There is a growing body of research into the effects of micronutrients on human mental health. There is evidence that multi-ingredient formulas are beneficial especially in relation to serious mental health disorders such as mood and anxiety disorders, attention-deficit hyperactivity disorder and obsessive-compulsive disorders. However there is almost no scientific research which looks at the effects of these formulas in an animal population. Therefore the aim of this study was to investigate the effects of a micronutrient formula, EMPowerplus, on anxiety behaviour in rats, and whether there is a relationship between dose and anxiolytic effect. In order to investigate this 40 male and 40 female rats received a diet consisting of either 0%, 1.25%, 2.5% or 5% EMP+ from when they were weaned (post natal day 30) until the end of testing 141 days later. Animals were tested in a Y maze, a light-dark emergence box and an open field at mid-adulthood (PND 136-138) and late adulthood (PND 186-188). Results found that animals receiving the 5% supplemented diet occupied the centre squares the most, occupied the corner squares the least and ambulated the most in the open field compared to the other experimental groups and control groups. No significant differences were found in the Y maze or Light-dark box. Animals were found to display more anxiety-like behaviour at time 2 than at time 1 regardless of receiving a supplemented diet or not. Overall a higher dose of EMP+ was associated with the greatest reduction in anxiety related behaviour. Due to the impact of the September 4th, 2010 Canterbury Earthquake caution should be taken when interpreting these results.
The aim of this thesis was to examine the spatial and the temporal patterns of anxiety and chest pain resulting from the Canterbury, New Zealand earthquaeks. Three research objectives were identified: examine any spatial or termporal clusters of anxiety and chest pain; examine the associations between anxiety, chest pain and damage to neighbourhood; and determine any statistically significant difference in counts of anxiety and chest pain after each earthquake or aftershock which resulted in severe damage. Measures of the extent of liquefaction the location of CERA red-zones were used as proxy measures for earthquake damage. Cases of those who presented to Christchurch Public Hospital Emergency Department with either anxiety or chest pain between May 2010 and April 2012 were aggregated to census area unit (CAU) level for analysis. This thesis has taken a unique approach to examining the spatial and spatio-temporal variations of anxiety and chest pain after an earthquake and offers unique results. This is the first study of its kind to use a GIS approach when examining Canterbury specific earthquake damage and health variables at a CAU level after the earthquakes. Through the use of spatio-termporal scan modelling, negative and linear regression modelling and temporal linear modelling with dummy variables this research was able to conclude there are significant spatial and temporal variations in anxiety and chest pain resulting from the earthquakes. The spatio-termporal scan modelling identified a hot cluster of both anxiety and chest pain within Christchurch at the same time the earthquakes occurred. The negative binomial model found liquefaction to be a stronger predictor of anxiety than the Canterbury Earthquake Recovery Authority's (CERA) land zones. The linear regression model foun chest pain to be positively associated with all measures of earthquake damage with the exception of being in the red-zone. The temporal modelling identified a significant increase in anxiety cases one month after a major earthquake, and chest pain cases spiked two weeks after an earthquake and gradually decreased over the following five weeks. This research was limited by lack of control period data, limited measures of earthquake damage, ethical restrictions, and the need for population tracking data. The findings of this research will be useful in the planning and allocation of mental wellbeing resources should another similar event like the Canterbury Earthquakes occur in New Zealand.
Following exposure to trauma, stress reactions are initially adaptive. However, some individuals’ psychological response can become maladaptive with long-lasting impairment to functioning. Most people with initial symptoms of stress recover, and thus it is important to distinguish individuals who are at risk of continuing difficulties so that resources are allocated appropriately. Investigations of predictors of PTSD development have largely focused on relational and combat-related trauma, with very limited research looking at natural disasters. This study assessed the nature and severity of psychological difficulties experienced in 101 people seeking treatment following exposure to a significant earthquake that killed 185 people. Peritraumatic dissociation, posttraumatic stress symptoms, symptoms of anxiety, symptoms of depression, and social isolation were assessed. Descriptive analyses revealed the sample to be a highly impaired group, with particularly high levels of posttraumatic stress symptoms. Path analysis was used to determine whether the experience of some psychological difficulties predicted experience of others. As hypothesised, peritraumatic dissociation was found to predict posttraumatic stress symptoms and symptoms of anxiety. Posttraumatic stress symptoms then predicted symptoms of anxiety and symptoms of depression. Depression and anxiety were highly correlated. Contrary to expectations, social isolation was not significantly related to any other psychological variables. These findings justify the provision of psychological support following a natural disaster and suggest the benefit of assessing peritraumatic dissociation and posttraumatic stress symptoms soon after the event to identify people in need of monitoring and intervention.
