Media Coverage, Forecasted Posttraumatic Stress Symptoms, and Psychological Responses Before and After an Approaching Hurricane

IMPORTANCE: Exposure to disaster-related media coverage is associated with negative mental health outcomes. However, risk factors that render individuals vulnerable to this exposure are unknown. Hurricane-associated media exposure was expected to explain the association between forecasted posttraumatic stress (PTS) and adjustment after the hurricane. OBJECTIVE: To examine forecasted PTS responses and media coverage as risk factors for negative mental health outcomes in the context of media coverage of an approaching disaster (Hurricane Irma). DESIGN, SETTING, AND PARTICIPANTS: In a representative probability community sample of 1637 adults from Florida, respondents completed 2 online surveys: the first during the 60 hours before Hurricane Irma’s landfall (wave 1; September 8-11, 2017) and the second approximately 1 month later (wave 2; October 12-29, 2017). Poststratification weights were applied to facilitate population-based inferences. Data were analyzed from October 19 through 31, 2018. MAIN OUTCOMES AND MEASURES: Posttraumatic stress responses, psychological distress, functional impairment, and worry about future events. RESULTS: The wave 1 survey included 1637 participants (57.0% response rate); 1478 participants were retained at the wave 2 follow-up (90.3% retention) (weighted proportion of women, 62.2%; mean [SD] age, 59.1 [15.2] years). The final weighted sample closely approximated US Census benchmarks for the state of Florida. Data analyses using structural equation modeling revealed that exposure to media coverage of the hurricane (β = 0.21; 95% CI, 0.11-0.31; P < .001) and forecasted PTS (β = 0.44; 95% CI, 0.35-0.52; P < .001) were significantly associated with adjustment after the hurricane. In addition, a significant indirect path from forecasted PTS to adjustment after the storm occurred through exposure to hurricane-related media coverage (β = 0.07; 95% CI, 0.05-0.08; P < .001). Covariates included demographics, mental health diagnoses before the storm, perceived evacuation zone status, and degree of hurricane exposure. CONCLUSIONS AND RELEVANCE: Results of this study provide a more thorough understanding of how psychological factors before hurricanes are associated with adjustment after hurricanes via media consumption. The findings may also demonstrate the importance of considering prestorm psychological factors when assessing poststorm outcomes, with implications for the media and public health efforts.