Chronic Mental Health Sequelae of Climate Change Extremes: A Case Study of the Deadliest Californian Wildfire

Abstract

Introduction. Weather-related disasters, such as wildfires exacerbated by a rise in global temperatures, need to be better studied in terms of their mental health impacts. This study focuses on the mental health sequelae of the deadliest wildfire in California to date, the Camp Fire of 2018. Methods. We investigated a sample of 725 California residents with different degrees of disaster exposure and measured mental health using clinically validated scales for post-traumatic stress disorder (PTSD), major depressive disorder (MDD) and generalized anxiety disorder (GAD). Data were collected at a chronic time-point, six months post-wildfire. We used multiple regression analyses to predict the mental health outcomes based on self-reported fire exposure. Additionally, we included vulnerability and resilience factors in hierarchical regression analyses. Results. Our primary finding is that direct exposure to large scale fires significantly increased the risk for mental health disorders, particularly for PTSD and depression. Additionally, the inclusion of vulnerability and resilience factors in the hierarchical regression analyses led to the significantly improved prediction of all mental health outcomes. Childhood trauma and sleep disturbances exacerbated mental health symptoms. Notably, self-reported resilience had a positive effect on mental health, and mindfulness was associated with significantly lower depression and anxiety symptoms. Conclusion. Overall, our study demonstrated that climate-related extreme events, such as wildfires, can have severe mental illness sequelae. Moreover, we found that pre-existing stressful life events, resilient personality traits and lifestyle factors can play an important role in the prevalence of psychopathology after such disasters. Unchecked climate change projected for the latter half of this century may severely impact the mental wellbeing of the global population, and we must find ways to foster individual resiliency.

The Impact of Wildfires on Mental Health: A Scoping Review

“…Studies have looked at other outcomes or symptoms associated with PTSD post-wildfire including sleep disturbance and insomnia, anger, attachment style, interpersonal violence, and a term known as vicarious traumatization which is the development of PTSD symptoms from indirect trauma exposure [ 43 , 46 , 48 , 50 , 51 , 62 , 70 , 73 ].…”

“…Our literature search did not reveal a review specific to risk factors for developing PTSD post-bushfire, but such factors have been investigated by several primary studies. In adults, demographic factors such as female gender, widowed status, or fewer years of education, lower socioeconomic status, and non-caucasian ethnicity are associated risk factors, although gender was not always been found to be significant [ 26 , 32 , 69 , 73 , 78 ]. Trauma-related factors significant to increasing one’s risk of post-wildfire PTSD include personal witnessing of burning homes, having fear for one’s life or lives of loved ones, losing a loved one, significant property damage, or feeling a lack of support from family, friends, and/or the government [ 22 , 26 , 32 , 34 , 42 , 57 , 62 , 69 ].…”

“…There were fewer studies in the literature search investigating risk factors for depression post-bushfire in comparison to PTSD. However, some patient factors that have been identified in adults include female gender, age greater than 40 years old, a greater number of adverse experiences in childhood, a prior history of depressive disorder or anxiety disorder, and prior treatment with an antidepressant [ 14 , 33 , 64 , 71 , 73 ]. Other researchers did not find an association between demographic factors or gender and depression [ 57 , 78 ].…”

“…Although survey scales may be the best tool researchers have to quantify resiliency, they underestimate the fluidity and complexity of its constantly adapting components including patient characteristics and family and community supports. Individuals with high resilience scores after experiencing a wildfire had lower scores on screening measures for mental health disorders including PTSD, depression, and anxiety, and increased self-esteem and quality of life scores [ 17 , 73 ]. There is existing research on the relationship between resiliency factors such as coping strategies, group involvement, and psychotherapy with mental health outcomes post-wildfire [ 35 , 47 , 49 , 54 ].…”

A Systematic Review of the Impact of Wildfires on Sleep Disturbances

“…Belleville and colleagues [ 40 ] also found that sleep disturbances, sleep quality and insomnia were significantly associated with PTSD three months post-fires ( p < 0.01). Furthermore, higher levels of sleep disturbances on the Patient-Reported Outcomes Measurement Information System (PROMIS) were associated with higher scores on the PTSD-Checklist (PCL-5, Blevins et al, 2015) [ 44 ].…”