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Lai BS, Riobueno-Naylor A, Baum C, Hawkins SS. Population-level effects of Hurricane Sandy on adolescent health. J Affect Disord 2024:S0165-0327(24)01335-1. [PMID: 39181166 DOI: 10.1016/j.jad.2024.08.108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2024] [Revised: 08/19/2024] [Accepted: 08/20/2024] [Indexed: 08/27/2024]
Abstract
BACKGROUND Disasters are increasing in frequency and intensity due to climate change. Youth are the largest and most vulnerable group exposed to disasters. More evidence is needed regarding how youth mental health and health behaviors vary based on disaster exposure, how mental health influences health behaviors, and how diverse groups of youth may be differentially affected. METHODS Using data from the Youth Risk Behavior Survey and Federal Emergency Management Agency, we examined the impact of Hurricane Sandy (2012) on mental health (sadness, suicidality) and health behaviors (substance use, physical activity, screen time, sexual behaviors) of 240,365 youth. Difference-in-differences regression analyses evaluated pre-disaster (2005-2011) and post-disaster (2013-2019) changes. RESULTS There were 83,442 (34.7 %) adolescents (51.2 % female, 18.1 % non-Hispanic White) located in 6 districts exposed to Hurricane Sandy and 156,923 (65.3 %) adolescents located in 13 non-exposed districts. Exposure was associated with differences in substance use, physical (in)activity, and risky sexual behaviors, but not mental health outcomes. Mental health did not moderate the association between disaster exposure and health behaviors. Hispanic adolescents and those identifying as Other races/ethnicities were most vulnerable to post-disaster negative health outcomes. LIMITATIONS Study limitations include questionnaire design, cross-sectional data, sampling, and possible response biases. CONCLUSIONS Findings provide critical information about youth mental health and health behaviors following disasters, as well as how youth may differ in their responses. Findings provide guidance for early identification and resource allocation for youth at higher risk for post-disaster health issues.
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Affiliation(s)
- Betty S Lai
- Department of Counseling, Developmental, and Educational Psychology, Lynch School of Education, Boston College, USA.
| | - Alexa Riobueno-Naylor
- Department of Counseling, Developmental, and Educational Psychology, Lynch School of Education, Boston College, USA
| | - Christopher Baum
- Department of Economics, Morrissey College of Arts and Sciences, Boston College, USA; School of Social Work, Boston College, USA
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MacDermid Wadsworth SM, Topp D, Lester P, Stander V, Christ SL, Whiteman S, Knobloch L. Long-term consequences of mothers' and fathers' wartime deployments: Protocol for a two-wave panel study. PLoS One 2024; 19:e0295007. [PMID: 38498486 PMCID: PMC10947692 DOI: 10.1371/journal.pone.0295007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Accepted: 11/13/2023] [Indexed: 03/20/2024] Open
Abstract
Multiple adjustment difficulties have been associated with children's exposure to recent parental wartime military deployments, but long-term consequences have not yet been systematically studied. This investigation will assess direct and indirect relationships between exposures to parental deployments early in life and later youth adjustment. Parents' psychological health and family processes will be examined as mediators, and parents' and children's vulnerability and support will be examined as moderators. Archival data will be combined with new data gathered from two children and up to two parents in families where children will be aged 11 to 16 at the first data collection and will have experienced at least one parental deployment, for at least one child prior to age 6. Data are being gathered via telephone interviews and web-based surveys conducted twice one year apart. Outcomes are indicators of children's social-emotional development, behavior, and academic performance. Notable features of this study include oversampling of female service members, inclusion of siblings, and inclusion of families of both veterans and currently serving members. This study has potentially important implications for schools, community organizations and health care providers serving current and future cohorts of military and veteran families.
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Affiliation(s)
- Shelley M. MacDermid Wadsworth
- Department of Human Development and Family Science, Purdue University, West Lafayette, Indiana, United States of America
| | - Dave Topp
- Department of Human Development and Family Science, Purdue University, West Lafayette, Indiana, United States of America
| | - Patricia Lester
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, California, United States of America
| | - Valerie Stander
- Naval Health Research Center, San Diego, California, United States of America
| | - Sharon L. Christ
- Department of Human Development and Family Science, Purdue University, West Lafayette, Indiana, United States of America
| | - Shawn Whiteman
- Department of Human Development and Family Studies, Utah State University, Logan, Utah, United States of America
| | - Leanne Knobloch
- Department of Communication, University of Illinois, Urbana, Illinois, United States of America
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La Greca AM, Burdette ET, Brodar KE. Climate change and extreme weather disasters: evacuation stress is associated with youths' somatic complaints. Front Psychol 2023; 14:1196419. [PMID: 37425189 PMCID: PMC10323363 DOI: 10.3389/fpsyg.2023.1196419] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Accepted: 05/23/2023] [Indexed: 07/11/2023] Open
Abstract
Objective Climate-change has brought about more frequent extreme-weather events (e.g., hurricanes, floods, and wildfires) that may require families to evacuate, without knowing precisely where and when the potential disaster will strike. Recent research indicates that evacuation is stressful for families and is associated with psychological distress. Yet, little is known about the potential impact of evacuation stressors on child health. After Hurricane Irma, which led to a mass evacuation in Florida, we examined whether evacuation stressors and hurricane exposure were uniquely associated with youth somatic complaints, and whether youth psychological distress (i.e., symptoms of posttraumatic stress, anxiety, and depression) served as a potential mediating pathway between evacuation stressors, hurricane experiences, and somatic complaints. Method Three months after Irma, 226 mothers of youth aged 7-17 years (N=226; M age = 9.76 years; 52% boys; 31% Hispanic) living in the five southernmost Florida counties reported on evacuation stressors, hurricane-related life threat and loss/disruption, and their child's psychological distress and somatic complaints using standardized measures. Results Structural equation modeling revealed a good model fit (χ2 = 32.24, p = 0.003, CFI = 0.96, RMSEA = 0.08, SRMR = 0.04). Even controlling for life-threatening hurricane experiences (β = 0.26) and hurricane loss and disruption (β = 0.26), greater evacuation stressors were associated with greater symptoms of youth psychological distress (β = 0.34; p's < 0.001), and greater psychological distress was associated with more somatic complaints (β = 0.67; p < 0.001). Indirect effects revealed that evacuation stressors (p < 0.001), actual life-threatening events (p < 0.01), and loss and disruption (p < 0.01) were all uniquely and indirectly associated with youths' somatic complaints via youth psychological distress. Discussion Findings suggest that even coping with the threat of a disaster may be sufficient to prompt psychological and physical health symptoms in youth. Due in part to climate change, threats of disaster occur much more often than actual disaster exposure, especially for areas that are prone to hurricanes or wildfires. Preparing youth and families residing in vulnerable areas for potential disaster evacuation or sheltering-in-place appears critical. Encouraging families to develop Disaster Plans and teaching stress management skills may reduce both youth distress and somatic health problems.
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Chen C, Li C, Chen M, Wang L, Zhu Y, Zhu Z. Coping and post-traumatic stress disorder symptoms among Chinese youth in the peak and remission periods of COVID-19. CHILDREN AND YOUTH SERVICES REVIEW 2022; 143:106690. [PMID: 36267155 PMCID: PMC9568280 DOI: 10.1016/j.childyouth.2022.106690] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/05/2021] [Revised: 05/26/2022] [Accepted: 10/08/2022] [Indexed: 06/16/2023]
Abstract
The COVID-19 pandemic has exposed emergent vulnerability to adolescents' mental health. This longitudinal study investigated the association between coping at the peak of the COVID outbreak (T1) and Post-Traumatic Stress Disorder (PTSD) symptoms concurrently, and at the remission periods of COVID in China three months (T2) and six months (T3) later in a sample of 6th to 12th-grade students (N = 782). The results showed that forward-focus coping was negatively associated with PTSD symptoms across all three timepoints and predicted reduced risk for more PTSD symptoms at T2, and trauma-focus coping was positively associated with PTSD symptoms across all three timepoints and predicted higher risk of PTSD symptoms both at T2 and T3. There was an interaction effect of trauma-focus coping and T1 symptoms on later symptoms (T3) - trauma-focus coping was more detrimental for those who had more initial symptoms. The results showed the beneficial effects of future-oriented coping and harmful effects of trauma-focus coping for Chinese youth during the epidemic. Clinical implications of the results were discussed.