The current study examined the psychological effects of recurring earthquake aftershocks in the city of Christchurch, New Zealand, which began in September 2010. Although it has been identified that exposure to ongoing adverse events such as continuing terrorist attacks generally leads to the development of increasing symptomology over time, differences in perceived controllability and blame between man-made and natural adverse events may contribute to differences in symptom trajectories. Residents of two Christchurch suburbs differentially affected by the earthquakes (N = 128) were assessed on measures of acute stress disorder, generalised anxiety, and depression, at two time points approximately 4-5 months apart, in order to determine whether symptoms intensified or declined over time in the face of ongoing aftershocks. At time 1, clinically significant levels of acute stress were identified in both suburbs, whereas clinical elevations in depression and anxiety were only evident in the most affected suburb. By time 2, both suburbs had fallen below the clinical range on all three symptom types, identifying a pattern of habituation to the aftershocks. Acute stress symptoms at time 2 were the most highly associated with the aftershocks, compared to symptoms of generalised anxiety and depression which were identified by participant reports to be more likely associated with other earthquake-related factors, such as insurance troubles and less frequent socialisation. The finding that exposure to ongoing earthquake aftershocks leads to a decline in symptoms over time may have important implications for the assessment of traumatic stress-related disorders, and provision of services following natural, as compared to man-made, adverse events.
Natural hazard disasters often have large area-wide impacts, which can cause adverse stress-related mental health outcomes in exposed populations. As a result, increased treatment-seeking may be observed, which puts a strain on the limited public health care resources particularly in the aftermath of a disaster. It is therefore important for public health care planners to know whom to target, but also where and when to initiate intervention programs that promote emotional wellbeing and prevent the development of mental disorders after catastrophic events. A large body of literature assesses factors that predict and mitigate disaster-related mental disorders at various time periods, but the spatial component has rarely been investigated in disaster mental health research. This thesis uses spatial and spatio-temporal analysis techniques to examine when and where higher and lower than expected mood and anxiety symptom treatments occurred in the severely affected Christchurch urban area (New Zealand) after the 2010/11 Canterbury earthquakes. High-risk groups are identified and a possible relationship between exposure to the earthquakes and their physical impacts and mood and anxiety symptom treatments is assessed. The main research aim is to test the hypothesis that more severely affected Christchurch residents were more likely to show mood and anxiety symptoms when seeking treatment than less affected ones, in essence, testing for a dose-response relationship. The data consisted of mood and anxiety symptom treatment information from the New Zealand Ministry of Health’s administrative databases and demographic information from the National Health Index (NHI) register, when combined built a unique and rich source for identifying publically funded stress-related treatments for mood and anxiety symptoms in almost the whole population of the study area. The Christchurch urban area within the Christchurch City Council (CCC) boundary was the area of interest in which spatial variations in these treatments were assessed. Spatial and spatio-temporal analyses were done by applying retrospective space-time and spatial variation in temporal trends analysis using SaTScan™ software, and Bayesian hierarchical modelling techniques for disease mapping using WinBUGS software. The thesis identified an overall earthquake-exposure effect on mood and anxiety symptom treatments among Christchurch residents in the context of the earthquakes as they experienced stronger increases in the risk of being treated especially shortly after the catastrophic 2011 Christchurch earthquake compared to the rest of New Zealand. High-risk groups included females, elderly, children and those with a pre-existing mental illness with elderly and children especially at-risk in the context of the earthquakes. Looking at the spatio-temporal distribution of mood and anxiety symptom treatments in the Christchurch urban area, a high rates cluster ranging from the severely affected central city to the southeast was found post-disaster. Analysing residential exposure to various earthquake impacts found that living in closer proximity to more affected areas was identified as a risk factor for mood and anxiety symptom treatments, which largely confirms a dose-response relationship between level of affectedness and mood and