Demoralization and the longitudinal course of PTSD following Hurricane Mitch

Background and Objectives: Numerous studies of disasters have used measures of non-specific distress as outcome measures. The utility of these measures as predictive of the long-term outcome of disasters has remained unclear, in particular the relationship with PTSD. This study examines whether demoralization is predictive and a useful concept to examine the long-term outcome of disaster related PTSD. Methods: The 1998 Hurricane Mitch that impacted Honduras was examined two-months (n = 800) and two-years following the disaster in a longitudinal community-based sample of 604 adults. Respondents were selected from a stratified sample in Tegucigalpa based on exposure and social economic status. PTSD diagnosed using the CIDI module at both periods of time. Demoralization was measured using the PERI-D at 2-months post-disaster. Results: The PERI-D, increased demoralization, was significantly associated with PTSD at two-month and two-years. In addition, increased demoralization was associated with increased risk of PTSD chronicity. Decreased demoralization was associated with PTSD remission. New onset PTSD was associated increased demoralization; however, the finding was not appreciated after controlling for potential confounders. Conclusions: Demoralization can be measured using a simple screening questionnaire that may be a useful in identifying individuals who may be at increased risk for PTSD in the short-term, as well as in the long-term following a disaster.