scholar