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Corso CB, Hoppe R, Kliewer W, Wike T, Winter MA. Emotion Regulation in Families: Exploring the Link between Parent-Child Alexithymia and Child Post-Traumatic Stress Symptoms Amidst the COVID-19 Pandemic. Child Psychiatry Hum Dev 2024:10.1007/s10578-024-01728-9. [PMID: 38874751 DOI: 10.1007/s10578-024-01728-9] [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] [Accepted: 06/07/2024] [Indexed: 06/15/2024]
Abstract
The COVID-19 pandemic comprises a mass trauma for children and families, and children may face particular vulnerability to post-traumatic stress symptoms (PTSS) through processes of parent and child emotional dysregulation, such as alexithymia. With 88 U.S. children (Mage = 9.94 years; 54.5% female; 59.1% White) and their parents/caregivers (68.2% female; 59.1% White), a path model was tested in which child alexithymia symptoms partially mediated the association between parent alexithymia symptoms and child COVID-19-related posttraumatic stress symptoms (PTSS). We also tested an alternative model in which child alexithymia symptoms moderated the association between parent alexithymia symptoms and child PTSS. The hypothesized mediation model was supported (β = 0.15, SE = 0.05, 95% CI: [0.07, 0.25], p < 0.001), whereas the hypothesized moderator model was not (β = 0.06, p = 0.44). Findings highlight the importance of parents' emotional understanding and regulation for child mental health during mass traumas such as pandemics.
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Affiliation(s)
- Casey B Corso
- Department of Psychology, Virginia Commonwealth University, 808 West Franklin St, Box 842018, Richmond, VA, 23284-2018, USA
| | - Rebecca Hoppe
- Department of Psychology, Virginia Commonwealth University, 808 West Franklin St, Box 842018, Richmond, VA, 23284-2018, USA
| | - Wendy Kliewer
- Department of Psychology, Virginia Commonwealth University, 808 West Franklin St, Box 842018, Richmond, VA, 23284-2018, USA
| | - Traci Wike
- School of Social Work, Virginia Commonwealth University, Box 842027, Richmond, VA, 23284-2027, USA
| | - Marcia A Winter
- Department of Psychology, Virginia Commonwealth University, 808 West Franklin St, Box 842018, Richmond, VA, 23284-2018, USA.
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Njoroge WFM, Tieu T, Eckardt D, Himes M, Alexandre C, Hall W, Wisniewski K, Popoola A, Holloway K, Rodriguez Y, Kornfield S, Momplaisir F, Wang X, Gur R, Waller R. The impact of the pandemic on mothers and children, with a focus on syndemic effects on black families: the "Prenatal to Preschool" study protocol. Front Psychiatry 2024; 14:1281666. [PMID: 38260788 PMCID: PMC10801187 DOI: 10.3389/fpsyt.2023.1281666] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Accepted: 12/07/2023] [Indexed: 01/24/2024] Open
Abstract
Introduction Racism, a known social determinant of health, affects the mental health and well-being of pregnant and postpartum women and their children. Convincing evidence highlights the urgent need to better identify the mechanisms and the ways in which young children's development and mental health are adversely impacted by their mothers' experiences of racism. With the additional stressor of the COVID-19 pandemic, the criticality of improving knowledge of these domains has never been starker. The proposed project will address these questions and move the field forward to create targeted, culturally informed preventative interventions, thus achieving mental health equity for all children and families. Methods This prospective research is a cohort study that will longitudinally observe the outcomes of a cohort of mothers and their children recruited during the initial phase of the COVID-19 pandemic. Data will be parent/caregiver questionnaires assessing mental health, racism, support, and resilience at multiple time points with the first beginning at 24 months, clinical interviews with mothers, electronic medical records of mothers, and videotaped dyadic interactions at child age 24 and 48 months. A subset of Black participants will be asked to participate in qualitative interviews at child age 36 months. Results Analyze will be performed within and across Black and Non-Latino/a/e/x white (NLW) groups, and comparing mothers and fathers/secondary caregivers. Descriptive and multivariate analyzes will be run to better characterize how young children's development and mental health may be adversely impacted by their caregiver's experiences of racism. Discussion This prospective longitudinal mixed-methods study evaluates the simultaneous effects of the COVID-19 pandemic and racism on mothers and their developing children to characterize cross-racial differences, providing insight into risk and resilience factors in early development and the peripartum period.
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Affiliation(s)
- Wanjikũ F. M. Njoroge
- Perelman School of Medicine, Department of Psychiatry, University of Pennsylvania, Philadelphia, PA, United States
- Department of Child and Adolescent Psychiatry and Behavioral Sciences, Children’s Hospital of Philadelphia, Philadelphia, PA, United States
- PolicyLab, Children’s Hospital of Philadelphia, Philadelphia, PA, United States
- Lifespan Brain Institute (LiBI), Children’s Hospital of Philadelphia and Penn Medicine, University of Pennsylvania, Philadelphia, PA, United States
| | - Tiffany Tieu
- Department of Child and Adolescent Psychiatry and Behavioral Sciences, Children’s Hospital of Philadelphia, Philadelphia, PA, United States
- PolicyLab, Children’s Hospital of Philadelphia, Philadelphia, PA, United States
| | - Devlin Eckardt
- Clinical Research Support Office, Children’s Hospital of Philadelphia, Philadelphia, PA, United States
| | - Megan Himes
- Department of Child and Adolescent Psychiatry and Behavioral Sciences, Children’s Hospital of Philadelphia, Philadelphia, PA, United States
- Lifespan Brain Institute (LiBI), Children’s Hospital of Philadelphia and Penn Medicine, University of Pennsylvania, Philadelphia, PA, United States
| | - Christina Alexandre
- Department of Child and Adolescent Psychiatry and Behavioral Sciences, Children’s Hospital of Philadelphia, Philadelphia, PA, United States
- PolicyLab, Children’s Hospital of Philadelphia, Philadelphia, PA, United States
| | - Waynitra Hall
- Department of Child and Adolescent Psychiatry and Behavioral Sciences, Children’s Hospital of Philadelphia, Philadelphia, PA, United States
- PolicyLab, Children’s Hospital of Philadelphia, Philadelphia, PA, United States
| | - Kate Wisniewski
- Department of Child and Adolescent Psychiatry and Behavioral Sciences, Children’s Hospital of Philadelphia, Philadelphia, PA, United States
- PolicyLab, Children’s Hospital of Philadelphia, Philadelphia, PA, United States
| | - Ayomide Popoola
- Department of Child and Adolescent Psychiatry and Behavioral Sciences, Children’s Hospital of Philadelphia, Philadelphia, PA, United States
- PolicyLab, Children’s Hospital of Philadelphia, Philadelphia, PA, United States
| | - Kayla Holloway
- Department of Child and Adolescent Psychiatry and Behavioral Sciences, Children’s Hospital of Philadelphia, Philadelphia, PA, United States
- PolicyLab, Children’s Hospital of Philadelphia, Philadelphia, PA, United States
- Department of Neuroscience, University of Pennsylvania, Philadelphia, PA, United States
| | - Yuheiry Rodriguez
- Department of Psychology, University of Pennsylvania, Philadelphia, PA, United States
| | - Sara Kornfield
- Lifespan Brain Institute (LiBI), Children’s Hospital of Philadelphia and Penn Medicine, University of Pennsylvania, Philadelphia, PA, United States
- Penn Center for Women’s Behavioral Wellness, Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States
| | - Florence Momplaisir
- Perelman School of Medicine, Division of Infectious Diseases, University of Pennsylvania, Philadelphia, PA, United States
| | - Xi Wang
- PolicyLab, Children’s Hospital of Philadelphia, Philadelphia, PA, United States
| | - Raquel Gur
- Perelman School of Medicine, Department of Psychiatry, University of Pennsylvania, Philadelphia, PA, United States
- Department of Child and Adolescent Psychiatry and Behavioral Sciences, Children’s Hospital of Philadelphia, Philadelphia, PA, United States
- Lifespan Brain Institute (LiBI), Children’s Hospital of Philadelphia and Penn Medicine, University of Pennsylvania, Philadelphia, PA, United States
| | - Rebecca Waller
- Lifespan Brain Institute (LiBI), Children’s Hospital of Philadelphia and Penn Medicine, University of Pennsylvania, Philadelphia, PA, United States
- Department of Psychology, University of Pennsylvania, Philadelphia, PA, United States
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Affiliation(s)
- Frederica Perera
- From the Department of Environmental Health Sciences and Columbia Center for Children's Environmental Health, Columbia University, New York (F.P.); and the Departments of Medicine, Pediatrics, Otolaryngology, and Epidemiology and Population Health, Stanford University, Stanford, CA (K.N.)
