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Weems CF, McCurdy BH, Scozzafava MD. Toward a Developmental Model of Continuity and Change in PTSD Symptoms following Exposure to Traumatic and Adverse Experiences. JOURNAL OF CHILD & ADOLESCENT TRAUMA 2023; 16:391-402. [PMID: 37234837 PMCID: PMC10205928 DOI: 10.1007/s40653-021-00398-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 08/03/2021] [Indexed: 05/28/2023]
Abstract
A developmental understanding of the expression of posttraumatic stress (PTS) symptoms following trauma in childhood requires identifying continuity and change in not just overall symptoms but in the individual symptoms as well. Such models of change also require understanding multiple dimensions of time. That is, longitudinal change-the passage of time-may have different effects on symptom expression depending on when in time an individual entered the study - such as what age they were when first assessed. This paper addresses these ideas with an overview of the developmental differences in the assessment of PTS from the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders, (DSM-5), longitudinal research on posttraumatic stress disorder (PTSD) symptoms, and providing synthesis within a symptom network perspective. We then provide an illustration of how individual PTSD symptoms change over time at different ages (elementary versus middle school) with a secondary analysis of data from a previously reported study (n = 191 youth, aged 8-15, assessed at two time points six months apart). The reanalysis of the data suggests both continuity and change in symptoms over time (i.e., some symptoms were more stable than other symptoms) with differences in symptom rates and their longitudinal change as a function of age (i.e., some symptoms more common or more stable in younger versus older or older versus younger). We close with avenues for future research aimed at better understanding symptom cascades over time and at different ages and potential implications for future iterations of assessment/classification systems.
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Affiliation(s)
- Carl F. Weems
- Department of Human Development and Family Studies, Iowa State University Ames, 4380, Palmer, IA 50011 USA
| | - Bethany H. McCurdy
- Department of Human Development and Family Studies, Iowa State University Ames, 4380, Palmer, IA 50011 USA
| | - Mikaela D. Scozzafava
- Department of Human Development and Family Studies, Iowa State University Ames, 4380, Palmer, IA 50011 USA
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Gutmann MT, Aysel M, Özlü-Erkilic Z, Popow C, Akkaya-Kalayci T. Mental health problems of children and adolescents, with and without migration background, living in Vienna, Austria. Child Adolesc Psychiatry Ment Health 2019; 13:35. [PMID: 31528201 PMCID: PMC6737609 DOI: 10.1186/s13034-019-0295-y] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2019] [Accepted: 08/31/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Compared to their indigenous peers, migrant children and adolescents are at increased risk for mental health problems. The aim of our study was to compare psychological disorders of children and adolescents with Turkish migration background and their native Austrian peers. METHODS We analysed 302 children and adolescents aged between 7 and 18 years. The sample consisted of 100 Austrian and 100 Turkish outpatients with mental health problems, and 102 healthy controls, 52 with Austrian and 50 with Turkish background, recruited from various Viennese local child and youth centres. RESULTS Native patients had more frequently externalizing problems (42.1%) compared to the Turkish-speaking sample (28%). However, in the control group, Turkish-speaking children and adolescents had higher levels of internalizing, depressive and anxiety symptoms compared to their native peers. CONCLUSIONS We found noticeable differences in psychological problems among children and adolescents with and without migration background. We assume that migration-related stress factors are responsible for these differences. Also, children and adolescents with migration background seek for psychological help less frequently than their indigenous peers.
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Affiliation(s)
- Maria Teresa Gutmann
- 0000 0004 0520 9719grid.411904.9Department of Child and Adolescent Psychiatry and Psychotherapy, General Hospital Baden-Mödling, Fürstenweg 8, 2371 Hinterbrühl, Austria
| | - Metin Aysel
- 0000 0004 1937 0650grid.7400.3Department of Child and Adolescent Psychiatry and Psychotherapy, University of Zürich, Rämistrasse 71, 8006 Zurich, Switzerland
| | - Zeliha Özlü-Erkilic
- 0000 0000 9259 8492grid.22937.3dOutpatient Clinic of Transcultural Psychiatry and Migration-Induced Disorders in Childhood and Adolescence, Department of Child and Adolescent Psychiatry, Medical University of Vienna, Währinger Gürtel 18-20, 1090 Vienna, Austria
| | - Christian Popow
- 0000 0000 9259 8492grid.22937.3dDepartment of Child and Adolescent Psychiatry, Medical University of Vienna, Währinger Gürtel 18-20, 1090 Vienna, Austria
| | - Türkan Akkaya-Kalayci
- 0000 0000 9259 8492grid.22937.3dOutpatient Clinic of Transcultural Psychiatry and Migration-Induced Disorders in Childhood and Adolescence, Department of Child and Adolescent Psychiatry, Medical University of Vienna, Währinger Gürtel 18-20, 1090 Vienna, Austria
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Taylor LK, Goldberg MG, Tran MHD. Promoting Student Success: How Do We Best Support Child and Youth Survivors of Catastrophic Events? Curr Psychiatry Rep 2019; 21:82. [PMID: 31410584 DOI: 10.1007/s11920-019-1067-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
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.
