Objective The purpose of the study was to explore the relationship between posttraumatic stress (PTS) and posttraumatic growth (PTG) after Hurricane Katrina, and the role of demographics, pre-disaster psychological distress, hurricane-related stressors, and psychological resources (optimism and purpose) in predicting each. Method Participants were 334 low-income mothers (82.0% non-Hispanic Black) living in the New Orleans area prior to Hurricane Katrina, who completed surveys in the year prior to the hurricane (T1), and one and three years thereafter (T2 and T3). Results Higher T2 and T3 PTS full-scale and symptom cluster subscales (intrusion, avoidance, and hyperarousal) were significantly associated with higher T3 PTG, and participants who surpassed the clinical cut-off for probable PTSD at both T2 and T3 had significantly higher PTG than those who never surpassed the clinical cut-off. Older and non-Hispanic Black participants, as well as those who experienced a greater number of hurricane-related stressors and bereavement, reported significantly greater T3 PTS and PTG. Participants with lower T2 optimism reported significantly greater T3 intrusive symptoms, whereas those with higher T1 and T2 purpose reported significantly greater T3 PTG. Conclusions Based on the results, we suggest practices and policies that identify disaster survivors at greater risk for PTS, as well as longitudinal investigations of reciprocal and mediational relationships between psychological resources, PTS, and PTG.

Previous research on functional outcome in bipolar disorder (BD) has uncovered various factors that exacerbate psychosocial disability over the course of illness, including genetics, illness severity, stress, anxiety, and cognitive impairment. This paper presents an integrated view of these findings that accounts for the precipitous decline in psychosocial functioning after illness onset. The proposed model highlights a number of reciprocal pathways among previously studied factors that trap people in a powerful cycle of ailing forces. The paper discusses implications to patient care as well as the larger social changes required for shifting the functional trajectory of people with BD from psychosocial decline to growth.

This longitudinal study examined characteristics of a discrete mood episode that predict re-hospitalization for bipolar disorder, highlighting associated cognitive dysfunction as a potential mechanism linking episode severity and relapse. Eighty-two inpatients meeting DSM-IV-TR diagnostic criteria for bipolar I disorder completed the study. Twenty-two of the patients were readmitted to the hospital within 3 months of discharge. The study compared these patients to the remaining 60 patients who were not readmitted to the hospital during this period. Patients were compared on several factors related to the severity of the mood episode and the course of illness more generally. Analysis also compared the groups on measures of mood and neuro-cognitive functioning, assessed 24–48 hours before initial hospitalization discharge. Re-hospitalized patients had longer initial hospital stays (t = −3.10, p<0.01), higher rates of psychosis while in the hospital (Chi square=5.1, p<0.02), and lower GAF scores on discharge (t = 2.37, p<0.05). The groups did not differ in age of illness onset or number of previous psychiatric hospitalizations. With respect to neuro-cognitive functioning, analysis indicated poorer performance for re-hospitalized patients on measures of executive functioning (Wilks’ Lambda, F (7, 71) = 9.0, p<0.001), IQ (Wilks’ Lambda, F (2, 76) = 5.06, p<0.01), and memory (Wilks’ Lambda, F (6,72) = 4.19, p<0.001). Trends in the expected direction emerged for attention/working memory tests (Wilks’ Lambda, F (7, 71) = 1.79, p<0.10). Results highlight features of a discrete mood episode associated with increased rates of re-hospitalization. This study observed connections among episode severity, cognitive dysfunction at hospital discharge and re-hospitalization.

This mixed-methods study aimed to gain knowledge of the lived experience of posttraumatic growth (PTG) in 32 low-income Black mothers whose New Orleans’ homes were damaged or destroyed by Hurricane Katrina, and half of whom had relocated indefinitely to Houston. Data from in-depth interviews with participants were examined in conjunction with quantitative scores on the Posttraumatic Growth Inventory (PTGI; Tedeschi & Calhoun, 1996). Participants were interviewed face-to-face on a range of postdisaster experiences, including positive changes, in 2009. Participants also completed the PTGI via a telephone survey within six months of being interviewed. Most (26 out of 32) participants described experiencing PTG within the 5 domains of the PTGI, with the domains most frequently coded, in descending order, being New Possibilities, Relating to Others, Personal Strength, Appreciation for Life, and Spiritual Change. PTG stemmed heavily from exposure to opportunities in survivors’ postdisaster communities, including increased racial diversity, improved neighborhoods, and new educational and economic opportunities. Participants’ frequency of all PTG codes was associated with their overall PTGI scores with a small-to-moderate effect size (r = .32; p = .078) in a relationship that trended toward significance. Without minimizing the catastrophic losses they entail, disasters may in some cases create spaces for PTG for survivors, including through new opportunities in areas where survivors formerly experienced oppression. Policymakers should examine how to make such opportunities available, visible and accessible to individuals absent a disaster.