| | - Kari Nadeau
- From the Department of Environmental Health Sciences and Columbia Center for Children's Environmental Health, Columbia University, New York (F.P.); and the Departments of Medicine, Pediatrics, Otolaryngology, and Epidemiology and Population Health, Stanford University, Stanford, CA (K.N.)
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Waller R, Powell T, Rodriguez Y, Corbett N, Perlstein S, White LK, Barzilay R, Wagner NJ. The Impact of the COVID-19 Pandemic on Children's Conduct Problems and Callous-Unemotional Traits. Child Psychiatry Hum Dev 2021; 52:1012-1023. [PMID: 33405026 PMCID: PMC7786862 DOI: 10.1007/s10578-020-01109-y] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/05/2020] [Indexed: 01/06/2023]
Abstract
The COVID-19 pandemic has dramatically altered family life, but whether family exposures to and worries about the COVID-19 pandemic has impacted child conduct problems (CP) and callous-unemotional (CU) traits is unknown. Thus, we evaluated 303 parents (Mage = 38.04; SD = 5.21; 92.4% biological mothers) and children (Mage = 6.43; SD = 2.13; 51.8% female) during a four-month period early in the pandemic. We examined associations between parental exposures to COVID-19, parental worries about the pandemic, harsh and warm parenting practices, and child CP and CU traits. Although more parental worries were not directly related to parenting practices, more worry about COVID-19 was specifically related to higher levels of child CP, particularly parental worries about themselves or family members contracting the virus. Our findings add to a growing literature demonstrating the burden that the pandemic has placed on families and its implications for children's mental health.
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Affiliation(s)
- Rebecca Waller
- Department of Psychology, University of Pennsylvania, Philadelphia, PA, 19104, USA
| | - Tralucia Powell
- Department of Psychological and Brain Sciences, Boston University, 64 Cummington Mall, Boston, MA, 02215, USA
| | - Yuheiry Rodriguez
- Department of Psychology, University of Pennsylvania, Philadelphia, PA, 19104, USA
| | - Natalie Corbett
- Department of Psychology, University of Pennsylvania, Philadelphia, PA, 19104, USA
| | - Samantha Perlstein
- Department of Psychology, University of Pennsylvania, Philadelphia, PA, 19104, USA
| | - Lauren K White
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, 19104, USA
- Lifespan Brain Institute, Children's Hospital of Philadelphia and Penn Medicine, University of Pennsylvania, Philadelphia, PA, 19104, USA
- Department of Child and Adolescent Psychiatry and Behavioral Sciences, Children's Hospital of Philadelphia, Philadelphia, PA, 19104, USA
| | - Ran Barzilay
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, 19104, USA
- Lifespan Brain Institute, Children's Hospital of Philadelphia and Penn Medicine, University of Pennsylvania, Philadelphia, PA, 19104, USA
- Department of Child and Adolescent Psychiatry and Behavioral Sciences, Children's Hospital of Philadelphia, Philadelphia, PA, 19104, USA
| | - Nicholas J Wagner
- Department of Psychological and Brain Sciences, Boston University, 64 Cummington Mall, Boston, MA, 02215, USA.
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Information-Seeking and Use of Primary Care Mental Health Services Among Gulf Coast Survivors of Natural Disasters. Disaster Med Public Health Prep 2021; 15:735-740. [PMID: 32624084 DOI: 10.1017/dmp.2020.99] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVES This study sought to understand factors related to weather-related disaster survivors' health information and mental health-care-seeking behaviors. METHODS In November 2017, we conducted a quantitative survey of 170 Gulf Coast residents who experienced weather-related disasters. The survey assessed how individual and psychosocial factors affect health-care-seeking behavior. RESULTS Nearly 66% of participants reported a high frequency of depression and/or anxiety symptoms, yet only 39% saw a medical professional. Of participants who visited a medical professional, 76% sought information from nonmedical sources. Seeking medical care was strongly correlated with seeking information from nonmedical sources and previous healthcare experiences, but not with fear and stigma. CONCLUSIONS Positive communication and strong support systems have the potential to mitigate the reluctance people have in seeking help for mental health problems. Although it is discouraging that few people seek professional care, it is promising that participants were not avoiding care due to fear of being stigmatized. Less opposition to mental health care by survivors offers opportunity for mental health professionals to treat the psychological problems survivors experience. Providing necessary information may make headway to mental health care where it is greatly needed.
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Lee JY, Chang OD, Ammari T. Using social media Reddit data to examine foster families' concerns and needs during COVID-19. CHILD ABUSE & NEGLECT 2021; 121:105262. [PMID: 34411874 PMCID: PMC8440933 DOI: 10.1016/j.chiabu.2021.105262] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/18/2021] [Revised: 07/07/2021] [Accepted: 08/02/2021] [Indexed: 06/12/2023]
Abstract
BACKGROUND COVID-19 is likely to have negatively impacted foster families but few data sources are available to confirm this. OBJECTIVE The current study used Reddit social media data to examine how foster families are faring in the pandemic. Discussion topics were identified and examined for changes before and after COVID-19. PARTICIPANTS AND SETTING Comments were collected from three Reddit online discussion boards dedicated to foster families (N = 11,830). METHODS We used machine learning techniques, including Latent Dirichlet Allocation, for topic modeling and textual analysis for qualitative coding of the Reddit comments. RESULTS Results showed that three main topics had both significant quantitative and meaningful qualitative changes before and after COVID-19. There were significant increases in conversation about becoming a foster parent (F = 5.75, p = 0.02) and activities for foster children (F = 10.61, p = 0.001), whereas there was a significant decrease in discussing permanency (F = 9.46, p = 0.003) before and after the onset of COVID-19. Qualitative coding showed that regarding the topic of becoming a parent, excitement over approval of foster care license before COVID-19 shifted to foster families' increased anxieties about delays in their licensing cases after COVID-19. For permanency, content changed from the best interest of the child and reunifications before COVID-19 to concerns over family separations and permanency challenges after COVID-19. Regarding activities for foster children, content related to everyday activities before COVID-19 changed to specific activities foster children and families could do during lockdowns. Results suggest areas child welfare workers may focus on to better support foster families during and after the pandemic.
