COMMUNITY PATTERNS OF PSYCHIATRIC-DISORDERS AFTER THE EXXON-VALDEZ OIL-SPILL

Objective: This study examined the relationship between exposure to th e Exxon Valdez oil spill and subsequent cleanup efforts and the preval ence of generalized anxiety disorder, post-traumatic stress disorder ( PTSD), and depressive symptoms in 13 Alaska communities. Method: A com munity survey of 599 men and women was conducted approximately 1 year after the spill occurred. Questions from the National Institute of Men tal Health Diagnostic Interview Schedule were used to assess symptoms of generalized anxiety disorder and PTSD. The Center for Epidemiologic Studies Depression (CES-D) Scale was used to assess levels of depress ive symptoms. Results: The post-spill (i.e., 1-year) prevalence of gen eralized anxiety disorder and PTSD for the study communities with all degrees of exposure was 20.2% and 9.4%, respectively. The prevalence o f respondents with CES-1) Scale scores above 16 and 18 was 16.6% and 1 4.2%, respectively. When compared with the unexposed group, members of the high-exposure group were were 3.6 times as likely to have general ized anxiety disorder, 2.9 times as likely to have PTSD, 1.8 times as likely to have a CES-D Scale score of 16 and above, and 2.1 times as l ikely to have a CES-D Scale score of 18 and above. Women exposed to th is event were particularly vulnerable to these conditions, and Alaska Natives were particularly vulnerable to depressive symptoms after the oil spill. Conclusions. The results suggest that the oil spill's impac t on the psychosocial environment was as significant as its impact on the physical environment. The Exxon Valdez experience suggests a numbe r of implications for the mental health needs of disaster victims, par ticularly in primary care settings.