Post-Traumatic Stress among Evacuees from the 2016 Fort McMurray Wildfires: Exploration of Psychological and Sleep Symptoms Three Months after the Evacuation

Genevieve Belleville, Marie-Christine Ouellet, Charles M Morin, Genevieve Belleville, Marie-Christine Ouellet, Charles M Morin

Abstract

This study documents post-traumatic stress symptoms after the May 2016 wildfires in Fort McMurray (Alberta, Canada). A sample of 379 evacuees completed an online questionnaire from July to September 2016, and a subsample of 55 completed a psychiatric/psychological diagnostic interview. According to a self-report questionnaire, 62.5% of respondents had a provisional post-traumatic stress disorder (PTSD). The interview confirmed that 29.1% met criteria for PTSD, 25.5% for depression, and 43.6% for insomnia; in most cases, insomnia was definitely or probably related to the fires. Traumatic exposure may elicit or exacerbate sleep problems, which are closely associated with PTSD after a disaster.

Keywords: mental health; post-traumatic stress disorder; psychological distress; sleep.

Conflict of interest statement

The authors declare no conflict of interest.

References

    1. Norris F.H., Friedman M.J., Watson P.J., Byrne C.M., Diaz E., Kaniasty K. 60,000 disaster victims speak: Part I. An empirical review of the empirical literature, 1981–2001. Psychiatry. 2002;65:207–239. doi: 10.1521/psyc.65.3.207.20173.
    1. Marshall G.N., ScheIl T.L., Elliott M.N., Rayburn N.R., Jaycox L.H. Psychiatric disorders among adults seeking emergency disaster assistance after a wildland-urban interface fire. Psychiatr. Serv. 2007;58:509–514. doi: 10.1176/ps.2007.58.4.509.
    1. Clayer J.R., Bookless-Pratz C., Harris R.L. Some health consequences of a natural disaster. Med. J. Aust. 1985;143:182–184.
    1. Bryant R.A., Waters E., Gibbs L., Gallagher H.C., Pattison P., Lusher D., MacDougall C., Harms L., Block K., Snowdon E., et al. Psychological outcomes following the Victorian Black Saturday bushfires. Aust. N. Z. J. Psychiatry. 2014;48:634–643. doi: 10.1177/0004867414534476.
    1. Brown M.R.G., Agyapong V., Greenshaw A.J., Cribben I., Brett-MacLean P., Drolet J., McDonald-Harker C., Omeje J., Mankowsi M., Noble S., et al. After the Fort McMurray wildfire there are significant increases in mental health symptoms in grade 7–12 students compared to controls. BMC Psychiatry. 2019;19 doi: 10.1186/s12888-018-2007-1.
    1. Agyapong V.I.O., Hrabok M., Juhas M., Omeje J., Denga E., Nwaka B., Akinjise I., Corbett S.E., Moosavi S., Brown M., et al. Prevalence rates and predictors of generalized anxiety disorder symptoms in residents of Fort McMurray six months after a wildfire. Front. Psychiatry. 2018;9 doi: 10.3389/fpsyt.2018.00345.
    1. Fergusson D.M., Horwood L.J., Boden J.M., Mulder R.T. Impact of a major disaster on the mental health of a well-studied cohort. JAMA Psychiatry. 2014;71:1025–1031. doi: 10.1001/jamapsychiatry.2014.652.
    1. Goldmann E., Galea S. Mental health consequences of disasters. Annu. Rev. Public Health. 2014;35:169–183. doi: 10.1146/annurev-publhealth-032013-182435.
    1. Laugharne J., Van de Watt G., Janca A. After the fire: The mental health consequences of fire disasters. Curr. Opin. Psychiatry. 2011;24:72–77. doi: 10.1097/YCO.0b013e32833f5e4e.
    1. Miller K.E., Brownlow J.A., Woodward S., Gehrman P.R. Sleep and Dreaming in Posttraumatic Stress Disorder. Curr. Psychiatry Rep. 2017;19:71. doi: 10.1007/s11920-017-0827-1.
    1. Murphy M.J., Peterson M.J. Sleep disturbances in depression. Sleep Med. Clin. 2015;10:17–23. doi: 10.1016/j.jsmc.2014.11.009.
