Revista Internacional de Saúde Mental e Psiquiatria

Mental Health Symptoms in Post-earthquake Miami Haitians: Cumulative Effect of Disaster-related Stressful Events

Antoine Messiah, Guillaume Vaiva, Erick Gokalsing, Raymond Tempier, Naomie Jean and Juan M Acuna

Purpose: This study evaluated correlates of mental health symptoms among Haitians living in Miami-Dade County, 2-3 years following the 2010 Haiti earthquake, using 3 types of exposure variables: (1) basic exposure status (direct/indirect/no), (2) total of earthquake-related stressful events, (3) a combination of the two former variables. The novelty of the design was that it allowed studying disaster-related accumulated stress among people indirectly exposed to a disaster, which had not been done previously to the investigators’ knowledge.

Methods: A random-sample household survey was conducted from October 2011 through December 2012, in Miami-Dade County, Florida. Haitian participants (N=421) were assessed for their earthquake exposure and related stressful events, and for symptoms of posttraumatic stress disorder (PTSD), of generalized anxiety, and of major depression, using standardized screening scales and thresholds.

Results: We found a dose-response association for each type of exposure variable with 5 outcomes: percentage of respondents exceeding threshold for PTSD (PCL-C ≥ 44), for anxiety (BAI ≥ 26), and for depression (CES-D ≥ 16); at least one scale exceeds its threshold; and number of scales exceeding their respective threshold. Stepwise logistic or linear regressions produced stronger associations for the combined exposure variable with all outcomes, except for anxiety which was more strongly associated with basic exposure status.

Conclusions: The number of disaster-related stressful events is an important correlate of mental health symptoms, including among people indirectly exposed to the disaster. Those indirectly exposed represent a population much larger than those directly exposed, deserving equal mental mental-health attention. Evaluation of accumulated stress and emergence of psychopathology among persons indirectly exposed to disaster should be the focus of further research and of public health interventions.