Psychiatr Q DOI 10.1007/s11126-014-9333-3 ORIGINAL PAPER
Gender Differences in Psychological Reactions to Hurricane Sandy Among New York Metropolitan Area Residents Yaira Hamama-Raz • Yuval Palgi • Amit Shrira • Robin Goodwin Krzysztof Kaniasty • Menachem Ben-Ezra
•
Ó Springer Science+Business Media New York 2014
Abstract Hurricane Sandy was a natural disaster of large proportions—a category 3 storm at its peak intensity that struck New York Metropolitan Area on October, 2012. The death and destruction caused by a hurricane can rise numerous of mental health vulnerabilities such as, acute stress disorder, posttraumatic stress disorder, depression, and anxiety. Gender has been identified as one critical variable that can impact vulnerability to adverse effects of trauma, as well as how these reactions are managed. The present research provides an evaluation of gender differences regarding posttraumatic stress symptoms, recollections of national disasters and fears of future negative life events. It also aims to explore information seeking and sources of assistance that were utilized during Hurricane Sandy. An online survey sample of 1,000 people from New York Metropolitan Area completed a battery of self-report questionnaires four weeks after the storm. Results revealed that recollections of national disaster and fear of future events were found to be
Y. Hamama-Raz (&) M. Ben-Ezra School of Social Work, Ariel University, 8 Maklish st’ Petach Tikva, 4955807 Ariel, Israel e-mail: [email protected]; [email protected] M. Ben-Ezra e-mail: [email protected] Y. Palgi Department of Gerontology, University of Haifa, Haifa, Israel A. Shrira Interdisciplinary Department of Social Sciences, Faculty of Social Sciences, Bar-Ilan University, Ramat-Gan, Israel R. Goodwin School of Social Sciences, Brunel University, Uxbridge, UK K. Kaniasty Department of Psychology, Indiana University of Pennsylvania, Indiana, USA K. Kaniasty Polish Academy of Sciences, Warsaw, Poland
123
Psychiatr Q
significantly different among women compared to men. Additionally, women were more inclined toward information seeking through Facebook than men, although no gender differences emerged when examining sources of support. The results indicate that disaster practitioners should tailor gender sensitive interventions. Keywords symptoms
Gender differences Hurricane Information seeking Posttraumatic stress
Introduction Natural disasters routinely elicit high levels of property damage and pose severe threats to life and well-being [1]. Hurricane Sandy was a natural disaster of large proportions— a category 3 storm at its peak intensity that struck the New York Metropolitan Area on October 29, 2012. It caused massive damage; at least 285 people were killed along the path of the storm, and preliminary estimates of losses due to damage and business interruption is $68 billion (2012 USD) [2]. As such, Hurricane Sandy can be labeled as a highly stressful event that may have affected the behavioral, emotional and cognitive responses of those who were exposed. Studies have repeatedly documented considerable variability in the responses of different persons to similar traumatic events [3–5]. Gender has been identified as one critical variable that can impact vulnerability to adverse effects of trauma, as well as how these reactions are managed [6]. Regarding this, research literature consistently reports that men experience traumatic events more often than women, and that women and men differ in the type of traumatic events they experience [7–9]. With natural disasters, it seems that gender is not given sufficient attention [10] and more information is needed on factors that might underlie the gender differences in postdisaster psychological functioning observed in some studies. Thus, in the current study we sought to explore gender differences in reaction to Hurricane Sandy. Being that professionals should tailor suitable interventions sensitive to gender needs, it is important to deepen our understanding regarding the reactions of men compared to those of women in the face of natural disasters such as a hurricane. Moreover, given that the type of trauma may at least partially account for gender difference in rates of psychological distress [11], it is essential to expand our knowledge regarding the role of gender in reaction to natural disaster. In this paper, we consider the ‘‘Conservation of Resources’’ (COR) theory [12] as a theoretical frame that may shed light in explaining increased vulnerability to post-disaster psychological adversity between gender. This theory defines resources as ‘‘objects, personal characteristics, conditions, or energies that are valued in their own right or that are valued because they act as conduits to the achievement or protection of valued resources’’ [13, p. 339]. The primary tenet of this theory is that the more resources an individual loses because of trauma, the less he or she will be able to adjust successfully [13]. When an individual loses resources because of trauma, he or she must then invest further resources to restore the ones that are lost. The experience of resource loss also makes the individual vulnerable to further loss, resulting in a resource loss spiral [12]. An extensive body of research supports the notion that loss of resources predicts psychological distress following various traumatic experiences, including floods, hurricanes, earthquakes, the September 11 attacks, and mass shootings [14–19].