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Affiliation(s)
- Leslie K Taylor
- Department of Psychiatry & Behavioral Sciences, McGovern Medical School, University of Texas Health Science Center, 1941 East Rd, Houston, TX, 77054, USA.
| | - Melissa G Goldberg
- Department of Psychiatry & Behavioral Sciences, McGovern Medical School, University of Texas Health Science Center, 1941 East Rd, Houston, TX, 77054, USA
| | - Minh-Hao D Tran
- Department of Psychiatry & Behavioral Sciences, McGovern Medical School, University of Texas Health Science Center, 1941 East Rd, Houston, TX, 77054, USA
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Berger E. Multi-tiered Approaches to Trauma-Informed Care in Schools: A Systematic Review. SCHOOL MENTAL HEALTH 2019. [DOI: 10.1007/s12310-019-09326-0] [Citation(s) in RCA: 46] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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5
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Gibbs L, Nursey J, Cook J, Ireton G, Alkemade N, Roberts M, Gallagher HC, Bryant R, Block K, Molyneaux R, Forbes D. Delayed Disaster Impacts on Academic Performance of Primary School Children. Child Dev 2019; 90:1402-1412. [PMID: 30675903 PMCID: PMC6790682 DOI: 10.1111/cdev.13200] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Social disruption caused by natural disasters often interrupts educational opportunities for children. However, little is known about children's learning in the following years. This study examined change in academic scores for children variably exposed to a major bushfire in Australia. Comparisons were made between children attending high, medium, and low disaster-affected primary schools 2-4 years after the disaster (n = 24,642; 9-12 years). The results showed that in reading and numeracy expected gains from Year 3 to Year 5 scores were reduced in schools with higher levels of bushfire impact. The findings highlight the extended period of academic impact and identify important opportunities for intervention in the education system to enable children to achieve their academic potential.
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Lee MS, Bhang SY. Assessment Tools for the Mental Health of School-Aged Children and Adolescents Exposed to Disaster: A Systematic Review (1988-2015). Soa Chongsonyon Chongsin Uihak 2018; 29:88-100. [PMID: 32595301 PMCID: PMC7289459 DOI: 10.5765/jkacap.180002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2018] [Revised: 04/03/2018] [Accepted: 04/24/2018] [Indexed: 11/05/2022] Open
Abstract
Objectives In this study, we aimed to conduct a systematic review of studies investigating psychosocial factors affecting children exposed to disasters. Methods In total, 140 studies were retrieved. The studies were published from 1988 to 2015. A systematic review was performed using the PRISMA guidelines. MEDLINE, EMBASE, Cochrane Central, Web of Science, PsycINFO, PubMed, and Google Scholar were searched. Each database was searched using the following terms: 'Child,' 'Adolescent,' 'Youth,' 'Disaster,' 'Posttraumatic,' 'Psychosocial,' 'Assessment,' 'Evaluation,' and 'Screening.' The identified studies were subjected to data extraction and appraisal. Results The database search identified 713 articles. Based on the titles and abstracts, the full texts of 118 articles were obtained. The findings of this review can be used as a basis for the design of a psychosocial evaluation tool for disaster preparedness. Conclusion Given the paramount importance of post-disaster evaluation and the weaknesses of current disaster evaluation tools, the need to develop valid and reliable tools and psychometric evaluations cannot be overstated. Our findings provide current evidence supporting various assessments in children, who are very vulnerable psychologically following disasters.
