1 - (IOP 5) The Intersection of Posttraumatic Stress Disorder and Climate Change: A Meta-analysis of Predictors of PTSD Following Extreme Weather Events

Objective: Extreme weather events (e.g., Hurricane Helene, LA County wildfires) are increasing in intensity and frequency due to climate change (EPA, 2021). These outcomes are not distributed equitably, with individuals holding racial and ethnic minority identities reporting greater exposure to climate disasters and worse subsequent posttraumatic stress disorder (PTSD; Alexander et al., 2017; Davidson et al., 2013). Better understanding key predictors of PTSD in the wake of a disaster is essential to allocating limited resources to those at greatest risk. Moreover, identifying predictors of PTSD may elucidate etiological factors that could be harnessed for psychological interventions to prevent chronic symptoms.

Method: PubMed, PsycInfo and PTSDPubs were systematically searched in February 2025 for acute post-disaster longitudinal studies examining PTSD severity or diagnosis in adults following extreme weather events (e.g., hurricanes) or weather-related sequelae (e.g., wildfires). Eligible studies included a pre-disaster or acutely post-disaster ( < 18 months) time point with any potential predictor variable(s) and at least one other time point including a validated measure of PTSD. Abstract and full-text review of articles were conducted by at least two reviewers. Effect sizes of demographic (e.g., gender), pre-event (e.g., pre-disaster psychopathology), and environmental factors (e.g., social support) were extracted and synthesized as Pearson correlation coefficients using random effects modeling. Publication bias was evaluated using the trim and fill method (Duval & Tweedie, 2000). Methodological quality of studies was rated using an adapted 9-item dichotomous rating scale (National Heart, Lung, and Blood Institute, 2014). This study design was pre-registered on prospero.com.
Preliminary

Results: Thirty-eight unique samples (N = 19,327) were included from a total of 3,447 citations reviewed, with a majority collected in North America (65.79%). The most frequent disaster type was hurricanes/typhoons (52.63%, k = 20). Ten predictors were extracted, with small to moderate effects (|r| = .02 - .29). Severity of disaster exposure (r = .27), income (r = -.29), and prior psychopathology (r = .27) emerged as the strongest predictors of PTSD. Methodological quality was varied (range = 38-88 out of 100), with failure to report a sample size justification (89.5%) and failure to use a valid and reliable disaster severity measure (85.7%) as the most common issues.

Conclusions: This is the first meta-analysis to examine predictors of PTSD following an extreme weather event, with public health significance for mitigating climate change’s impact on trauma-related disorders. Consistent with prior meta-analyses of predictors of PTSD following any trauma type (e.g,. Ozer et al., 2003), the small- to moderate-sized effects suggest predictors cumulatively confer risk. Notably, access to resources like higher income may buffer against mental health problems, potentially pointing to the swift provision of financial assistance as a key intervention in disaster settings. Future work should investigate modifiable predictors of PTSD, such as coping strategies, that could potentially be harnessed in early interventions.