123
Psychiatr Q
Considering the above, some studies show that women are at greater risk for posttraumatic stress disorder (PTSD) than men following exposure to potentially traumatic events [20, 21]. Tolin and Foa [9] conducted a meta-analysis on studies from the past 25 years and found that within types of potentially traumatic events, including natural disasters, accidents, combat, and physical assault, women had higher rates of PTSD and a greater severity of PTSD than men. Likewise, in a study conducted among Hurricane Katrina’s survivors, Picou and Hudson [22] revealed that women were characterized by higher levels of depression and PTSD symptoms compared to men. This pattern was also observed previously in other studies conducted among survivors of Hurricane Katrina [23, 24]. Yet, other studies have found gender to have only a limited effect as a predictor for PTSD [3]. Furthermore, Fullerton et al. [25] in their study of motor vehicle accident victims found no gender difference in meeting the overall reexperiencing criterion for a diagnosis of PTSD. These authors reported, however, that women had a higher incidence of reporting specific reexperiencing symptoms, such as being triggered by situation similar to the accident and having distressing memories of the accident. These findings may point out that women might be more prone to recollections of prior disasters. Thus, in the current study we evaluated gender differences in posttraumatic stress symptoms, recollections of national disasters and future fears of negative life events. Based on the above, we assumed that measuring more sensitive measures of mental health vulnerability, beside of the clinical ones, may promote the knowledge of gender differences in relation to natural disaster as hurricanes. Alongside possible gender differences in the mental health vulnerability, gender differences in the use of social support have been repeatedly reported [26]. Seeking social support includes turning to friends, relatives, or other people for emotional, tangible, or informational support. It is well-known that social support offers important protection for mental health particularly for women [27]. Higher levels of social support, for example, have been associated with better post-disaster psychological functioning [3, 28]. Lowe et al. [29] examined the influence of pre-disaster perceived social support on post disaster psychological distress among survivors of Hurricane Katrina. Their results revealed that participants who perceived greater pre-disaster social support had less pre-disaster psychological distress, experienced fewer hurricane-related stressors, and perceived more support in the aftermath of the hurricane. These factors, in turn, were associated with less post-disaster psychological distress. Women have also been found to have higher levels of social support than men [30]. In regards to types of support, it has been suggested that women may utilize emotional support obtained from others more than men while men may utilize instrumental and informational support obtained from others more than women [31]. Regarding this, we assumed that women will be more likely to use social support in comparison to men. Another way of seeking support has to do with information seeking. Previous research has suggested that in a time of crisis people are motivated to engage in information seeking from available sources and attempt to update their knowledge and understanding of the event in order to further alleviate negative affective experiences [32–34]. In this aspect, women were found to be more inclined toward information seeking in times of crisis [35, 36]. Moreover, research findings clearly show that women tend to seek help from informal support systems more than men do. However, the findings about formal support systems are more controversial [37]. Some researchers found that women were more likely to identify a need for help, but that no gender differences were manifested in actual help seeking after an emotional problem was recognized or indicated [38]. Other researchers
123
Psychiatr Q
claim that gender differences in help-seeking vary according to social context and problem type [39]. In line with this, research on Hurricane Katrina survivors reports no significant differences detected between men and women in terms of their likelihood to use general information seeking to cope with the aftermath of the storm [36]. Considering the lack of other findings toward natural disaster in relation to information seeking, our study explored the sources of information each gender preferred to use and the sources of assistances they reported they utilized. In summary, the current study offers a research question addressing variability in responses to Hurricane Sandy between the genders in the following variables: post-traumatic stress symptoms (PTSS), recollections of national disasters and fears of future negative life events, engagement with social support, and information seeking. We expect the following: (a) women will be more likely to report higher levels of post-traumatic stress symptoms (PTSS), recollections of national disasters and fears of future negative life events than men; (b) women will display higher levels of engagement with social support and information seeking compared to men.