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Affiliation(s)
- Chun Chen
- School of Humanities and Social Science, Chinese University of Hong Kong (Shenzhen), Shenzhen, PR China
| | - Chunbo Li
- Mental Health Center, Shanghai Jiao Tong University School of Medicine, PR China
| | | | | | - Yaqin Zhu
- Shanghai Shi Dai Middle School, PR China
| | - Zhuoying Zhu
- Mental Health Center, Shanghai Jiao Tong University School of Medicine, PR China
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Brackbill RM, Butturini E, Cone JE, Ahmadi A, Daniels RD, Farfel MR, Kubale T. Scientific Value of the Sub-Cohort of Children in the World Trade Center Health Registry. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:12461. [PMID: 36231761 PMCID: PMC9564973 DOI: 10.3390/ijerph191912461] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/04/2022] [Revised: 09/22/2022] [Accepted: 09/25/2022] [Indexed: 06/16/2023]
Abstract
The World Trade Center Health Registry (WTCHR) was established in 2002 as a public health resource to monitor the health effects from the World Trade Center (WTC) disaster. We evaluated the representativeness of the WTC youth population (<18 years on 11 September 2001) by comparing the distributions of age, gender, race/ethnic groups, and income to 2000 census data for the matched geographic area, including distance from disaster. There were 2379 WTCHR enrolled children living in Lower Manhattan south of Canal Street on 11 September 2001, along with 752 enrolled students who attended school in Lower Manhattan but were not area residents. The WTCHR sub-group of children who were residents was similar to the geographically corresponding census population on age and sex. Black and Hispanic children are moderately overrepresented at 0.9% and 2.4% in the WTCHR compared to 0.8% and 1.7% in census population, respectively, while lower-income households are slightly under-represented, 28.8% in the WTCHR and 30.8% for the corresponding census information. Asian children appear underrepresented at 3.0% participation compared to 6.3% in the census. While the demographics of WTCHR youth are somewhat skewed, the gaps are within expected patterns of under-representation observed in other longitudinal cohorts and can be effectively addressed analytically or through targeted study design.
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Affiliation(s)
- Robert M. Brackbill
- World Trade Center Health Registry, Division of Epidemiology, New York City Department of Health and Mental Hygiene, New York, NY 11101, USA
| | - Emma Butturini
- World Trade Center Health Program Division, National Institute for Occupational Safety and Health, U.S. Centers for Disease Control and Prevention, Atlanta, GA 30329, USA
| | - James E. Cone
- World Trade Center Health Registry, Division of Epidemiology, New York City Department of Health and Mental Hygiene, New York, NY 11101, USA
| | - Ayda Ahmadi
- World Trade Center Health Registry, Division of Epidemiology, New York City Department of Health and Mental Hygiene, New York, NY 11101, USA
| | - Robert D. Daniels
- World Trade Center Health Program Division, National Institute for Occupational Safety and Health, U.S. Centers for Disease Control and Prevention, Atlanta, GA 30329, USA
| | - Mark R. Farfel
- World Trade Center Health Registry, Division of Epidemiology, New York City Department of Health and Mental Hygiene, New York, NY 11101, USA
| | - Travis Kubale
- World Trade Center Health Program Division, National Institute for Occupational Safety and Health, U.S. Centers for Disease Control and Prevention, Atlanta, GA 30329, USA
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Raccanello D, Rocca E, Vicentini G, Brondino M. Eighteen Months of COVID-19 Pandemic Through the Lenses of Self or Others: A Meta-Analysis on Children and Adolescents' Mental Health. CHILD & YOUTH CARE FORUM 2022; 52:737-760. [PMID: 36059590 PMCID: PMC9421638 DOI: 10.1007/s10566-022-09706-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/26/2022] [Indexed: 12/02/2022]
Abstract
Background The COVID-19 pandemic can have a serious impact on children and adolescents' mental health. We focused on studies exploring its traumatic effects on young people in the first 18 months after that the pandemic was declared, distinguishing them also according to the type of informants (self-report and other-report instruments). Objective We applied a meta-analytic approach to examine the prevalence of depression, anxiety, posttraumatic stress disorder, and psychological distress among children and adolescents during the COVID-19 pandemic, considering the moderating role of kind of disorder and/or symptom, type of instrument, and continent. Method We used PsycINFO, PubMed, and Scopus databases to identify articles on the COVID-19 pandemic, applying the following filters: participants until 20 years of age, peer-review, English as publication language. Inclusion required investigating the occurrence of disorders and/or symptoms during the first 18 months of the pandemic. The search identified 26 publications. Results The meta-analysis revealed that the pooled prevalence of psychological disorders and/or symptoms for children and adolescents, who were not affected by mental health disturbances before the outbreak of the COVID-19 pandemic, was .20, 95% CI [.16, .23]. Moreover, we found a moderating role of type of instrument: occurrence was higher for self-report compared to other-report instruments. Conclusions The study presented an analysis of the psychological consequences for children and adolescents of the exposure to the COVID-19 pandemic, soliciting further research to identify factors underlying resilience. Notwithstanding limitations such as the small number of eligible articles and the fact that we did not examine the role of further characteristics of the studies (such as participants' age or design), this meta-analysis is a first step for future research documenting the impact of such an unexpected and devastating disaster like the COVID-19 pandemic.
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Affiliation(s)
- Daniela Raccanello
- Department of Human Sciences, University of Verona, Lungadige Porta Vittoria 17, 37129 Verona, Italy
| | - Emmanuela Rocca
- Department of Human Sciences, University of Verona, Lungadige Porta Vittoria 17, 37129 Verona, Italy
| | - Giada Vicentini
- Department of Human Sciences, University of Verona, Lungadige Porta Vittoria 17, 37129 Verona, Italy
| | - Margherita Brondino
- Department of Human Sciences, University of Verona, Lungadige Porta Vittoria 17, 37129 Verona, Italy
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Safarpour H, Sohrabizadeh S, Malekyan L, Safi-Keykaleh M, Pirani D, Daliri S, Bazyar J. Suicide Death Rate after Disasters: A Meta-Analysis Study. Arch Suicide Res 2022; 26:14-27. [PMID: 32674715 DOI: 10.1080/13811118.2020.1793045] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
BACKGROUND Disasters have undesirable effects on health among individuals such as psychosocial disorders which may lead lead to suicide in some cases. Thus, the present study aimed to measure the rate of suicide death after disasters all over the world. METHODS In the present meta-analysis study, all of the articles published in English until the end of 2019 were probed in electronic databases such as Web of Science, PubMed, Cochrane Library, Science Direct, PsycINFO, PsycARTICLES, and Google Scholar. Then, the data were imported to STATA ver.13 software and analyzed through fixed- and random-effects models, meta-regression, and Cochrane statistical tests. RESULTS A total of 11 studies including a sample size of 65495867 were considered. Suicide death rates before and after the disasters were calculated as 13.61 (CI95%: 11.59-15.77) vs. 16.68 (CI95%: 14.5-19:0) among the whole population, 28.36 (CI 95%:11.29-45.43) vs. 32.17 (CI95%: 17.71-46.62) among men, and 12.71 (CI95%: 5.98-19.44) vs 12.69 (CI95%: 5.17-20.21) among women. The rate of suicide death significantly increased in the whole population and men, while no significant difference was reported among women. CONCLUSION Suicide death rate increases after disasters indicating the destructive impact of this phenomenon on peoples' health. Therefore, implementing supportive and interventional measures is highly suggested after disasters in order to prevent suicide death among the affected people.
