Psychological Distress in Parents and School-Functioning of Adolescents: Results from the World Trade Center Registry

Hospitalizations among World Trade Center Health Registry Enrollees Who Were under 18 Years of Age on 9/11, 2001-2016

Much of the literature on hospitalizations post-September 11, 2001 (9/11) focuses on adults but little is known about post-9/11 hospitalizations among children. Data for World Trade Center Health Registry enrollees who were under 18-years old on 9/11 were linked to New York State hospitalization data to identify hospitalizations from enrollment (2003-2004) to December 31, 2016. Logistic regression was used to analyze factors associated with hospitalization. Of the 3151 enrollees under age 18 on 9/11, 243 (7.7%) had at least one 9/11-related physical health hospitalization and 279 (8.9%) had at least one 9/11-related mental health hospitalization. Individuals of non-White race, those living in New York City Housing Authority housing, those exposed to the dust cloud on 9/11, and those with probable 9/11-related PTSD symptoms were more likely to be hospitalized for a 9/11-related physical health condition. Older age and having probable 9/11-related PTSD symptoms at baseline were associated with being hospitalized for a 9/11-related mental health condition. Dust cloud exposure on 9/11 and PTSD symptoms were associated with hospitalizations among those exposed to 9/11 as children. Racial minorities and children living in public housing were at greater risk of hospitalization. Continued monitoring of this population and understanding the interplay of socioeconomic factors and disaster exposure will be important to understanding the long-term effects of 9/11.

Prevalence and Associated Factors of Psychological Distress Among Secondary School Students in Mekelle City, Tigray Region, Ethiopia: Cross-Sectional Study

Background

Psychological distress is defined as a state of emotional suffering characterized by the combination of symptoms of depression and anxiety. It is more prevalent in school adolescents than in the general population. There are no published studies that reflect the current status of psychological distress among Ethiopian school adolescents. So, this study aimed to determine the prevalence and associated factors of psychological distress among secondary students in Mekelle Town, North Ethiopia.

Methods

A school-based cross-sectional study was done among 782 from May 15 to June 15, 2018. Stratified multistage sampling procedure was used to select study subjects. Data were collected using a pretested and structured self-administered questionnaire. Psychological distress was assessed using Kessler Psychological Distress Scale (K10). Binary logistic regression models were fitted to identify associated factors. Adjusted odds ratio with its 95% confidence interval was used to declare the statistical significance between psychological distress and associated factors.

Results

A total of 845 students were enrolled in the study, with a response rate of 92.54%. The mean age of the participants was 16.24 years (SD=±1.17). Prevalence of psychological distress among the study participants was 34.9%. Being female [AOR = 2.30; 95% CI: (1.28, 4.12)], current alcohol use [AOR = 3.08; 95% CI: (1.64, 5.77)], physical fight [AOR = 2.99; 95% CI: (1.69-5.28)], contact sexual abuse [AOR=2.37; 95% CI: (1.23, 4.55)], non-contact sexual abuse [AOR = 1.91; 95% CI: (1.04, 3.49)], and being bullied [AOR = 1.81; 95% CI: (1.03, 3.29)] were significantly associated with psychological distress.

Conclusion

The prevalence of psychological distress in this study was high. Therefore, it is recommended to strengthen the activities that help to reduce or ameliorate the major causes of psychological distress.

Promoting Student Success: How Do We Best Support Child and Youth Survivors of Catastrophic Events?

PURPOSE OF REVIEW

School mental health services have achieved recognition for increased access to care and intervention completion rates. While best practice recommendations include connection of school mental health programming to multi-tiered systems of support that promote early identification and intervention, many schools struggle to operationalize student screening for trauma exposure, trauma symptoms, and service identification. Relatedly, progress monitoring for trauma symptoms, and the effect of trauma on school functioning in the context of catastrophic events, can also be difficult to systematically collect.

RECENT FINDINGS

Research regarding the effects of catastrophic events, such as exposure to natural disasters, terrorist attacks, war, or the journey to refugee status on children and youths school functioning, indicates salient age and gender differences among student responses. In addition, school professionals have been identified as sources of social support for students and as potential brokers to school linked intervention resources for children, youth, and their families. Based on our review, we outline recommendations for school professionals, including potential changes to school policies and procedures, and delineate future research questions.

Behavior problems in adolescence and subsequent mental health in early adulthood: results from the World Trade Center Health Registry Cohort

BACKGROUND

The present study examined the association between 9/11-related adolescent behavioral problems on mental health outcomes in early adulthood.

METHODS

Data from enrollees of the World Trade Center Health Registry, who completed at least one adolescent (2006-2007 or 2011-2012) and adult survey (2011-2012 or 2015-2016), were analyzed. Adolescent behavioral difficulties were assessed using the adolescent-reported Strengths and Difficulties Questionnaire (SDQ). Adult mental health outcomes included binge drinking, smoking status history, 9/11-related post-traumatic stress disorder (PTSD), depression, and the self-reported number of physician mental health diagnoses. Multivariable regression was used to estimate associations of SDQ scores with mental health outcomes.

RESULTS

Of the 297 enrollees, 16.8% (n = 50) had abnormal/borderline SDQ scores as an adolescent. Binge drinking was not associated with adolescent SDQ scores. Enrollees with abnormal/borderline SDQ scores as an adolescent were more likely to be a consistent smoker (odds ratio (OR): 5.6, 95% confidence interval (CI): 1.2-25.2), have probable PTSD (OR: 3.5, 95% CI: 1.3-9.8), depression (OR: 6.2, 95% CI: 2.7-13.9), and to have two or more self-reported physician-diagnosed mental health conditions as an adult (OR 5.6, 95% CI: 2.0-12.5).

CONCLUSIONS

The findings of this study underscore the need to intervene early with children exposed to traumatic events so as to avert later adolescent and adult problem behaviors.

Parental posttraumatic stress and child behavioral problems in world trade center responders

BACKGROUND

We investigated trans-generational associations between Post Traumatic Stress Disorder (PTSD) symptoms in World Trade Center (WTC) responders and behavioral problems in their children.

METHODS

Participants were WTC responders-8034 police and 8352 non-traditional (eg, construction workers)-with one or more children at the time of their first visit to the World Trade Center Health Program (WTC-HP). Self-report questionnaires were administered approximately 4 years after the 9/11 WTC attack.

RESULTS

A total of 31.4% of non-traditional and 20.0% of police responders reported behavioral problems in their children. Non-traditional responder status, female sex, Hispanic ethnicity, more life stressors, more WTC-related PTSD symptoms, and dysphoric arousal symptoms were significant correlates of behavioral problems in responders' children.

CONCLUSIONS

Specific parental sociodemographic, psychosocial and clinical characteristics, as well as PTSD symptom severity, were significant correlates of child behavior problems. Findings encourage monitoring and early intervention for children of disaster responders, particularly those at highest risk.