HLTH 6740 Week 2 Research Finding Discussion Post Example

Week 2 Discussion: Initial Post

One Finding and Its Reach: Resilience After September 11 and What the 65% Does Not Show

The finding I chose from this week's reading is that resilience was the most common response among New York area residents in the six months after the September 11 attacks. In a probability sample of 2,752 adults, Bonanno and colleagues defined resilience as having no or only one symptom of posttraumatic stress and found it in 65.1% of the sample (Bonanno et al., 2006). Resilience was less common among the most highly exposed, but it never fell below about a third even in the groups with the highest rates of PTSD. That finding matters because it challenges the assumption that most people exposed to a disaster will need treatment.

Here is what the finding does not reach. First, it describes a single window, the first six months, so it cannot tell us whether people classified as resilient stayed that way or developed delayed problems. Second, resilience was defined by the absence of PTSD symptoms only; someone with significant depression or grief but few PTSD symptoms would count as resilient. Third, the sample was of the general population of a metropolitan area, so the 65% describes a mix of people with very different exposures, and it cannot be applied to a small group of directly affected survivors. Reviews of disaster research show that prevalence of PTSD differs sharply between direct victims and the general population (Galea et al., 2005). Fourth, the study concerns one event, a terrorist attack in a large, well-resourced city; earlier reviews found more impairment after mass violence and in less-resourced settings (Norris et al., 2002).

So the finding supports the claim that resilience is common after a disaster in a general population sample, and it should change how quickly anyone assumes survivors need treatment. It does not support the claim that most directly affected survivors are fine, or that resilience in the first months predicts long-term outcomes.

Reply to Maya K.

Maya, your finding, that debriefing did not prevent PTSD in the Cochrane review, is well chosen. One thing I would add to its reach: the review concerned single-session individual debriefing soon after trauma. It does not show that all early support is unhelpful, and the five-principle review we read this week argues for other kinds of early help. Saying that distinction explicitly would keep readers from overextending your finding.

Reply to Ben T.

Ben, thanks for bringing a longitudinal study into the thread; most of us cited single surveys. You cited the Katrina panel study's increase in PTSD between the first and second interviews as evidence that disaster distress generally worsens over time. That study itself noted that the increase ran contrary to most disaster research, where distress usually declines, and the authors linked much of it to unresolved hurricane-related stress. I would describe it as evidence that ongoing stressors can make distress worsen, rather than as the general pattern. That reading actually strengthens your point about follow-up, since it suggests the people whose stressors stay unresolved are the ones to watch.

References

Bonanno, G. A., Galea, S., Bucciarelli, A., & Vlahov, D. (2006). Psychological resilience after disaster: New York City in the aftermath of the September 11th terrorist attack. Psychological Science, 17(3), 181-186. https://doi.org/10.1111/j.1467-9280.2006.01682.x

Galea, S., Nandi, A., & Vlahov, D. (2005). The epidemiology of post-traumatic stress disorder after disasters. Epidemiologic Reviews, 27(1), 78-91. https://doi.org/10.1093/epirev/mxi003

Norris, F. H., Friedman, M. J., Watson, P. J., Byrne, C. M., Diaz, E., & Kaniasty, K. (2002). 60,000 disaster victims speak: Part I. An empirical review of the empirical literature, 1981-2001. Psychiatry, 65(3), 207-239. https://doi.org/10.1521/psyc.65.3.207.20173