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Taube Dayan S. Adolescence Outside the Restricted Zone: A Narrative Study of Nuclear Disaster Response Trajectories intertwining with Life (TiL). JOURNAL OF ADOLESCENT RESEARCH 2021. [DOI: 10.1177/07435584211062145] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Responses to trauma can involve complex meaning-making processes and the perception of ambiguous threats. This study sought to explore response trajectories to a nuclear disaster and their intertwining courses with ecological factors (Trajectories intertwining with Life—TiL) from adolescence onward among a non-evacuated population. Four women and four men (mean age 20) who were adolescents during the 2011 nuclear accident in Fukushima (mean age 14), and who grew up outside the restricted zone participated in the study. Semi-structured life story interviews were conducted in the form of in-depth qualitative inquiries. A holistic analysis was employed to identify the TiL patterns following the Fukushima nuclear disaster in the overall context of the stories and to reveal important themes throughout adolescence. Four TiL patterns were found: three trajectories corresponding with those identified in prior research and one newly identified trajectory. The perceived, distal, and continuous threat of radiation played a central role in all patterns and exerted secondary impacts throughout the lives of non-evacuated adolescents. The study’s implications shed light on rarely studied response trajectories to ambiguous Potentially Traumatic Events (PTEs) throughout adolescence and point out the benefits of using a life story approach to this end for the first time.
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Lai BS, La Greca AM, Brincks A, Colgan CA, D’Amico MP, Lowe S, Kelley ML. Trajectories of Posttraumatic Stress in Youths After Natural Disasters. JAMA Netw Open 2021; 4:e2036682. [PMID: 33587133 PMCID: PMC7885036 DOI: 10.1001/jamanetworkopen.2020.36682] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
IMPORTANCE Disaster exposure is associated with the development of posttraumatic stress (PTS) symptoms in youths. However, little is known about how to predict which youths will develop chronic PTS symptoms after disaster exposure. OBJECTIVE To evaluate PTS symptom trajectories among youths after 4 major US hurricanes and assess factors associated with those trajectories. DESIGN, SETTING, AND PARTICIPANTS This cohort study used integrative data analysis to combine data from 4 studies of youths' responses to natural disasters (hurricanes Andrew [1992], Charley [2004], Ike [2005], and Katrina [2008]) at time points ranging from 3 to 26 months after the disasters. Those studies recruited and surveyed youths aged 6 to 16 years at schools via convenience sampling of schools near the path of destruction for each hurricane. This study was conducted from August 2017 to August 2020, and pooled data were analyzed from February 2019 to October 2020. EXPOSURE Experience of a natural disaster during the ages of 6 to 16 years. MAIN OUTCOMES AND MEASURES Posttraumatic stress symptoms were assessed using the University of California, Los Angeles, Posttraumatic Stress Disorder Reaction Index (UCLA PTSD-RI) and the UCLA PTSD-RI-Revised. Latent class growth analyses were used to evaluate the youths' PTS symptom trajectories and associated factors. RESULTS Among 1707 youths included in the study, the mean (SD) age was 9.61 (1.60) years, 922 (54%) were female, and 785 (46%) self-identified as White non-Hispanic. Four PTS symptom trajectories were identified: chronic (171 participants [10%]), recovery (393 [23%]), moderate-stable (563 [33%]), and low-decreasing (580 [34%]). Older youths were less likely to be in the chronic group; compared with the chronic group, each 1-year increase in age was associated with increased odds of being in the other groups (recovery: odds ratio [OR], 1.78 [95% CI, 1.29-2.48]; moderate-stable: OR, 1.94 [95% CI, 1.43-2.62]; and low-decreasing: OR, 2.71 [95% CI, 1.99-3.71]). Compared with males, females had higher odds of being in the chronic group than in any other group (recovery group: OR, 0.48 [95% CI, 0.26-0.91]; moderate-stable group: OR, 0.37 [95% CI, 0.21-0.64]; and low-decreasing group: OR, 0.25 [95% CI, 0.14-0.44]). CONCLUSIONS AND RELEVANCE In this cohort study, few youths reported chronic distress, and trajectories among most youths reflected recovery or low-decreasing PTS symptoms. Older age and identification as male were factors associated with decreased odds of a chronic trajectory. Youths with chronic or moderate-stable trajectories may benefit from intervention.
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Affiliation(s)
- Betty S. Lai
- Department of Counseling, Developmental, and Educational Psychology, Lynch School of Education and Human Development, Boston College, Chestnut Hill, Massachusetts
| | | | - Ahnalee Brincks
- Department of Epidemiology and Biostatistics, Michigan State University, East Lansing
| | - Courtney A. Colgan
- Department of Counseling, Developmental, and Educational Psychology, Lynch School of Education and Human Development, Boston College, Chestnut Hill, Massachusetts
| | | | - Sarah Lowe
- Department of Social and Behavioral Sciences, Yale School of Public Health, New Haven, Connecticut
| | - Mary Lou Kelley
- Department of Psychology, Louisiana State University, Baton Rouge
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Hausman EM, Black SR, Bromet E, Carlson G, Danzig A, Kotov R, Klein DN. Reciprocal effects of maternal and child internalizing symptoms before and after a natural disaster. JOURNAL OF FAMILY PSYCHOLOGY : JFP : JOURNAL OF THE DIVISION OF FAMILY PSYCHOLOGY OF THE AMERICAN PSYCHOLOGICAL ASSOCIATION (DIVISION 43) 2020; 34:836-845. [PMID: 32324018 PMCID: PMC9013012 DOI: 10.1037/fam0000653] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
After natural disasters, mothers and children are vulnerable to internalizing symptoms, such as depression and anxiety, and levels of mothers' and children's symptoms are significantly associated. However, the disaster literature has rarely examined reciprocal effects within families. The present study capitalizes on the occurrence of Hurricane Sandy during the course of an ongoing longitudinal study to address this gap. Three-hundred and 47 children (54.2% male, 84.7% Caucasian) and their mothers completed measures of internalizing symptoms when the children were 9-years-old. Hurricane Sandy occurred an average of 1 year later. Eight weeks after the hurricane, mothers and children completed the same measures again. Mothers also reported on their family's stress exposure from Hurricane Sandy. After controlling for predisaster symptoms, longitudinal actor-partner interdependence models indicated that mother's and children's internalizing symptoms were linked. Mothers' prehurricane depression symptoms also predicted increases in children's depression symptoms over time independent of hurricane-related stress. Children's prehurricane anxiety symptoms predicted increases in mothers' depression symptoms only at low levels of hurricane-related stress. Rather than the emergence of reciprocal effects, mother's depression symptoms and children's internalizing symptoms changed in tandem after Hurricane Sandy. High levels of Hurricane Sandy stress did not produce symptom spillover effects, but rather may have interrupted the unfolding of normative developmental parent-child reciprocal symptom processes. (PsycInfo Database Record (c) 2020 APA, all rights reserved).
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Affiliation(s)
| | | | | | | | | | - Roman Kotov
- Department of Psychiatry, Stony Brook University
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Lai BS, La Greca AM, Colgan CA, Herge W, Chan S, Medzhitova J, Short M, Auslander B. Sleep Problems and Posttraumatic Stress: Children Exposed to a Natural Disaster. J Pediatr Psychol 2020; 45:1016-1026. [PMID: 32885231 DOI: 10.1093/jpepsy/jsaa061] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2020] [Revised: 07/02/2020] [Accepted: 07/06/2020] [Indexed: 01/22/2023] Open
Abstract
OBJECTIVE Sleep plays a critical role in children's growth and development. This study examined the frequency and persistence of children's sleep problems following a natural disaster, risk factors for children's sleep problems, and the bidirectional relationship between children's sleep problems and posttraumatic stress symptoms (PTSS) over time. METHODS This study assessed 269 children (53% female, M = 8.70 years, SD = 0.95) exposed to Hurricane Ike at 8 months (Time 1) and 15 months (Time 2) post-disaster. Children completed measures of hurricane exposure and related stressors, stressful life events, sleep problems, and PTSS. RESULTS Children's sleep problems were significantly correlated from Time 1 to Time 2 (r = .28, p < .001). Risk factors for sleep problems at Time 2 were younger age, sleep problems at Time 1, and PTSS, not including sleep items, at Time 1. Examinations of the bidirectional relationship between sleep problems and PTSS indicated that PTSS significantly predicted later sleep problems, but sleep problems did not significantly predict later PTSS. CONCLUSIONS Findings demonstrate that PTSS may contribute to the development and course of children's sleep problems post-disaster.