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Affiliation(s)
- Joyce Y Lee
- School of Social Work, University of Michigan, 1080 South University Avenue, Ann Arbor, MI 48109, USA; Department of Psychology, University of Michigan, 530 Church Street, Ann Arbor, MI 48109, USA.
| | - Olivia D Chang
- Department of Psychology, University of Michigan, 530 Church Street, Ann Arbor, MI 48109, USA
| | - Tawfiq Ammari
- School of Communication and Information, Rutgers University, New Brunswick, NJ 08901, USA
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Meir O, Satu K, Xie X, Abdissa N, Lubna P, Sangita J. The impact of Hurricane Katrina, a major natural disaster, on assisted reproductive outcomes through an analysis of 451,848 ART cycles. Sci Rep 2021; 11:17864. [PMID: 34504216 PMCID: PMC8429435 DOI: 10.1038/s41598-021-97402-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Accepted: 08/11/2021] [Indexed: 11/09/2022] Open
Abstract
To evaluate whether pregnancies conceived via assisted reproductive technology and exposed to Hurricane Katrina (HK), one of the most destructive natural disasters in United States history, were more prone to adverse perinatal outcomes, miscarriages, or sex disparities compared with pregnancies established but not directly exposed to the natural disaster. Retrospective cohort study. Women 18 years and older undergoing fresh ART cycles that resulted in singleton pregnancies and entered in the SART CORS database from 2004 to 2008. Incidence of full-term and preterm delivery, miscarriage rate, infant weight at birth, and infant sex ratio. Total follicle stimulating hormone (FSH) stimulation dosage and number of oocytes retrieved. Between January 2004 and December 2008, a total of 451,848 fresh autologous IVF cycles were recorded in SART CORS, leading to 190,624 pregnancies and 129,499 live births. After controlling for potential confounders, our results demonstrate no association between HK exposure and overall preterm deliveries (< 37 weeks) in women with singleton pregnancies conceived after ART. Other perinatal outcomes such as rate of spontaneous abortion or infant weight at birth in the exposed and unexposed groups were also not associated with HK. A comparison of pre and post disaster sex ratios revealed fewer males were born after HK (51.0% vs. 49.4%), showing a trend of decreased male infant births that was least in part associated with HK (CI 0.81-1.01; p = 0.07). Exposure to HK did not appear to affect perinatal outcomes such as the rate of preterm delivery or the rate of spontaneous abortion. Extreme stress may be a factor that contributes to a reduced male to female secondary sex ratio.
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Affiliation(s)
- Olcha Meir
- Albert Einstein College of Medicine, 1300 Morris Park Ave, Block Bldg 627, Bronx, NY, 10461, USA.
| | - Kuokkanen Satu
- Albert Einstein College of Medicine, 1300 Morris Park Ave, Block Bldg 627, Bronx, NY, 10461, USA
| | - Xianhong Xie
- Albert Einstein College of Medicine, 1300 Morris Park Ave, Block Bldg 627, Bronx, NY, 10461, USA
| | - Negassa Abdissa
- Albert Einstein College of Medicine, 1300 Morris Park Ave, Block Bldg 627, Bronx, NY, 10461, USA
| | - Pal Lubna
- Yale School of Medicine, New Haven, CT, USA
| | - Jindal Sangita
- Albert Einstein College of Medicine, 1300 Morris Park Ave, Block Bldg 627, Bronx, NY, 10461, USA
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Cadamuro A, Birtel MD, Di Bernardo GA, Crapolicchio E, Vezzali L, Drury J. Resilience in children in the aftermath of disasters: A systematic review and a new perspective on individual, interpersonal, group, and intergroup level factors. JOURNAL OF COMMUNITY & APPLIED SOCIAL PSYCHOLOGY 2021. [DOI: 10.1002/casp.2500] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Affiliation(s)
- Alessia Cadamuro
- Department of Biomedical, Metabolic and Neural Science University of Modena and Reggio Emilia Modena Italy
| | | | | | | | - Loris Vezzali
- Faculty of Medicine University of Modena and Reggio Emilia Modena Italy
| | - John Drury
- School of Psychology University of Sussex Brighton UK
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Chen S, Bagrodia R, Pfeffer CC, Meli L, Bonanno GA. Anxiety and resilience in the face of natural disasters associated with climate change: A review and methodological critique. J Anxiety Disord 2020; 76:102297. [PMID: 32957002 DOI: 10.1016/j.janxdis.2020.102297] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2020] [Revised: 08/29/2020] [Accepted: 08/31/2020] [Indexed: 12/17/2022]
Abstract
In the past two decades, climate change-related natural disasters, such as hurricanes, floods, and droughts have become increasingly frequent and severe, impacting the emotional and psychological well-being of those who are directly or indirectly exposed to them. Despite great interest in understanding differences in anxiety and resilience in response to natural disasters, enthusiasm appears to outstrip empirical clarity, as there remains considerable ambiguity as to determinants of resilient or pathological outcomes following exposure to natural disasters. In addition, there are several major methodological limitations in climate change and related natural disaster research, including the use of univariate analyses, cross-sectional design, and retrospective measures. Keeping these limitations in mind, we first review literature examining the mental health outcomes of natural disasters. Findings suggest that, overall, resilience is more common than pathological outcomes. Second, we use a multi-dimensional framework of resilience to selectively review factors at the event, individual, as well as family and community levels that could help inform resilient or pathological outcomes. Finally, we consider key limitations and future directions for research and practice in the field of anxiety and resilience in response to climate disasters.
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Affiliation(s)
- Shuquan Chen
- Department of Clinical and Counseling Psychology, Teachers College, Columbia University, United States.
| | - Rohini Bagrodia
- Department of Clinical and Counseling Psychology, Teachers College, Columbia University, United States
| | - Charlotte C Pfeffer
- Department of Clinical and Counseling Psychology, Teachers College, Columbia University, United States
| | - Laura Meli
- Department of Clinical and Counseling Psychology, Teachers College, Columbia University, United States
| | - George A Bonanno
- Department of Clinical and Counseling Psychology, Teachers College, Columbia University, United States.
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Hassan EM, Mahmoud HN, Ellingwood BR. Resilience of School Systems Following Severe Earthquakes. EARTH'S FUTURE 2020; 8:e2020EF001518. [PMID: 33283016 PMCID: PMC7685154 DOI: 10.1029/2020ef001518] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/12/2020] [Revised: 09/26/2020] [Accepted: 09/28/2020] [Indexed: 06/12/2023]
Abstract
Natural disasters may have catastrophic and long-lasting impacts on communities' physical, economic, and social infrastructure. Slow recovery of educational services following such events is likely to cause traumatic stress in children, lead families to out-migrate, and affect the community's overall social stability. Methods for quantifying and assessing the restoration process of educational systems and their dependencies on other supporting infrastructure have not received adequate attention. This study introduces, for the first time, a new framework to evaluate the functionality, recovery, and resilience of a school system following severe earthquake events. The framework considers both the quantity and quality of education services provided, school enrollment, and staff employment, as well as the interaction between various agents such as staff, students, parents, administration, and community. A virtual testbed community, Centerville, is utilized to highlight the application of this framework. The impact of school reopening policies on the number of students enrolled as well as the potential for homeschooling is also considered. The availability of various enrollment alternatives for students, backup classroom space and functioning utility systems, and facilitation of staff and supplies transfer between schools substantially increase the resilience of the education service.
