The Role of Fear-Related Behaviors in the 2013–2016 West Africa Ebola Virus Disease Outbreak

There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.

Abstract

The 2013–2016 West Africa Ebola virus disease pandemic was the largest, longest, deadliest, and most geographically expansive outbreak in the 40-year interval since Ebola was first identified. Fear-related behaviors played an important role in shaping the outbreak. Fear-related behaviors are defined as “individual or collective behaviors and actions initiated in response to fear reactions that are triggered by a perceived threat or actual exposure to a potentially traumatizing event. FRBs modify the future risk of harm.” This review examines how fear-related behaviors were implicated in (1) accelerating the spread of Ebola, (2) impeding the utilization of life-saving Ebola treatment, (3) curtailing the availability of medical services for treatable conditions, (4) increasing the risks for new-onset psychological distress and psychiatric disorders, and (5) amplifying the downstream cascades of social problems. Fear-related behaviors are identified for each of these outcomes. Particularly notable are behaviors such as treating Ebola patients in home or private clinic settings, the “laying of hands” on Ebola-infected individuals to perform faith-based healing, observing hands-on funeral and burial customs, foregoing available life-saving treatment, and stigmatizing Ebola survivors and health professionals. Future directions include modeling the onset, operation, and perpetuation of fear-related behaviors and devising strategies to redirect behavioral responses to mass threats in a manner that reduces risks and promotes resilience.

Related collections

Most cited references 80

Record: found
Abstract: found
Article: not found

Physiology and neurobiology of stress and adaptation: central role of the brain.

Bruce McEwen (2007)

The brain is the key organ of the response to stress because it determines what is threatening and, therefore, potentially stressful, as well as the physiological and behavioral responses which can be either adaptive or damaging. Stress involves two-way communication between the brain and the cardiovascular, immune, and other systems via neural and endocrine mechanisms. Beyond the "flight-or-fight" response to acute stress, there are events in daily life that produce a type of chronic stress and lead over time to wear and tear on the body ("allostatic load"). Yet, hormones associated with stress protect the body in the short-run and promote adaptation ("allostasis"). The brain is a target of stress, and the hippocampus was the first brain region, besides the hypothalamus, to be recognized as a target of glucocorticoids. Stress and stress hormones produce both adaptive and maladaptive effects on this brain region throughout the life course. Early life events influence life-long patterns of emotionality and stress responsiveness and alter the rate of brain and body aging. The hippocampus, amygdala, and prefrontal cortex undergo stress-induced structural remodeling, which alters behavioral and physiological responses. As an adjunct to pharmaceutical therapy, social and behavioral interventions such as regular physical activity and social support reduce the chronic stress burden and benefit brain and body health and resilience.

0 comments Cited 485 times – based on 0 reviews      Review now

Bookmark

Record: found
Abstract: found
Article: not found

Ebola virus disease in West Africa--the first 9 months of the epidemic and forward projections.

Bruce Aylward, Philippe Barboza, Luke Bawo … (2014)

On March 23, 2014, the World Health Organization (WHO) was notified of an outbreak of Ebola virus disease (EVD) in Guinea. On August 8, the WHO declared the epidemic to be a "public health emergency of international concern." By September 14, 2014, a total of 4507 probable and confirmed cases, including 2296 deaths from EVD (Zaire species) had been reported from five countries in West Africa--Guinea, Liberia, Nigeria, Senegal, and Sierra Leone. We analyzed a detailed subset of data on 3343 confirmed and 667 probable Ebola cases collected in Guinea, Liberia, Nigeria, and Sierra Leone as of September 14. The majority of patients are 15 to 44 years of age (49.9% male), and we estimate that the case fatality rate is 70.8% (95% confidence interval [CI], 69 to 73) among persons with known clinical outcome of infection. The course of infection, including signs and symptoms, incubation period (11.4 days), and serial interval (15.3 days), is similar to that reported in previous outbreaks of EVD. On the basis of the initial periods of exponential growth, the estimated basic reproduction numbers (R0 ) are 1.71 (95% CI, 1.44 to 2.01) for Guinea, 1.83 (95% CI, 1.72 to 1.94) for Liberia, and 2.02 (95% CI, 1.79 to 2.26) for Sierra Leone. The estimated current reproduction numbers (R) are 1.81 (95% CI, 1.60 to 2.03) for Guinea, 1.51 (95% CI, 1.41 to 1.60) for Liberia, and 1.38 (95% CI, 1.27 to 1.51) for Sierra Leone; the corresponding doubling times are 15.7 days (95% CI, 12.9 to 20.3) for Guinea, 23.6 days (95% CI, 20.2 to 28.2) for Liberia, and 30.2 days (95% CI, 23.6 to 42.3) for Sierra Leone. Assuming no change in the control measures for this epidemic, by November 2, 2014, the cumulative reported numbers of confirmed and probable cases are predicted to be 5740 in Guinea, 9890 in Liberia, and 5000 in Sierra Leone, exceeding 20,000 in total. These data indicate that without drastic improvements in control measures, the numbers of cases of and deaths from EVD are expected to continue increasing from hundreds to thousands per week in the coming months.