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Affiliation(s)
- Betty S Lai
- Department of Counseling, Developmental, and Educational Psychology, Lynch School of Education and Human Development, Boston College
| | | | - Courtney A Colgan
- Department of Counseling, Developmental, and Educational Psychology, Lynch School of Education and Human Development, Boston College
| | - Whitney Herge
- Psychology Department, Texas Scottish Rite Hospital for Children
| | - Sherilynn Chan
- Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center.,Department of Pediatrics, College of Medicine, University of Cincinnati
| | - Julia Medzhitova
- Department of Counseling, Developmental, and Educational Psychology, Lynch School of Education and Human Development, Boston College
| | - Mary Short
- Clinical, Health and Applied Sciences, College of Human Sciences and Humanities, University of Houston-Clear Lake
| | - Beth Auslander
- Department of Pediatrics, University of Texas Medical Branch
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Masten AS, Motti-Stefanidi F. Multisystem Resilience for Children and Youth in Disaster: Reflections in the Context of COVID-19. ADVERSITY AND RESILIENCE SCIENCE 2020; 1:95-106. [PMID: 32838305 PMCID: PMC7314620 DOI: 10.1007/s42844-020-00010-w] [Citation(s) in RCA: 198] [Impact Index Per Article: 49.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
In the context of rising disasters worldwide and the challenges of the COVID-19 pandemic, this commentary considers the implications of findings in resilience science on children and youth for disaster preparation and response. The multisystem challenges posed by disasters are illustrated by the COVID-19 pandemic. We discuss the significance of disasters in the history of resilience science and the emergence of a unifying systems definition of resilience. Principles of a multisystem perspective on resilience and major findings on what matters for young people in disasters are delineated with reference to the pandemic. Striking parallels are noted in the psychosocial resilience factors identified at the level of individual children, families, schools, and communities. These parallels suggest that adaptive capacities associated with resilience in these interacting systems reflect interconnected networks and processes that co-evolved and may operate in concert. As resilience science moves toward integrated theory, knowledge, and applications in practice, particularly in disaster risk reduction and resilience promotion, more focus will be needed on multisystem and multidisciplinary research, communication, training, and planning.
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Affiliation(s)
- Ann S. Masten
- University of Minnesota Twin Cities, Minneapolis, MN USA
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Pfefferbaum B. Children's Exposure to Single Incidents of Terrorism: Perspectives Over 25 Years Since the Oklahoma City Bombing. Curr Psychiatry Rep 2020; 22:39. [PMID: 32514785 DOI: 10.1007/s11920-020-01163-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
PURPOSE OF REVIEW This paper traces advances in our knowledge about children's exposure and reactions to terrorist events over the last 25 years, beginning with the 1995 Oklahoma City bombing, and offers observations about cross-cutting issues including implications for services. RECENT FINDINGS Direct and indirect interpersonal exposures have been examined in community samples and in samples of children selected because of their event experiences. Despite its present exclusion from the stressor criterion for a diagnosis of posttraumatic stress disorder, considerable research has documented an association between children's initial subjective reaction and outcomes. Few studies have examined the influence of community or distant effects on outcomes, but contact with media coverage has been well studied. This review confirms the central role of exposure in influencing children's reactions to terrorist incidents and supports recent efforts to distinguish specific experiences that constitute children's event exposures.
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Affiliation(s)
- Betty Pfefferbaum
- Department of Psychiatry and Behavioral Sciences, College of Medicine, University of Oklahoma Health Sciences Center, 920 Stanton L. Young Boulevard, WP3217, P.O. Box 26901, Oklahoma City, OK, 73126-0901, USA.
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Abstract
PURPOSE OF REVIEW We identify trends and gaps in the literature on the role of social support in the psychopathology and risky behavior of youths exposed to political violence and mass disasters. We also discuss the implications of recent research's findings and suggest directions for future research. RECENT FINDINGS Political violence and natural disasters inflict serious blows to adolescents' mental and physical health and may have reverberating, negative impacts throughout the nested social systems in which youths develop. However, many adolescents are not adversely affected, suggesting the presence of resilience. While the beneficial effects of social support from close others are well documented, along with situations under which perceived support may even increase stress, the exact mechanisms behind social support's protective effects have not been thoroughly studied. Different personality attributes and/or different concepts of the self may possibly contribute to-or harm-youths' resilience. There is considerable variability in research on adolescents' social support in the context of political violence and mass disasters, stressors that may erode social support. Thus, further investigation of social support's protective effects via longitudinal studies is highly important.
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Ferreira RJ, Buttell F, Cannon C. Ethical Issues in Conducting Research With Children and Families Affected by Disasters. Curr Psychiatry Rep 2018; 20:42. [PMID: 29777320 DOI: 10.1007/s11920-018-0902-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
PURPOSE OF REVIEW We review topical evidence on ethical issues in conducting disaster research with children and families affected by natural disasters, with an emphasis on analyzing specific vulnerabilities associated with children and families affected by disasters, identifying significant findings and trends of ethical guidelines and approaches, and discussing key observations into ethical research in a disaster setting. RECENT FINDINGS Current evidence indicates that there is a wide range of research methods for child disaster studies. Vulnerability as a concept in child disaster studies is more prevalent with several scholars underscoring the need for an ethical approach to disaster research. Current disaster research evidence suggests that there is specifically an interest in conducting disaster research with children and families. With the increase in investigations, it is strongly recommended that investigators adhere to ethical standards in research practice when conducting research with vulnerable populations (e.g., children) within a postdisaster context.
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Affiliation(s)
- Regardt J Ferreira
- Tulane School of Social Work, 127 Elk Place, New Orleans, LA, 70118, USA. .,Department of Social Work, University of the Free State, Bloemfontein, South Africa.
| | - Fred Buttell
- Tulane School of Social Work, 127 Elk Place, New Orleans, LA, 70118, USA.,Department of Social Work, University of the Free State, Bloemfontein, South Africa
| | - Clare Cannon
- Department of Social Work, University of the Free State, Bloemfontein, South Africa.,Department of Human Ecology, UC Davis, Davis, USA
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North CS, Mendoza S, Simic Z, Pfefferbaum B. Parent-reported behavioral and emotional responses of children to disaster and parental psychopathology. JOURNAL OF LOSS & TRAUMA 2018; 23:303-316. [PMID: 30745859 DOI: 10.1080/15325024.2018.1443710] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
Child disaster mental health research has been largely limited by investigation of one disaster at a time and inconsistent methods across different studies. This study assessed 160 survivors of 3 disasters with structured diagnostic interviews, asking about the behavioral and emotional disaster reactions their 266 children of ages 3-17. Most children had ≥1 postdisaster behavior change or disaster-related posttraumatic stress symptom. The children's postdisaster behavioral and emotional problems were associated with parental postdisaster psychopathology. The results underscore the importance of asking disaster survivors about their children's disaster reactions and considering parental disaster experiences and reactions in addressing their children's reactions.
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Affiliation(s)
- Carol S North
- Medical Director, The Altshuler Center for Education & Research, Metrocare Services, 1250 Mockingbird Lane, Suite 330, Dallas, Texas 75247-4914, 214-743-1200, The Nancy and Ray L. Hunt Chair in Crisis Psychiatry and Professor of Psychiatry, The University of Texas Southwestern Medical Center, 6363 Forest Park Rd., Room BL6.226, Dallas, Texas 75390-8828, 214-648-5375
| | - Steffi Mendoza
- Child and Adolescent Psychiatry Fellow, The University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd., Dallas, Texas 75390
| | - Zorica Simic
- Clinical Research Coordinator, The University of Texas Southwestern Medical Center, 6363 Forest Park Rd., Room BL6.310, Dallas, Texas 75390-8828, 214-648-4447
| | - Betty Pfefferbaum
- George Lynn Cross Research Professor Emeritus, Department of Psychiatry and Behavioral Sciences, College of Medicine, University of Oklahoma Health Sciences Center, 920 Stanton L. Young Blvd., WP3217, Oklahoma City, OK 73104, (405) 271-5251 x47639
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Lowell A, Suarez-Jimenez B, Helpman L, Zhu X, Durosky A, Hilburn A, Schneier F, Gross R, Neria Y. 9/11-related PTSD among highly exposed populations: a systematic review 15 years after the attack. Psychol Med 2018; 48:537-553. [PMID: 28805168 PMCID: PMC5805615 DOI: 10.1017/s0033291717002033] [Citation(s) in RCA: 57] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
BACKGROUND The 11 September 2001 (9/11) attacks were unprecedented in magnitude and mental health impact. While a large body of research has emerged since the attacks, published reviews are few, and are limited by an emphasis on cross-sectional research, short time frame, and exclusion of treatment studies. Additionally, to date, there has been no systematic review of available longitudinal information as a unique data set. Consequently, knowledge regarding long-term trajectories of 9/11-related post-traumatic stress disorder (PTSD) among highly exposed populations, and whether available treatment approaches effectively address PTSD within the context of mass, man-made disaster, remains limited. METHODS The present review aimed to address these gaps using a systematic review of peer-reviewed reports from October 2001 to May 2016. Eligible reports were of longitudinal studies of PTSD among highly exposed populations. We identified 20 reports of 9/11-related PTSD, including 13 longitudinal prevalence studies and seven treatment studies. RESULTS Findings suggest a substantial burden of 9/11-related PTSD among those highly exposed to the attack, associated with a range of sociodemographic and back-ground factors, and characteristics of peri-event exposure. While most longitudinal studies show declining rates of prevalence of PTSD, studies of rescue/recovery workers have documented an increase over time. Treatment studies were few, and generally limited by methodological shortcomings, but support exposure-based therapies. CONCLUSION Future directions for research, treatment, and healthcare policy are discussed.
