Cited by 102Posttraumatic Stress Disorder ResearchCOVID-19 and Mental HealthDisaster Management and Resilience

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The association between disaster exposure and media use on post-traumatic stress disorder following Typhoon Hato in Macao, China

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Hall, Brian J., Xiong, Ying Xin, Yip, Paul S. Y., Lao, Chao Kei, Shi, Wei, Sou, Elvo K. L., Chang, Kay, Wang, Li, Lam, Agnes I. F.·2019·European Journal of Psychotraumatology

DOI 10.1080/20008198.2018.1558709PMC PMC6338284

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Abstract

Background: Direct exposure to natural disasters and related losses are associated with post-traumatic stress disorder (PTSD). It is less clear whether indirect media exposure is associated with PTSD.Objective: This study investigated key exposure-related risk factors for PTSD and examined the effect of media exposure on the prevalence of disaster-related PTSD.Method: Typhoon Hato directly hit Macao on 23 August 2017. It was one of the most serious natural disasters ever to strike southern China. One month after the event, 1876 Chinese university students in Macao were recruited into a cross-sectional study (mean age 20.01 years, SD = 2.63; 66.2% female). Self-reported typhoon exposure, media use and exposure to disaster-related content, and PTSD symptoms were collected using an electronic survey. Univariable analyses assessed associations between risk factors and PTSD, which were then included in a series of multivariable logistic regressions.Results: The prevalence of PTSD was 5.1%. Adjusted models demonstrated that being male (vs female) [adjusted odds ratio (aOR) = 1.68, 95% confidence interval (CI) 1.07–2.63], home damage (aOR = 2.86, 95% CI 1.71–4.78), witnessing people injured (aOR = 2.33, 95% CI 1.36–4.00), and almost drowning during the storm (aOR = 8.99, 95% CI 1.92–41.99) were associated with PTSD. After adjusting for direct exposure, indirect exposure to disaster-related social media content, including information related to drowning victims (aOR = 1.29, 95% CI 1.00–1.67) and residents’ emotional reactions (aOR = 1.98, 95% CI 1.44–2.72), was associated with PTSD. Viewing more information about the storm itself (aOR = 0.37, 95% CI 0.28–0.49) and images of heroic acts (aOR = 0.72, 95% CI 0.55–0.94) were significantly associated with lower odds of PTSD.Conclusion: These findings add to the literature demonstrating that some types of media use and certain media content following a natural disaster are associated with PTSD.

