How Does Media Play into Trauma?

Source: Dana Rose Garfin, used with permission

Dr. Dana Rose Garfin is Assistant Adjunct Professor in the Sue & Bill Gross School of Nursing at the University of California, Irvine. She is Principal Investigator of the REACH (Resilience, Epidemiology, and Community Health Lab), which focuses on examining: 1) how negative life events and community disasters impact physical and mental health, and 2) how community-based interventions can help alleviate the harmful effects of such exposure.

She is currently exploring the long-term psychological effects of COVID-19 in a nationally representative sample of Americans as well as in a sample of Gulf Coast residents at risk for hurricane exposure during the era of COVID-19. Dr. Garfin's work is funded by the National Institute of Health and National Science Foundation. She holds an MA in Social Ecology and a Ph.D. in Psychology and Social Behavior.

Jamie Aten: How did you first get interested in this topic?

Dana Rose Garfin: When I started as a traumatic stress researcher, I was not necessarily interested in the effect of media exposure on psychological distress per se. I was interested in responses to natural disasters and the effects of large-scale violence on communities. However, in 2013, my colleagues and I ran a study of 4,675 Americans a few weeks after the Boston Marathon bombings. We found that one of the strongest predictors of acute stress symptoms (a precursor to the development of posttraumatic stress disorder [PTSD]) was media exposure to the coverage of the bombings. What was particularly striking was that the highest levels of media exposure were more strongly associated with acute stress symptoms than even direct exposure to the event. When the COVID-19 pandemic began to inundate the 24/7 new cycle, my colleagues and I became concerned about the implications of this intense media exposure on mental and physical health.

JA: What was the focus of your study?

DRG: The focus of the article was to review research about how high levels of media exposure could be harmful to your physical and mental health. We referred to longitudinal research we conducted after the Boston Marathon bombing, as well as a variety of other collective traumas including natural disasters, the Pulse nightclub shooting, and other public health crises (i.e., Ebola outbreak in 2014). These studies used epidemiological, representative samples of thousands of Americans, collected to match the demographic composition of the United States and smaller target regions (for example, we oversampled in Boston and New York after the Boston Marathon bombings; we surveyed a representative sample of Floridians after Hurricane Irma). This allows us to make inferences about how Americans (or target communities) overall respond to events. We use web-based platforms to administer our surveys, so people can take the survey on their computer, cell phone, or mobile device in the immediate aftermath of an event, which helps minimize recall bias and improves response rates.

JA: What did you discover in your study?

DRG: In all of these studies, we found that the more event-related media that people consumed, the higher their psychological distress. We also found that these effects persisted over time and that they were linked with functional impairment (i.e., when one’s physical and emotional health gets in the way of social and occupational functioning) months after the event. In other work, we found that the “acute stress response” (which can be thought of as immediate psychological distress after a trauma and is sometimes referred to as early PTSD) was linked with physical and mental health ailments months and even years after the event. This also highlights the concern that the immediate psychological distress one experiences after a traumatic event could have implications for physical and mental health down the road. In our Boston Marathon bombing study, we found that graphic images (like images of dead bodies or blood) were associated with higher posttraumatic stress responses and functional impairment months after the bombing. This finding showed us that what you see matters in addition to how much. We also found that these effects accumulate over time—exposure to a greater number of events online in real-time (for example, a shooting, a natural disaster, and a bombing) was associated with greater negative responses to a future event.

JA: Is there anything that surprised you in your findings, or that you weren't fully expecting?

DRG: I was surprised (and to some extent continue to be surprised) at how strong the effects of media exposure are on physical and mental health over time. As a trauma researcher, I would initially think that being exposed to an actual event in person would be much more distressing than witnessing it on television. And certainly, my other work on trauma-exposure has shown that direct exposure to a traumatic event can have lifelong implications for physical and mental health. (As an aside, the more individual-level direct traumas that you experience, the more sensitive you tend to be to media-based exposures.) Nevertheless, after conducting more than a dozen surveys on representative samples after exposure to a myriad of collective trauma, media exposure keeps showing up as one of the strongest predictors of distress over time.

Source: Photo by Brian McGowan on Unsplash

JA: How might readers apply what you found to their lives in the midst of COVID-19?

DRG: It is critical to stay informed during traumatic events, especially ongoing events like the COVID-19 pandemic, an approaching hurricane, and now the George Floyd protests and riots. People need to know what they are supposed to do with respect to local regulations and recommendations (e.g., curfews, stay-at-home orders, wearing masks). Media dependency theory is an old theory that posits people depend and rely on the media even more during times of crisis and I think this is even truer in contemporary times. That withstanding, I encourage people to pick one or two media sources to stay informed and try to limit repeated exposure, particularly to disturbing images. There is a tendency to want to stay glued to media coverage, and there is evidence that this feeds into a cycle of distress and exposure (you watch media coverage and feel distressed, so you watch more media coverage because you are thinking about the event, and then feel more distressed, etc). It is possible to stay informed without spending hours of your day exposing yourself to the same information repeatedly. This can reinforce the threat circuitry in your brain, which can lead to the traumatic stress response that can persist even after you walk away from the news. It can be even more difficult to step away from all this coverage when we are exposed to it all day at our fingertips (cell phones, computers, etc.) and endless scrolling and links do not necessarily have a true stop point like old school newspapers have (i.e., you finish reading the paper, put it down, and switch activities).

JA: How can readers use what you found to help others during COVID-19?

DRG: Be supportive and understanding of others who might be having a difficult time. Be available for them to talk to if you want, but do not force anyone to share who is not up to it. People heal and cope with problems in individual ways—for some, that involves communicating about the event, and for others, it does not. For people who do not want to talk about the event, they might enjoy spending time with you or talking about other things. Everybody responds differently to traumatic events. Some people might have a lot of direct exposure (e.g., lost their job, knew someone sick) and still be functioning pretty well. You might have someone else in your life who has not had that type of “direct” exposure but is experiencing many distress symptoms. Be compassionate, understanding, open-minded, and supportive. Suggesting activities that get your loved ones (and yourself!) out of the house (to the extent that local guidelines permit) and away from the constant barrage of media exposure could be helpful. Activities such as exercise, meditation, prayer, art, cooking, and connecting with friends and family could also help reduce stress.

JA: What are you currently working on that you might like to share about?

DRG: Currently, I have two projects, both generously funded by the National Science Foundation studying the psychological effects of the COVID-19 outbreak. The first, with Drs. Roxane Cohen Silver and E. Alison Holman (also from UCI), is a study of 6,500 Americans, assessed in the first six weeks after the COVID-19 pandemic was declared a national emergency. People were assessed in three cohorts, so we could see if people responded differently as the epidemic progressed in America. Media exposure and health-protective behaviors play a big role in that project. My other project, with Dr. Gabrielle Wong-Parodi (from Stanford University), involves following Gulf Coast residents who are dealing with COVID-19 in advance of what experts predict to be a very active hurricane season. We have surveyed almost 2,000 Gulf Coast residents and will be assessing them again after the threat of a landfilling major (Category 3 or higher) hurricane. We will keep you posted on the results.