Surviving or Thriving? Lifelong mental health in children with chronic physical illness

Chronic physical illness affects large numbers of children and families. Worldwide, 1 in 5 children has a chronic physical illness, including arthritis, asthma, cancer, chronic renal failure, congenital heart disease, cystic fibrosis, type-1 diabetes, and epilepsy. With the advances of medical therapies in the last decades, more and more children with chronic conditions live for a long time (Perrin, Bloom, & Gortmaker, 2007; van der Lee, Mokkink, Grootenhuis, Heymans, & Offringa, 2007). But how do these chronic conditions effect children in their adulthood? Does having a childhood chronic physical condition enhance the chance of mental health problems in adulthood? A recently published meta-analysis conducted by our research group (Secinti et al, 2017) focused on this question.

Having a chronic physical illness during childhood is a serious burden on its own. This is because the illness affects normal activities, may limit the child’s ability to function, or result in needing help from others or long periods of hospitalization (Stein, Bauman, Westbrook, Coupey, & Ireys, 1993). But having a physical condition also impacts mental health because these children face serious challenges in their daily lives due to their physical conditions (Ferro, Boyle, & Avison, 2015). A child with a chronic physical illness is more likely to have emotional problems than a healthy child. For example, children with chronic conditions are more likely to have emotional problems, such as anxiety and depression, as well as have behavioral problems (Pinquart & Shen, 2011a, 2011b, 2011c).

So, what happens to these children when they grow up?

We wanted to understand what happens, as children with chronic physical illnesses grow older. Do their emotional problems decrease, or persist and become more severe? To answer this question, we reviewed the literature on multiple childhood chronic physical illnesses (i.e., arthritis, asthma, cancer, chronic renal failure, congenital heart disease, cystic fibrosis, type-1 diabetes and epilepsy,) and found 37 studies that had been conducted in multiple regions across the world to assess the link between childhood chronic physical illness and adult emotional problems. We then analyzed the data provided by these studies, combining the information from more than 45,000 participants.

What did our study find?

The main analyses revealed that individuals with a childhood chronic physical illness were more likely to experience anxiety and depression in adulthood. Specifically, the odds of having depression was 1.31 higher and the odds of having anxiety was 1.47 higher in those with childhood chronic illness than in those without. This is an important finding, as it suggests that the effects of having a childhood chronic physical illness on the risk of emotional problems persist beyond childhood and adolescence into adulthood.

Our study also looked at a range of possible factors that might influence the strength of this association. Our findings indicated that factors related to childhood chronic illness, such as age at diagnosis and illness duration, and participant related factors, such as age and sex, did not change the effects. We also examined the association between childhood chronic physical illness and adult mental health separately for asthma, type-1 diabetes, and cancer. Our findings revealed that patients or survivors of childhood cancer were more likely to experience depression during adulthood. We also found the similar trends for childhood asthma and type-1 diabetes, but these results were inconclusive due to small number of studies and participants.

What do our findings mean?

Overall, this study, which is the most comprehensive analysis to date, provides evidence that individuals with a childhood chronic physical illness are at greater life-long risk of emotional problems. This finding is critically important in clinical care. Mental health assessment and treatment should be an integral component of comprehensive care of chronically ill children and adolescents. In addition, we would advocate implementing interventions to improve psychological well-being and resilience for children with chronic physical illnesses as a way to reduce the risk of emotional problems in adulthood.

Last week (8-14th of May) was a Mental Health Awareness Week. May is also a month marked for awareness around mental health issues. As stated by the Mental Health Foundation: ‘Good mental health is an asset that helps us to thrive’. This is indeed the case for children who experience many challenges in coping with and adapting to life with a chronic disease. Although a good progress has been achieved in the life expectancy of these children, we now need to achieve the same for the good health of their minds.

Author: Ekin Secinti (former MSc in Foundations of Clinical Psychology and Mental Health student and EDGE Lab researcher, Ekin is now undertaking clinical psychology doctorate training at Indiana University-Purdue University Indianapolis, Indianapolis, IN, USA)

 

References

Ferro, M.A., Boyle, M.H., & Avison, W.R. (2015). Association between trajectories of maternal depression and subsequent psychological functioning in youth with and without chronic physical illness. Health Psychology, 34, 820–828.

Perrin, J.M., Bloom, S.R., & Gortmaker, S.L. (2007). The increase of childhood chronic conditions in the United States. Journal of the American Medical Association, 297, 2755–2759.