Method Participants and Procedure Following approval by the Institutional Review Board of the School of Social Work at Ariel University, we used an online survey sample of 1,000 participants (response rate = 83.3 % out of a potential 1,200), aged 18 or older, who were drawn from affected states by Toluna (http://www.toluna-group.com), an Internet panel company. The survey was conducted during the 4th week of November 2012, 1 month after Hurricane Sandy struck the eastern coast of the United States. Internet panels are increasingly used as a viable means of data collection [40], and their representativeness is comparable to data from probability-based general population samples [41]. To recruit the study participants, Toluna sent e-mails to invite potential participants from their databases to enroll in the current study following a screening process to ensure eligibility (based on age, place of living and current English speaking level). We used a similar method employed in other medical and psychological studies [42, 43]. The participant’s mean age was 45.2 (SD = 14.3), 655 (65.5 %) were females, 606 (60.6 %) were married or in cohabitation, 455 (45.5 %) had a college degree or higher. For more details, see Table 1. Measure Participants completed the following battery of self-report questionnaires: Personal Data Regarding socio-demographic variables (gender, age, marital status, education). Exposure to Hurricane Sandy was measured by reporting on exposure to the following events: (1) home damage, (2) loss of property or belongings, (3) witnessed an injury related to Hurricane Sandy. After summing up the scale we aggregated it to exposed (scores 1–3)
123
178 (51.6 %)
Education college and above, yes (%)
1.48 (1.31) 1.24 (1.34)
World Trade Center Attacks 9/11 (mean) (SD)
1.26 (1.18) 1.80 (1.14) 1.96 (1.18) 1.87 (1.22)
Nuclear disaster (mean) (SD)
Personal accident or illness (mean) (SD)
Death of a close family member or a friend (mean) (SD)
Getting old (mean) (SD)
2.46 (.88)
Receiving financial support (mean) (SD)
125 (36.2 %) 61 (17.7 %)
Newspaper (yes) (%)
Social network (FACEBOOK) (yes) (%)
Bold values indicate the statistically significant
Impact of event scale (mean) (SD)
19.26 (22.77)
144 (41.7 %)
Radio (yes) (%)
PTSS symptoms
305 (88.4 %)
TV (yes) (%)
Sources of information
2.70 (.89)
Receiving psychological support (mean) (SD)
Sources of support
1.47 (1.21)
1.66 (1.21)
18.16 (19.94)
185 (28.2 %)
189 (28.95 %)
237 (36.2 %)
555 (84.7 %)
2.47 (.89)
2.75 (.84)
2.01 (1.22)
2.27 (1.21)
2.17 (1.09)
1.96 (1.16)
1.55 (1.22)
Hurricane (mean) (SD)
1.72 (1.16)
1.40 (1.38)
1.71 (1.31)
1.85 (1.21)
277 (42.3 %)
399 (60.9 %)
43.29 (14.30)
Women (n = 655)
Terror attack (mean) (SD)
Fear of future events
1.62 (1.27)
Hurricane Katrina (mean) (SD)
Hurricane Irene (mean) (SD)
Recollections of traumatic events
207 (60.0 %)
48.72 (13.61)
Men (n = 345)
Marital status, married (%)
Age (years) (SD)
Socio demographics variables
Variable
Table 1 Hurricane Sandy sample based on gender (n = 1,000)
.006
v2 = 2.748
.017
Gender Differences in Psychological Reactions to Hurricane Sandy Among New York Metropolitan Area Residents Yaira Hamama-Raz • Yuval Palgi • Amit Shrira • Robin Goodwin Krzysztof Kaniasty • Menachem Ben-Ezra
•
Ó Springer Science+Business Media New York 2014
Abstract Hurricane Sandy was a natural disaster of large proportions—a category 3 storm at its peak intensity that struck New York Metropolitan Area on October, 2012. The death and destruction caused by a hurricane can rise numerous of mental health vulnerabilities such as, acute stress disorder, posttraumatic stress disorder, depression, and anxiety. Gender has been identified as one critical variable that can impact vulnerability to adverse effects of trauma, as well as how these reactions are managed. The present research provides an evaluation of gender differences regarding posttraumatic stress symptoms, recollections of national disasters and fears of future negative life events. It also aims to explore information seeking and sources of assistance that were utilized during Hurricane Sandy. An online survey sample of 1,000 people from New York Metropolitan Area completed a battery of self-report questionnaires four weeks after the storm. Results revealed that recollections of national disaster and fear of future events were found to be