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Affiliation(s)
- Mi-Sun Lee
- Department of Psychiatry, Eulji University Hospital, Seoul, Korea
| | - Soo-Young Bhang
- Department of Psychiatry, Eulji University School of Medicine, Eulji University Hospital, Seoul, Korea
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Doyle MD, Lockwood B, Comiskey JG. Superstorm Sandy and the academic achievement of university students. DISASTERS 2017; 41:748-763. [PMID: 28133782 DOI: 10.1111/disa.12224] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Much of the literature on the consequences of natural disasters has focused on their physical and psychological ramifications. Few researchers have considered how the impacts of a natural disaster can influence academic achievement. This study analyses data collected from nearly 300 students at a mid-sized, private university in the northeast United States to determine if the effects of Cyclone Sandy in 2012 are associated with measures of academic achievement. The findings reveal that experiencing headaches after the event resulted in a higher likelihood of students suffering a loss of academic motivation. In addition, experiencing headaches and a loss of academic motivation were correlated with a lower grade point average (GPA) during the semester in which Sandy made landfall. However, the more direct effects of the superstorm, including displacement and a loss of power, did not have a significant bearing on academic achievement. Lastly, the paper examines the implications for higher education policy and future research.
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Affiliation(s)
- Matthew D Doyle
- Graduate Student, Department of Criminal Justice, Monmouth University, United States
| | - Brian Lockwood
- Associate Professor, Department of Criminal Justice, Monmouth University, United States
| | - John G Comiskey
- Assistant Professor, Department of Criminal Justice, Monmouth University, United States
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Covey HC, Grubb LM, Franzese RJ, Menard S. Adolescent Exposure to Violence and Adult Anxiety, Depression, and PTSD. ACTA ACUST UNITED AC 2017. [DOI: 10.1177/0734016817721294] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
The present study investigates how adolescent exposure to violence (AEV), in the form of parental physical abuse, witnessing parental violence, and exposure to violence in the neighborhood, is related to adult anxiety, depression, and post-traumatic stress disorder, controlling for more general adolescent violent victimization and for self-reports and parent reports of mental health problems in adolescence, on a national household-based probability sample of individuals who were adolescents in the mid-1970s and who were followed through early adulthood in the early 2000s. The results suggest that AEV is associated with mental health problems in adolescence but not, controlling for other variables, in adulthood, but there is continuity in mental health problems associated with AEV from adolescence to adulthood.
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Affiliation(s)
- Herbert C. Covey
- Adams County Department of Human Services, Commerce City, CO, USA
| | | | | | - Scott Menard
- Institute of Behavioral Science, University of Colorado, Boulder, CO, USA
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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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Strøm IF, Schultz JH, Wentzel-Larsen T, Dyb G. School performance after experiencing trauma: a longitudinal study of school functioning in survivors of the Utøya shootings in 2011. Eur J Psychotraumatol 2016; 7:31359. [PMID: 27171613 PMCID: PMC4864847 DOI: 10.3402/ejpt.v7.31359] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/19/2016] [Revised: 03/14/2016] [Accepted: 04/16/2016] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND The psychological impact on survivors of terrorism has been well documented. However, studies on adolescent survivors and the academic performance of high school students following a terrorist attack are lacking. OBJECTIVE This study investigated academic performance, absenteeism, and school support amongst survivors of a terrorist attack in Norway. METHOD Data from a longitudinal interview study were linked to officially registered grades of students (N=64) who successfully completed their 3-year senior high school program. Statistical tests of mean differences and linear regression were used to compare the survivors' registered grades with the national grade point average, before and after the event, as well as to assess absenteeism, self-reported grades and to test the association with school support. RESULTS The students' grades were lower the year after the event than they had been the year before, and they were also lower than the national grade point average (p<0.001). However, their grades improved in the last year of high school, indicating possible recovery. Absence from school increased after the event, compared to the previous year. However, students reported high satisfaction with school support. CONCLUSION The results indicate that academic functioning was reduced in the year after the traumatic event, but for students who successfully completed high school, the school situation improved 2 years after the event. The findings underscore the importance of keeping trauma-exposed students in school and providing support over time. A more defined educational approach to maintaining school attendance and educational measures which compensate for learning loss are needed in trauma-sensitive teaching.