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Affiliation(s)
- Emad M. Hassan
- Department of Civil and Environmental EngineeringColorado State UniversityFort CollinsCOUSA
| | - Hussam N. Mahmoud
- Department of Civil and Environmental EngineeringColorado State UniversityFort CollinsCOUSA
| | - Bruce R. Ellingwood
- Department of Civil and Environmental EngineeringColorado State UniversityFort CollinsCOUSA
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Fuchs R, Glaude M, Hansel T, Osofsky J, Osofsky H. Adolescent risk substance use behavior, posttraumatic stress, depression, and resilience: Innovative considerations for disaster recovery. Subst Abus 2020; 42:358-365. [PMID: 32813991 DOI: 10.1080/08897077.2020.1784357] [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] [Indexed: 12/13/2022]
Abstract
Natural and technological disasters cause long-term psychological trauma and increase substance use in adults. It is unclear whether these problems also occur in children and whether trauma influences long-term psychological outcomes due to developmental stages at the time of trauma. One community of interest is located in southeastern Louisiana, where, as children, many locals were exposed to Hurricane Katrina in 2005 and the Deepwater Horizon Oil Spill in 2010. We hypothesized individuals exposed to these disasters in early childhood would exhibit higher rates of anxiety, depression, and alcohol use as adolescents than the general population. To test this, we developed a questionnaire with a focus on severity of disaster exposure, indicators of psychological resilience, and current levels of anxiety, depression, and alcohol use. This survey was administered to over 1000 adolescents in local high schools throughout southeastern Louisiana. Structural equation modeling was performed to test correlations and moderation effects. We found disaster exposure was positively associated with trauma-like symptoms and substance use and psychological resilience was negatively related to these outcomes. These findings demonstrate childhood disaster exposure has the potential to cause chronic psychological distress and predispose individuals to substance use later in life. They also suggest resilience may be protective for disaster survivors. Future studies should expand these concepts to other age groups and types of disasters. Whether resilience-focused psychotherapy may be beneficial in these populations is also a relevant topic for exploration.
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Affiliation(s)
- Robert Fuchs
- Psychiatry, Louisiana State University Health Sciences Center, New Orleans, Louisiana, USA
| | - Maurya Glaude
- School of Social Work, Tulane University, New Orleans, Louisiana, USA
| | - Tonya Hansel
- School of Social Work, Tulane University, New Orleans, Louisiana, USA
| | - Joy Osofsky
- Psychiatry, Louisiana State University Health Sciences Center, New Orleans, Louisiana, USA
| | - Howard Osofsky
- Psychiatry, Louisiana State University Health Sciences Center, New Orleans, Louisiana, USA
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Impact of a natural disaster on access to care and biopsychosocial outcomes among Hispanic/Latino cancer survivors. Sci Rep 2020; 10:10376. [PMID: 32587352 PMCID: PMC7316979 DOI: 10.1038/s41598-020-66628-z] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2019] [Accepted: 05/25/2020] [Indexed: 12/11/2022] Open
Abstract
Cancer is the leading cause of death in Puerto Rico (PR). Hurricane Maria (HM) and its aftermath lead to widespread devastation on the island, including the collapse of the healthcare system. Medically fragile populations, such as cancer survivors, were significantly affected. The goal of this study was to assess the impact of HM on barriers to care, emotional distress, and inflammatory biomarkers among cancer survivors in PR. This exploratory longitudinal study was conducted in health care facilities and community support groups from PR. Cancer survivors (n = 50) and non-cancer participants (n = 50) completed psychosocial questionnaires and provided blood samples that were used to assess inflammatory cytokines levels. Among this cohort, we identified 41 matched cancer survivors/non-cancer participants pairs. Data were analyzed through descriptive, frequencies, correlational, and regression analyses. Cancer survivors that were affected by HM reported increased barriers in accessing medical care, which were directly associated with anxiety, perceived stress, and post-traumatic symptomatology. Moreover, being a cancer survivor, predicted more barriers to receiving health care, especially in the first six weeks after the event, after which the effect was attenuated. Several inflammatory cytokines, such as CD31, BDNF, TFF3, Serpin E-1, VCAM-1, Vitamin D BP, and PDGF-AA, were significantly upregulated in cancer survivors while MMP9 and Osteopontin both had significant positive correlations with barriers to care. HM significantly impacted Puerto Ricans psychosocial well-being. Cancer survivors had significant barriers to care and showed increased serum inflammatory cytokines but did not show differences in anxiety, stress, and post-traumatic symptoms compared to non-cancer participants.
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Sherman M, Covert H, Brown L, Langhinrichsen-Rohling J, Hansel T, Rehner T, Buckner A, Lichtveld M. Enterprise Evaluation: A New Opportunity for Public Health Policy. JOURNAL OF PUBLIC HEALTH MANAGEMENT AND PRACTICE 2020; 25:479-489. [PMID: 31348163 PMCID: PMC6716577 DOI: 10.1097/phh.0000000000000862] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Standard evaluation practice in public health remains limited to evaluative measures linked to individual projects, even if multiple interrelated projects are working toward a common impact. Enterprise evaluation seeks to fill this policy gap by focusing on cross-sector coordination and ongoing reflection in evaluation. We provide an overview of the enterprise evaluation framework and its 3 stages: collective creation, individual data collection, and collective analysis. We illustrate the application of enterprise evaluation to the Gulf Region Health Outreach Program, 4 integrated projects that aimed to strengthen health care in Louisiana, Mississippi, Alabama, and the Florida Panhandle after the Deepwater Horizon oil spill. Shared commitment to sustainability and strong leadership were critical to Gulf Region Health Outreach Program's success in enterprise evaluation. Enterprise evaluation provides an important opportunity for funding agencies and public health initiatives to evaluate the impact of interrelated projects in a more holistic and multiscalar manner than traditional siloed approaches to evaluation.