Y. Hamama-Raz (&) M. Ben-Ezra School of Social Work, Ariel University, 8 Maklish st’ Petach Tikva, 4955807 Ariel, Israel e-mail: [email protected]; [email protected] M. Ben-Ezra e-mail: [email protected] Y. Palgi Department of Gerontology, University of Haifa, Haifa, Israel A. Shrira Interdisciplinary Department of Social Sciences, Faculty of Social Sciences, Bar-Ilan University, Ramat-Gan, Israel R. Goodwin School of Social Sciences, Brunel University, Uxbridge, UK K. Kaniasty Department of Psychology, Indiana University of Pennsylvania, Indiana, USA K. Kaniasty Polish Academy of Sciences, Warsaw, Poland
123
Psychiatr Q
significantly different among women compared to men. Additionally, women were more inclined toward information seeking through Facebook than men, although no gender differences emerged when examining sources of support. The results indicate that disaster practitioners should tailor gender sensitive interventions. Keywords symptoms
Gender differences Hurricane Information seeking Posttraumatic stress
Introduction Natural disasters routinely elicit high levels of property damage and pose severe threats to life and well-being [1]. Hurricane Sandy was a natural disaster of large proportions— a category 3 storm at its peak intensity that struck the New York Metropolitan Area on October 29, 2012. It caused massive damage; at least 285 people were killed along the path of the storm, and preliminary estimates of losses due to damage and business interruption is $68 billion (2012 USD) [2]. As such, Hurricane Sandy can be labeled as a highly stressful event that may have affected the behavioral, emotional and cognitive responses of those who were exposed. Studies have repeatedly documented considerable variability in the responses of different persons to similar traumatic events [3–5]. Gender has been identified as one critical variable that can impact vulnerability to adverse effects of trauma, as well as how these reactions are managed [6]. Regarding this, research literature consistently reports that men experience traumatic events more often than women, and that women and men differ in the type of traumatic events they experience [7–9]. With natural disasters, it seems that gender is not given sufficient attention [10] and more information is needed on factors that might underlie the gender differences in postdisaster psychological functioning observed in some studies. Thus, in the current study we sought to explore gender differences in reaction to Hurricane Sandy. Being that professionals should tailor suitable interventions sensitive to gender needs, it is important to deepen our understanding regarding the reactions of men compared to those of women in the face of natural disasters such as a hurricane. Moreover, given that the type of trauma may at least partially account for gender difference in rates of psychological distress [11], it is essential to expand our knowledge regarding the role of gender in reaction to natural disaster. In this paper, we consider the ‘‘Conservation of Resources’’ (COR) theory [12] as a theoretical frame that may shed light in explaining increased vulnerability to post-disaster psychological adversity between gender. This theory defines resources as ‘‘objects, personal characteristics, conditions, or energies that are valued in their own right or that are valued because they act as conduits to the achievement or protection of valued resources’’ [13, p. 339]. The primary tenet of this theory is that the more resources an individual loses because of trauma, the less he or she will be able to adjust successfully [13]. When an individual loses resources because of trauma, he or she must then invest further resources to restore the ones that are lost. The experience of resource loss also makes the individual vulnerable to further loss, resulting in a resource loss spiral [12]. An extensive body of research supports the notion that loss of resources predicts psychological distress following various traumatic experiences, including floods, hurricanes, earthquakes, the September 11 attacks, and mass shootings [14–19].