anxiety symptom treatments. However, little changes in the spatial distribution of mood and anxiety symptom treatments occurred in the Christchurch urban area over time indicating that these results may have been biased by pre-existing spatial disparities. Additionally, the post-disaster mobility activity from severely affected eastern to the generally less affected western and northern parts of the city seemed to have played an important role as the strongest increases in treatment rates occurred in less affected northern areas of the city, whereas the severely affected eastern areas tended to show the lowest increases. An investigation into the different effects of mobility confirmed that within-city movers and temporary relocatees were generally more likely to receive care or treatment for mood or anxiety symptoms, but moving within the city was identified as a protective factor over time. In contrast, moving out of the city from minor, moderately or severely damaged plain areas of the city, which are generally less affluent than Port Hills areas, was identified as a risk factor in the second year post-disaster. Moreover, residents from less damaged plain areas of the city showed a decrease in the likelihood of receiving care or treatment for mood or anxiety symptoms compared to those from undamaged plain areas over time, which also contradicts a possible dose-response relationship. Finally, the effects of the social and physical environment, as well as community resilience on mood and anxiety symptom treatments among long-term stayers from Christchurch communities indicate an exacerbation of pre-existing mood and anxiety symptom treatment disparities in the city, whereas exposure to ‘felt’ earthquake intensities did not show a statistically significant effect. The findings of this thesis highlight the complex relationship between different levels of exposure to a severe natural disaster and adverse mental health outcomes in a severely affected region. It is one of the few studies that have access to area-wide health and impact information, are able to do a pre-disaster / post-disaster comparison and track their sample population to apply spatial and spatio-temporal analysis techniques for exposure assessment. Thus, this thesis enhances knowledge about the spatio-temporal distribution of adverse mental health outcomes in the context of a severe natural disaster and informs public health care planners, not only about high-risk groups, but also where and when to target health interventions. The results indicate that such programs should broadly target residents living in more affected areas as they are likely to face daily hardship by living in a disrupted environment and may have already been the most vulnerable ones before the disaster. Special attention should be focussed on women, elderly, children and people with pre-existing mental illnesses as they are most likely to receive care or treatment for stress-related mental health symptoms. Moreover, permanent relocatees from affected areas and temporarily relocatees shortly after the disaster may need special attention as they face additional stressors due to the relocation that may lead to the development of adverse mental health outcomes needing treatment.
Earthquake events can be sudden, stressful, unpredictable, and uncontrollable events in which an individual’s internal and external assumptions of their environment may be disrupted. A number of studies have found depression, and other psychological symptoms may be common after natural disasters. They have also found an association between depression, losses and disruptions for survivors. The present study compared depression symptoms in two demographically matched communities differentially affected by the Canterbury (New Zealand) earthquakes. Hypotheses were informed by the theory of learned helplessness (Abramson, Seligman & Teasdale, 1978). A door-to-door survey was conducted in a more physically affected community sample (N=67) and a relatively unaffected community sample (N=67), 4 months after the February 2011 earthquake. Participants were again assessed approximately 10 months after the quake. Measures of depression, acute stress, anxiety, aftershock anxiety, losses, physical disruptions and psychological disruptions were taken. In addition, prior psychological symptoms, medication, alcohol and cigarette use were assessed. Participants in the more affected community reported higher depression scores than the less affected community. Overall, elevated depressive score at time 2 were predicted by depression at time 1, acute stress and anxiety symptoms at time 2, physical disruptions following the quake and psychosocial functioning disruptions at time 2. These results suggest the influence of acute stress, anxiety and disruptions in predicting depression sometime after an earthquake. Supportive interventions directed towards depression, and other psychological symptoms, may prove helpful in psychological adjustment following ongoing disruptive stressors and uncontrollable seismic activity.
