Anger is a well-recognised but little understood emotion in postdisaster contexts. For service providers working in recovery environments, it is critical to understand anger to ensure effective ...supports and interventions are mobilised. This article describes findings from a study conducted four years after the 2009 Victorian Black Saturday bushfires. Thirty-eight community and service-provider participants were interviewed as individuals, dyads, or within focus groups about their own and others' experiences of anger. Postdisaster anger was described as more immediate, intense, and frequent than predisaster, and seen by participants as destructive, productive, and justified. Experiences and understandings differed by gender, and related to aggression, violence, and family violence. Service provision was a key trigger for anger, with leadership styles, community expectations, and community members' level of control over decision making being factors that shaped experience. Based on these findings, five proposed principles for anger-sensitive practice in disaster contexts, along with wider considerations for understanding anger, are provided.
IMPLICATIONS
This article provides unique understandings of the experience of anger following disaster, which are useful for social workers, community members and leaders, and other service providers.
Research findings about anger experiences and outcomes postdisaster are synthesised into proposed principles for practice with disaster-impacted communities (that can potentially build capability prior to disasters).
Disasters pose a documented risk to mental health, with a range of peri- and post-disaster factors (both pre-existing and disaster-precipitated) linked to adverse outcomes. Among these, increasing ...empirical attention is being paid to the relation between disasters and violence.
This study examined self-reported experiences of assault or violence victimisation among communities affected by high, medium, and low disaster severity following the 2009 bushfires in Victoria, Australia. The association between violence, mental health outcomes and alcohol misuse was also investigated.
Participants were 1016 adults from high-, medium- and low-affected communities, 3-4 years after an Australian bushfire disaster. Rates of reported violence were compared by areas of bushfire-affectedness. Logistic regression models were applied separately to men and women to assess the experience of violence in predicting general and fire-related post-traumatic stress disorder, depression and alcohol misuse.
Reports of experiencing violence were significantly higher among high bushfire-affected compared with low bushfire-affected regions. Analyses indicated the significant relationship between disaster-affectedness and violence was observed for women only, with rates of 1.0, 0 and 7.4% in low, medium and high bushfire-affected areas, respectively. Among women living in high bushfire-affected areas, negative change to income was associated with an increased likelihood of experiencing violence (odds ratio, 4.68). For women, post-disaster violence was associated with more severe post-traumatic stress disorder and depression symptoms.
Women residing within high bushfire-affected communities experienced the highest levels of violence. These post-disaster experiences of violence are associated with post-disaster changes to income and with post-traumatic stress disorder and depression symptoms among women. These findings have critical implications for the assessment of, and interventions for, women experiencing or at risk of violence post-disaster.
Many studies show that long-term poor mental health outcomes for disaster-affected people are predicted by postdisaster stressors. Despite this finding, existing recovery frameworks vary in how these ...stressors are conceptualised. This paper examines community members' subjective perceptions of what they found problematic and useful in their recoveries after the Australian 2009 Black Saturday bushfires, and considers them in the light of these frameworks. We report the findings from responses to semi-structured survey questions as part of the Beyond Bushfires study, 3-4 years after these bushfires (n = 811). Participants identified the biggest problems as managing rebuilding processes and managing their own mental health, memories of the Black Saturday fires, and their concerns for family members. The four most useful supports were family, friends, rebuilding resources, and their community. We found a complex interplay of the same factors operating as both stressors and supports, particularly in relation to family levels of coping.
IMPLICATIONS
Disaster recovery efforts require the simultaneous management of physical rebuilding and human processes.
Families, friends, and neighbours are underestimated resources in postdisaster recovery.
Given the complex interplay of the same factors operating as both stressors and supports, interventions are needed that maximise the positive dimensions of these factors. To manage this complexity, multiple frameworks are needed to guide disaster recovery.
