Natural disaster and depression: A prospective investigation of reactions to the 1993 Midwest Floods

A statewide sample of 1735 Iowa residents, approximately half of whom were victims of the 1993 Midwest Floods, participated in interviews I year prior to, and 30 to 90 days after, the disaster Employing a rigorous methodology including both control-group comparisons and predisaster assessments, we p erformed a systematic evaluation of the disaster's impact. Overall, the dis aster led to true but small rises in depressive symptoms and diagnoses 60-9 0 days postflood. The disaster-psychopathology effect was not moderated by predisaster depressive symptoms or diagnostically defined depression; rathe r, predisaster symptoms and diagnoses uniquely contributed to increases in postdisaster distress. However, increases in symptoms as a function of floo d impact were slightly greater among respondents with the lowest incomes an d among residents living in small rural communities, as apposed to on farms or in cities. Implications for individual- and community-level disaster re sponse are discussed.