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Affiliation(s)
- Ida Frugård Strøm
- Norwegian Centre for Violence and Traumatic Stress Studies, Oslo, Norway;
| | - Jon-Håkon Schultz
- Norwegian Centre for Violence and Traumatic Stress Studies, Oslo, Norway
- Department of Education, University of Tromsø, The Arctic University of Norway, Tromsø, Norway
| | - Tore Wentzel-Larsen
- Norwegian Centre for Violence and Traumatic Stress Studies, Oslo, Norway
- Centre for Child and Adolescent Mental Health, Eastern and Southern Norway, Oslo, Norway
| | - Grete Dyb
- Norwegian Centre for Violence and Traumatic Stress Studies, Oslo, Norway
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
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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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Abstract
A growing literature has begun to address the cognitions that influence children's disaster reactions as well as the effects of disasters on children's cognitions. These cognitions must be viewed in the context of developmental and cultural considerations as well as disaster-related factors such as exposure and secondary stressors. This review examines the extant literature on children's cognitions related to disasters and terrorism including threat appraisal, beliefs, attention and concentration, memory, academic achievement, and executive functioning. The review highlights areas where research is lacking such as the effect of disasters on children's attention, concentration, content of disaster memories, and executive functioning. It also notes findings that may advance post-disaster screening and intervention.
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Affiliation(s)
- Betty Pfefferbaum
- Department of Psychiatry and Behavioral Sciences, College of Medicine and Terrorism and Disaster Center, University of Oklahoma Health Sciences Center, 920 Stanton L. Young Boulevard, P.O. Box 26901, WP-3217, Oklahoma City, OK, 73126-0901, USA.
| | - Mary A Noffsinger
- Courtroom Sciences, Inc., 4950 North O'Connor Road, Suite 100, Irving, TX, 75062, USA
| | - Anne K Jacobs
- Terrorism and Disaster Center, University of Oklahoma Health Sciences Center, P.O. Box 26901, WP-3217, Oklahoma City, OK, 73126-0901, USA
| | - Vandana Varma
- Kansas University School of Medicine, 1010 N. Kansas Street, Wichita, KS, 67214, USA
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Weems CF, Scott BG, Graham RA, Banks DM, Russell JD, Taylor LK, Cannon MF, Varela RE, Scheeringa MA, Perry AM, Marino RC. Fitting anxious emotion-focused intervention into the ecology of schools: results from a test anxiety program evaluation. PREVENTION SCIENCE : THE OFFICIAL JOURNAL OF THE SOCIETY FOR PREVENTION RESEARCH 2016; 16:200-10. [PMID: 24810999 DOI: 10.1007/s11121-014-0491-1] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Emotion-focused prevention and intervention efforts in schools have been promoted as a significant developmental and public health priority. This paper reports the results of a longitudinal study testing central premises of a school-based prevention model aimed at promoting positive emotional development through targeting test anxiety. Test anxiety interventions may be a practical strategy for conducting emotion-focused prevention and intervention efforts because of a natural fit within the ecology of the school setting. At-risk youth (n = 1,048) from urban public schools were screened and 325 with elevated test anxiety were offered the intervention in one of two waves (immediate intervention vs. waitlist). The intervention was associated with decreases in test anxiety, anxiety disorder, and depression symptoms. Critically, results suggest high participant satisfaction and growth curve analysis of follow-up assessments (end of the year, the next school year, and a subsequent school year) demonstrated positive developmental trajectories consistent with predictions (e.g., initial change in test anxiety predicted change in other symptoms). Findings provide evidence for the ecological validity of targeting test anxiety in school-based, emotion-focused prevention efforts.
