Research Letter: Flooding, displacement, peritraumatic experience and disaster-related PTSD in northern New South Wales – The critical need for quality data to plan mental health support

Jo Longman; Kazi Rahman; Veronica Matthews; James Bennett-Levy

doi:10.1177/00048674231203901

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Research Letter: Flooding, displacement, peritraumatic experience and disaster-related PTSD in northern New South Wales – The critical need for quality data to plan mental health support

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Research Letter: Flooding, displacement, peritraumatic experience and disaster-related PTSD in northern New South Wales – The critical need for quality data to plan mental health support

Jo Longman, Kazi Rahman, Veronica Matthews and James Bennett-Levy

Australian and New Zealand journal of psychiatry, Vol.57(12), pp.1580-1582

12/2023

DOI: https://doi.org/10.1177/00048674231203901

PMID: 37791723

Appears in Recent Faculty of Health Publications

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Abstract

Introduction Northern NSW (NNSW) is a ‘hotspot’ for disasters, particularly floods. Floods can have powerful impacts on mental health, including post-traumatic stress disorder (PTSD). Previous disaster research has found that peritraumatic experience – ‘ . . . the emotional and physiological distress experienced during and/or immediately after a traumatic event’ (Bunnell et al., 2018) – is highly associated with subsequent development of PTSD. In this Research Letter, we present updated findings from a NNSW study in 2017 of the link between peritraumatic experience and PTSD (not previously included in papers published from this study). These data are particularly pertinent as in 2022 there was more extreme flooding in NNSW with numerous reports of peritraumatic experience, which would suggest there is likely to be a huge unmet need for effective PTSD treatment in the coming years. Methods Following major flooding in NNSW in 2017, our team at the University Centre for Rural Health (part of the University of Sydney based in NNSW) undertook a cross-sectional survey on paper and online, measuring the mental health and well-being of the NNSW community 6 months following the 2017 floods. A community-academic partnership enabled a broad recruitment strategy with a focus on recruiting minority groups (e.g. Indigenous, socio-economically disadvantaged) known to be disproportionately affected by disasters (Matthews et al., 2019). We assessed several exposure measures including inundation of flood water in respondents’ homes and/or businesses, displacement from home and peritraumatic experience at the time of the flood, and several important mental health outcomes known to be of concern following a disaster, including PTSD. The survey estimated probable PTSD among respondents using the Posttraumatic Stress Disorder Checklist - (PCL-6), a validated measure comprising a series of agreement/disagreement statements about recent experiences of intrusive memories, numbing/avoidance and hyper-arousal symptoms that people sometimes have after severe rain and flooding. The diagnostic performance of this measure has proved satisfactory in primary care settings, including for minority populations (sensitivity, 80–92%; specificity, 72–76%) (Spoont et al., 2013). The study was approved by the University of Sydney Human Research Ethics Committee (reference – 2017/589) and the Aboriginal Health and Medical Research Council Human Research Ethics Committee (reference – 1294/17). Results In total, 2530 respondents participated, all of whom provided their informed consent for inclusion before completing the questionnaire. We reported that people whose homes and/or businesses were inundated were at particularly high risk for probable PTSD (adjusted odds ratio = 13.72; 99% confidence interval [CI] = [4.53, 41.56]) as were those who had been displaced from home for more than 6 months (adjusted odds ratio = 24.43; 99% CI = [7.05, 84.69]) compared with respondents who were not exposed to the flood (Matthews et al., 2019). Here, we report a new analysis from our 2017 flood study which indicates that peritraumatic experience was highly associated with probable PTSD at 6 months. For example, of 255 respondents in 2017 who thought they may be badly injured or feared for their life during the flood, 115 (45%) reported probable PTSD at 6 months compared with 247 (12%) among the 2071 who did not report a peritraumatic experience (Table 1). The (adjusted) odds of reporting probable PTSD for the 139 respondents who thought they may be badly injured or feared for their life and thought a loved one might be badly injured or their life was in danger, and felt terrified, hopeless or helpless at the time of the flood was 6.5 times greater (95% CI = [4.4, 9.5]) than respondents who did not report these peritraumatic experiences.

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Title: Research Letter: Flooding, displacement, peritraumatic experience and disaster-related PTSD in northern New South Wales – The critical need for quality data to plan mental health support
Creators: Jo Longman - University of Sydney
Kazi Rahman - University of Sydney
Veronica Matthews - University of Sydney
James Bennett-Levy - University of Sydney
Publication Details: Australian and New Zealand journal of psychiatry, Vol.57(12), pp.1580-1582
Publisher: Sage
Number of pages: 3
Grant note: NSW Office of Environment Heritage University of Sydney University of Wollongong Northern NSW Local-Health District Western Sydney University
Identifiers: 991013173812202368
Academic Unit: Faculty of Health
Language: English
Resource Type: Letter/Communication

Research Letter: Flooding, displacement, peritraumatic experience and disaster-related PTSD in northern New South Wales – The critical need for quality data to plan mental health support

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