123
Psychiatr Q
Considering the above, some studies show that women are at greater risk for posttraumatic stress disorder (PTSD) than men following exposure to potentially traumatic events [20, 21]. Tolin and Foa [9] conducted a meta-analysis on studies from the past 25 years and found that within types of potentially traumatic events, including natural disasters, accidents, combat, and physical assault, women had higher rates of PTSD and a greater severity of PTSD than men. Likewise, in a study conducted among Hurricane Katrina’s survivors, Picou and Hudson [22] revealed that women were characterized by higher levels of depression and PTSD symptoms compared to men. This pattern was also observed previously in other studies conducted among survivors of Hurricane Katrina [23, 24]. Yet, other studies have found gender to have only a limited effect as a predictor for PTSD [3]. Furthermore, Fullerton et al. [25] in their study of motor vehicle accident victims found no gender difference in meeting the overall reexperiencing criterion for a diagnosis of PTSD. These authors reported, however, that women had a higher incidence of reporting specific reexperiencing symptoms, such as being triggered by situation similar to the accident and having distressing memories of the accident. These findings may point out that women might be more prone to recollections of prior disasters. Thus, in the current study we evaluated gender differences in posttraumatic stress symptoms, recollections of national disasters and future fears of negative life events. Based on the above, we assumed that measuring more sensitive measures of mental health vulnerability, beside of the clinical ones, may promote the knowledge of gender differences in relation to natural disaster as hurricanes. Alongside possible gender differences in the mental health vulnerability, gender differences in the use of social support have been repeatedly reported [26]. Seeking social support includes turning to friends, relatives, or other people for emotional, tangible, or informational support. It is well-known that social support offers important protection for mental health particularly for women [27]. Higher levels of social support, for example, have been associated with better post-disaster psychological functioning [3, 28]. Lowe et al. [29] examined the influence of pre-disaster perceived social support on post disaster psychological distress among survivors of Hurricane Katrina. Their results revealed that participants who perceived greater pre-disaster social support had less pre-disaster psychological distress, experienced fewer hurricane-related stressors, and perceived more support in the aftermath of the hurricane. These factors, in turn, were associated with less post-disaster psychological distress. Women have also been found to have higher levels of social support than men [30]. In regards to types of support, it has been suggested that women may utilize emotional support obtained from others more than men while men may utilize instrumental and informational support obtained from others more than women [31]. Regarding this, we assumed that women will be more likely to use social support in comparison to men. Another way of seeking support has to do with information seeking. Previous research has suggested that in a time of crisis people are motivated to engage in information seeking from available sources and attempt to update their knowledge and understanding of the event in order to further alleviate negative affective experiences [32–34]. In this aspect, women were found to be more inclined toward information seeking in times of crisis [35, 36]. Moreover, research findings clearly show that women tend to seek help from informal support systems more than men do. However, the findings about formal support systems are more controversial [37]. Some researchers found that women were more likely to identify a need for help, but that no gender differences were manifested in actual help seeking after an emotional problem was recognized or indicated [38]. Other researchers
123
Psychiatr Q
claim that gender differences in help-seeking vary according to social context and problem type [39]. In line with this, research on Hurricane Katrina survivors reports no significant differences detected between men and women in terms of their likelihood to use general information seeking to cope with the aftermath of the storm [36]. Considering the lack of other findings toward natural disaster in relation to information seeking, our study explored the sources of information each gender preferred to use and the sources of assistances they reported they utilized. In summary, the current study offers a research question addressing variability in responses to Hurricane Sandy between the genders in the following variables: post-traumatic stress symptoms (PTSS), recollections of national disasters and fears of future negative life events, engagement with social support, and information seeking. We expect the following: (a) women will be more likely to report higher levels of post-traumatic stress symptoms (PTSS), recollections of national disasters and fears of future negative life events than men; (b) women will display higher levels of engagement with social support and information seeking compared to men.