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Affiliation(s)
- Mya Sherman
- Center for Gulf Coast Environmental Health Research, Leadership & Strategic Initiatives (Ms Sherman and Dr Covert) and Department of Global Environmental Health Sciences (Dr Lichtveld), School of Public Health and Tropical Medicine, Tulane University, New Orleans, Louisiana; Evaluation and Research, Louisiana Public Health Institute, New Orleans, Louisiana (Dr Brown); Gulf Coast Behavioral Health Resiliency Center, University of South Alabama, Mobile, Alabama (Dr Langhinrichsen-Rohling); Department of Psychiatry, Louisiana State University Health Sciences Center, New Orleans, Louisiana (Dr Hansel); School of Social Work, The University of Southern Mississippi, Hattiesburg, Mississippi (Dr Rehner); and Community Health Cooperative, Atlanta, Georgia (Dr Buckner)
| | - Hannah Covert
- Center for Gulf Coast Environmental Health Research, Leadership & Strategic Initiatives (Ms Sherman and Dr Covert) and Department of Global Environmental Health Sciences (Dr Lichtveld), School of Public Health and Tropical Medicine, Tulane University, New Orleans, Louisiana; Evaluation and Research, Louisiana Public Health Institute, New Orleans, Louisiana (Dr Brown); Gulf Coast Behavioral Health Resiliency Center, University of South Alabama, Mobile, Alabama (Dr Langhinrichsen-Rohling); Department of Psychiatry, Louisiana State University Health Sciences Center, New Orleans, Louisiana (Dr Hansel); School of Social Work, The University of Southern Mississippi, Hattiesburg, Mississippi (Dr Rehner); and Community Health Cooperative, Atlanta, Georgia (Dr Buckner)
| | - Lisanne Brown
- Center for Gulf Coast Environmental Health Research, Leadership & Strategic Initiatives (Ms Sherman and Dr Covert) and Department of Global Environmental Health Sciences (Dr Lichtveld), School of Public Health and Tropical Medicine, Tulane University, New Orleans, Louisiana; Evaluation and Research, Louisiana Public Health Institute, New Orleans, Louisiana (Dr Brown); Gulf Coast Behavioral Health Resiliency Center, University of South Alabama, Mobile, Alabama (Dr Langhinrichsen-Rohling); Department of Psychiatry, Louisiana State University Health Sciences Center, New Orleans, Louisiana (Dr Hansel); School of Social Work, The University of Southern Mississippi, Hattiesburg, Mississippi (Dr Rehner); and Community Health Cooperative, Atlanta, Georgia (Dr Buckner)
| | - Jennifer Langhinrichsen-Rohling
- Center for Gulf Coast Environmental Health Research, Leadership & Strategic Initiatives (Ms Sherman and Dr Covert) and Department of Global Environmental Health Sciences (Dr Lichtveld), School of Public Health and Tropical Medicine, Tulane University, New Orleans, Louisiana; Evaluation and Research, Louisiana Public Health Institute, New Orleans, Louisiana (Dr Brown); Gulf Coast Behavioral Health Resiliency Center, University of South Alabama, Mobile, Alabama (Dr Langhinrichsen-Rohling); Department of Psychiatry, Louisiana State University Health Sciences Center, New Orleans, Louisiana (Dr Hansel); School of Social Work, The University of Southern Mississippi, Hattiesburg, Mississippi (Dr Rehner); and Community Health Cooperative, Atlanta, Georgia (Dr Buckner)
| | - Tonya Hansel
- Center for Gulf Coast Environmental Health Research, Leadership & Strategic Initiatives (Ms Sherman and Dr Covert) and Department of Global Environmental Health Sciences (Dr Lichtveld), School of Public Health and Tropical Medicine, Tulane University, New Orleans, Louisiana; Evaluation and Research, Louisiana Public Health Institute, New Orleans, Louisiana (Dr Brown); Gulf Coast Behavioral Health Resiliency Center, University of South Alabama, Mobile, Alabama (Dr Langhinrichsen-Rohling); Department of Psychiatry, Louisiana State University Health Sciences Center, New Orleans, Louisiana (Dr Hansel); School of Social Work, The University of Southern Mississippi, Hattiesburg, Mississippi (Dr Rehner); and Community Health Cooperative, Atlanta, Georgia (Dr Buckner)
| | - Timothy Rehner
- Center for Gulf Coast Environmental Health Research, Leadership & Strategic Initiatives (Ms Sherman and Dr Covert) and Department of Global Environmental Health Sciences (Dr Lichtveld), School of Public Health and Tropical Medicine, Tulane University, New Orleans, Louisiana; Evaluation and Research, Louisiana Public Health Institute, New Orleans, Louisiana (Dr Brown); Gulf Coast Behavioral Health Resiliency Center, University of South Alabama, Mobile, Alabama (Dr Langhinrichsen-Rohling); Department of Psychiatry, Louisiana State University Health Sciences Center, New Orleans, Louisiana (Dr Hansel); School of Social Work, The University of Southern Mississippi, Hattiesburg, Mississippi (Dr Rehner); and Community Health Cooperative, Atlanta, Georgia (Dr Buckner)
| | - Ayanna Buckner
- Center for Gulf Coast Environmental Health Research, Leadership & Strategic Initiatives (Ms Sherman and Dr Covert) and Department of Global Environmental Health Sciences (Dr Lichtveld), School of Public Health and Tropical Medicine, Tulane University, New Orleans, Louisiana; Evaluation and Research, Louisiana Public Health Institute, New Orleans, Louisiana (Dr Brown); Gulf Coast Behavioral Health Resiliency Center, University of South Alabama, Mobile, Alabama (Dr Langhinrichsen-Rohling); Department of Psychiatry, Louisiana State University Health Sciences Center, New Orleans, Louisiana (Dr Hansel); School of Social Work, The University of Southern Mississippi, Hattiesburg, Mississippi (Dr Rehner); and Community Health Cooperative, Atlanta, Georgia (Dr Buckner)
| | - Maureen Lichtveld
- Center for Gulf Coast Environmental Health Research, Leadership & Strategic Initiatives (Ms Sherman and Dr Covert) and Department of Global Environmental Health Sciences (Dr Lichtveld), School of Public Health and Tropical Medicine, Tulane University, New Orleans, Louisiana; Evaluation and Research, Louisiana Public Health Institute, New Orleans, Louisiana (Dr Brown); Gulf Coast Behavioral Health Resiliency Center, University of South Alabama, Mobile, Alabama (Dr Langhinrichsen-Rohling); Department of Psychiatry, Louisiana State University Health Sciences Center, New Orleans, Louisiana (Dr Hansel); School of Social Work, The University of Southern Mississippi, Hattiesburg, Mississippi (Dr Rehner); and Community Health Cooperative, Atlanta, Georgia (Dr Buckner)
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Mbwayo AW, Mathai M, Harder VS, Nicodimos S, Vander Stoep A. Trauma among Kenyan School Children in Urban and Rural Settings: PTSD Prevalence and Correlates. JOURNAL OF CHILD & ADOLESCENT TRAUMA 2020; 13:63-73. [PMID: 32318229 PMCID: PMC7163810 DOI: 10.1007/s40653-019-00256-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/14/2023]
Abstract
This study estimated the prevalence and correlates of PTSD in Kenyan school children during a period of widespread post-election violence. The UCLA PTSD Reaction Index was administered to 2482 primary and secondary school students ages 11-17 from rural and urban communities. A high proportion of school children had witnessed people being shot at, beat up or killed (46.9%) or had heard about the violent death or serious injury of a loved one (42.0%). Over one quarter (26.8%, 95% CI = 25.1% - 28.7%) met criteria for PTSD. Correlates of PTSD included living in a rural (vs urban) area (AOR = 1.72, 95% CI = 1.41-2.11), attending primary (vs secondary) school (AOR = 2.25, 95% CI = 1.67-3.04) and being a girl (with girl as referent AOR = .70, 95% CI = .57-.86). We recommend training Kenyan teachers to recognize signs of emotional distress in school children and psychosocial counselors to adapt empirically-supported mental health interventions for delivery in primary and secondary school settings.
