{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T12:58:04Z","timestamp":1790686684981,"version":"4.1.0"},"reference-count":64,"publisher":"Cambridge University Press (CUP)","license":[{"start":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T00:00:00Z","timestamp":1790640000000},"content-version":"unspecified","delay-in-days":271,"URL":"https:\/\/www.cambridge.org\/core\/terms"}],"funder":[{"DOI":"10.13039\/100006545","name":"National Institute on Minority Health and Health Disparities","doi-asserted-by":"publisher","award":["R01MD013866,R01MD016426"],"award-info":[{"award-number":["R01MD013866,R01MD016426"]}],"id":[{"id":"10.13039\/100006545","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Disaster med. public health prep."],"published-print":{"date-parts":[[2026]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec id=\"S1935789326104388_sec1\">\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To examine the associations between various hurricane-related exposures and psychiatric and substance use disorders among Puerto Rican adults following Hurricane Maria and to identify disaster-related exposures that may contribute to psychiatric morbidity in hurricane- and typhoon-prone settings.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S1935789326104388_sec2\">\n                    <jats:title>Materials and Methods<\/jats:title>\n                    <jats:p>Hurricane-related exposures were grouped into personal, property, utility\/resource losses, and unsanitary\/hazardous exposures. Logistic regression models were run to examine the associations between the number of hurricane-related exposures and disorders.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S1935789326104388_sec3\" sec-type=\"results\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Each additional hurricane-related exposure was associated with a 1.1 percentage-point increase in the probability of any mood disorder (\n                      <jats:italic>P<\/jats:italic>\n                      &lt; 0.001), a 1.3 percentage-point increase in the probability of any anxiety disorder (\n                      <jats:italic>P<\/jats:italic>\n                      &lt; 0.001), and a 2.0 percentage-point increase in the probability of any disorder (\n                      <jats:italic>P<\/jats:italic>\n                      &lt; 0.001). Each additional utility\/resource loss exposure was associated with a 2.3 percentage-point increase in the probability of any anxiety disorder (\n                      <jats:italic>P<\/jats:italic>\n                      = 0.001). Each additional unsanitary\/hazardous exposure was associated with a 1.9 percentage-point increase in the probability of any mood disorder (\n                      <jats:italic>P<\/jats:italic>\n                      = 0.017). Findings varied when individual disorders were examined. No associations were found between exposures and substance use disorders.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S1935789326104388_sec4\" sec-type=\"conclusions\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Utility\/resource losses and unsanitary\/hazardous conditions emerged as important correlates of post-disaster psychiatric disorders, suggesting that these often-overlooked exposures should be incorporated into disaster assessments and recovery planning.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1017\/dmp.2026.10438","type":"journal-article","created":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T12:21:04Z","timestamp":1790684464000},"source":"Crossref","is-referenced-by-count":0,"title":["The Associations of Various Types of Hurricane-Related Exposures with Psychiatric and Substance Use Disorders in Puerto Rico Following Hurricane Maria"],"prefix":"10.1017","volume":"20","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0161-6208","authenticated-orcid":false,"given":"Damaris","family":"Lopez Mercado","sequence":"first","affiliation":[{"name":"University of Hawai\u2019i at M\u0101noa Myron B Thompson School of Social Work"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexandra C.","family":"Rivera-Gonz\u00e1lez","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/00d9ah105","id-type":"ROR","asserted-by":"publisher"}],"name":"University of California Merced School of Social Sciences Humanities and Arts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katyana M.","family":"Santiago","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/00h25w961","id-type":"ROR","asserted-by":"publisher"}],"name":"University of Puerto Rico Medical Sciences Campus"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jim P.","family":"Stimpson","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/05byvp690","id-type":"ROR","asserted-by":"publisher"}],"name":"The University ofTexas Southwestern