Individual responses to natural disasters are highly variable. The psychological and behavioural response trajectories of those who manage to cope well with adverse life events are in need of further investigation. Increased alcohol use is often observed in communities exposed to mass traumas, particularly among those exposed to severe levels of trauma, with males drinking more than females. The current study examined patterns of alcohol use and motivations for drinking among a sample of psychologically resilient individuals with varying levels of exposure to the Canterbury earthquakes (N = 91) using structured and semi-structured interviews and self-report measures. As hypothesised, there was a significant increase in alcohol consumption since the earthquakes began, and males reported significantly higher levels of pre-earthquake and current alcohol consumption than females. Contrary to expectations, there was no association between traumatic exposure severity and alcohol consumption. While participants reported anxiety-based coping motives for drinking at levels comparable to those reported by other studies, depression-based coping motives were significantly lower, providing partial support for the hypothesis that participants would report coping motives for drinking at levels comparable to those found by other researchers. No gender differences in drinking motives were found. As expected, current alcohol consumption was positively correlated with anxiety and depression-based coping motives for drinking. Psychological resilience was not significantly associated with alcohol use, however resilience was negatively associated with depression-based coping motives for drinking. These findings have inter-generational and international implications for post-traumatic intervention.
The University of Canterbury Dept. of Chemistry has weathered the Canterbury Earthquake of September 4, 2010 very well due to a combination of good luck, good planning and dedicated effort. We owe a great deal to university Emergency Response Team and Facilities Management Personnel. The overall emergency preparedness of the university was tested to a degree far beyond anything else in its history and shown to be well up to scratch. A strong cooperative relationship between the pan-campus controlling body and the departmental response teams greatly facilitated our efforts. Information and assistance was provided promptly, as and when we needed it without unnecessary bureaucratic overheads. At the departmental level we are indebted to the technical staff who implemented the invaluable pre-quake mitigation measures and carried the majority of the post-quake clean-up workload. These people put aside their personal concerns and anxieties at a time when magnitude-5 aftershocks were still a regular occurrence.
A natural disaster will inevitably strike New Zealand in the coming years, damaging educational facilities. Delays in building quality replacement facilities will lead to short-term disruption of education, risking long-term inequalities for the affected students. The Christchurch earthquake demonstrated the issues arising from a lack of school planning and support. This research proposes a system that can effectively provide rapid, prefabricated, primary schools in post-disaster environments. The aim is to continue education for children in the short term, while using construction that is suitable until the total replacement of the given school is completed. The expandable prefabricated architecture meets the strength, time, and transport requirements to deliver a robust, rapid relief temporary construction. It is also adaptable to any area within New Zealand. This design solution supports personal well-being and mitigates the risk of educational gaps, PTSD linked with anxiety and depression, and many other mental health disorders that can impact students and teachers after a natural disaster.
Abstract. Natural (e.g., earthquake, flood, wildfires) and human-made (e.g., terrorism, civil strife) disasters are inevitable, can cause extensive disruption, and produce chronic and disabling psychological injuries leading to formal diagnoses (e.g., post-traumatic stress disorder [PTSD]). Following natural disasters of earthquake (Christchurch, Aotearoa/New Zealand, 2010–11) and flood (Calgary, Canada, 2013), controlled research showed statistically and clinically significant reductions in psychological distress for survivors who consumed minerals and vitamins (micronutrients) in the following months. Following a mass shooting in Christchurch (March 15, 2019), where a gunman entered mosques during Friday prayers and killed and injured many people, micronutrients were offered to survivors as a clinical service based on translational science principles and adapted to be culturally appropriate. In this first translational science study in the area of nutrition and disasters, clinical results were reported for 24 clients who completed the Impact of Event Scale – Revised (IES-R), the Depression Anxiety Stress Scales (DASS), and the Modified-Clinical Global Impression (M-CGI-I). The findings clearly replicated prior controlled research. The IES-R Cohen’s d ESs were 1.1 (earthquake), 1.2 (flood), and 1.13 (massacre). Effect sizes (ESs) for the DASS subscales were also consistently positive across all three events. The M-CGI-I identified 58% of the survivors as “responders” (i.e., self-reported as “much” to “very much” improved), in line with those reported in the earthquake (42%) and flood (57%) randomized controlled trials, and PTSD risk reduced from 75% to 17%. Given ease of use and large ESs, this evidence supports the routine use of micronutrients by disaster survivors as part of governmental response.