Pinquart, M., & Shen, Y. (2011a). Anxiety in children and adolescents with chronic physical illnesses: A meta-analysis. Acta Paediatrica, 100, 1069–1076.

Pinquart, M.,&Shen, Y. (2011b). Behavior problems in children and adolescents with chronic physical illness: A meta-analysis. Journal of Pediatric Psychology, 36, 1003–1016.

Pinquart, M., & Shen, Y. (2011c). Depressive symptoms in children and adolescents with chronic physical illness: An updated meta-analysis. Journal of Pediatric Psychology, 36, 375–384.

Secinti, E., Thompson, E. J., Richards, M., & Gaysina, D. (2017). Research Review: Childhood chronic physical illness and adult emotional health–a systematic review and meta‐analysis. Journal of Child Psychology and Psychiatry. Published online: doi:10.1111/jcpp.12727

Stein, R.E., Bauman, L.J., Westbrook, L.E., Coupey, S.M., & Ireys, H.T. (1993). Framework for identifying children who have chronic conditions: The case for a new definition. Journal of Pediatrics, 122, 342–347.

van der Lee, J.H., Mokkink, L.B., Grootenhuis, M.A., Heymans, H.S., & Offringa, M. (2007). Definitions and measurement of chronic health conditions in childhood: A systematic review. Journal of the American Medical Association, 297, 2741–2751.

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King Lab goes to Westminster

By Dr Sarah King

Last Tuesday was Posters in Parliament, a day organised by the British Conference of Undergraduate Research, to allow students to visit Westminster and present their research to Members of Parliament.  Robert Tempelaar, who spent the summer working in my lab (as a junior research associate funded by the Alzheimer’s Society), was presenting our work on testing genetic methods to alter APOE4, a risk gene for Alzheimer’s disease. There was lots of interest in Robert’s poster, including Caroline Lucas, our local MP, who I think got the gist of it!

As well as being a fantastic opportunity to show off our work to a new audience, it was really interesting to see others at work.  We watched the first parliamentary session of the day from the viewing balcony. First, the Ministers from the Department of Business Energy and Industrial Strategy fielded questions from both sides of the House as to how they are planning to support British research and industry after Brexit.  Then, the House began to fill in readiness for Theresa May’s statement on the European Council.  Coming the day after the Brexit bill was passed through Government, this was fascinating.  She said her bit and then was pummeled by questions, again from both sides of the House (I was both surprised and pleased by the number of politicians I recognised). Good deals, bad deals, no deals… Brexit may mean Brexit, but what does Brexit mean?  It was an interesting to get to see parliament in action, but I think I’ll stick with my day job!

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A Student Voice

Watch the second episode of the psychology vlog to find out how Psychology faculty listen to the Student Voice. Prof Robin Banerjee (Deputy Head of School),  Alison Pike (Director of Teaching and Learning), and Dr Richard De Visser (Director of Student Experience) talk about module and course evaluations, the role of student reps, and where the buck stops!

Students have more power than they think — make your voice heard.

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Life as a postdoc – 10 things to consider

By Dr Christiane Oedekoven

 

I am currently working as a postdoc in Chris Bird’s Episodic Memory Lab after doing my first postdoc in Tuebingen, in a more clinical setting. Of course, every lab is different, and obviously not everyone has the same experience, but the issues we discussed in a DREADED seminar last term might be helpful if you are considering to move on to a postdoctoral position.

  1. Interesting job

    CC_Photo by Phlebotomy Tech

Let’s face it, ideally a postdoc involves researching a topic you find interesting, maybe something you have started working on during your PhD, maybe a completely different field. In my career I carried on to research episodic memory in older adults with memory problems, which I find fascinating. To have a job that is challenging and motivating and involves learning something new is more than a lot of other jobs have to offer.

  1. More independence

In comparison to your PhD, your relationship to your PI is on more equal terms. This is especially true if you come with your own funding (if you happen to be one of the mythical creatures who manage to get a postdoctoral fellowship, for instance). But even working on a project on your PI’s grant comes with more independence than a PhD. A postdoc is a job and not a studentship anymore. Should the job not meet your expectations, you can leave without worrying about the effect on your thesis.

  1. Time/Flexibility

Working in academia often allows the possibility of carrying out large portions of your work anywhere you want to and moreover often comes with the absolute plus of flexible working hours. Instead of working a regular 9-5 job, it allows for personal preferences, such as starting later and working later or allows for working around family life. While this combination is potentially dangerous (see 10), it also holds the possibility of great freedom.