Medical Center"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5512-8552","authenticated-orcid":false,"given":"Ligia M.","family":"Chavez","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/00h25w961","id-type":"ROR","asserted-by":"publisher"}],"name":"University of Puerto Rico Medical Sciences Campus"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brent","family":"Langellier","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/04bdffz58","id-type":"ROR","asserted-by":"publisher"}],"name":"Drexel University Dornsife School of Public Health"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jonathan","family":"Purtle","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/0190ak572","id-type":"ROR","asserted-by":"publisher"}],"name":"New York University School of Global Public Health"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark","family":"Stehr","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/04bdffz58","id-type":"ROR","asserted-by":"publisher"}],"name":"Drexel University Bennett S LeBow College of Business"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jan M.","family":"Eberth","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/02smfhw86","id-type":"ROR","asserted-by":"publisher"}],"name":"Virginia Tech"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Glorisa","family":"Canino","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/00h25w961","id-type":"ROR","asserted-by":"publisher"}],"name":"University of Puerto Rico Medical Sciences Campus"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexander N.","family":"Ortega","sequence":"additional","affiliation":[{"name":"University of Hawai\u2019i at M\u0101noa Myron B Thompson School of Social Work"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"56","published-online":{"date-parts":[[2026,9,29]]},"reference":[{"key":"S1935789326104388_r8","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0092899"},{"key":"S1935789326104388_r50","doi-asserted-by":"publisher","DOI":"10.1586\/eri.11.155"},{"key":"S1935789326104388_r21","doi-asserted-by":"publisher","DOI":"10.1007\/s11920-020-01157-0"},{"key":"S1935789326104388_r47","doi-asserted-by":"publisher","DOI":"10.1080\/20008066.2025.2592408"},{"key":"S1935789326104388_r40","doi-asserted-by":"publisher","DOI":"10.1176\/ajp.154.11.1593"},{"key":"S1935789326104388_r61","doi-asserted-by":"publisher","DOI":"10.3109\/10826080902962128"},{"key":"S1935789326104388_r12","doi-asserted-by":"publisher","DOI":"10.1007\/s00127-022-02355-2"},{"key":"S1935789326104388_r5","doi-asserted-by":"publisher","DOI":"10.1146\/annurev-publhealth-032013-182435"},{"key":"S1935789326104388_r28","doi-asserted-by":"publisher","DOI":"10.2105\/AJPH.2020.305814"},{"key":"S1935789326104388_r38","doi-asserted-by":"publisher","DOI":"10.1016\/j.annepidem.2014.04.009"},{"key":"S1935789326104388_r13","doi-asserted-by":"publisher","DOI":"10.1002\/da.20838"},{"key":"S1935789326104388_r24","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMsa1803972"},{"key":"S1935789326104388_r32","doi-asserted-by":"publisher","DOI":"10.3886\/ICPSR22325.v2"},{"key":"S1935789326104388_r49","doi-asserted-by":"publisher","DOI":"10.1186\/s12889-020-8424-3"},{"key":"S1935789326104388_r26","unstructured":"26. Michaud, J , Kates, J. Public health in Puerto Rico after Hurricane Maria. 2017 Accessed March 18, 2026, https:\/\/www.kff.org\/other\/issue-brief\/public-health-in-puerto-rico-after-hurricane-maria\/"},{"key":"S1935789326104388_r57","doi-asserted-by":"publisher","DOI":"10.5694\/mja2.51595"},{"key":"S1935789326104388_r15","doi-asserted-by":"publisher","DOI":"10.1002\/cpp.2335"},{"key":"S1935789326104388_r27","doi-asserted-by":"publisher","DOI":"10.1080\/09518398.2022.2061072"},{"key":"S1935789326104388_r42","doi-asserted-by":"publisher","DOI":"10.1007\/s10464-013-9579-1"},{"key":"S1935789326104388_r17","doi-asserted-by":"publisher","DOI":"10.5127\/pr.032813"},{"key":"S1935789326104388_r36","doi-asserted-by":"publisher","DOI":"10.1002\/mpr.168"},{"key":"S1935789326104388_r48","doi-asserted-by":"publisher","DOI":"10.1186\/s12889-025-24118-9"},{"key":"S1935789326104388_r63","doi-asserted-by":"publisher","DOI":"10.1111\/j.1467-7717.2009.01136.x"},{"key":"S1935789326104388_r56","doi-asserted-by":"publisher","DOI":"10.1093\/eurpub\/ckz111"},{"key":"S1935789326104388_r29","doi-asserted-by":"publisher","DOI":"10.2105\/AJPH.2024.307585"},{"key":"S1935789326104388_r37","doi-asserted-by":"publisher","DOI":"10.1001\/jama.1994.03520100096046"},{"key":"S1935789326104388_r41","doi-asserted-by":"publisher","DOI":"10.1002\/mpr.1828"},{"key":"S1935789326104388_r54","article-title":"Strengthening healthcare system resilience: a comprehensive framework for tropical cyclone preparedness and response","volume":"48","author":"Hertelendy","year":"2025","journal-title":"Lancet Reg Health Am."