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Affiliation(s)
- Carl F Weems
- Department of Psychology, University of New Orleans, New Orleans, LA, 70148, USA,
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Thordardottir EB, Valdimarsdottir UA, Hansdottir I, Hauksdóttir A, Dyregrov A, Shipherd JC, Elklit A, Resnick H, Gudmundsdottir B. Sixteen-year follow-up of childhood avalanche survivors. Eur J Psychotraumatol 2016; 7:30995. [PMID: 27534741 PMCID: PMC4989177 DOI: 10.3402/ejpt.v7.30995] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2016] [Revised: 07/19/2016] [Accepted: 07/22/2016] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Every year a substantial number of children are affected by natural disasters worldwide. However, data are scarce on long-term psychological impact of natural disasters on children's health. Identifying risk factors and outcomes associated with the long-term sequelae of posttraumatic stress disorder (PTSD) can provide a gateway to recovery as well as enhancement of preventive measures. OBJECTIVE Among childhood avalanche survivors, we aimed to investigate risk factors for PTSD symptoms and the relationship between socioeconomic status (SES) and PTSD symptoms in adulthood. METHODS Childhood survivors (aged 2-19 at the time of exposure) of two avalanches were identified through nationwide registers 16 years later. The Posttraumatic Diagnostic Scale was used to assess current PTSD symptoms. One-way ANOVA was used to explore PTSD symptoms by background and trauma-specific factors, as well as associations with current SES. Predictors of PTSD symptoms were examined by multivariable regression analysis. RESULTS Response rate was 66% (108/163). Results from univariate ANOVA analysis revealed that female sex was associated with PTSD symptoms (F=5.96, p<0.05). When adjusted for age and sex, PTSD symptoms were associated with lower education (F=7.62, p<0.001), poor financial status (F=12.21, p<0.001), and unemployment and/or disability (F=3.04, p<0.05). In a multivariable regression model, when adjusting for age and sex, lack of social support (t=4.22, p<0.001) and traumatic reactions of caregivers (t=2.49, p<0.05) in the aftermath of the disaster independently predicted PTSD 16 years post-trauma. CONCLUSIONS Lingering PTSD symptoms after childhood exposure to a disaster may negatively influence socioeconomic development in adulthood. Strengthening children's support systems post-disaster may prevent the long-term sequelae of symptoms.
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Affiliation(s)
- Edda Bjork Thordardottir
- Centre of Public Health Sciences, Faculty of Medicine, School of Health Sciences, University of Iceland, Reykjavik, Iceland;
| | - Unnur Anna Valdimarsdottir
- Centre of Public Health Sciences, Faculty of Medicine, School of Health Sciences, University of Iceland, Reykjavik, Iceland.,Department of Epidemiology, Harvard School of Public Health, Boston, MA, USA.,Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Ingunn Hansdottir
- Faculty of Psychology, School of Health Sciences, University of Iceland, Reykjavik, Iceland
| | - Arna Hauksdóttir
- Centre of Public Health Sciences, Faculty of Medicine, School of Health Sciences, University of Iceland, Reykjavik, Iceland
| | - Atle Dyregrov
- Center for Crisis Psychology, Bergen, Norway.,Department of Clinical Psychology, Faculty of Psychology, University of Bergen, Bergen, Norway
| | - Jillian C Shipherd
- National Center for PTSD, VA Boston Healthcare System, Boston, MA, USA.,Department of Psychiatry, Boston University School of Medicine, Boston, MA, USA
| | - Ask Elklit
- Department of Psychology, University of Southern Denmark, Odense, Denmark.,Department of Psychology, University of Ulster, Londonderry, Northern Ireland
| | - Heidi Resnick
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC, USA
| | - Berglind Gudmundsdottir
- Mental Health Services, Landspitali - The National University Hospital of Iceland, Reykjavik, Iceland.,Faculty of Medicine, School of Health Sciences, University of Iceland, Reykjavik, Iceland
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Vezzali L, Drury J, Versari A, Cadamuro A. Sharing distress increases helping and contact intentions via social identification and inclusion of the other in the self: Children’s prosocial behaviour after an earthquake. GROUP PROCESSES & INTERGROUP RELATIONS 2015. [DOI: 10.1177/1368430215590492] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
We surveyed young children ( N = 517) affected by two major earthquakes to shed light on the role of identity processes in relation to the common observation that disasters can bring survivors closer together and enhance helping amongst them. As expected, posttraumatic stress symptoms caused by the earthquake were positively associated with intentions to have contact with and help other survivors of the earthquake, these effects being sequentially mediated by inclusion of the other in the self and by one-group representation. These findings extend previous research on both the antecedents and the behavioural effects of identity-fusion. The results are also the first quantitative test of a social identity account of collective resilience in children. We argue that these findings have practical as well as theoretical significance, as they demonstrate the adaptive function of group processes in informal responses to disasters.
