Effects of Hurricane Katrina on Postpartum Mental Health

卡特里娜飓风对产后心理健康的影响

• 批准号: 7146623
• 负责人: Emily Wheeler Harville
• 金额: $ 16.71万
• 依托单位: TULANE UNIVERSITY OF LOUISIANA
• 依托单位国家: 美国
• 财政年份: 2006
• 资助国家: 美国
• 起止时间: 2006-03-15 至 2008-02-29
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7146623
• 关键词: anxiety; behavioral /social science research tag; breast feeding; clinical research; cortisol; depression; disasters; experience; female; health behavior; human subject; interview; longitudinal human study; maternal behavior; mental health epidemiology; postpartum; postpartum depression; posttraumatic stress disorder; psychological adaptation; psychological stressor; psychopathology; religion; smoking; social support network; tobacco abuse; women' s health

DESCRIPTION (provided by applicant): Hurricane Katrina has been described as "the worst catastrophe, or set of catastrophes" in the country's history. Natural disasters can lead to long-lasting psychopathology. New mothers are already at high risk for depression and anxiety, and also are potentially at high risk for disaster-related mental illness. Mothers who are anxious or depressed may be unable to care for themselves and their infants optimally. Child development may also be directly affected by stress during pregnancy; stress causes the release of glucocorticoids, which may determine the setpoint of the fetus' HPA axis and/or alter brain development. No previous research has specifically targeted postpartum mental health in the aftermath of a disaster. The specific hypotheses we will test are 1) women who had more severe experiences of the hurricane will be at greater risk for postpartum psychopathology than women with little direct experience of the hurricane. 2) The effect of hurricane experience will be moderated by the social support a woman receives, her baseline level of resources, and her religious faith. 3) Women who had a more severe experience of the hurricane will be more likely to smoke postpartum and less likely to breastfeed than women who did not. 4) Women who were severely exposed to the hurricane or are depressed will have higher cortisol levels, while women with PTSD will have lower cortisol levels. We propose to recruit 250 women who experienced the hurricane extensively during their pregnancies (125 evacuees now living in Baton Rouge and 125 women in New Orleans) and a comparison group of 125 Baton Rouge residents. We will interview the mothers at 2, 6, and 12 months postpartum, including information about experience during the hurricane; depression, anxiety, and post- traumatic stress disorder; health behaviors; social support; resilience; religiosity; and infant temperament. Cortisol will be measured in a subset of 75 women. With the longitudinal design, we will establish correlations and causality among the factors of disaster experience, maternal mental health, and health behavior. Our purpose is to document the effects of a major natural disaster on a population; to identify characteristics of the hurricane experience that could be modified to improve maternal and child health after disasters; to examine health behaviors affected by disaster, to allow for prevention and intervention; and to explore the effects of stress during and after pregnancy.

描述（由申请人提供）：卡特里娜飓风被描述为该国历史上“最严重的灾难或一组灾难”。自然灾害会导致持久的心理病理学。新妈妈已经有抑郁和焦虑的高风险，并且可能面临与灾难有关的精神疾病的高风险。焦虑或沮丧的母亲可能无法最佳地照顾自己和婴儿。在怀孕期间，儿童发育也可能直接受到压力的影响；应力会导致糖皮质激素的释放，这可能决定胎儿HPA轴的设定和/或改变脑发育。在灾难发生后，以前没有研究专门针对产后心理健康。我们将检验的具体假设是1）与飓风直接经验​​的女性相比，在飓风中拥有更严重的飓风经历的妇女将面临产后心理病理学的风险更大。 2）飓风经历的影响将受到妇女所获得的社会支持，基准资源水平和宗教信仰的调节。 3）比没有飓风的妇女更有可能吸烟，而不是没有飓风的妇女母乳喂养的可能性更低。 4）严重暴露于飓风或抑郁症的妇女的皮质醇水平较高，而患有PTSD的女性则具有较低的皮质醇水平。我们建议在怀孕期间招募250名妇女，这些妇女在怀孕期间广泛经历过飓风（现在居住在巴吞鲁日（Baton Rouge）和新奥尔良的125名妇女）和一个由125个巴吞鲁日居民组成的比较组。我们将在产后2、6和12个月时采访母亲，包括有关飓风期间经验的信息；抑郁，焦虑和创伤后应激障碍；健康行为；社会支持；弹力;宗教信仰；和婴儿气质。皮质醇将以75名妇女为单位进行测量。通过纵向设计，我们将在灾难经验，孕产妇心理健康和健康行为的因素之间建立相关性和因果关系。我们的目的是记录主要自然灾害对人群的影响；确定飓风经验的特征，可以修改以改善灾难后的孕产妇和儿童健康；检查受灾难影响的健康行为，以进行预防和干预；并探索怀孕期间和后压力的影响。