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Affiliation(s)
- A. Lowell
- Department of Psychiatry, Columbia University Medical Center, New York, NY, USA
- New York State Psychiatric Institute, New York, NY, USA
| | - B. Suarez-Jimenez
- Department of Psychiatry, Columbia University Medical Center, New York, NY, USA
- New York State Psychiatric Institute, New York, NY, USA
| | - L. Helpman
- Department of Psychiatry, Columbia University Medical Center, New York, NY, USA
- New York State Psychiatric Institute, New York, NY, USA
| | - X. Zhu
- Department of Psychiatry, Columbia University Medical Center, New York, NY, USA
- New York State Psychiatric Institute, New York, NY, USA
| | - A. Durosky
- New York State Psychiatric Institute, New York, NY, USA
| | - A. Hilburn
- New York State Psychiatric Institute, New York, NY, USA
| | - F. Schneier
- Department of Psychiatry, Columbia University Medical Center, New York, NY, USA
- New York State Psychiatric Institute, New York, NY, USA
| | - R. Gross
- Department of Epidemiology, Columbia University Medical Center, New York, NY, USA
- Department of Epidemiology and Preventive Medicine, Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
- Division of Psychiatry, Chaim Sheba Medical Center, Tel Hashomer, Israel
| | - Y. Neria
- Department of Psychiatry, Columbia University Medical Center, New York, NY, USA
- New York State Psychiatric Institute, New York, NY, USA
- Department of Epidemiology, Columbia University Medical Center, New York, NY, USA
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18
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Lai BS, Osborne MC, Piscitello J, Self-Brown S, Kelley ML. The relationship between social support and posttraumatic stress symptoms among youth exposed to a natural disaster. Eur J Psychotraumatol 2018; 9:1450042. [PMID: 29696072 PMCID: PMC5912434 DOI: 10.1080/20008198.2018.1450042] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2017] [Accepted: 02/25/2018] [Indexed: 11/22/2022] Open
Abstract
Background: Children are a vulnerable population following a natural disaster, due to their age and dependence on adults. The primary presenting problem children report after disasters is posttraumatic stress symptoms (PTSS). Prior research suggests that PTSS is inversely related to social support, which is often disrupted after a disaster. Objective: This study examined the relationship between social support (from parents, teachers, and peers) and PTSS in children affected by Hurricane Katrina. The research contributes to the literature by examining the mechanisms that drive this relationship over time. Methods: In this study, 426 children were followed over four timepoints, beginning 3-7 months after Hurricane Katrina and concluding 25-27 months post-hurricane. Three path models analysed the relationship between social support (from parents, teachers, and peers, measured by the Social Support Scale for Children) and PTSS (measured by the UCLA PTSD Reaction Index). Covariates included child age, minority status, gender, perceived life threat, and actual life threat. Nonsignificant paths were trimmed from the final models. Global fit indices were examined to determine model fit. Results: In the parent and peer social support models, PTSS exhibited statistically significant effects on social support from one wave to the next. In the teacher model, this was only true between Waves 2 and 3. Social support showed a statistically significant effect on PTSS between Wave 2 and Wave 3 in the peer model (standardized estimate = -0.26, p < .0001). No paths from social support to PTSS were significant in the parent and teacher models. Conclusion: Findings support a social selection model in which PTSS undermine social support, particularly in the first two years post-disaster. If these findings are replicated, this suggests that, in cases of limited funding, PTSS should be prioritized, given their cascading effects on social support.
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Affiliation(s)
- Betty S Lai
- School of Public Health, Georgia State University, Atlanta, GA, USA
| | | | | | | | - Mary Lou Kelley
- Department of Psychology, Louisiana State University, Baton Rouge, LA, USA
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20
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Adebäck P, Schulman A, Nilsson D. Children exposed to a natural disaster: psychological consequences eight years after 2004 tsunami. Nord J Psychiatry 2018; 72:75-81. [PMID: 28990835 DOI: 10.1080/08039488.2017.1382569] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
BACKGROUND There is a need for studies that follow up children and adolescents for many years post disaster since earlier studies have shown that exposure during natural disasters constitutes a risk factor for poor psychological health. AIMS The main aim was to examine whether there was an association between severity of exposures during a natural disaster experienced in childhood or adolescence and posttraumatic stress symptoms, psychological distress, self-rated health, diagnosis of depression, anxiety or worry, thoughts about or attempted suicide, physical symptoms or daily functioning eight years later in young adulthood. A second aim was to compare psychological distress and self-rated health of exposed young adults with a matched population-based sample. METHOD Young adults, who experienced the 2004 tsunami as children between 10 and 15 years of age, responded to a questionnaire eight years post disaster. The results were compared to a matched population sample. RESULTS The results showed that the likelihood for negative psychological outcomes was higher for those who had been exposed to several types of exposures during this natural disaster. CONCLUSIONS The negative psychological impact on children and adolescents can still be present eight years post-disaster and seems to have association with the type of exposure; loss, physical presence and subjective experience. It is important for clinicians, who meet young adults seeking help, to be conscious about the impact as long as eight years post disaster and to be aware of possible clinical implications associated with severity of exposures.
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Affiliation(s)
- Petra Adebäck
- a Department of Neurobiology Care Sciences and Society, Division of Family Medicine and Primary Care , Karolinska Institutet , Huddinge , Sweden
| | - Abbe Schulman
- a Department of Neurobiology Care Sciences and Society, Division of Family Medicine and Primary Care , Karolinska Institutet , Huddinge , Sweden
| | - Doris Nilsson
- a Department of Neurobiology Care Sciences and Society, Division of Family Medicine and Primary Care , Karolinska Institutet , Huddinge , Sweden.,b Department for Behavioral Sciences and Learning, Section for Clinical Psychology , Linköping University , Linköping , Sweden
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21
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Lai BS, Lewis R, Livings MS, La Greca AM, Esnard AM. Posttraumatic Stress Symptom Trajectories Among Children After Disaster Exposure: A Review. J Trauma Stress 2017; 30:571-582. [PMID: 29193316 PMCID: PMC5953201 DOI: 10.1002/jts.22242] [Citation(s) in RCA: 47] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2016] [Revised: 06/30/2017] [Accepted: 07/13/2017] [Indexed: 11/06/2022]
Abstract
Natural disasters, such as hurricanes and floods, are increasing in frequency and scope. Youth exposed to disasters are at risk for developing posttraumatic stress symptoms (PTSS). However, not all youth who report initially elevated PTSS report persistent PTSS that last beyond the first three to six months postdisaster. Thus, it is crucial to understand how and why youth differ in their patterns of PTSS. This study reviewed the literature on children's postdisaster PTSS, evaluating the typical number and types of patterns for children's PTSS trajectories, as well as risk and protective factors predicting trajectory membership. This review identified eight empirical studies on youth PTSS trajectories following natural disasters; these studies included 8,306 children aged 3 to 18 years. All studies identified resilience, recovery, and chronic trajectories. Evidence for a delayed trajectory was mixed. Proportions of children falling into each trajectory varied widely across studies, but overall, resilience was the most prevalent trajectory. These findings were consistent across study factors (i.e., analytic strategy, assessment timing, and study selection criteria). Female gender, disaster exposure, negative coping, and lack of social support were significant risk factors for chronic trajectories across several studies. Future research should combine individual level participant data across studies of children's responses to disasters to better understand PTSS trajectories.