    1. Norris F.H., Sherrieb K., Galea S. Prevalence and consequences of disaster-related illness and injury from Hurricane Ike. Rehabil Psychol. 2010;55:221–230. doi: 10.1037/a0020195.
    1. Babson K.A., Feldner M.T. Temporal relations between sleep problems and both traumatic event exposure and PTSD: A critical review of the empirical literature. J. Anxiety Disord. 2010;24:1–15. doi: 10.1016/j.janxdis.2009.08.002.
    1. van Kamp I., van der Velden P.G., Stellato R.K., Roorda J., van Loon J., Kleber R.J., Gersons B.B., Lebret E. Physical and mental health shortly after a disaster: First results from the Enschede firework disaster study. Eur. J. Public Health. 2006;16:253–259. doi: 10.1093/eurpub/cki188.
    1. Bonanno G.A. Loss, trauma, and human resilience: Have we underestimated the human capacity to thrive after extremely aversive events? Am. Psychol. 2004;59:20–28. doi: 10.1037/0003-066X.59.1.20.
    1. Bonanno G.A., Mancini A.D. Beyond resilience and PTSD: Mapping the heterogeneity of responses to potential trauma. Psychol. Trauma. 2012;4:74–83. doi: 10.1037/a0017829.
    1. Math S.B., Nirmala M.C., Moirangthem S., Kumar N.C. Disaster Management: Mental Health Perspective. Indian J. Psychol. Med. 2015;37:261–271. doi: 10.4103/0253-7176.162915.
    1. Tempest E.L., Carter B., Beck C.R., Rubin G.J. Secondary stressors are associated with probable psychological morbidity after flooding: A cross-sectional analysis. Eur. J. Public Health. 2017;27:1042–1047. doi: 10.1093/eurpub/ckx182.
    1. Ehlers A., Clark D.M. A cognitive model of posttraumatic stress disorder. Behav. Res. Ther. 2000;38:319–345. doi: 10.1016/S0005-7967(99)00123-0.
    1. Frissa S., Hatch S.L., Fear N.T., Dorrington S., Goodwin L., Hotopf M. Challenges in the retrospective assessment of trauma: Comparing a checklist approach to a single item trauma experience screening question. BMC Psychiatry. 2016;16 doi: 10.1186/s12888-016-0720-1.
    1. Blake D.D., Weathers F.W., Nagy L.M., Kaloupek D.G., Gusman F.D., Charney D.S., Keane T.M. The development of a Clinician-Administered PTSD Scale. J. Trauma Stress. 1995;8:75–90. doi: 10.1002/jts.2490080106.
    1. Sheehan D.V., Lecrubier Y., Sheehan K.H., Amorim P., Janavs J., Weiller E., Hergueta T., Baker R., Dunbar G.C. The Mini-International Neuropsychiatric Interview (M.I.N.I.): The development and validation of a structured diagnostic psychiatric interview for DSM-IV and ICD-10. J. Clin. Psychiatry. 1998;59(Suppl. 20):S22–S33.
    1. American Psychiatric Association . Diagnostic and Statistical Manual of Mental Disorders: DSM-5™. 5th ed. American Psychiatric Publishing, Inc.; Arlington, VA, USA: 2013.
    1. Forbes D., Creamer M., Biddle D. The validity of the PTSD checklist as a measure of symptomatic change in combat-related PTSD. Behav. Res. Ther. 2001;39:977–986. doi: 10.1016/S0005-7967(00)00084-X.
    1. Kroenke K., Spitzer R.L., Williams J.B. The PHQ-9: Validity of a brief depression severity measure. J. Gen. Intern. Med. 2001;16:606–613. doi: 10.1046/j.1525-1497.2001.016009606.x.
    1. Bastien C.H., Vallieres A., Morin C.M. Validation of the Insomnia Severity Index as an outcome measure for insomnia research. Sleep Med. 2001;2:297–307. doi: 10.1016/S1389-9457(00)00065-4.
    1. Buysse D.J., Reynolds C.F., Monk T.H., Berman S.R., Kupfer D.J. The Pittsburgh Sleep Quality Index: A new instrument for psychiatric practice and research. Psychiatry Res. 1989;28:193–213. doi: 10.1016/0165-1781(89)90047-4.