},{"key":"S1935789326104388_r34","doi-asserted-by":"publisher","DOI":"10.1007\/s10802-012-9654-3"},{"key":"S1935789326104388_r52","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-025-13418-0"},{"key":"S1935789326104388_r1","first-page":"e37031","article-title":"Mental health disorders due to disaster exposure: a systematic review and meta-analysis","volume":"15","author":"Keya","year":"2023","journal-title":"Cureus."},{"key":"S1935789326104388_r59","doi-asserted-by":"publisher","DOI":"10.1080\/02791072.2017.1397304"},{"key":"S1935789326104388_r6","doi-asserted-by":"publisher","DOI":"10.1017\/dmp.2024.327"},{"key":"S1935789326104388_r11","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2458-11-145"},{"key":"S1935789326104388_r60","doi-asserted-by":"publisher","DOI":"10.3109\/10673229709030550"},{"key":"S1935789326104388_r64","doi-asserted-by":"publisher","DOI":"10.1186\/s12954-022-00715-4"},{"key":"S1935789326104388_r9","unstructured":"9. King, J , Longman, J , Matthews, V , et al. Disruptions and mental-health outcomes following cyclone Debbie. The Australian Journal of Emergency Management. 2020;35(3):62\u201370."},{"key":"S1935789326104388_r46","doi-asserted-by":"publisher","DOI":"10.1192\/bji.2022.31"},{"key":"S1935789326104388_r39","doi-asserted-by":"publisher","DOI":"10.1002\/mpr.280"},{"key":"S1935789326104388_r33","doi-asserted-by":"publisher","DOI":"10.1007\/s10802-010-9483-1"},{"key":"S1935789326104388_r25","doi-asserted-by":"publisher","DOI":"10.7249\/rhq-09-02-10"},{"key":"S1935789326104388_r43","unstructured":"43. Statistical Software: Release 18. StataCorp LLC; 2023."},{"key":"S1935789326104388_r14","doi-asserted-by":"publisher","DOI":"10.1007\/s10566-015-9311-4"},{"key":"S1935789326104388_r30","doi-asserted-by":"publisher","DOI":"10.1007\/s40572-019-00245-5"},{"key":"S1935789326104388_r16","doi-asserted-by":"publisher","DOI":"10.1016\/j.janxdis.2017.01.003"},{"key":"S1935789326104388_r10","doi-asserted-by":"publisher","DOI":"10.1186\/s12889-016-4000-2"},{"key":"S1935789326104388_r23","doi-asserted-by":"publisher","DOI":"10.5334\/aogh.3869"},{"key":"S1935789326104388_r44","doi-asserted-by":"publisher","DOI":"10.1007\/s11069-020-03951-8"},{"key":"S1935789326104388_r51","doi-asserted-by":"publisher","DOI":"10.1037\/tra0000573"},{"key":"S1935789326104388_r53","first-page":"62","article-title":"Disruptions and mental-health outcomes following cyclone Debbie","volume":"35","author":"King","year":"2020","journal-title":"Aust J Emerg Manag."},{"key":"S1935789326104388_r58","doi-asserted-by":"publisher","DOI":"10.1001\/archpsyc.64.12.1427"},{"key":"S1935789326104388_r22","doi-asserted-by":"publisher","DOI":"10.1037\/hea0000433"},{"key":"S1935789326104388_r62","doi-asserted-by":"publisher","DOI":"10.1080\/15504263.2023.2260328"},{"key":"S1935789326104388_r45","doi-asserted-by":"publisher","DOI":"10.1017\/dmp.2024.169"},{"key":"S1935789326104388_r3","doi-asserted-by":"publisher","DOI":"10.1080\/00332747.2015.1129874"},{"key":"S1935789326104388_r18","doi-asserted-by":"publisher","DOI":"10.1089\/env.2024.0029"},{"key":"S1935789326104388_r19","doi-asserted-by":"publisher","DOI":"10.1017\/S1049023X17006574"},{"key":"S1935789326104388_r55","doi-asserted-by":"publisher","DOI":"10.1017\/S1049023X2200053X"},{"key":"S1935789326104388_r2","doi-asserted-by":"publisher","DOI":"10.1002\/jts.22973"},{"key":"S1935789326104388_r4","doi-asserted-by":"publisher","DOI":"10.1192\/bjpo.bp.115.002170"},{"key":"S1935789326104388_r7","first-page":"21","article-title":"Beyond the storms: exploring predictors of posttraumatic stress and posttraumatic growth among survivors of hurricanes Irma and Maria in Puerto Rico","author":"Meadows","year":"2025","journal-title":"J Clim Chang Health"},{"key":"S1935789326104388_r31","doi-asserted-by":"publisher","DOI":"10.1007\/s00127-019-01653-6"},{"key":"S1935789326104388_r35","doi-asserted-by":"publisher","DOI":"10.1002\/jcop.21590"},{"key":"S1935789326104388_r20","doi-asserted-by":"publisher","DOI":"10.1017\/dmp.2023.28"}],"container-title":["Disaster Medicine and Public Health Preparedness"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.cambridge.org\/core\/services\/aop-cambridge-core\/content\/view\/S1935789326104388","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T12:21:09Z","timestamp":1790684469000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.cambridge.org\/core\/product\/identifier\/S1935789326104388\/type\/journal_article"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026]]},"references-count":64,"alternative-id":["S1935789326104388"],"URL":"https:\/\/doi.org\/10.1017\/dmp.2026.10438","relation":{},"ISSN":["1935-7893","1938-744X"],"issn-type":[{"value":"1935-7893","type":"print"},{"value":"1938-744X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026]]},"article-number":"e169"}}