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2006 (1)

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Dissertation
Posttraumatic stress disorder and disasters in Peru : the role of personality and social support.

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Abstract

One of the most studied negative mental health consequences after disaster exposure is Post Traumatic Stress Disorder (PTSD; APA, 1994). Yet, disaster exposure alone is not enough to develop PTSD. Hence, a wide variety of risk and vulnerability factors for PTSD have been specified, including peritraumatic experiences, personality (Cox, MacPherson, Enns, & McWilliams, 2004) and social support (Kaniasty, 2005). Although the majority of disasters occur in developing countries (Emergency Disaster Database, 2006), most disaster research has been done in developed countries (Norris et al., 2002). In Peru, for example, where disasters (e.g, floods, landslides) are relatively common, no systematic empirical studies have been reported on the psychological consequences of these disasters. Thus, there is an urgent need to investigate the mental health consequences of disasters in Peru as well as the predictors of these consequences in order to identify and help those affected by disaster. In the first place, however, this requires the availability of psychometric instruments validated in Peru. Hence, this study had two main aims. (1) The first aim was to select, translate and study the psychometric properties of instruments that evaluate post-trauma distress (i.e., the Impact of Event Scale Revised, and the Clinician Administered PTSD Scale), the within the person variable of Personality (i.e., the Depressive Experiences Questionnaire), Peritraumatic Distress (i.e., the Peritraumatic Distress Inventory) and Peritraumatic Dissociation (i.e., RAND Peritraumatic Dissociative Experiences Scale), and the outside the person variable of Social support (the Social Support Questionnaire for Transaction and for Satisfaction); (2) The second aim of this study was to understand the role of both within the person factors (i.e., the personality dimensions of Dependency and Self-criticism and peritraumatic dissociation) and outside the person variables (i.e., received and perceived social support), in the development and maintenance of PTSD symptoms and PTSD diagnosis after disaster exposure in Peru. We hypothesized that the relationship between peritraumatic dissociation and PTSD was mediated by peritraumatic distress. In addition, we expected the personality dimensions of Dependency and Self-criticism to be differentially related to PTSD symptoms. In particular, we hypothesized that only Self-criticism, but not Dependency, would be related to PTSD avoidance symptoms. Finally, we also investigated whether social support acted as a moderator or mediator between Dependency, Self-criticism, and PTSD symptoms and diagnosis. Participants were 562 Peruvian university students, and two samples of Peruvian disaster survivors, namely 88 survivors of the “South Earthquake” from the city of Moquegua (June 2001), and 174 survivors of the “Lomo de Corvina Fire” from the city of Lima. Results provided in general support for both the reliability and validity of the psychometric instruments evaluated. Furthermore, results also showed that, as hypothesized, peritraumatic distress mediated the relationship between peritraumatic dissociation and PTSD diagnosis. In addition, as expected, Self-criticism was consistently related to PTSD symptoms and diagnosis both cross-sectionally and longitudinally. In line with our hypotheses, Dependency, was associated with reexperience and arousal symptoms, but not with avoidance symptoms. However Dependency did not predict PTSD symptoms or diagnosis over time. Finally, while dependent individuals seemed to be able to generate social support in the aftermath of disaster, self-critical individuals appeared to “degenerate” their social networks. Results suggest that Self-criticism might be a vulnerability factor for chronic PTSD, while Dependency may only be implicated in the immediate aftermath of disaster. Implications of these results for future research and intervention programs are discussed.

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