Cox regression reveals optimism reduces PTSD incidence while language proficiency predicts PTSD outcomes in migrants.
The purpose of the present study was to examine internal and contextual predictors of two interrelated phenomena among Puerto Rican Hurricane Maria survivors who relocated to the U.S. mainland after the storm: (a) incidence of positive posttraumatic stress disorder (PTSD) screen among hurricane survivors who had not previously screened positive and (b) remission from positive PTSD among those who had previously screened positive. Participants were 319 Puerto Rican Hurricane Maria survivors on the U.S. mainland assessed between 2020 and 2023. We employed Cox proportional hazards regression to model several predictors of positive PTSD screen incidence and remission for each outcome using five waves of data. Higher English proficiency (adjusted hazard ratio [AHR] = 50%), language stress (AHR = 44%), discrimination (AHR = 33%), and hurricane trauma (AHR = 31%) emerged as predictors of positive PTSD screen incidence. Optimism, on the other hand, was associated with a reduced likelihood of PTSD incidence (AHR = -26%). Similarly, optimism emerged as the strongest predictor of remission from a positive PTSD screen (AHR = 39%), whereas higher English proficiency (AHR = -38%) and exposure to hurricane trauma (AHR = -32%) indicated a reduced likelihood of remission from PTSD. We observed a rapid initial remission from positive PTSD screen for a substantial portion of the sample. Participants who are proficient in English language may be most likely to screen positive for PTSD over time and least likely to remit from a positive PTSD screen. Findings underscore the importance of optimism and higher English proficiency for both decreased incidence of and increased remission from PTSD. (PsycInfo Database Record (c) 2025 APA, all rights reserved).
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