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Karacaoğlu, Ö. C., & Özkaya, A. (2024) · Sociology International Journal · doi:10.15406/sij.2024.08.00373 · Cited by 4
Exposure to COVID ‐19‐related media content and mental health during the initial outbreak of COVID ‐19 in China
Liu, T., Zhang, S., & Zhang, H. (2022) · Scandinavian Journal of Psychology · doi:10.1111/sjop.12805 · Cited by 4
Different responses of two adjacent artificial beaches to Typhoon Hato in Zhuhai, China
Zhu, J., Wang, Q., Zhan, C., Sun, F., Hua, W., Liu, J., Qi, H., & Yu, Y. (2024) · Journal of Oceanology and Limnology · doi:10.1007/s00343-023-2401-5 · Cited by 3
“This typhoon was one of the strongest typhoons to affect the region of the Zhujiang River Delta in southern China over the last several decades (Takagi et al., 2018; Hall et al., 2019).”
High incidence of trauma-related psychopathology in Lebanese expatriates after the Beirut explosion
Rached, G., Fiani, D., Slim, M., Dib, S.-M., Chabbouh, A., Daou, M. A. Z., & Torbey, S. (2025) · European Journal of Trauma & Dissociation · doi:10.1016/j.ejtd.2025.100578 · Cited by 2
Help-Seeking Preferences and Influencing Factors Among Chinese Nurses Exposed to COVID-19: A Person-Centered Approach
Wu, Z., Shi, W., Chen, Y., Lowe, S. R., & Liu, J. (2024) · Journal of Community Health Nursing · doi:10.1080/07370016.2024.2314076 · Cited by 2
“The scale indicated good validity (e.g., Hall et al., 2019) among the Chinese population and displayed good reliability in this study (Cronbach’s α = 0.788).”
Influential
Mental Health Effects of Media Exposure Following a Natural Disaster
Fröhlich, J., Lindsey, A. B., & Radunovich, H. L. (2021) · EDIS · doi:10.32473/edis-fy1499-2021 · Cited by 2
What Are the Differences in Psychological Outcomes Between People Who Posted COVID-19-Related Content on Social Media and Those Who Did Not?
Zhang, S., Zhang, Y., Xue, D., Zhang, H., Chao, M., & Liu, T. (2023) · Psychiatry Investigation · doi:10.30773/pi.2022.0146 · Cited by 2
Health Professionals in the Disaster Recovery Space
Schafer, C., Kornhaber, R. A., McLean, L., Ingham, V., & Cleary, M. L. (2020) · Issues in Mental Health Nursing · doi:10.1080/01612840.2020.1789789 · Cited by 2
“An essential component to maintaining calm is limited exposure to media reports (Hall et al., 2019).”
Background
Pandemic Exposure and Adolescent Anxiety: Roles of Negative Media Exposure and Negative Coping StylesPreprint
Chen, Z.-J., Li, Q., Li, T., Chen, B., Wang, J., & Zhen, R. (2023) · Research Square · doi:10.21203/rs.3.rs-2901425/v1 · Cited by 3
A cross-sectional study to assess the post-traumatic stress disorder among discharged coronavirus disease-19-infected individuals in Karnataka, Southern India
Gudegowda, K. S., George, R., Iswarya, P., & Sobagaiah, R. T. (2023) · Journal of Current Research in Scientific Medicine · doi:10.4103/jcrsm.jcrsm_77_22 · Cited by 1
Turkish validity and reliability of the screening scale for indirect trauma caused by media exposure to social disasters (SITMES)
Güzel, A., & Kesim, S. İ. (2024) · Journal of Contingencies and Crisis Management · doi:10.1111/1468-5973.12616 · Cited by 1
Perceived social support, emotional self-disclosure, and posttraumatic growth in children following a typhoon: a three-wave cross-lagged study
He, Z., Li, Y., Ye, Y., & Zhou, X. (2025) · European Journal of Psychotraumatology · doi:10.1080/20008066.2025.2478793 · Cited by 1
“Here, trauma exposure was assessed using a self-developed trauma exposure scale (Huang et al., 2024), which was adapted from other typhoon exposure scales and was used in previous studies (e.g. Chan & Rhodes, 2014; Hall et al., 2019).”
The longitudinal association between COVID ‐19 stressors and adolescents' diurnal cortisol: The mediating effects of parental anxiety and behaviours
Li, M., He, F., Lan, Q., Zhang, C., Zang, Y., & Wang, L. (2024) · Infant and Child Development · doi:10.1002/icd.2541 · Cited by 1
THE TROIKA OF COVID-19, MEDIA EXPOSURE, AND MENTAL HEALTH: THE MEDIATING ROLE OF WORRY AND INTOLERANCE OF UNCERTAINTY
(2023) · Pakistan Journal of Humanities and Social Sciences Research · doi:10.37605/pjhssr.v6i1.333
Avoidant Coping In Response To Racial Trauma Promotes Flourishing
Wu, E. W.-N. (2022) · doi:10.46569/20.500.12680/8p58pm17m · Cited by 1
Impact of Social Media Infodemics on Mental Health among Health Colleges’ Students at Saudi Universities during COVID-19 Pandemic
Nour, M. O., Sinky, T. H., & Natto, H. A. (2022) · The Open Public Health Journal · doi:10.2174/18749445-v15-e2202040
Social Media Use and Online Racial Discrimination Associated with Negative Psychological Outcomes of Asian Americans and Racial Groups: A Cross-Sectional Survey in the United States during COVID-19 (Preprint)Preprint
Layug, A., Krishnamurthy, S., McKenzie, R., & Feng, B. (2022) · doi:10.2196/preprints.38589
Комунікація без заподіяння шкоди: оглядове дослідження висвітлення в медіа травматичних подій
Onufriv, S., Abdelhamid, O., & van Dormolen, S. (2023) · doi:10.30970/vjo.2023.52-53.11747
The War in Ukraine and Indirect Traumatization in the Czech Republic
Nešpor, K. (2023) · Cognitive Remediation Journal · doi:10.5507/crj.2023.002
“Hall et al. (2019) state that information about victims and the emotional reactions of those affected have a particularly negative impact. - In preventing secondary traumatization, Pe’er and Slone (2022) recommend training skills that are related to selfregulation.”
Background
Analysis of the Fourth Vaccination Intention of the Elderly for COVID-19 Based on RPA Theory
Chai, Z., Jiao, X., & Yang, Z. (2023) · Lecture Notes in Education Psychology and Public Media · doi:10.54254/2753-7048/8/20230318