0 comments Cited 165 times – based on 0 reviews      Review now

Bookmark

Record: found
Abstract: found
Article: not found

Depression, anxiety and their relationship with chronic diseases: a review of the epidemiology, risk and treatment evidence.

David M Clarke, Kay C Currie (2009)

To review the evidence for an association between depression and anxiety and the National Health Priority Area conditions -- heart disease, stroke, diabetes mellitus, asthma, cancer, arthritis and osteoporosis -- and for the effectiveness of treatments for depression and anxiety in these settings. Systematic literature search of systematic reviews, meta-analyses and evidence-based clinical practice guidelines published between 1995 and 2007, inclusive. Each review was examined and summarised by two people before compilation. Depression is more common in all disease groups than in the general population; anxiety is more common in people with heart disease, stroke and cancer than in the general population. Heterogeneity of studies makes determination of risk and the direction of causal relationships difficult to determine, but there is consistent evidence that depression is a risk factor for heart disease, stroke and diabetes mellitus. Antidepressants appear to be effective for treating depression and/or anxiety in patients with heart disease, stroke, cancer and arthritis, although the number of studies in this area is small. A range of psychological and behavioural treatments are also effective in improving mood in patients with cancer and arthritis but, again, the number of studies is small. The evidence for the association of physical illness and depression and anxiety, and their effects on outcome, is very strong. Further research to establish the effectiveness of interventions is required. Despite the limits of current research, policy and practice still lags significantly behind best evidence-based practice. Models of integrated care need to be developed and trialled.

0 comments Cited 158 times – based on 0 reviews      Review now

Bookmark

All references

Author and article information

Contributors

James M. Shultz: 305-219-9011 , jamesmichaelshultz@gmail.com

Janice L. Cooper: 1-404-420-5165 , janice.cooper@cartercenter.org

Florence Baingana: 256-07740-544230 , kamayonza@gmail.com

Maria A. Oquendo: 212-543-5835 , mao4@columbia.edu

Zelde Espinel: 786-202-7450 , z.espinel@gmail.com

Benjamin M. Althouse: 425-777-9615 , balthouse@intven.com

Louis Herns Marcelin: 305-284-8493 , Lmarcel2@med.miami.edu

Sherry Towers: 630-308-8187 , smtowers@asu.edu

Maria Espinola: 513-558-7607 , maria.espinola@uc.edu

Clyde B. McCoy: 305-243-6005 , cmccoy@med.miami.edu

Laurie Mazurik: 1-416-480-6100 , laurie.mazurik@cbrnecc.ca

Milton L. Wainberg: 646-774-6430 , mlw35@cumc.columbia.edu

Yuval Neria: 646-774-8092 , ny126@columbia.edu

Andreas Rechkemmer: 303-871-2493 , andreas.rechkemmer@du.edu

Journal

Journal ID (nlm-ta): Curr Psychiatry Rep

Journal ID (iso-abbrev): Curr Psychiatry Rep

Title: Current Psychiatry Reports

Publisher: Springer US (New York )

ISSN (Print): 1523-3812

ISSN (Electronic): 1535-1645

Publication date (Electronic): 13 October 2016

Publication date (Print): 2016

Volume: 18

Issue: 11

Electronic Location Identifier: 104

Affiliations

[1 ]GRID grid.26790.3a, ISNI 0000000419368606, Center for Disaster and Extreme Event Preparedness (DEEP Center), , University of Miami Miller School of Medicine, ; 251 174 St. #2319, Sunny Isles Beach, Miami, FL USA