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Affiliation(s)
- Betty S. Lai
- School of Public Health, Georgia State University, Atlanta, Georgia, USA
| | - Rayleen Lewis
- School of Public Health, Georgia State University, Atlanta, Georgia, USA
| | | | | | - Ann-Margaret Esnard
- Andrew Young School of Policy Studies, Georgia State University, Atlanta, Georgia, USA
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22
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Graham RA, Osofsky JD, Osofsky HJ, Hansel TC. School based post disaster mental health services: decreased trauma symptoms in youth with multiple traumas. ACTA ACUST UNITED AC 2017. [DOI: 10.1080/1754730x.2017.1311798] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
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Lai BS, Esnard AM, Lowe SR, Peek L. Schools and Disasters: Safety and Mental Health Assessment and Interventions for Children. Curr Psychiatry Rep 2016; 18:109. [PMID: 27778233 DOI: 10.1007/s11920-016-0743-9] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
This article draws on experiences and lessons from global disasters and utilizes the United Nations Comprehensive School Safety Framework to highlight the necessary role of safe schools in protecting children, as well as adult staff, from the immediate threats and long-term implications of disasters. Specifically, we focus on three well-established pillars of school safety: Pillar I: Safe Learning Facilities; Pillar II: Disaster Management; and Pillar III: Risk Reduction and Resilience Education. In addition, we propose a potential fourth pillar, which underscores the function of schools in postdisaster mental health assessment and intervention for children. We argue that schools offer a central location and trusted institutional space for mental health assessment and intervention after disasters. We also examine the important linkages between schools, child mental health, and household and family recovery. We conclude with recommendations for filling gaps in research and practice related to ensuring the safety of schools and the associated health and well-being of children in the face of future disasters.
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Affiliation(s)
- Betty S Lai
- School of Public Health, Georgia State University, 1 Park Place, Atlanta, GA, 30303, USA.
| | - Ann-Margaret Esnard
- Andrew Young School of Policy Studies, Georgia State University, 14 Marietta Street, NW, Atlanta, GA, 30303, USA
| | - Sarah R Lowe
- Department of Psychology, Montclair State University, 1 Normal Avenue, Montclair, NJ, 07043, USA
| | - Lori Peek
- Department of Sociology, Colorado State University, B-237 Clark Building, Fort Collins, CO, 80523, USA
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Liberty K, Tarren-Sweeney M, Macfarlane S, Basu A, Reid J. Behavior Problems and Post-traumatic Stress Symptoms in Children Beginning School: A Comparison of Pre- and Post-Earthquake Groups. PLOS CURRENTS 2016; 8:ecurrents.dis.2821c82fbc27d0c2aa9e00cff532b402. [PMID: 28503358 PMCID: PMC5419821 DOI: 10.1371/currents.dis.2821c82fbc27d0c2aa9e00cff532b402] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
INTRODUCTION Literature reviews caution that estimating the effects of disasters on the behavior of children following a disaster is difficult without baseline information and few studies report the effects of earthquakes on young children. In addition the relationship between age at the time of disaster and consequential behavior problems have not been reported for young children who experience disaster-related stress during a developmentally sensitive period. METHODS Behavior problems and symptoms of post-traumatic stress (PTS) were reported for two groups of children from nearby neighborhoods during their first term at school, using the Behavior Problem Index by teacher report, following approved informed consent procedures. Data on one group, "Pre-EQ" (N=297), was collected four years before the beginning of the earthquakes on children born 2001-2002. Data on the second group, "Post-EQ" (N=212), was collected approximately three to four years after the beginning of the earthquakes on children born 2007-2009 and living in heavily damaged neighborhoods. The Post-EQ group had significantly more children from high socioeconomic neighborhoods but no other significant differences on main demographic characteristics. RESULTS The mean behavior problem score was significantly higher in the Post-EQ group (Mean =6.11) as compared to the Pre-EQ group (Mean = 3.78). PTS symptoms were also significantly higher in the Post-EQ group (Mean =2.91) as compared to the Pre-EQ group (Mean=1.98) and more children had high PTS scores (20.9% v. 8.8%, OR= 2.73, 95%CI =1.57, 4.76). Model testing identified that a younger age at the time of exposure was the only significant predictor of high numbers of PTS symptoms in the Post-EQ group. Discussion: Rates of teacher-reported behavior problems in young children more than doubled following the Christchurch earthquakes. Younger children may be more vulnerable to the effects of earthquakes that occur during a developmentally sensitive period. Additional research is needed to consider the effects of age and duration of disaster effects to better understand the effects of disasters on children, their families and communities.
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Affiliation(s)
- Kathleen Liberty
- School of Health Sciences, University of Canterbury, Christchurch, New Zealand
| | - Michael Tarren-Sweeney
- School of Health Sciences, University of Canterbury, New Zealand; Centre for Brain and Mental Health Research, University of Newcastle, Australia
| | - Sonja Macfarlane
- Te Oranga School of Human Development & Movement Studies / Te Kura Toi Tangata Faculty of Education, University of Waikato, Hamilton, New Zealand
| | - Arindam Basu
- School of Health Sciences, University of Canterbury, Christchurch, New Zealand
| | - James Reid
- Deptartment of General Practice and Rural Health. Dunedin School of Medicine, University of Otago, Dunedin, New Zealand
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Abstract
Children exposed to disasters are a vulnerable population, making the assessment of children post-disaster an important issue. Utilizing a Multiple Gating Stepped Care framework, we highlight recent literature related to post-disaster assessment and intervention for children. In particular, we focus on screening, clinical evaluation, and feedback-informed service delivery. Screening allows large populations of children to be assessed at a relatively low cost. Children identified by screening as being at risk may then be assessed through more in-depth clinical evaluations, in order to assess clinical symptoms, strengths, and stressors, and to make determinations about appropriate interventions. Continued assessment during therapy provides important feedback for the delivery of appropriate care. New formats for assessment, as well as issues related to identifying sources for assessment, are discussed. Recommendations for future directions are provided.
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Review of Coping in Children Exposed to Mass Trauma: Measurement Tools, Coping Styles, and Clinical Implications. Prehosp Disaster Med 2016; 31:169-80. [PMID: 26887259 DOI: 10.1017/s1049023x16000169] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Evidence-based practice requires the use of data grounded in theory with clear conceptualization and reliable and valid measurement. Unfortunately, developing a knowledge base regarding children's coping in the context of disasters, terrorism, and war has been hampered by a lack of theoretical consensus and a virtual absence of rigorous test construction, implementation, and evaluation. This report presents a comprehensive review of measurement tools assessing child and adolescent coping in the aftermath of mass trauma, with a particular emphasis on coping dimensions identified through factor analytic procedures. Coping measurement and issues related to the assessment of coping are reviewed. Concepts important in instrument development and psychometric features of coping measures used in disasters, terrorism, and war are presented. The relationships between coping dimensions and both youth characteristics and clinical outcomes also are presented. A discussion of the reviewed findings highlights the difficulty clinicians may experience when trying to integrate the inconsistencies in coping dimensions across studies. Incorporating the need for multiple informants and the difference between general and context-specific coping measures suggests the importance of a multilevel, theoretical conceptualization of coping and thus, the use of more advanced statistical measures. Attention also is given to issues deemed important for further exploration in child disaster coping research.