INTRODUCTION: After the 2011 Canterbury earthquake, the provision of school social work was extended into a larger number of schools in the greater Christchurch region to support discussions of their practice priorities and responses in post-earthquake schools. FINDINGS: Two main interpretations of need are reflected in the school social workers’ accounts of their work with children and families. Firstly, hardship-focused need, which represented children as adversely influenced by their home circumstances; the interventions were primarily with parents. These families were mainly from schools in low socioeconomic areas. Secondly, anxiety-based need, a newer practice response, which emphasised children who were considered particularly susceptible to the impacts of the disaster event. This article considers how these practitioners conceptualised and responded to the needs of the children and their families in this context. METHOD: A qualitative study examining recovery policy and school social work practice following the earthquakes including 12 semi-structured interviews with school social workers. This article provides a Foucauldian analysis of the social worker participants’ perspectives on emotional and psychological issues for children, particularly those from middle-class families; the main interventions were direct therapeutic work with children themselves. Embedded within these practice accounts are moments in which the social workers contested the predominant, individualising conceptualisations of need to enable more open-ended, negotiable, interconnected relationships in post-earthquake schools. IMPLICATIONS: In the aftermath of disasters, school social workers can reflect on their preferred practice responses and institutional influences in schools to offer children and families opportunities to reject the prevalent norms of risk and vulnerability.
Over the last six years, Canterbury residents have lived through two major earthquakes and thousands of aftershocks, with such events negatively impacting psychological health. Research shows rates of post-traumatic stress symptoms in children have doubled post-quake, and a classroom containing children who are experiencing chronically high physiological arousal has been shown to be a stressful environment for teachers. Such stress therefore negatively impacts teachers’ ability to sleep well, meaning many Christchurch teachers may suffer from insomnia, a debilitating condition leading to psychological distress and often comorbid with other mental health conditions. The present research sought to investigate the use of a broadspectrum micronutrient formula called EMPowerplus (EMP+) for chronic insomnia in teachers. This study examined the effect of EMP+ over an 8-10 week period using a multiple-baseline design with placebo. Seventeen teachers were randomized to one of three baseline sequences where they completed a one week baseline period, before receiving five, nine, or 14 days, of placebo as well as 8-10 weeks of the micronutrient formula. After completion of the trial, a three-month follow up was conducted. All participants completed the trial, and results showed a statistically reliable and clinically significant decrease in insomnia severity (Cohen’s dav = - 1.37), on at least one or more aspects of the sleep diary, and on emotional exhaustion (Cohen’s dav = -1.08). EMP+ also statistically significantly reduced insomnia severity compared to placebo (Cohen’s dav = -0.66). Statistically significant reduction was not seen in stress, anxiety and depression scores as compared to placebo, and these levels were not generally clinically raised to begin with. Sixteen out of 17 participants were compliant, and side effects were generally mild and transitory. The current study provides evidence for the beneficial effect of micronutrient supplementation on chronic insomnia in Christchurch teachers working in a stressful environment. Future research incorporating measurement of nutritional intake and proinflammatory biomarkers, as well as conducting comparisons to other conventional treatments, is recommended.
Following a natural disaster, children are prone to various reactions and maladaptive responses as a result of exposure to a highly stressful and potentially traumatic event. Children’s responses can range from an acute stress response to post-traumatic-stress disorder or may fall somewhere in between. While responses to highly stressful events vary, a common finding is that children will develop sleep problems. This was found following the Christchurch September 2010 and February 2011 earthquakes. The purpose of this study was to investigate the context and phenomenology of the sleep problems of a small number of children experiencing these and the 2016 Kaikoura earthquakes, including possible mechanisms of effect. Participants were four families, including four mothers, one father and four children. The design of this study was unique. Interview data was subjected to a content analysis, extracted themes were organised according to an ecological-transactional framework and then the factors were subject to an analysis, based on the principles of clinical reasoning, in order to identify possible mechanisms of effect. Parents reported 16 different sleep problems across children, as well as other behaviours possibly indicative of post-traumatic stress response. In total, 34 themes and 26 interactions were extracted in relation to factors identified across participants about the children’s sleep and the families’ earthquake experiences. This demonstrated how complex it is to explore the development of sleep problems in the context of disaster. Key factors identified by parents that likely played a key role in the development and perpetuation of sleep problems included earthquake related anxiety, parental mental health and conflict, the child’s emotional and behavioural problems and other negative life events following the earthquakes. The clinical implications of the analysis included being aware that such families, may not have had access to specialized support around their children’s sleep. This was much needed due to the strain such problems place on the family, especially in a post-disaster community such as Christchurch.