Anger is an important dimension of affect and a prominent feature of posttraumatic mental health, but it is commonly overlooked in postdisaster settings. We aimed to examine the distribution and ...implications of significant anger problems in the aftermath of a natural disaster, via analyses of Beyond Bushfires survey data from 736 residents of rural communities 5 years after the 2009 Black Saturday bushfires in Victoria, Australia. Assessments included the five‐item Dimensions of Anger Reaction (DAR‐5) scale along with measures of PTSD, depression, and significant mental illness, and indicators of life satisfaction, suicidality, hostile aggressive behavior, and violence exposure. The results indicated that approximately 10% of respondents from areas highly affected by the bushfires scored above the provisional cutoff criteria for significant anger problems on the DAR‐5, which was a more than 3‐fold increase, OR = 3.26, relative to respondents from areas of low‐to‐moderate bushfire impact. The rates were higher among women, younger participants, and those who were unemployed, and co‐occurred commonly, although not exclusively, with other postdisaster mental health problems. Anger problems were also associated with lower life satisfaction, β = −.31, an 8‐fold increase in suicidal ideation, OR = 8.68, and a nearly 13‐fold increase in hostile aggressive behavior, OR = 12.98. There were associations with anger problems and violence exposure, which were reduced when controlling for covariates, including probable PTSD. The findings provide evidence indicating that anger is a significant issue for postdisaster mental health and should be considered routinely alongside other posttraumatic mental health issues.
Research on mental health following disasters has led to the identification of many individual protective and risk factors for postdisaster mental health. However, there is little understanding of ...the exact influence that disasters have on the functioning of intimate relationships. Especially relevant are attachment styles, which are likely to play an important role in the provision and perception of social support between partners, and subsequent mental health outcomes. Heterosexual couples (N = 127) affected by the 2009 Victorian "Black Saturday" Bushfires in southeastern Australia were surveyed for disaster experiences, posttraumatic stress disorder (PTSD) symptoms, depression, and attachment style between May 2012 and January 2013, approximately 3 years after the disaster. Using actor-partner interdependence models (APIM), we examined both intrapersonal and interpersonal associations of attachment anxiety and avoidance with depression and PTSD, in combination with shared disaster exposure. Male partners' attachment avoidance was associated with depression and PTSD in both partners. By contrast, a female partner's attachment avoidance was associated with greater depression and PTSD in herself, but fewer PTSD symptoms in a male partner. Amid the chronic stressors of a postdisaster setting, the attachment avoidance of the male partner may play a particularly negative role, with his tendency toward isolation and denial becoming especially maladaptive for the couple as a whole. The female partner's attachment avoidance is likewise an important factor, but its associations with negative social support and relationship breakup must be clarified to understand its impact on partnership functioning.
In the disaster literature, psycho-social recovery is conceptualised typically as the alleviation of traumatic stress, with the alleviation of disaster-related grief as a less prominent part of this. ...Yet, incorporating grief understandings into recovery conceptualisations post disaster is important. This paper explores these conceptualisations by analysing participants' bereavement experiences following the Black Saturday bushfires. It draws on data from Beyond Bushfires, a mixed-methods study (n = 1,016) in which survey and interview data relating to individual loss and recovery experiences were examined. The loss through death of friends and community members was found to be predictive of poorer mental health outcomes, although prolonged grief outcomes were rare. The sense of relationshipsas being 'like family' was identified by interviewees as an important dimension of their particuiarcommunities, as was coping with multiple deaths and the hierarchy of grief that emerged, and the stress of notifying others of these deaths. The implications of these impacts are considered for social work research and practice.
Determine incidence and risk factors for readmissions in early infancy.
Secondary analysis of data from the Cesarean Section Optimal Antibiotic Prophylaxis trial. All unplanned revisits (unplanned ...clinic, ER visits, and hospital readmissions) and hospital readmissions (initial discharge to 3-month follow-up) were analyzed.
295 (15.9%) of 1850 infants had revisits with risk factors being ethnicity (adjusted odds ratio (aOR): 0.6 for Hispanic), maternal postpartum antibiotics (1.89), azithromycin treatment (1.22), small for gestational age (1.68), apnea (3.82), and hospital stay after birth >90th percentile (0.49). 71 (3.8%) of 1850 infants were readmitted with risk factors being antenatal steroids (aOR 2.49), elective repeat C/section (0.72), postpartum maternal antibiotics (2.22), O
requirement after delivery room (2.82), and suspected/proven neonatal sepsis (0.55).
Multiple risk factors were identified, suggesting potential impact on the neonatal microbiome (maternal postpartum antibiotics) or issues related to access/cost of care (Hispanic ethnicity associated with fewer revisits).
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