The Impact of COVID-19 Media Information Exposure on College Students' Psychological Anxiety
Qingfeng, B., Chuting, H., Liren, S., Meiqian, X., Nuo, D., Jiayi, G., & Jiayao, D. (2023) · Applied & Educational Psychology · doi:10.23977/appep.2023.040806
“The research also found that the information reported by the media has the function of emotional awakening, and the negative emotions of individuals will be awakened by the negative information, which will aggravate psychological anxiety([10]).”
Background
Media Effect to Risk Perception and Protective Behavior During COVID-19 in Indonesia Partial Least Squares Modeling Analysis
Ayunin, E. N., Arumsari, I., Suraya, I., & Sari, M. P. (2023) · Media Kesehatan Masyarakat Indonesia · doi:10.30597/mkmi.v19i4.26642
“3,16,24 This was proven in this study, and correlation analysis results showed that the information content about the case update was associated significantly with negative emotionality, although in the results of the multivariate analysis, the information content was not the most influential…”
Result
“Not Liking the Look of This”: Examining the Relationship Between COVID-Related Social Media Exposure and Mental Health Symptoms
Punjabi, P., Jensen, A., Ortega, A. M., & Perez, A. (2024) · Psi Chi Journal of Psychological Research · doi:10.24839/2325-7342.jn29.1.59
Until the shaken snowglobe settles: Feeling unsettled when using social media during COVID-19
Landrum, B., & Garza, G. J. (2024) · Cyberpsychology Journal of Psychosocial Research on Cyberspace · doi:10.5817/cp2024-2-8
Genetic predisposition to digital device use and the risk of five psychiatric disorders
Liu, Q., & Zhang, Z. (2025) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2025.1463212
Does Feeling Safe Mean Being Free From Distress? Assessment of the Co‐Existing Trajectories of Posttraumatic Stress Disorder and Feelings of Safety in Children Following a Natural Disaster
He, Z., Li, Y., Ye, Y., Liu, Z., Peng, N., & Zhou, X. (2025) · Stress and Health · doi:10.1002/smi.70059
Temporal associations between adolescents’ psychological inflexibility and posttraumatic stress symptoms after a super typhoon: Examining the mediation of cognitive emotion regulation
Li, Y., Ye, Y., Liu, Z., He, Z., Huang, J., & Zhou, X. (2025) · Behaviour Research and Therapy · doi:10.1016/j.brat.2025.104820
Breaking news, breaking minds? Social media engagement and peritraumatic stress behavior immediately after the Russian – Ukrainian war outbreak. The role of peritraumatic anxiety and dispositional resilience
Măirean, C., Cobzeanu, A., & Dănilă, O. (2025) · Computers in Human Behavior Reports · doi:10.1016/j.chbr.2025.100808
Effects of disaster-related social media content on post-traumatic stress: the mediating role of negative emotions
Yoo, W., & Shin, D. (2025) · Asian Journal of Communication · doi:10.1080/01292986.2025.2594806
“A different study on Typhoon Hato revealed that exposure to disaster-related social media content, such as information about the victims of drowning, positively correlated with PTS (Hall et al., 2019).”
Sosyal Medya Kullanıcılarında İkincil Travmatik Stres ve Psikolojik Dayanıklılık Arasındaki İlişkide Öz-Şefkatin Aracılık Rolü
Çar, R. Ş. Ç., & Koç, M. S. (2025) · Sosyal Çalışma Dergisi · doi:10.70989/scd.1787930 · Cited by 1
Additional file 1 of The impact of health education videos on general public’s mental health and behavior during COVID-19
Yang, Q., Wu, Z., Xie, Y., Xiao, X., Wu, J., Sang, T., Zhang, K., Song, H., Wu, X., & Xu, X. (2021) · Figshare · doi:10.6084/m9.figshare.16714005
Changes and predictive factors of psychological symptoms in adolescents following the typhoon ‘Yagi’: a latent change score analysis
Fan, W., Yang, A., & LIANG, Y. (2026) · European Journal of Psychotraumatology · doi:10.1080/20008066.2025.2602296
“…one’s own or others’ physical integrity, damage to housing, shortages of basic necessities such as food, water, and medical care, and the loss of pets have all been shown to be closely associated with post-disaster psychological symptoms (Chan & Rhodes, 2014; Hall et al., 2019; Shi & Hall, 2023).”
Influential
Psychiatric outcomes after primary and secondary earthquake exposure: effects of loss, media, and treatment
Torun, H. O., Akdöner, B., Sarıkavak, T., & Kırlı, U. (2026) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2025.1715590
Post-traumatic stress disorder, depression and the role of media witnessing after wildfires
Kurt, G. (2026) · Discover Public Health · doi:10.1186/s12982-026-01416-0 · Cited by 1
“Evidence shows that increased exposure to news coverage of mass trauma events such as natural disasters, terrorist attacks, and pandemics predicts anxiety, depression, and post-traumatic stress symptoms, even for people who have not been directly exposed to the traumatic event [23–26].”
Disaster and Media Response
Rajkumar, R. P. (2026) · Springer eBooks · doi:10.1007/978-981-95-3690-0_16
Diverse Short Video Exposure and Post-Traumatic Growth among 2021 Henan Floods Victims: A 3-month Follow-up Study via Network Approach
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Development and validation of a short doomscrolling scale
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Witnessing trauma in the digital era: Uncensored media associates with posttraumatic stress in perinatal women
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The Seen and Unseen Traumas in Disasters and Crises
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Virtual Wounds: Reimagining Adverse Childhood Experiences (ACEs) in the Digital World
Méndez-Diaz, N., Hussein, Y. A., & Kauffman, S. (2026) · International Journal of Systemic Therapy · doi:10.1080/2692398x.2026.2722803