Method Participants and Procedure Following approval by the Institutional Review Board of the School of Social Work at Ariel University, we used an online survey sample of 1,000 participants (response rate = 83.3 % out of a potential 1,200), aged 18 or older, who were drawn from affected states by Toluna (http://www.toluna-group.com), an Internet panel company. The survey was conducted during the 4th week of November 2012, 1 month after Hurricane Sandy struck the eastern coast of the United States. Internet panels are increasingly used as a viable means of data collection [40], and their representativeness is comparable to data from probability-based general population samples [41]. To recruit the study participants, Toluna sent e-mails to invite potential participants from their databases to enroll in the current study following a screening process to ensure eligibility (based on age, place of living and current English speaking level). We used a similar method employed in other medical and psychological studies [42, 43]. The participant’s mean age was 45.2 (SD = 14.3), 655 (65.5 %) were females, 606 (60.6 %) were married or in cohabitation, 455 (45.5 %) had a college degree or higher. For more details, see Table 1. Measure Participants completed the following battery of self-report questionnaires: Personal Data Regarding socio-demographic variables (gender, age, marital status, education). Exposure to Hurricane Sandy was measured by reporting on exposure to the following events: (1) home damage, (2) loss of property or belongings, (3) witnessed an injury related to Hurricane Sandy. After summing up the scale we aggregated it to exposed (scores 1–3)
123
178 (51.6 %)
Education college and above, yes (%)
1.48 (1.31) 1.24 (1.34)
World Trade Center Attacks 9/11 (mean) (SD)
1.26 (1.18) 1.80 (1.14) 1.96 (1.18) 1.87 (1.22)
Nuclear disaster (mean) (SD)
Personal accident or illness (mean) (SD)
Death of a close family member or a friend (mean) (SD)
Getting old (mean) (SD)
2.46 (.88)
Receiving financial support (mean) (SD)
125 (36.2 %) 61 (17.7 %)
Newspaper (yes) (%)
Social network (FACEBOOK) (yes) (%)
Bold values indicate the statistically significant
Impact of event scale (mean) (SD)
19.26 (22.77)
144 (41.7 %)
Radio (yes) (%)
PTSS symptoms
305 (88.4 %)
TV (yes) (%)
Sources of information
2.70 (.89)
Receiving psychological support (mean) (SD)
Sources of support
1.47 (1.21)
1.66 (1.21)
18.16 (19.94)
185 (28.2 %)
189 (28.95 %)
237 (36.2 %)
555 (84.7 %)
2.47 (.89)
2.75 (.84)
2.01 (1.22)
2.27 (1.21)
2.17 (1.09)
1.96 (1.16)
1.55 (1.22)
Hurricane (mean) (SD)
1.72 (1.16)
1.40 (1.38)
1.71 (1.31)
1.85 (1.21)
277 (42.3 %)
399 (60.9 %)
43.29 (14.30)
Women (n = 655)
Terror attack (mean) (SD)
Fear of future events
1.62 (1.27)
Hurricane Katrina (mean) (SD)
Hurricane Irene (mean) (SD)
Recollections of traumatic events
207 (60.0 %)
48.72 (13.61)
Men (n = 345)
Marital status, married (%)
Age (years) (SD)
Socio demographics variables
Variable
Table 1 Hurricane Sandy sample based on gender (n = 1,000)
.006
v2 = 2.748
.017
