An Evaluation of Perceived Health Risk and Depressive Symptoms before a Disaster in Predicting Postdisaster Inflammation

Exposure to major life stressors is associated with subsequent enhanced inflammation-related disease processes. Depressive symptoms exacerbate stress-induced inflammatory responses. Moreover, those who report a high degree of perceived health risk prior to being exposed to a major life stressor such as a disaster are at risk of poor health outcomes. The present study examined whether perceived health risk and depressive symptoms prior to a disaster were associated with post-disaster inflammation markers. The sample included 124 participants (mean age 55 (SD=16) years; 69% women). At a baseline visit, participants completed self-report measures of perceived health risk and depressive symptoms (Center for Epidemiologic Studies Depression Scale; CES-D) in addition to a blood draw for the assessment of inflammation markers (C-reactive protein, tumor necrosis factor receptor 1, and interleukin-6). All participants lived near a large petrochemical complex where an unexpected explosion occurred. A second blood sample was obtained two to six months after the explosion. No significant differences in inflammation markers were found between pre- and post-disaster assessments (p > .21). An interaction between pre-disaster perceived health risk and depressive symptoms in predicting post-disaster circulating inflammation markers was identified (Cohen’s f2 = .051). Specifically, pre-disaster perceived health risk was associated with post-disaster circulating inflammation markers if pre-disaster depressive symptoms were greater than 8.10 on the CES-D. These findings add to our understanding of the complex interactions between stress, depression, and immune responses. Indeed, findings provide a potential mechanism (i.e., inflammation) explaining the association between exposure to major life stressors and negative mental and physical health outcomes.