Authors: Hall, B. J., Xiong, Y. X., Yip, P. S. Y., Lao, C. K., Shi, W., Sou, E. K. L., Chang, K., Wang, L., & Lam, A. I. F.
Affiliations: Johns Hopkins University (US)
Global and Community Mental Health Research Group, Faculty of Social Sciences, The University of Macao, Macao (SAR), People’s Republic of China
University of Macau (MO)
Chinese Academy of Sciences (CN)
Corresponding author: Hall, Brian J.
ORCID: Hall, Brian J.
Lao, Chao Kei
Shi, Wei
Sou, Elvo K. L.
Chang, Kay
Wang, Li
Lam, Agnes I. F.
Venue: European Journal of Psychotraumatology
Publisher: Informa UK Limited
Published: 2019-01-14
Volume: 10
Issue: 1
Pages: 1558709-1558709
ISSN: 2000-8066 (ISSN-L)
DOI: 10.1080/20008198.2018.1558709
PMC: PMC6338284
OpenAlex: W2910901184
Cited by: 102
References: 51
Citations by year: 2026: 11 · 2025: 12 · 2024: 16 · 2023: 13 · 2022: 14 · 2021: 21 · 2020: 11 · 2019: 4
FWCI: 14.60
Type: journal article
Language: en
Open access: gold
doi.org
Licence: cc-by-nc
creativecommons.org/licenses/by-nc/4.0/ (vor)
Locations: European Journal of Psychotraumatology (publishedVersion, cc-by-nc)
Europe PMC (PubMed Central) (publishedVersion, cc-by-nc)
PubMed Central (publishedVersion, cc-by-nc)
PubMed (publishedVersion)
Institutional Repository of Institute of Psychology, Chinese Academy of Sciences (Institute of Psychology, Chinese Academy of Sciences) (submittedVersion)
DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
Institutional Repository of Institute of Psychology, Chinese Academy of Sciences (Institute of Psychology, Chinese Academy of Sciences) (submittedVersion, cc-by-nc-sa)
Funders: Macao Government RSKTO (MYRG-2015-111)
Topics: Social Sciences › Psychology › Clinical Psychology › Posttraumatic Stress Disorder Research
Social Sciences › Psychology › Clinical Psychology › COVID-19 and Mental Health
Social Sciences › Sociology and Political Science › Disaster Management and Resilience
Keywords: post-traumatic stress disorder, Typhoon Hato, disaster exposure, media exposure, social media, natural disasters, university students, housing damage, drowning, risk factors, gender differences, Macau, psychological resilience, disaster recovery, disaster narratives, disaster imagery

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The association between disaster exposure and media use on post-traumatic stress disorder following Typhoon Hato in Macao, China

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