Multilevel Social Mechanisms of Post-Disaster Depression

Int J Environ Res Public Health. 2021 Jan 6;18(2):391. doi: 10.3390/ijerph18020391.

Abstract

This exploratory study empirically shows how community social capital is related to post-disaster depression, whereas most disaster mental health research has focused on posttraumatic stress disorder. We tested the validity of earlier found multilevel social and individual mechanisms of posttraumatic stress for symptoms of post-disaster depression. We used data (n = 231) from a community study after a flood in Morpeth (2008), a rural town in northern England. At the salutary community level, our multilevel analyses showed that, in communities with high social capital, individuals employ less individual social support and coping effort, which protects individuals from developing symptoms of depression. Yet, on the 'dark' individual level of our model, we found that perceiving the disaster as less traumatic after a year was related to more feelings of depression in contrast to previous findings for posttraumatic stress. Our explanation of this finding is that, when the appraisal of the disaster as threatening fades into the background, individuals may perceive the full scope of the disaster aftermath and start to feel depressed. We also found that more social support is related to more depression. Although depressed people may attract or receive more social support, this social support can paradoxically become disabling by reinforcing a sense of dependence, thereby undermining self-esteem and leading to feelings of helplessness. Our results imply that to curb post-disaster depression, boosting community level social capital may be an important starting point for building resilience. At the same time, interventionists need to identify risk groups for whom the stressful experience becomes less intrusive and who experience the burden of dependency on an unequal relationship with ones' social inner circle.

Keywords: England; depression; multilevel modeling; social capital; social impact of flood.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Depression / epidemiology
  • Depression / etiology
  • Disasters*
  • England
  • Humans
  • Mental Health
  • Social Support
  • Stress Disorders, Post-Traumatic* / epidemiology