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Affiliation(s)
| | - Muthoni Mathai
- Department of Psychiatry, University of Nairobi, Nairobi, Kenya
| | | | - Semret Nicodimos
- Child Health Institute, University of Washington, Seattle, WA USA
| | - Ann Vander Stoep
- Department of Psychiatry and Behavioral Sciences and Department of Epidemiology, University of Washington, Box 354920, Seattle, WA 98195 USA
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Measuring Adolescent Coping Styles Following a Natural Disaster: An ESEM Analysis of the Kidcope. SCHOOL MENTAL HEALTH 2018. [DOI: 10.1007/s12310-018-9288-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Stover CS, Keeshin B. Research domain criteria and the study of trauma in children: Implications for assessment and treatment research. Clin Psychol Rev 2018; 64:77-86. [PMID: 27863803 PMCID: PMC5423862 DOI: 10.1016/j.cpr.2016.11.002] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2014] [Revised: 05/07/2015] [Accepted: 11/07/2016] [Indexed: 10/20/2022]
Abstract
By definition, the Diagnostic and Statistical Manual (DSM) diagnosis of posttraumatic stress disorder (PTSD) requires exposure to a traumatic event. Yet, the DSM diagnostic requirements for children and adolescents for PTSD may fail to capture traumatized youth with significant distress and functional impairment. Many important studies have utilized PTSD diagnosis as a mechanism for grouping individuals for comparative studies examining brain functioning, neuroendocrinology, genetics, attachment, and cognition; however, focusing only on those with the diagnosis of PTSD can miss the spectrum of symptoms and difficulties that impact children who experience trauma and subsequent impairment. Some studying child trauma have focused on examining brain and biology of those with exposure and potential impairment rather than only those with PTSD. This line of inquiry, complementary to PTSD specific studies, has aided our understanding of some of the changes in brain structure and neuroregulatory systems at different developmental periods following traumatic exposure. Application of the Research Domain Criteria (RDoC) framework proposed by NIMH to the study of child trauma exposure and subsequent impairment is an opportunity to examine domains of function and how they are impacted by trauma. Research to date has focused largely in the areas of negative valence, regulatory, and cognitive systems, however those studying complex or developmental trauma have identified an array of domains that are impacted which map onto many of the RDoC categories. This paper will review the relevant literature associated with child trauma as it relates to the RDoC domains, outline areas of needed research, and describe their implications for treatment and the advancement of the field.
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Affiliation(s)
- Carla Smith Stover
- University of South Florida, 13301 Bruce B. Downs Blvd., Tampa, FL 33647, Salt Lake City, Utah, United States.
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17
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Abstract
The projected behavioral impacts of global climate change emanate from environmental changes including temperature elevation, extreme weather events, and rising air pollution. Negative affect, interpersonal and intergroup conflict, and possibly psychological distress increase with rising temperature. Droughts, floods, and severe storms diminish quality of life, elevate stress, produce psychological distress, and may elevate interpersonal and intergroup conflict. Recreational opportunities are compromised by extreme weather, and children may suffer delayed cognitive development. Elevated pollutants concern citizens and may accentuate psychological distress. Outdoor recreational activity is curtailed by ambient pollutants. Limitations and issues in need of further investigation include the following: lack of data on direct experience with climate change rather than indirect assessments related to projected changes; poor spatial resolution in environmental exposures and behavioral assessments; few rigorous quasi-experimental studies; overreliance on self-reports of behavioral outcomes; little consideration of moderator effects; and scant investigation of underlying psychosocial processes to explain projected behavioral impacts.
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Affiliation(s)
- Gary W Evans
- Department of Design and Environmental Analysis and Department of Human Development, Cornell University, Ithaca, New York 14850, USA;
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18
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Perceptions of Resilience and Physical Health Symptom Improvement Following Post Disaster Integrated Health Services. Disaster Med Public Health Prep 2018; 13:223-229. [PMID: 29916794 DOI: 10.1017/dmp.2018.35] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
OBJECTIVE Theorists and researchers have linked resilience with a host of positive psychological and physical health outcomes. This paper examines perceptions of resilience and physical health symptoms in a sample of individuals exposed to multiple community disasters following involvement in integrated mental health services. METHODS A multiwave naturalistic design was used to follow 762 adult clinic patients (72% female; 28% minority status), ages 18-92 years (mean age=40 years), who were evaluated for resilience and physical health symptoms prior to receiving services and at 1, 3, and 6 months' follow-up. RESULTS Data indicated increases in perceptions of resilience and decreased physical health symptoms reported over time. Results also indicated that resilience predicted physical health symptoms, such that resilience and physical health symptoms were negatively associated (ie, improved resilience was associated with decreases in physical health symptoms). These effects were primarily observed for those individuals with previous exposure to natural disasters. CONCLUSIONS Findings provide correlational evidence for behavioral health treatment provided as part of a stepped-care, collaborative model in reducing physical health symptoms and increasing resilience post-disaster. Controlled trials are warranted. (Disaster Med Public Health Preparedness. 2019;13:223-229).
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Myles P, Swenshon S, Haase K, Szeles T, Jung C, Jacobi F, Rath B. A comparative analysis of psychological trauma experienced by children and young adults in two scenarios: evacuation after a natural disaster vs forced migration to escape armed conflict. Public Health 2018; 158:163-175. [PMID: 29628203 DOI: 10.1016/j.puhe.2018.03.012] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2017] [Revised: 03/05/2018] [Accepted: 03/08/2018] [Indexed: 10/17/2022]
Abstract
OBJECTIVES Little is known about the psychological trauma experienced by children and young adults (CYAs) following displacement after natural disasters vs migration from conflict zones. In both instances, the decision to leave is usually cast by the family, and the life of CYAs is suddenly disrupted by external circumstances. STUDY DESIGN An anonymous survey. METHODS The same survey instrument, provided by the National Child Traumatic Stress Network (NCTSN), was used to survey self-reported health needs among CYAs during the aftermath of Hurricane Katrina (Health Survey for Children and Adolescents After Katrina) in October 2005-February 2006 and again during the peak of refugee arrivals in Berlin between October 2015 and March 2016. A weighted index to measure cumulative exposure to traumatic stresses during migration was developed along with an unweighted psychological impact score based on the 22-item NCTS psychological impact questionnaire. Spearman's correlation coefficient (rho) was used to assess the correlation between age and the two psychological impact indices. The two-tailed t-test was used to investigate differences in trauma experienced and psychological impact by gender. Logistic regression was used to investigate differences in types of traumatic stress experienced and psychological impact among CYAs displaced because of Hurricane Katrina and those seeking asylum in Berlin. RESULTS The Katrina cohort included a total of 1133 CYAs, the Berlin cohort, a total of 405 CYAs. The median age in the Katrina cohort was 6.73 years (standard deviation [SD] 5.67, range 0-24; 50.13% males) compared with 17.64 years (SD, range 0-24; 83% males) in the Berlin cohort. Comparative analyses were adjusted to age and gender and revealed significant differences between the two cohorts, both with regards to the amount of trauma experienced and the psychological impact. A statistically significant and moderate positive correlation was observed between trauma experienced and psychological impact of migration in the refugee population (rho = 0.4955, P < 0.001); the correlation was less pronounced but still significant in the Katrina cohort (rho = 0.0942, P = 0.0015). Free-text responses revealed that in addition to common concerns about health, housing and safety, refugees were also pre-occupied with language acquisition and the adaptation to a new culture. CONCLUSIONS The observed differences in the experience and the consequences of trauma in displaced CYAs warrant additional investigation. It was replicated that human-made disaster seems to show more traumatising potential than natural disaster. Stakeholders need to be aware of the potential medium and long-term consequences of migration/evacuation and allocate resources accordingly.