  1. Relaxed work atmosphere

Working at a university is so much more relaxed than many other offices. For me it was probably the combined experience of coming to the UK (more relaxed than Germany) and having worked in a clinical environment before coming here to Sussex. I find the atmosphere really friendly and not as competitive as other places and the hierarchies are less steep than in clinical contexts. Plus the dress code is quite casual J

  1. Job uncertainty

This is THE most obvious downside of being a postdoctoral researcher. Across the university, this is the topic research staff is most worried about. Having a postdoctoral position most likely means there is a fixed end to the project/contract you are working on, and a contract usually lasts 1-3 years.

  1. Future plans

You should ask yourself every so often: do I want to stay in academia? According to a Vitae survey 78% of research staff would like to stay in academia, but probably all of us have thought about leaving research before. What made me think really hard about the future in academia was a graph by the Royal Society in their publication “The Scientific Century”, which shows the number of people staying in academia based on recent data from HEFCE and HESA. Of everyone doing a PhD, only 0.45% eventually become professors. Is that a bleak prospect? Depends how you see it. But it is definitely worth considering how else you might be able to put your experience to work (see 9).

  1. Money

Compared to your friends who have jobs in the “real world” being a postdoc does not come with the big money. Obviously it is an improvement to whatever you earned during your time as a PhD and in my opinion number 1 and 3 outweigh this downside.

  1. Mobility

Doing a postdoc often involves moving for a job that fits your profile and/or your preferences. Different countries treat postdocs differently. To my knowledge a postdoc in the USA is often seen more as an extension of grad school and you are more likely treated as a student. In comparison it is definitely seen as a job in Europe. Here in Sussex we have come quite a long way in being recognized as research staff rather than more mature PhD students.

  1. Experience and skills from your PhD

While you might wonder which “real world” job you might like to do, the argument might come up that you have no previous experience with it. Think again. Often skills learned during your PhD transfer well into other environments. For example during my PhD I used to do neuropsychological testing in a memory clinic with the idea I might recruit patients there. While the recruitment idea failed, I learned a lot about working with patients and memory tests and this was very valuable for every job I had since, academic as well as clinical.

  1. Workload

I guess this is not particular to postdoc contracts, but there are no official working hours in our contract, but rather a phrasing along the lines “until the work is done”. The work is never done. There is always another paper to write, another analysis to do… If you would like to have a job that never comes home with you, you should reconsider. But of course this also depends on you, how much you let it intrude. While your job is great fun (see 1), having a social life outside of work might be, too.

 

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Thesis Boot Camp

By Molly Berenhaus

Right before the holiday season, I decided to attend the doctoral school’s Thesis Boot Camp and was pleasantly surprised by how much I accomplished and learned. One limitation was that the writing workshops mostly catered to the humanities so, in addition to sharing top tips, I’ll also be translating the strategies (on the fly) for us psych folk. I’ll also note how the strategies differ from (incorrect) implicit assumptions I’ve held:

  • Develop a routine that works for you, specifically: I’ve held onto the implicit assumption that there is a “right” way to do a PhD despite my supervisors and classmates telling me no. Despite this, I know there are others like me comparing themselves to other doctoral students and subsequently, feeling inferior. At thesis boot camp, we were encouraged to figure out what works for us
  • Try and remove any psychological barriers between you and your writing:…No one at boot camp actually said that, but I think it summarizes what Liz was trying to get across. Specifically: writing is a form of thinking. It’s difficult to form an argument until you start writing so “shut up and write!” That being said, the reason we were told previous attendees wrote as many as 20,000 words in one weekend was because it was “first draft material” or what I refer to as my “messy outline.” As we all know,  psychology articles tend to be pretty information-dense; thus, I knew that if I was going to get anything out of this intensive writing weekend, I needed to bring along some version of my messy outline and then write from that. I also spent half a day editing what I’d already written. Thus, I “only” managed to write 6,000ish words, but I still felt pretty proud of myself (for the most part).
  • On the subject of editing, dont edit while you write:Something I found REALLY helpful was the notion that multi-taking while writing is not time- or cognitively-efficient. This idea might seem like common sense, but if you’re anything like me, you rarely listen to logic when it comes to writing well, because writing a thesis is stress-inducing. Well, because the boot camp was only two days, I thought I might as well give this logical notion a whirl and by George, it worked! When I was writing content, I only let myself make tiny edits on the sentence I’d just written (because that’s how I write), and I’d try not to let myself go back and read what I just wrote (my worst, self-induced time-suck). After that, I’d only let myself do organization, content-based edits (we were encouraged to break down the process of editing into distinguishable tasks), etc and then, when I was happy with what I was trying to say, I’d copyedit.
  • Collect evidence based on facts, not emotions: we were encouraged to try out the pomodoro technique (25 mins on, 5 mins break x 3, 25 mins on, long break – REPEAT) for the morning of the first break. Liz encouraged us to base our daily/weekly goals on how much work you achieve on average during one pomodoro in addition to how many pomodoros you can realistically do in a day. I know that at least for me, if I’m feeling particularly motivated, I’ll set myself a word-count goal that is way to high. The only issue with this is that I end up disappointing myself rather feeling accomplished by the end of the day.
  • If your time management/organizationmethod stresses you out, find/make a new one: If you’re anything like me, getting through your doctorate is a mind-warp (in lieu of a different phrase). Not only is the work challenging, but, because we’re often not credited for how difficult it is to go from dependent undergrad (or whatever) to independent, kickass researcher, we end up feeling inferior to our classmates. I think this is a mind-game that more PhD students would benefit from tackling. There is no right way to do a PhD and thus, there is no right way to organize your time!