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Ponnamperuma T, Nicolson NA. Negative Trauma Appraisals and PTSD Symptoms in Sri Lankan Adolescents. JOURNAL OF ABNORMAL CHILD PSYCHOLOGY 2016; 44:245-55. [PMID: 25691386 PMCID: PMC4729791 DOI: 10.1007/s10802-015-9985-y] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
The cognitive model posits that negative appraisals play an important role in posttraumatic stress disorder, in children as well as in adults. This study examined correlates of negative appraisals in relation to trauma exposure and their relationship to posttraumatic stress symptoms (PTSS) in 414 Sri Lankan adolescents, aged 12 to 16, living in areas impacted in varying degrees by the 2004 tsunami. In 2008, participants completed measures of negative appraisals, lifetime traumatic events, posttraumatic stress symptoms, internalizing symptoms, ongoing adversity, and social support. The majority (70 %) of the participants reported multiple traumatic events; 25 % met DSM-IV criteria for full or partial PTSD. Adolescents who had experienced more severe events, abusive events, greater cumulative trauma, or greater current adversity reported more negative appraisals. In regression analyses controlling for known risk factors such as female gender, cumulative trauma, ongoing adversity, and low social support, negative appraisals were the best predictor of PTSS, explaining 22 % of the variance. This relationship appeared specific to PTSS, as negative appraisals did not predict internalizing symptoms. Findings confirm the link between negative cognitions concerning traumatic events and persistent PTSS in adolescents, but longitudinal studies are needed to determine whether appraisals contribute to symptom maintenance over time.
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Affiliation(s)
- Thyagi Ponnamperuma
- Department of Community Medicine, Faculty of Medicine, University of Ruhuna, Matara, Sri Lanka
| | - Nancy A Nicolson
- Department of Psychiatry & Psychology, School for Mental Health and Neuroscience, Maastricht University, Box 616, 6200 MD, Maastricht, The Netherlands.
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Child Disaster Mental Health Services: a Review of the System of Care, Assessment Approaches, and Evidence Base for Intervention. Curr Psychiatry Rep 2016; 18:5. [PMID: 26719308 DOI: 10.1007/s11920-015-0647-0] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Several decades of research have informed our knowledge of children's reactions to disasters and the factors that influence their reactions. This article describes the system of care for child disaster mental health services using population risk to determine needed services and a stepped care approach built on assessment and monitoring to advance children to appropriate services. To assess the evidence base for disaster interventions, recent reviews of numerous child disaster mental health interventions are summarized.
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Danielson CK, Sumner JA, Adams ZW, McCauley JL, Carpenter M, Amstadter AB, Ruggiero KJ. Adolescent Substance Use Following a Deadly U.S. Tornado Outbreak: A Population-Based Study of 2,000 Families. JOURNAL OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY 2015; 46:732-745. [PMID: 26605673 DOI: 10.1080/15374416.2015.1079780] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
Despite conceptual links between disaster exposure and substance use, few studies have examined prevalence and risk factors for adolescent substance use and abuse in large, population-based samples affected by a recent natural disaster. We addressed this gap using a novel address-based sampling methodology to interview adolescents and parents who were affected by the 4th deadliest tornado outbreak in U.S. HISTORY Postdisaster interviews were conducted with 2,000 adolescent-parent dyads living within a 5-mile radius of the spring 2011 U.S. tornadoes. In addition to descriptive analyses to estimate prevalence, hierarchical linear and logistic regression analyses were used to examine a range of protective and risk factors for substance use and abuse. Approximately 3% reported substance abuse since the tornado. Greater number of prior traumatic events and older age emerged as consistent risk factors across tobacco and alcohol use and substance abuse since the tornado. Tornado incident characteristics, namely, greater loss of services and resources after the tornado and posttraumatic stress disorder since the tornado, were associated with greater alcohol consumption. Service loss increased risk for binge drinking, whereas, for substance abuse, posttraumatic stress disorder increased risk and parent presence during the tornado decreased risk. Greater family tornado exposure was associated with a greater number of cigarettes smoked in female but not male teen participants. Both trauma and non-trauma-related factors are relevant to postdisaster substance abuse among adolescents. Future research should examine the role of broader ecological systems in heightening or curtailing substance use risk for adolescents following disaster exposure.
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Affiliation(s)
- Carla Kmett Danielson
- a Department of Psychiatry & Behavioral Sciences , Medical University of South Carolina
| | - Jennifer A Sumner
- b Department of Epidemiology , Columbia University Mailman School of Public Health
| | - Zachary W Adams
- a Department of Psychiatry & Behavioral Sciences , Medical University of South Carolina
| | - Jenna L McCauley
- a Department of Psychiatry & Behavioral Sciences , Medical University of South Carolina
| | - Matthew Carpenter
- a Department of Psychiatry & Behavioral Sciences , Medical University of South Carolina
| | | | - Kenneth J Ruggiero
- d College of Nursing , Medical University of South Carolina.,e Ralph H. Johnson VAMC
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Psychiatric disorders and suicide attempts in Swedish survivors of the 2004 southeast Asia tsunami: a 5 year matched cohort study. Lancet Psychiatry 2015; 2:817-24. [PMID: 26236006 DOI: 10.1016/s2215-0366(15)00124-8] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/08/2015] [Revised: 03/16/2015] [Accepted: 03/17/2015] [Indexed: 11/20/2022]
Abstract
BACKGROUND Survivors of natural disasters are thought to be at an increased risk of psychiatric disorders, however the extent of this risk, and whether it is linked to pre-existing psychopathology, is not known. We aimed to establish whether Swedish survivors of tsunamis from the 2004 Sumatra-Andaman earthquake had increased risks of psychiatric disorders and suicide attempts 5 years after repatriation. METHODS We identified Swedish survivors repatriated from southeast Asia (8762 adults and 3742 children) and 864 088 unexposed adults and 320 828 unexposed children matched for sex, age, and socioeconomic status. We retrieved psychiatric diagnoses and suicide attempts from the Swedish patient register for the 5 years after the tsunami (from Dec 26, 2004, to Jan 31, 2010) and estimated hazard ratios (HRs), then adjusted for pre-tsunami psychiatric disorders, and, for children, for parental pre-tsunami disorders. FINDINGS Exposed adults were more likely than unexposed adults to receive any psychiatric diagnosis (547 [6·2%] vs 47 734 [5·5%]; adjusted HR 1·21, 95% CI 1·11-1·32), particularly stress-related disorders (187 [2·1%] vs 8831 [1·0%]; 2·27, 1·96-2·62) and suicide attempts (38 [0·43%] vs 2752 [0·32%]; 1·54, 1·11-2·13), but not mood or anxiety disorders. Risk of psychiatric diagnoses did not differ between exposed and unexposed children and adolescents (248 [6·6] vs 22 081 [6·9%]; 0·98, 0·86-1·11), although exposed children and adolescents had a higher risk for suicide attempts with uncertain intent (1·43; 1·01-2·02) and stress-related disorders (1·79; 1·30-2·46), mainly during the first 3 months after the tsunami. INTERPRETATION The 2004 tsunami was, independently of previous psychiatric morbidity, associated with an increased risk of severe psychopathology, mainly stress-related disorders and suicide attempts, in children and adults. Survivors of natural disasters should be targeted with early interventions and active long-term follow-up to prevent, detect, and alleviate psychiatric disorders that might follow. FUNDING The Swedish Council for Working Life and Social Research, Swedish Board of Health and Welfare, Polish Ministry of Science and Higher Education, Swedish Society for Medical Research.
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Perceptions of Trauma and Loss among Children and Adolescents Exposed to Disasters a Mixed-Methods Study. CURRENT PSYCHOLOGY 2015. [DOI: 10.1007/s12144-015-9348-4] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
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Lai BS, Beaulieu B, Ogokeh CE, Self-Brown S, Kelley ML. Mother and Child Reports of Hurricane Related Stressors: Data from a Sample of Families Exposed to Hurricane Katrina. CHILD & YOUTH CARE FORUM 2015; 44:549-565. [PMID: 27087768 PMCID: PMC4828036 DOI: 10.1007/s10566-014-9289-3] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Families exposed to disasters such as Hurricane Katrina are at risk for numerous adverse outcomes. While previous literature suggests that the degree of disaster exposure corresponds with experiencing negative outcomes, it is unclear if parents and children report similar levels of disaster exposure. OBJECTIVE The purpose of this paper was to examine levels of disaster stressor agreement among mother-child dyads affected by Hurricane Katrina, and to examine whether discrepancies in disaster stressor reports are associated with higher levels of posttraumatic stress (PTS) symptoms. METHODS Participants in this study consisted of 353 dyads of mothers (age M = 38.79 years, SD = 7.52; 68% African American) and children (52% girls; age M = 11.61 years, SD = 1.57) exposed to Hurricane Katrina. Parents and children were assessed at two timepoints, 3 - 7 months and 14 - 17 months postdisaster. Parent and child responses to items regarding hurricane related stressor exposure and PTS symptoms were analyzed. RESULTS Agreement on hurricane related exposures was predominately slight to moderate, with kappas ranging from κ = .19 to κ = .83. Polynomial regression analyses revealed that when mothers reported low levels of Immediate Loss/Disruption stressors and children reported high levels of these stressors, children reported higher levels of Time 2 PTS symptoms, b = -.72 (.33), p = .03. CONCLUSIONS Overall, levels of mother-child response agreement were low. Discrepancies in mother and child reports predicted higher levels of child PTS symptoms. Clinicians may want to query both parents and children about their disaster experiences when working with families postdisaster.