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Affiliation(s)
- P Myles
- Department of Epidemiology and Public Health, University of Nottingham, Nottingham, UK
| | - S Swenshon
- Psychologische Hochschule, Berlin, Germany
| | - K Haase
- Psychologische Hochschule, Berlin, Germany
| | - T Szeles
- Psychologische Hochschule, Berlin, Germany
| | - C Jung
- Psychologische Hochschule, Berlin, Germany
| | - F Jacobi
- Psychologische Hochschule, Berlin, Germany
| | - B Rath
- Department of Epidemiology and Public Health, University of Nottingham, Nottingham, UK; Vienna Vaccine Safety Initiative, Berlin, Germany; Tulane Hospital for Children, New Orleans, LA, USA.
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Bell JE, Brown CL, Conlon K, Herring S, Kunkel KE, Lawrimore J, Luber G, Schreck C, Smith A, Uejio C. Changes in extreme events and the potential impacts on human health. JOURNAL OF THE AIR & WASTE MANAGEMENT ASSOCIATION (1995) 2018; 68:265-287. [PMID: 29186670 PMCID: PMC9039910 DOI: 10.1080/10962247.2017.1401017] [Citation(s) in RCA: 85] [Impact Index Per Article: 14.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/02/2017] [Accepted: 10/19/2017] [Indexed: 05/20/2023]
Abstract
UNLABELLED Extreme weather and climate-related events affect human health by causing death, injury, and illness, as well as having large socioeconomic impacts. Climate change has caused changes in extreme event frequency, intensity, and geographic distribution, and will continue to be a driver for change in the future. Some of these events include heat waves, droughts, wildfires, dust storms, flooding rains, coastal flooding, storm surges, and hurricanes. The pathways connecting extreme events to health outcomes and economic losses can be diverse and complex. The difficulty in predicting these relationships comes from the local societal and environmental factors that affect disease burden. More information is needed about the impacts of climate change on public health and economies to effectively plan for and adapt to climate change. This paper describes some of the ways extreme events are changing and provides examples of the potential impacts on human health and infrastructure. It also identifies key research gaps to be addressed to improve the resilience of public health to extreme events in the future. IMPLICATIONS Extreme weather and climate events affect human health by causing death, injury, and illness, as well as having large socioeconomic impacts. Climate change has caused changes in extreme event frequency, intensity, and geographic distribution, and will continue to be a driver for change in the future. Some of these events include heat waves, droughts, wildfires, flooding rains, coastal flooding, surges, and hurricanes. The pathways connecting extreme events to health outcomes and economic losses can be diverse and complex. The difficulty in predicting these relationships comes from the local societal and environmental factors that affect disease burden.
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Affiliation(s)
- Jesse E. Bell
- Cooperative Institute for Climate and Satellites–NC, North Carolina State University, Asheville, NC, USA
| | - Claudia Langford Brown
- Karna, LLC, for Climate and Health Program, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Kathryn Conlon
- Climate and Health Program, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Stephanie Herring
- National Oceanic and Atmospheric Administration, National Centers for Environmental Information, Boulder, CO, USA
| | - Kenneth E. Kunkel
- Cooperative Institute for Climate and Satellites–NC, North Carolina State University, Asheville, NC, USA
| | - Jay Lawrimore
- National Oceanic and Atmospheric Administration, National Centers for Environmental Information, Asheville, NC, USA
| | - George Luber
- Climate and Health Program, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Carl Schreck
- Cooperative Institute for Climate and Satellites–NC, North Carolina State University, Asheville, NC, USA
| | - Adam Smith
- National Oceanic and Atmospheric Administration, National Centers for Environmental Information, Asheville, NC, USA
| | - Christopher Uejio
- Department of Geography, Florida State University, Tallahassee, FL, USA
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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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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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23
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Mouchenik Y, Dauriac-Le Masson V, Marquer C, Marty-Chevreuil A, Georges R, Derivois D, Moro MR. Traumatismes et résiliences chez les enfants de 3 à 6ans dans trois quartiers de Port-au-Prince après le séisme de 2010 en Haïti. Encephale 2017; 43:27-31. [DOI: 10.1016/j.encep.2016.04.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2014] [Accepted: 04/13/2015] [Indexed: 10/21/2022]
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Abstract
Natural and manmade crises impact community-level behavioral health, including mental health and substance use. This article shares findings from a larger project about community behavioral health, relevant to the ongoing water crisis in Flint, Michigan, using data from a larger study, involving monthly surveys of a panel of key informants from Genesee County. The data come from open-response questions and are analyzed as qualitative data using grounded theory techniques. Although respondents were not asked about the water issues in Flint, participants commented that the water situation was increasing stress, anxiety, and depression among the city's population. Participants thought these mental health issues would affect the entire community but would be worse among low-income, African American populations in the city. Mental health consequences were related not only to the water contamination but to distrust of public officials who are expected and have the authority to resolve the issues. The mental health effects of this public health crisis are significant and have received inadequate attention in the literature. Public health response to situations similar to the water issues in Flint should include sustained attention mental health.
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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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Scannell L, Cox RS, Fletcher S, Heykoop C. "That was the Last Time I Saw my House": The Importance of Place Attachment among Children and Youth in Disaster Contexts. AMERICAN JOURNAL OF COMMUNITY PSYCHOLOGY 2016; 58:158-73. [PMID: 27460461 DOI: 10.1002/ajcp.12069] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/05/2023]
Abstract
Place attachment is important for children and youth's disaster preparedness, experiences, recovery, and resilience, but most of the literature on place and disasters has focused on adults. Drawing on the community disaster risk reduction, recovery, and resilience literature as well as the literature on normative place attachment, children and youth's place-relevant disaster experiences are examined. Prior to a disaster, place attachments are postulated to enhance children and youth's disaster preparedness contributions and reinforce their pre-disaster resilience. During a disaster, damage of, and displacement from, places of importance can create significant emotional distress among children and youth. Following a disaster, pre-existing as well as new place ties can aid in their recovery and bolster their resilience moving forward. This framework enriches current theories of disaster recovery, resilience, and place attachment, and sets an agenda for future research.