[2 ]The Carter Center, Mental Health Program Liberia, Monrovia, Liberia

[3 ]GRID grid.11194.3c, ISNI 0000000406200548, Makerere University School of Public Health, ; Kampala, Uganda

[4 ]GRID grid.413734.6, ISNI 0000000084991112, Department of Psychiatry, , Columbia University and New York State Psychiatric Institute, ; New York, NY USA

[5 ]GRID grid.26790.3a, ISNI 0000000419368606, Department of Psychiatry and Behavioral Health, , University of Miami Miller School of Medicine and Jackson Memorial Hospital, ; Miami, FL USA

[6 ]Institute for Disease Modeling, Bellevue, WA USA

[7 ]GRID grid.34477.33, ISNI 0000000122986657, University of Washington, ; Seattle, WA USA

[8 ]GRID grid.24805.3b, ISNI 0000000106872182, New Mexico State University, ; Las Cruces, NM USA

[9 ]GRID grid.209665.e, ISNI 0000000119411940, Santa Fe Institute, ; Santa Fe, NM USA

[10 ]GRID grid.501822.c, Interuniversity Institute for Research and Development (INURED), ; Port-au-Prince, Haiti

[11 ]GRID grid.26790.3a, ISNI 0000000419368606, Department of Anthropology, , University of Miami, ; Coral Gables, FL USA

[12 ]GRID grid.215654.1, ISNI 0000000121512636, Simon A. Levin Mathematical, Computational and Modeling Sciences Center, , Arizona State University, ; Tempe, AZ USA

[13 ]GRID grid.24827.3b, ISNI 0000000121799593, Department of Psychiatry and Behavioral Neuroscience, , University of Cincinnati College of Medicine, ; Cincinnati, OH USA

[14 ]GRID grid.26790.3a, ISNI 0000000419368606, Department of Public Health Sciences and Comprehensive Drug Research Center, , University of Miami Miller School of Medicine, ; Miami, FL USA

[15 ]GRID grid.413104.3, ISNI 0000000097431587, Department of Emergency Medicine, , Sunnybrook Health Sciences Centre, ; Toronto, ON Canada

[16 ]GRID grid.413734.6, ISNI 0000000084991112, Department of Psychiatry, , Columbia University and the New York State Psychiatric Institute, ; New York, NY USA

[17 ]GRID grid.266239.a, ISNI 0000000121657675, Graduate School of Social Work (GSSW), , University of Denver, ; Denver, CO USA

Article

Publisher ID: 741

DOI: 10.1007/s11920-016-0741-y

PMC ID: 5241909

PubMed ID: 27739026

SO-VID: 03159b4b-a5d4-4f44-9ec5-764e1a141e26

License:

This article is made available via the PMC Open Access Subset for unrestricted research re-use and secondary analysis in any form or by any means with acknowledgement of the original source. These permissions are granted for the duration of the World Health Organization (WHO) declaration of COVID-19 as a global pandemic.

History

Custom metadata

ScienceOpen disciplines: Clinical Psychology & Psychiatry

Keywords: ebola,ebola virus disease (evd),fear,fear-related behaviors,pandemic,outbreak

Data availability:

ScienceOpen disciplines: Clinical Psychology & Psychiatry

Keywords: ebola, ebola virus disease (evd), fear, fear-related behaviors, pandemic, outbreak

The Role of Fear-Related Behaviors in the 2013–2016 West Africa Ebola Virus Disease Outbreak

Read this article at

Abstract

Related collections

Karger: Coronavirus / COVID-19

Most cited references 80

Physiology and neurobiology of stress and adaptation: central role of the brain.

Ebola virus disease in West Africa--the first 9 months of the epidemic and forward projections.

Depression, anxiety and their relationship with chronic diseases: a review of the epidemiology, risk and treatment evidence.

Author and article information

Contributors

Journal

Affiliations

Article

History

Categories

Custom metadata

Comments

Comment on this article

Similar content 160

Cited by 136

Most referenced authors 669