From 2010, Canterbury, a province of Aotearoa New Zealand, experienced three major disaster events. This study considers the socio-ecological impacts on cross-sectoral suicide prevention agencies and their service users of the 2010 – 2016 Canterbury earthquake sequence, the 2019 Christchurch mosque attacks and the COVID-19 pandemic in Canterbury. This study found the prolonged stress caused by these events contributed to a rise in suicide risk factors including anxiety, fear, trauma, distress, alcohol misuse, relationship breakdown, childhood adversity, economic loss and deprivation. The prolonged negative comment by the media on wellbeing in Canterbury was also unhelpful and affected morale. The legacy of these impacts was a rise in referrals to mental health services that has not diminished. This adversity in the socio-ecological system also produced post-traumatic growth, allowing Cantabrians to acquire resilience and help-seeking abilities to support them psychologically through the COVID-19 pandemic. Supporting parental and teacher responses, intergenerational support and targeted public health campaigns, as well as Māori family-centred programmes, strengthened wellbeing. The rise in suicide risk led to the question of what services were required and being delivered in Canterbury and how to enable effective cross-sectoral suicide prevention in Canterbury, deemed essential in all international and national suicide prevention strategies. Components from both the World Health Organisation Suicide Prevention Framework (WHO, 2012; WHO 2021) and the Collective Impact model (Hanleybrown et al., 2012) were considered by participants. The effectiveness of dynamic leadership and the essential conditions of resourcing a supporting agency were found as were the importance of processes that supported equity, lived experience and the partnership of Māori and non-Māori stakeholders. Cross-sectoral suicide prevention was found to enhance the wellbeing of participants, hastening learning, supporting innovation and raising awareness across sectors which might lower stigma. Effective communication was essential in all areas of cross-sectoral suicide prevention and clear action plans enabled measurement of progress. Identified components were combined to create a Collective Impact Suicide Prevention framework that strengthens suicide prevention implementation and can be applied at a local, regional and national level. This study contributes to cross-sectoral suicide prevention planning by considering the socio- ecological, policy and practice mitigations required to lower suicide risk and to increase wellbeing and post-traumatic growth, post-disaster. This study also adds to the growing awareness of the contribution that social work can provide to suicide prevention and conceptualises an alternative governance framework and practice and policy suggestions to support effective cross-sectoral suicide prevention.
Abstract The original intention for the Partnership Community Worker (PCW) project in 2006 was for it to be an extension of the Pegasus Health General Practice and furthermore to be a bridge between the community and primary healthcare. It was believed that a close working relationship between the Practice Nurse and the PCW would help the target population of Māori, Pacifica and low income people to address and overcome their perceived barriers to healthcare which included: finance, transport, anxiety, cultural issues, communication, or lack of knowledge. Seven years later although the PCW project has been deemed a success in the Canterbury District Health Board annual reports (2013-14) and community and government agencies, including the Christchurch Resettlement Service (2012), many of the Pegasus Health General Practices have not utilised the project to its full extent, hence the need for this research. I was interested in finding out in the first instance if the model had changed and, if so why, and in the second instance if the promotional material currently distributed by Pegasus Health Primary Health Organisation reflected the daily practice of the PCW. A combination of methods were used including: surveys to the Pegasus Health General Practices, interviews with PCWs, interviews with managers of both the PCW host organisations and referring agencies to the PCW project. All the questions asked of all the participants in this research were focussed on their own perception of the role of the PCW. Results showed that the model has changed and although the publications were not reflecting the original intention of the project they did reflect the daily practice of the PCWs who are now struggling to meet much wider community expectations and needs. Key Results: Partnership Community Worker (PCW) interviews: Seventeen PCWs of the 19 employed were interviewed face to face. A number expressed interest in more culturally specific training and some are pursuing qualifications in social work; for many pay parity is an issue. In addition, many felt overwhelmed by the expectations around clients with mental health issues and housing issues now, post-earthquakes. Medical Practice surveys: Surveys were sent to eighty-two Pegasus Health medical practices and of these twenty five were completed. Results showed the full capacity of the PCW role was not clearly understood by all with many believing it was mostly a transport service. Those who did understand the full complexity of the role were very satisfied with the outcomes. PCW Host Community Manager Interviews: Of the ten out of twelve managers interviewed, some wished for more communication with Pegasus Health management because they felt aspects of both the PCW role and their own role as managers had become blurred over time. Referring organisations: Fifteen of the fifty referring community or government organisations participated. The overall satisfaction of the service was high and some acknowledged the continuing need for PCWs to be placed in communities where they were well known and trusted. Moreover results also showed that both the Canterbury earthquakes 2010-2011 and the amalgamation of Partnership Health PHO and Pegasus Health Charitable Limited in 2013 have contributed to the change of the model. Further future research may also be needed to examine the long term effects on the people of Canterbury involved in community work during the 2011-2014 years.
