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Employing a rigorous methodology including both control\u2010group comparisons and predisaster assessments, we performed a systematic evaluation of the disaster's impact. Overall, the disaster led to true but small rises in depressive symptoms and diagnoses 60\u201390 days postflood. The disaster\u2013psychopathology effect was not moderated by predisaster depressive symptoms or diagnostically defined depression; rather, predisaster symptoms and diagnoses uniquely contributed to increases in postdisaster distress. However, increases in symptoms as a function of flood impact were slightly greater among respondents with the lowest incomes and among residents living in small rural communities, as opposed to on farms or in cities. Implications for individual\u2010 and community\u2010level disaster response are discussed.<\/jats:p>","DOI":"10.1023\/a:1005188515149","type":"journal-article","created":{"date-parts":[[2002,12,21]],"date-time":"2002-12-21T21:06:43Z","timestamp":1040504803000},"page":"495-518","source":"Crossref","is-referenced-by-count":132,"title":["Natural Disaster and Depression: A Prospective Investigation of Reactions to the 1993 Midwest Floods"],"prefix":"10.1002","volume":"28","author":[{"given":"Elizabeth M.","family":"Ginexi","sequence":"first","affiliation":[{"name":"George Washington University  USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karen","family":"Weihs","sequence":"additional","affiliation":[{"name":"George Washington University  USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samuel J.","family":"Simmens","sequence":"additional","affiliation":[{"name":"George Washington University  USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Danny R.","family":"Hoyt","sequence":"additional","affiliation":[{"name":"Iowa State University  USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2000,8]]},"reference":[{"key":"e_1_2_1_2_1","volume-title":"Diagnostic and statistical manual of mental disorders","year":"1980"},{"key":"e_1_2_1_3_1","doi-asserted-by":"publisher","DOI":"10.1177\/0013916592243004"},{"key":"e_1_2_1_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1540-4560.1983.tb00144.x"},{"key":"e_1_2_1_5_1","first-page":"11","volume-title":"Disasters and mental health: Contemporary perspectives and innovations in services to disaster victims","author":"Bolin R. 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