I have more notes from what I learned at Thesis Boot Camp but not enough time to write all of them up (this girl has got to finish her thesis). That being said, if you’re keen to hear more of my ramblings, I’d love to go for a coffee. If you know me, you know I’m pretty chatty. My email is mb397@sussex.ac.uk

Molly’s post was originally published in Jenny Rusted’s Lab Group blog 

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Final Year Student Retreat in January 2017

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We are organising a retreat for our final year students between 23rd and 25th January 2017 with all sort of activities. The retreat is free of charge and includes 2 days and 1 night in the lovely YHA South Downs near Lewes. All food and accommodation will be provided. The hostel is 200 metres away from Southease Station with links to Lewes, and it also has free parking spaces for those with a car (transport not included).

We have created a programme full of activities that range from employability (CV writing, presentation & interviewing skills, and 1-2-1 CV drop-in sessions) to well-being (procrastination & mindfulness), which will be facilitated with the help of the University Careers Centre and external consultants. This will also be a great opportunity to meet faculty in a more informal environment. We have arranged sessions focused on how to do a dissertation, from data collection to writing up, which will be very helpful for your next term. Some former students will come and talk about what they are doing now, and how studying psychology at Sussex has helped them. And there will be time for fun too! We hope you like murder mysteries… 000345_south_downs_lounge_002

You can view the full programme here

If there are any other activities that you would like to see in the programme, we want to know! Please, fill the expression of interest form and let us know which day you would prefer to go and which activities interest you the most. This form will help us get an early estimate of the numbers so we can organise everything accordingly. If you are interested in coming to the retreat, please, complete it. Would you like to pick your room and/or your roommates? you can do it in the room allocation spreadsheet.

000345_south_downs_dorm_011Although the retreat is completely free, we are asking for a £25 deposit to reserve a place. The deposit will be fully refunded upon attendance. You can pay your deposit here: Psychology Student Retreat. The last day to register is Friday 9th December by 6pm (the last day of term).

Please do follow the links and register your interest ASAP to help us coordinate the event. If you have any questions about the Retreat, Megan Hurst (M.Hurst@sussex.ac.uk) and Dave Smalley (davidsm@sussex.ac.uk) would be happy to answer them.

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JRA Memories

By George Britton

 

Once I found out that I got the JRA award, I found myself explaining what the scheme is, and what I was going to do, to countless people.  The reality of the project is only sinking in as I carry it out. In the process I have met lots of researchers, attended lab meetings and carried out fieldwork in an exotic location (Eastbourne). I also got to attend a social group for LGBT residents of Brighton and Hove over 50, called Older and Out. They were friendly, interesting and they even gave me lunch. Not every project combines this direct involvement with the community and lab-based psychology, so I feel very lucky.