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16
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Weems CF, Russell JD, Graham RA, Neill EL, Banks DM. Developmental differences in the linkages between anxiety control beliefs and posttraumatic stress in youth. Depress Anxiety 2015; 32:356-63. [PMID: 25421545 DOI: 10.1002/da.22319] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2014] [Revised: 09/03/2014] [Accepted: 09/06/2014] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND Anxiety control beliefs have emerged as a trans-diagnostic risk factor for anxiety disorders and a potential mechanism of change in cognitive and behavioral therapies. The purpose of this study was to examine the association between anxiety control beliefs and anxiety disorder symptoms following exposure to hurricanes in youth and test a developmental hypothesis about those associations. METHODS A large school-based sample of (N = 1048) children and adolescents with a history of exposure to natural disaster were assessed with the short form of the Anxiety Control Questionnaire for Children (ACQ-C), symptom measures (PTSD and generalized anxiety disorder symptoms) and level of disaster exposure. Developmental differences in the association between ACQ-C scores and symptoms were tested, as well as the ACQ-C's ability to assess symptoms beyond level of exposure. RESULTS ACQ-C scores were associated with symptoms beyond level of exposure, but age moderated the strength of the association. Modeling the interaction suggested that the ACQ-C short had incremental validity beyond hurricane exposure in youth over 12 years. CONCLUSIONS Findings extend previous work to a novel population of youth and add to the developmental understanding of the role of anxiety control beliefs in anxiety regulation. Age differences in the linkages between anxiety control and symptoms is consistent with a developmental model where low perceived control exhibited by younger children may be less indicative of problems with anxiety but may instead be related to normal cognitive development.
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Affiliation(s)
- Carl F Weems
- Department of Psychology, University of New Orleans, Louisiana
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17
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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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Nail JE, Christofferson J, Ginsburg GS, Drake K, Kendall PC, McCracken JT, Birmaher B, Walkup JT, Compton SN, Keeton C, Sakolsky D. Academic Impairment and Impact of Treatments Among Youth with Anxiety Disorders. CHILD & YOUTH CARE FORUM 2014. [DOI: 10.1007/s10566-014-9290-x] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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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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Feo P, Di Gioia S, Carloni E, Vitiello B, Tozzi AE, Vicari S. Prevalence of psychiatric symptoms in children and adolescents one year after the 2009 L'Aquila earthquake. BMC Psychiatry 2014; 14:270. [PMID: 25248437 PMCID: PMC4177260 DOI: 10.1186/s12888-014-0270-3] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2013] [Accepted: 09/16/2014] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND In 2009, an earthquake devastated the Abruzzo region in Italy. Despite the occurrence of several disasters in this country, no study on mental health of Italian children has ever been conducted in complex emergencies. Objective of the study was to assess the prevalence of psychiatric symptoms among children in the affected area 12 to 17 months after the event. METHODS A community sample of 1839 3-14 years children was identified from the general population assigned to 37 paediatricians of the National Health System, including children living in the earthquake epicentre, the surrounding earthquake zone, and the adjacent non-affected areas. Psychiatric symptoms were assessed with the Child Behavior Checklist (CBCL) and the Youth Self Report (YSR), completed by 452 children aged 11-14 years. The association between symptoms and sociodemographic, health, family, and earthquake-related factors was examined. RESULTS The prevalence of CBCL-defined cases was 14.9% in the epicentre, 13.0% in the remainder earthquake zone, 13.9% in the unaffected area (p = .876). No differences among areas were found when comparing the YSR results. Prevalence of CBCL-defined post-traumatic stress (PTS) cases was 8.4% in the epicentre, 4.0% in the remainder earthquake zone, 2.2% in the unaffected area (p = .002). PTS and anxiety were significantly more frequent in the epicentre than in other areas only in the 6-10 year-old children group (respectively p = .009 and p = .014). In multivariate logistic analyses, factors associated with PTS were living in the epicentre (OR = 3.6) and child or maternal history of mental health care prior to the earthquake (respectively OR = 7.1 and OR = 4.5). CONCLUSIONS Children living in the epicentre, particularly those 6-10 years old, had the highest prevalence of CBCL-defined cases, and of PTS and anxiety symptoms one year after the earthquake. No signs of increased psychopathology were detected in younger (3-5 years) or older children (11-14 years). Family and health related factors showed stronger association with psychiatric outcomes than earthquake-related factors. The identification of populations at higher risk of developing psychiatric symptoms has implications for public health interventions in complex emergencies.