Research on responses to trauma has historically focused on the negative repercussions of a struggle with adversity. However, more recently, researchers have begun to examine posttraumatic growth: the positive psychological change that emerges from the struggle with a potentially traumatic event. Associations have been found between posttraumatic growth and greater peritraumatic distress, greater objective severity of trauma exposure, greater perceived stressfulness of events, social support, female gender, cognitive and behavioural responses to trauma, and personality measures. Posttraumatic growth has been measured typically in individuals with varying levels of posttraumatic stress disorder symptoms and other psychological difficulties, such as depression and anxiety. Although some theory and research posits that higher resilience would prohibit posttraumatic growth, no studies have examined posttraumatic growth in a resilient sample. The Canterbury earthquake sequence of 2010 and 2011 involved potentially traumatic events that saw the community struggle with a variety of challenges. However, in the midst of earthquake destruction, some positive initiatives emerged, driven by locals. The Gap Filler project (using city spaces left empty from fallen buildings for art and interactive community projects) and the Student Volunteer Army (groups of volunteers coordinated to help others in need) are examples of this. In this context, it seemed likely that posttraumatic growth was occurring and might be seen in individuals who were coping well with challenges. Culture is theorised to influence the posttraumatic growth process (Calhoun, Cann, & Tedeschi, 2010), and the nature of the trauma undergone is also likely to influence the process of growth. The current thesis measures posttraumatic growth quantitatively and qualitatively in a New Zealand sample. It measures and describes posttraumatic growth in a resilient population after the earthquake sequence of 2010 and 2011 in Canterbury, New Zealand. Findings are used to test current models of posttraumatic growth for individuals coping well after trauma and to elaborate on mechanisms proposed by models such as the comprehensive model of posttraumatic growth (Calhoun et al., 2010) and the organismic valuing theory of growth through adversity (Joseph & Linley, 2005). Correlates of posttraumatic growth are examined and likely supporting factors of posttraumatic growth are identified for this population. Study 1 used quantitative analysis to explore correlates of posttraumatic growth and found that greater posttraumatic growth related to greater peritraumatic distress, greater perceived stressfulness of earthquake events, greater objective stressfulness of earthquake events, greater difficulty with stressful life events, less satisfaction with social support, and female gender. Findings from Study 1 give important detail about the nature of distress included in the comprehensive model of posttraumatic growth (Calhoun et al., 2010) for this population. Levels of posttraumatic growth were lower than those in North American studies but similar to those in a Chinese study. The current sample, however, showed lower endorsement of Relating to Others than the Chinese study, perhaps because of cultural differences. Study 2 used qualitative analysis to examine the experience of posttraumatic growth in the sample. The theme of ‘a greater sense of community’ was found and adds to the comprehensive model of posttraumatic growth, in that an expression of posttraumatic growth (a greater connection with others) can inform ongoing social processing in the posttraumatic growth process. Having a formal or informal role in earthquake recovery appeared to influence self-concept and reflection; this elaborates on the influence of role on reflection in Calhoun et al.’s model. Findings illustrate possible mechanisms of the organismic valuing process theorised by Joseph and Linley (2005). Implications include the importance of providing opportunities for individuals to take on a role after a crisis, encouraging them to act to respond to difficulties, and encouraging them to meet personal needs for relatedness, competence, and autonomy. Finding positive aspects to a difficult situation, as well as acknowledging adversity, can be supported in future to help individuals process their traumas. As a society, we can help individuals cope with adversity by providing ways they can meet their needs for relatedness, competence, and autonomy. Community groups likely provide opportunities for members to act in ways that meet such needs. This will allow them to effectively act to meet their needs in times of crisis.