My main tasks in the eight-week period were to gather pictures of objects and to show them to people aged 60 to 80 who don’t have any severe memory problems. For every object they recognise, the participants will tell me any memories they have of it. The memory could be nothing more than a name (“that’s a  kettle”) or they could have a different quality- the memory of the specific kettle that was in your house. This kind of memory can have all sorts of details, including where it was kept or used and who used it. The objects are common household items from the 50s and 60s which people in our target age range are likely to remember, mostly photographed at the excellent How We Lived Then museum in Eastbourne. For example, a teasmade (have you heard of it?) would have been present in almost every house in the UK at one point, but they’ve been out of fashion for a long time. When presented with this kind of object, there’s a chance that memories which hadn’t been recalled for decades could come back. I’ve found that almost everyone I talk to has something interesting to say about the project, or some useful object to suggest that I hadn’t thought of. People love to reminisce about their favourite things anyway, making the theme and purpose of the project quite easy to engage people with. So the JRA is a good for conversation and applying for post-grad courses.

dscf5238                                 dscf5201

I’m around halfway now, and I have gathered my pictures and set up to start interviewing. At every stage I find seemingly small tasks are more complex and time-consuming than I estimate, but knowing that I’m doing something both beyond and for my own education has the strange effect of making it enjoyable anyway. Applying for ethical approval and recruiting participants are good examples of what I’m talking about. I can’t imagine many people would Photoshop over 100 images onto a neutral background just for the fun of it! I think the skills and organisation needed to deal with these tasks are best learned from getting involved, which is partly why I applied for a JRA in the first place. It’s going to make my third-year project smoother and more enjoyable, because I won’t be confronted with all the admin and practical issues for the first time.

Hopefully, my project will actually contribute to a further research program that investigates the role of various brain structures in the recollection of memories in people who are suffering from Alzheimer’s-related dementia. Pleasant reminiscence for people whose memories are intact, can become a surprise relief from the confusion of dementia in those with Alzheimer’s Disease. This is a cool aspect of my JRA; not only does it concern the treatment of a society-wide and worsening medical problem (maybe helping to improve quality of life for sufferers in the process) but it could contribute, even in a small way, to our understanding of human memory.

 

George was a Junior Research Associate in The Episodic Memory Group led by Dr Chris Bird during the summer.

You can read other stories about the JRA scheme here: 

My summer as a Junior Research Associate by Alex Earl

Dan Goodwin: Junior Research Associate by Dan Goodwin

Experience with the JRA scheme by Ruihan Wu

Clara Wilson’s JRA experience by Clara Wilson

 

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Assessment & Feedback FAQs

We start a new audiovisual section to answer some of the most frequently asked questions. The Director of Teaching and Learning of Psychology, Dr Alison Pike, and two of our undergraduate students, Leila Davis and Judith Luxmoore, explain the assessment and feedback processes.

0:27 — What are the marking criteria and where do I find them?
1:16 — Who marks my work?
2:01 — What will the feedback look like?

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How storybook illustrations impact word learning

By Zoe Flack

My research area is developmental psychology. In particular, I am investigating how different aspects of storybook reading with preschool children can help (or hinder!) word learning.  Luckily, children like hearing stories, and adults enjoy reading them.  But in addition to the enjoyment factor, children also learn new words from the storybooks they hear. This means that storybook reading is a great activity to help children increase their vocabularies—which has many benefits, especially for school readiness.

Research has shown that storybook illustrations are important. For example, we know that children learn words better if illustrations are realistic.  We also know that children look within illustrations for the things they hear in the story: so if the story mentions a girl dropping an ice-cream, children will look at the ice-cream in the illustration.  But when there are multiple illustrations displayed at once, how do young children who haven’t yet learned to read know which illustration to look at while listening to a story?

Children’s storybooks are designed with eye-catching illustrations, and many books display multiple illustrations per page (see e.g., The Incredible Book Eating Boy by Oliver Jeffers contains 6 illustrations on pages 7-8).  Even if children understand that the left page is read before the right page, they will not necessarily know when the reader moves from one page to the other.  At its worst this may mean children are trying to search through the wrong illustration for clues to make sense of new vocabulary, or that they search through more visual information than necessary.

We tested this in the WORD Lab with 3½-year-old children.  We read children three stories from a set of storybooks, arranged in one of three ways.  Storybooks with two illustrations displayed at a time (i.e., one illustration on the left page and one on the right), one illustration displayed at a time (i.e., left side blank, one illustration on the right) or with one large illustration. We included the large illustration format to check that image size could not account for any effects we found. The large illustration format (A3) was the twice the size of the other books (the two illustration format is two A4 pages, so has the same surface area).

illustrations-fig-1

Set within the books were two novel objects, which were named and depicted twelve times throughout three books.  (Research shows children can learn about 1-2 words from a storybook at this age.)  After hearing their three storybooks read, children were asked to identify each of these objects twice from an array of other similar novel objects.  This is a standard testing method for word learning research of this kind with children of this age.