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Affiliation(s)
- Betty S Lai
- School of Public Health, Georgia State University
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Cadamuro A, Versari A, Vezzali L, Trifiletti E. Preventing the detrimental effect of posttraumatic stress in young children: The role of theory of mind in the aftermath of a natural disaster. EUROPEAN JOURNAL OF DEVELOPMENTAL PSYCHOLOGY 2015. [DOI: 10.1080/17405629.2015.1055240] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
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Pfefferbaum B, Jacobs AK, Griffin N, Houston JB. Children's disaster reactions: the influence of exposure and personal characteristics. Curr Psychiatry Rep 2015; 17:56. [PMID: 25980513 DOI: 10.1007/s11920-015-0598-5] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
This paper reviews children's reactions to disasters and the personal and situational factors that influence their reactions. Posttraumatic stress disorder (PTSD) and posttraumatic stress reactions are the most commonly studied outcomes, though other conditions also occur including anxiety, depression, behavior problems, and substance use. More recently, traumatic grief and posttraumatic growth have been explored. New research has delineated trajectories of children's posttraumatic stress reactions and offered insight into the long-term consequences of their disaster experiences. Risk factors for adverse outcomes include pre-disaster vulnerabilities, perception of threat, and loss and life disruptions post-disaster. Areas in need of additional research include studies on the timing and course of depression and anxiety post-event and their interactions with other disorders, disaster-related functional and cognitive impairment, positive outcomes, and coping.
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Affiliation(s)
- Betty Pfefferbaum
- Department of Psychiatry and Behavioral Sciences, College of Medicine, University of Oklahoma Health Sciences Center, P.O. Box 26901, WP3217, Oklahoma City, OK, 73126-0901, USA,
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Pfefferbaum B, Jacobs AK, Houston JB, Griffin N. Children's disaster reactions: the influence of family and social factors. Curr Psychiatry Rep 2015; 17:57. [PMID: 25980512 DOI: 10.1007/s11920-015-0597-6] [Citation(s) in RCA: 48] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
This review examines family (demographics, parent reactions and interactions, and parenting style) and social (remote effects, disaster media coverage, exposure to secondary adversities, and social support) factors that influence children's disaster reactions. Lower family socioeconomic status, high parental stress, poor parental coping, contact with media coverage, and exposure to secondary adversities have been associated with adverse outcomes. Social support may provide protection to children in the post-disaster environment though more research is needed to clarify the effects of certain forms of social support. The interaction of the factors described in this review with culture needs further exploration.
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Affiliation(s)
- Betty Pfefferbaum
- Department of Psychiatry and Behavioral Sciences, College of Medicine, University of Oklahoma Health Sciences Center, P.O. Box 26901 - WP3217, Oklahoma City, OK, 73126, USA,
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Weems CF. Biological correlates of child and adolescent responses to disaster exposure: a bio-ecological model. Curr Psychiatry Rep 2015; 17:51. [PMID: 25980506 DOI: 10.1007/s11920-015-0588-7] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Exposure to both human-caused and natural disasters is associated with a number of postevent reactions in youth including the experience of symptoms of several mental disorders. There is wide variability in these responses, with some youth having very intense exposure to the disaster and yet showing resilience or even personal growth, while others with low exposure sometimes show intensely negative reactions. Research findings are reviewed in this article to identify biological correlates of risk and resilience focusing on potential genetic, neurobiological, and physiological factors linked to the reactions of children exposed to disasters. A bio-ecological model is presented to couch this review of biological correlates of disaster exposure. The model predicts susceptibility to negative reactions after disaster exposure, and the biological correlates of disaster reactions can be understood in terms of this susceptibility as it relates to biological markers of the fear system.
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Affiliation(s)
- Carl F Weems
- Department of Human Development and Family Studies, Iowa State University, 4380 Palmer, Ames, IA, 50011-4380, USA,
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Abstract
The goal of this paper was to critically evaluate the literature on children coping with mass trauma published between the years 2011 and 2014 and to emphasize interesting and important findings with the aim of proposing a new comprehensive model for better understanding the process of coping with these events in this unique developmental stage. Using a variety of databases, 26 research papers were selected. The papers were divided into two main categories, natural and manmade disasters. The findings suggest that several areas in this context still lack foundational knowledge and should be further investigated. Thus, it has been suggested that future research should emphasize the developmental stage of the children, the cultural context and atmosphere in which the investigated children grow up and live, and the type of event (acute vs. chronic; natural vs. manmade). A more comprehensive coping model which addresses these omissions and combines main theories is suggested for use in future research as well.
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Affiliation(s)
- Orna Braun-Lewensohn
- Conflict Management & Resolution Program, Department of Interdisciplinary Studies, Ben-Gurion University of the Negev, Beer Sheva, Israel,
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School Dissatisfaction in a Post-disaster Environment: The Mediating Role of Posttraumatic Stress Symptoms. CHILD & YOUTH CARE FORUM 2015. [DOI: 10.1007/s10566-015-9316-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Louisiana State University Health Sciences Center Katrina Inspired Disaster Screenings (KIDS): Psychometric Testing of the National Child Traumatic Stress Network Hurricane Assessment and Referral Tool. CHILD & YOUTH CARE FORUM 2015. [DOI: 10.1007/s10566-015-9313-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Self-Reported Emotional and Behavioral Problems, Family Functioning and Parental Bonding Among Psychiatric Outpatient Adolescent Offspring of Croatian Male Veterans with Partial PTSD. CHILD & YOUTH CARE FORUM 2015. [DOI: 10.1007/s10566-015-9299-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Scott BG, Sanders AFP, Graham RA, Banks DM, Russell JD, Berman SL, Weems CF. Identity Distress among Youth Exposed to Natural Disasters: Associations with Level of Exposure, Posttraumatic Stress, and Internalizing Problems. IDENTITY-AN INTERNATIONAL JOURNAL OF THEORY AND RESEARCH 2014; 14:255-267. [PMID: 25505851 DOI: 10.1080/15283488.2014.944697] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Identity distress involves intense or prolonged upset or worry about personal identity issues including long-term goals, career choice, friendships, sexual orientation and behavior, religion, values and beliefs, and group loyalties. Research suggests that trauma exposure and subsequent PTSD symptoms may negatively impact identity development and psychological adjustment. However, little is known about their specific associations with identity distress and internalizing problems among disaster-exposed adolescents. The purpose of this study was to examine these relationships in a sample of 325 adolescents (60% female; 89% African American) who experienced a major natural disaster and its aftermath. The results indicated that identity distress was positively associated with age, hurricane exposure, PTSD symptoms, and internalizing problems. Linear regression analyses also showed that identity distress was uniquely associated with internalizing symptoms and that there was an indirect effect of hurricane exposure on identity distress via PTSD symptoms. Finally, PTSD symptoms moderated the link between identity distress and internalizing symptoms, with a significant positive slope found for youth with more PTSD symptoms. Findings were generally consistent with previous work and predictions, and add to the extant knowledge about identity distress by providing data on the linkages between disaster exposure, posttraumatic stress and internalizing problems in adolescents.
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Cognitive Performance in the Aftermath of a Natural Disaster: The Role of Coping Strategies, Theory of Mind and Peer Social Support. CHILD & YOUTH CARE FORUM 2014. [DOI: 10.1007/s10566-014-9272-z] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
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Carrión VG, Weems CF. Introduction to a Special Issue on Research with Youth Exposed to Disasters and Violence. CHILD & YOUTH CARE FORUM 2013. [DOI: 10.1007/s10566-013-9212-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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