    1. Germain A., Hall M., Krakow B., Shear M.K., Buysse D.J. A brief sleep scale for Posttraumatic Stress Disorder: Pittsburgh Sleep Quality Index Addendum for PTSD. J. Anxiety Disord. 2005;19:233–244. doi: 10.1016/j.janxdis.2004.02.001.
    1. Foa E.B., Ehlers A., Clark D.M., Tolin D.F., Orsillo S.M. The Posttraumatic Cognitions Inventory (PTCI): Development and validation. Psychol. Assess. 1999;11:303–314. doi: 10.1037/1040-3590.11.3.303.
    1. Folkman S., Lazarus R.S. Manual for the Ways of Coping Questionnaire. Consulting Psychologists Press; Palo Alto, CA, USA: 1988.
    1. Weathers F.W., Litz B.T., Keane T.M., Palmieri P.A., Marx B.P., Schnurr P.P. The PTSD Checklist for DSM-5 (PCL-5) [(accessed on 27 February 2019)];2013 National Center for PTSD. Available online: .
    1. Morin C.M., Belleville G., Belanger L., Ivers H. The insomnia severity index: Psychometric indicators to detect insomnia cases and evaluate treatment response. Sleep. 2011;34:601–608. doi: 10.1093/sleep/34.5.601.
    1. Steinglass P., Gerrity E. Natural disasters and post-traumatic stress disorder: Short-term versus long-term recovery in two disaster-affected communities. J. Appl. Soc. Psychol. 1990;20:1746–1765. doi: 10.1111/j.1559-1816.1990.tb01509.x.
    1. Statistics Canada Canadian Community Health Survey: Mental Health and Well-Being 2003. [(accessed on 27 February 2019)]; Available online: .
    1. Wang J., Smailes E., Sareen J., Fick G.H., Schmitz N., Patten S.B. The prevalence of mental disorders in the working population over the period of global economic crisis. Can. J. Psychiatry. 2010;55:598–605. doi: 10.1177/070674371005500908.
    1. Morin C.M., LeBlanc M., Bélanger L., Ivers H., Mérette C., Savard J. Prevalence of insomnia and its treatment in Canada. Can. J. Psychiatry. 2011;56:540–548. doi: 10.1177/070674371105600905.
    1. Koren D., Arnon I., Lavie P., Klein E. Sleep complaints as early predictors of posttraumatic stress disorder: A 1-year prospective study of injured survivors of motor vehicle accidents. Am. J. Psychiatry. 2001;159:855–857. doi: 10.1176/appi.ajp.159.5.855.
    1. Belleville G., Guay S., Marchand A. Persistence of sleep disturbances following cognitive-behavior therapy for posttraumatic stress disorder. J. Psychosom. Res. 2011;70:318–327. doi: 10.1016/j.jpsychores.2010.09.022.
    1. Galovski T.E., Monson C., Bruce S.E., Resick P.A. Does cognitive-behavioral therapy for PTSD improve perceived health and sleep impairment? J. Trauma Stress. 2009;22:197–204. doi: 10.1002/jts.20418.
    1. Casement M.D., Swanson L.M. A meta-analysis of imagery rehearsal for post-trauma nightmares: Effects on nightmare frequency, sleep quality, and posttraumatic stress. Clin. Psychol. Rev. 2012;32:566–574. doi: 10.1016/j.cpr.2012.06.002.
    1. Talbot L.S., Maguen S., Metzler T.J., Schmitz M., McCaslin S.E., Richards A., Perlis M.L., Posner D.A., Weiss B., Ruoff L., et al. Cognitive behavioral therapy for insomnia in posttraumatic stress disorder: A randomized controlled trial. Sleep. 2014;37:327–341. doi: 10.5665/sleep.3408.
    1. Lowe S.R., Joshi S., Pietrzak R.H., Galea S., Cerdá M. Mental health and general wellness in the aftermath of Hurricane Ike. Soc. Sci. Med. 2015;124:162–170. doi: 10.1016/j.socscimed.2014.11.032.
    1. Prins M.A., Verhaak P.F., Bensing J.M., van der Meer K. Health beliefs and perceived need for mental health care of anxiety and depression—The patients’ perspective explored. Clin. Psychol. Rev. 2008;28:1038–1058. doi: 10.1016/j.cpr.2008.02.009.

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