Children who were read the two page illustration versions of the storybooks learned significantly fewer words than those who were read the one illustration, or the large one illustration storybook versions.  In our study, children in the one illustration conditions had fewer illustrations to search through to find the relevant information.

Since these children can’t read, it is likely they learned fewer words because they did not know where to look. We wondered if providing a supporting gesture to guide children toward the correct page might help.  So we read another group of children the two illustrations books, but this time we used a sweeping gesture to highlight which page we were reading from.  These children performed as well as the children who had seen the one illustration storybooks in the first experiment. This suggests that simply guiding children’s attention to the correct page helps them focus on the right illustrations, and this in turn might help them concentrate on the new words.

Our findings fit well with Cognitive Load Theory, which suggests that learning rates are affected by how complicated a task is.  In this case, by giving children less information at once, or guiding them to the correct information, we can help children learn more words. We are excited by the findings, which could also shed light on discrepancies between research comparing print storybooks and e-books, since e-books often present just one illustration at a time.

We have some exciting ideas for follow up studies, so, if you know a child aged 3-4 who might like to visit us to hear some stories or play some games at WORD Lab, please sign up here.

 

Zoe is doing a PhD with Dr Jessica Horst in the WORD LAB. This post is based on the presentation Zoe gave in the School’s PhD Presentation Conference in June 2016, where she won the best presentation award.

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What is the role of shared identities in the aftermath of floods?

By Evangelos Ntontis

As a PhD student at the School of Psychology of Sussex University, I recently had the honour of winning the 2016 PhD poster conference. Of course winning is accompanied with writing a blog for the School’s website, so I’ll take this short space to briefly write about my overall research.

Currently I am starting the second year of my PhD and my interests fall within social psychology. I am a member of the ‘Crowds and Identities’ research group led by John Drury, and our focus is on large-scale events that usually involve crowds (be it riots and protests, migration and refugees, mass emergencies and disasters, collective action etc.).

My PhD project focuses on flooding and the role of shared identities in the response and recovery of communities. Putting it simply, a vast amount of research has shown that belonging to and identifying with groups is good for our well-being, since it provides a sense of belonging and we are more likely to offer and receive more support from other group members. Also, from studies of events like earthquakes and bombings we know that the shared experience of adversity can unite people with no previous affiliations and they come to see themselves as sharing a common identity and group. Applying these principles and findings in flood-hit communities, we are investigating if and how the shared community identity arises, the role of identification with the broader community and its effects for the provision of support to those in need, the heightened expectations of future support, as well as the impact on individual well-being and perceptions of the community’s ability to recover efficiently.ctis-_dweaanpni

I focus on the city of York, which was affected by floods in December 2015. I visited York for one week and interviewed York residents in order to get a better idea of the situation, and the poster described my first complete interview study which is currently being prepared for submission in a peer-reviewed journal. Our participants reported that a sense of unity was felt during the floods because of the shared experience of the floods, because of experiencing common problems which led in having shared future goals, as well as because of identifying with those affected, even without sustaining any damage. People also reported various types of social support that were provided to those affected, like practical support, emotional support, coordinated support which individuals themselves would not be able to accomplish, and heightened expectations of future support.

We also need to emphasize the important role of rhetoric for the recovery process of communities in the aftermath of disasters. During the emergency events people come together and form groups, which as we saw can have individual and collective benefits. However, it can take a long time for communities to fully recover, and certainly the problems do not disappear straight after the waters recede and the emergency responders leave the affected area. Groups and the sense of collectivity need to persist over time so that all types of social support keep flowing towards the affected residents. This can be achieved through invocations of the community and the collective, as well as through broad community group boundaries that will include both affected and non-affected residents. Thus people who identify with the community will tend to see others as fellow community members regardless of their status, which will make the provision of support easier and with prolonged benefits for the recovery process.

Overall, these findings are a good first indicator of the positive role that shared identities can have during the recovery period, and a solid ground for us to move on and investigate those identity processes from more methodological approaches such as surveys and ethnographic analyses.

With regards to the poster itself, I need to say a big Thank you to Khalifah Alfadhli and John Drury for their useful tips. To Khalifah for constantly scolding me and persisting that I reduce the amount of text (and it was really difficult for him to be satisfied, especially when taking into account that it was an interview study with lots of extracts!), and to John for insisting that I use more background pictures.

 

If you want to know more about poster presentations, you can read a post by Ellen Thompson, the 2015 PhD Poster Presentation winner, here: Do multiple Adverse Childhood Experiences (ACEs) lead to anxiety and depression in later life?

 

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