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Affiliation(s)
- Paolo Feo
- />Department of Neuroscience, Child and Adolescent Neuropsychiatry Unit, Bambino Gesù Children’s Hospital, IRCCS, Piazza Sant’Onofrio 4, 00165 Rome, Italy
| | - Simona Di Gioia
- />Department of Neuroscience, Child and Adolescent Neuropsychiatry Unit, Bambino Gesù Children’s Hospital, IRCCS, Piazza Sant’Onofrio 4, 00165 Rome, Italy
| | - Emanuela Carloni
- />Multifactorial Diseases and Complex Phenotypes Research Area, Bambino Gesù Children’s Hospital, IRCCS, Rome, Italy
| | | | - Alberto Eugenio Tozzi
- />Multifactorial Diseases and Complex Phenotypes Research Area, Bambino Gesù Children’s Hospital, IRCCS, Rome, Italy
| | - Stefano Vicari
- />Department of Neuroscience, Child and Adolescent Neuropsychiatry Unit, Bambino Gesù Children’s Hospital, IRCCS, Piazza Sant’Onofrio 4, 00165 Rome, Italy
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Lai BS, Auslander BA, Fitzpatrick SL, Podkowirow V. Disasters and Depressive Symptoms in Children: A Review. CHILD & YOUTH CARE FORUM 2014; 43:489-504. [PMID: 25067897 PMCID: PMC4109828 DOI: 10.1007/s10566-014-9249-y] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
BACKGROUND Disasters are destructive, potentially traumatic events that affect millions of youth each year. OBJECTIVE The purpose of this paper was to review the literature on depressive symptoms among youth after disasters. Specifically, we examined the prevalence of depression, risk factors associated with depressive symptoms, and theories utilized in this research area. METHODS We searched MEDLINE, PsycInfo, and PubMed electronic databases for English language articles published up to May 1, 2013. Reference lists from included studies were reviewed to capture additional studies. Only quantitative, peer reviewed studies, conducted with youth under the age of 18 years, that examined postdisaster depressive symptoms were included. Seventy-two studies met inclusion criteria. Prevalence of depressive symptoms, disaster type, correlates of depressive symptoms, and theories of depressive symptoms were reviewed. RESULTS Only 27 studies (38%) reported on prevalence rates among youth in their sample. Prevalence rates of depression among youth postdisaster ranged from 2% to 69%. Potential risk factors were identified (e.g., female gender, exposure stressors, posttraumatic stress symptoms). Theories were examined in less than one-third of studies (k = 21). CONCLUSIONS Given the variability in prevalence rates, difficulty identifying a single profile of youth at risk for developing depressive symptoms, and lack of a unifying theory emerging from the studies, recommendations for future research are discussed. Use of established batteries of assessments could enable comparisons across studies. Merging existing theories from children's postdisaster and depression literatures could aid in the identification of risk factors and causal pathways.
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Affiliation(s)
- Betty S Lai
- School of Public Health, Georgia State University
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22
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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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Abstract
BACKGROUND For school-aged children with reading difficulties, an emerging and important area of investigation concerns determining predictors of intervention response. Previous studies have focused exclusively on cognitive and broadly defined behavioral variables. What has been missing, however, are studies examining anxiety, which is among the most commonly experienced difficulty for youth. OBJECTIVE The present study examined anxiety among children classified as typically achieving or showing inadequate/adequate response following an intervention for reading problems. METHODS Participants were 153 ethnically-diverse children (84 male, 69 female) evaluated in the winter and spring of their first-grade academic year. Children completed several standardized measures of reading achievement involving decoding and fluency along with a multidimensional anxiety rating scale. RESULTS Repeated measures ANOVA revealed significant main effects for time and scale and significant interactions for time*scale and group*scale. Logistic regression examined whether anxiety predicted response to intervention (Y/N) at the end of the school-year. CONCLUSIONS Results showed overall decreases in anxiety over time, with the exception of the harm avoidance area which increased and also interacted with group (children with decoding/fluency difficulties reported less harm avoidance than typically achieving children). The harm avoidance area was most pertinent across analyses highlighting the potential importance of targeting this area; however, none of the anxiety scales predicted response group at the end of the intervention. Ongoing research is needed in this area in order to identify characteristics of inadequate responders to reading intervention programs and/or inform interventions that incorporate these socioemotional factors.
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Pfefferbaum B, Weems CF, Scott BG, Nitiéma P, Noffsinger MA, Pfefferbaum RL, Varma V, Chakraburtty A. Research Methods in Child Disaster Studies: A Review of Studies Generated by the September 11, 2001, Terrorist Attacks; the 2004 Indian Ocean Tsunami; and Hurricane Katrina. CHILD & YOUTH CARE FORUM 2013; 42:285-337. [PMID: 24443635 PMCID: PMC3892998 DOI: 10.1007/s10566-013-9211-4] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
BACKGROUND A comprehensive review of the design principles and methodological approaches that have been used to make inferences from the research on disasters in children is needed. OBJECTIVE To identify the methodological approaches used to study children's reactions to three recent major disasters-the September 11, 2001, attacks; the 2004 Indian Ocean Tsunami; and Hurricane Katrina. METHODS This review was guided by a systematic literature search. RESULTS A total of 165 unduplicated empirical reports were generated by the search and examined for this review. This included 83 references on September 11, 29 on the 2004 Tsunami, and 53 on Hurricane Katrina. CONCLUSIONS A diversity of methods has been brought to bear in understanding children's reactions to disasters. While cross-sectional studies predominate, pre-event data for some investigations emerged from archival data and data from studies examining non-disaster topics. The nature and extent of the influence of risk and protective variables beyond disaster exposure are not fully understood due, in part, to limitations in the study designs used in the extant research. Advancing an understanding of the roles of exposure and various individual, family, and social factors depends upon the extent to which measures and assessment techniques are valid and reliable, as well as on data sources and data collection designs. Comprehensive assessments that extend beyond questionnaires and checklists to include interviews and cognitive and biological measures to elucidate the negative and positive effects of disasters on children also may improve the knowledge base.
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Affiliation(s)
- Betty Pfefferbaum
- Department of Psychiatry and Behavioral Sciences, College of Medicine, University of Oklahoma Health Sciences Center, WP 3470, P.O. Box 26901, Oklahoma City, OK 73126-0901, USA. Terrorism and Disaster Center, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
| | - Carl F. Weems
- Department of Psychology, University of New Orleans, New Orleans, LA, USA
| | - Brandon G. Scott
- Department of Psychology, University of New Orleans, New Orleans, LA, USA
| | - Pascal Nitiéma
- Department of Biostatistics and Epidemiology, College of Public Health, University of Oklahoma, Health Sciences Center, Oklahoma City, OK, USA. Terrorism and Disaster Center, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
| | - Mary A. Noffsinger
- Courtroom Sciences, Inc., Irving, TX, USA. Terrorism and Disaster Center, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
| | - Rose L. Pfefferbaum
- Liberal Arts Department, Phoenix Community College, Phoenix, AZ, USA. Terrorism and Disaster Center, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
| | - Vandana Varma
- Terrorism and Disaster Center, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
| | - Amarsha Chakraburtty
- College of Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
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Scott BG, Lapré GE, Marsee MA, Weems CF. Aggressive behavior and its associations with posttraumatic stress and academic achievement following a natural disaster. JOURNAL OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY 2013; 43:43-50. [PMID: 23795776 DOI: 10.1080/15374416.2013.807733] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Despite an abundance of evidence linking maltreatment and violence-related trauma exposure to externalizing problems in youth, there is surprisingly little evidence to support a direct link between disaster exposure and youth aggressive behavior. This study tested the theory that there is primarily an indirect association between disaster exposure and aggression via posttraumatic stress disorder (PTSD) symptoms. The current study also examined the association between aggression and academic achievement. A sample of 191 4th- to 8th-grade minority youth who experienced Hurricane Katrina were assessed for aggressive behavior using the Peer Conflict Scale (PCS), disaster exposure, PTSD symptoms, and academic achievement. Structural equation modeling of the set of associations was consistent with the theory suggesting that there is an indirect link between disaster exposure and aggression through PTSD symptoms. Aggression was negatively associated with academic achievement, and modeling indicated that the set of associations was age and gender invariant. Findings advance the theoretical understanding of the linkage between aggression and disaster exposure. Findings also support the utility of the PCS in disaster research and the link between PCS scores and academic achievement.
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