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Affiliation(s)
- Leila Scannell
- ResilienceByDesign Lab, Disaster and Emergency Management, School of Humanitarian Studies, Royal Roads University, Victoria, BC, Canada.
| | - Robin S Cox
- ResilienceByDesign Lab, Disaster and Emergency Management, School of Humanitarian Studies, Royal Roads University, Victoria, BC, Canada
| | - Sarah Fletcher
- ResilienceByDesign Lab, Disaster and Emergency Management, School of Humanitarian Studies, Royal Roads University, Victoria, BC, Canada
| | - Cheryl Heykoop
- ResilienceByDesign Lab, Disaster and Emergency Management, School of Humanitarian Studies, Royal Roads University, Victoria, BC, Canada
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Yagi J, Fujiwara T, Yambe T, Okuyama M, Kawachi I, Sakai A. Does social capital reduce child behavior problems? Results from the Great East Japan Earthquake follow-up for Children Study. Soc Psychiatry Psychiatr Epidemiol 2016; 51:1117-23. [PMID: 27168182 DOI: 10.1007/s00127-016-1227-2] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2015] [Accepted: 04/16/2016] [Indexed: 10/21/2022]
Abstract
PURPOSE We sought to investigate the association between social capital and child behavior problems in Iwate prefecture, Japan, in the aftermath of the 2011 Great East Japan Earthquake. METHODS Children and their caregivers were recruited from four nursery schools in coastal areas affected by the tsunami, as well as one in an unaffected inland area (N = 94). We assessed the following via caregiver questionnaire: perceptions of social capital in the community, child behavior problems (Child Behavior Checklist, Strength and Difficulty Questionnaire), post-traumatic stress disorder (PTSD) symptoms, child's exposure to trauma (e.g. loss of family members), and caregiver's mental health (Impact of Event Scale-R for PTSD symptoms; K6 for general mental health). We collected details on trauma exposure by interviewing child participants. Structural equation modeling was used to assess whether the association between social capital and child behavior problems was mediated by caregiver's mental health status. RESULTS Children of caregivers who perceived higher community social capital (trust and mutual aid) showed fewer PTSD symptoms. Furthermore, caregiver's mental health mediated the association between social trust and child PTSD symptoms. Social capital had no direct impact on child behavior problems. CONCLUSIONS Community social capital was indirectly associated (via caregiver mental health status) with child behavior problems following exposure to disaster. Community development to boost social capital among caregivers may help to prevent child behavior problems.
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Affiliation(s)
- Junko Yagi
- Department of Psychiatry, Iwate Medical University, Morioka, Iwate, Japan
| | - Takeo Fujiwara
- Department of Social Medicine, National Research Institute for Child Health and Development, Setagaya-ku, Tokyo, Japan. .,Department of Global Health Promotion, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo, Japan.
| | - Takehito Yambe
- Department of Psychiatry, Iwate Medical University, Morioka, Iwate, Japan
| | - Makiko Okuyama
- Department of Psychosocial Medicine, National Center for Child Health and Development, Setagaya-ku, Tokyo, Japan
| | - Ichiro Kawachi
- Department of Social and Behavioral Sciences, Harvard T. H. Chan School of Public Health, Boston, USA
| | - Akio Sakai
- Department of Psychiatry, Iwate Medical University, Morioka, Iwate, Japan
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Supporting Social and Emotional Skills After a Disaster: Findings from a Mixed Methods Study. SCHOOL MENTAL HEALTH 2016. [DOI: 10.1007/s12310-016-9180-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Osofsky JD, Osofsky HJ, Weems CF, King LS, Hansel TC. Trajectories of post-traumatic stress disorder symptoms among youth exposed to both natural and technological disasters. J Child Psychol Psychiatry 2015; 56:1347-55. [PMID: 25898776 DOI: 10.1111/jcpp.12420] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/11/2015] [Indexed: 11/28/2022]
Abstract
BACKGROUND Theorists and researchers have demonstrated multiple trajectories of symptoms following disasters (Ecology and Society, 13, 2008, 9), highlighting the importance of obtaining more knowledge about exposed youth who demonstrate resilience as well as those who suffer chronic difficulties. This paper examines trajectories of post-traumatic stress disorder (PTSD) symptoms following exposure to hurricanes and the Deepwater Horizon Oil Spill to increase understanding of resilience and chronic reactions to both natural and technological disasters. METHODS A multiwave longitudinal design was used to follow N = 4,619 youth who were evaluated for PTSD symptoms, hurricane exposure, and oil spill exposure/stress at four time points over a period of 4 years. Trajectories were identified with cluster analyses and multilevel modeling. RESULTS Individual trajectories were statistically identified consistent with theory. The largest group exhibited stable-low symptoms (52%), a second group showed steep declines following initial symptoms (21%), a third group exhibited increasing symptoms (18%), and a fourth group showed stable-high symptoms (9%). Both hurricane exposure and oil spill stress predicted trajectories and overall levels of PTSD symptoms. CONCLUSIONS Results identified an effect of oil spill stress and hurricane exposure on symptom levels and trajectories of exposed youth. Results provide prospective data to support theories of multiple symptom trajectories following disasters and reinforce the importance of research that utilizes a developmental perspective to consider the long-term effects of disasters in youth. Findings highlight the importance of identifying symptoms and predictors of resilience as well as factors that contribute to resilience.
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Affiliation(s)
- Joy D Osofsky
- Department of Psychiatry, Louisiana State University Health Sciences Center, New Orleans, LA, USA
| | - Howard J Osofsky
- Department of Psychiatry, Louisiana State University Health Sciences Center, New Orleans, LA, USA
| | - Carl F Weems
- Department of Psychology, University of New Orleans, New Orleans, LA, USA
| | - Lucy S King
- Department of Psychiatry, Louisiana State University Health Sciences Center, New Orleans, LA, USA
| | - Tonya C Hansel
- Department of Psychiatry, Louisiana State University Health Sciences Center, New Orleans, LA, USA
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Jacobs MB, Harville EW. Long-Term Mental Health Among Low-Income, Minority Women Following Exposure to Multiple Natural Disasters in Early and Late Adolescence Compared to Adulthood. CHILD & YOUTH CARE FORUM 2015; 44:511-525. [PMID: 26412956 DOI: 10.1007/s10566-015-9311-4] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
BACKGROUND High impact experiences following a natural disaster have been shown to influence later psychopathology. Individual-level factors such as age may also contribute to a disaster's impact on mental health, though it is unclear whether young age confers a protective effect or represents a period of increased risk as compared to adulthood. OBJECTIVE The present study evaluated the influence of adolescent age and hurricane experiences on mental health in the years following multiple hurricanes in the New Orleans region. METHODS 794 women, currently aged 18-45, participating in a cohort study of lifetime adversity and reproductive health completed a survey about hurricane experience and current mental health. Joint associations between disaster experience and age at the time of disaster on depression and post-traumatic stress disorder (PTSD) were evaluated. RESULTS Compared to women who were adults at the time of the disaster, being in early adolescence resulted in reduced depression and PTSD up to 9-years post-disaster, controlling for hurricane experiences, time since disaster, and income. A similar effect was not observed among older adolescents. Increased endorsement of feeling one's life was in danger and experiencing illness or injury resulted in increased odds of depression, while danger was associated with increased odds of PTSD. CONCLUSIONS Younger age at the time of a natural disaster may confer a protective effect on mental health outcomes post-disaster, even when disaster experiences are considered, potentially representing the importance of parental support and cognitive development on disaster effects.
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Affiliation(s)
- Marni B Jacobs
- Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, 1440 Canal Street, Suite 2000, New Orleans, LA 70112-2715, USA
| | - Emily W Harville
- Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, 1440 Canal Street, Suite 2000, New Orleans, LA 70112-2715, 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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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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Fujiwara T, Yagi J, Homma H, Mashiko H, Nagao K, Okuyama M. Clinically significant behavior problems among young children 2 years after the Great East Japan Earthquake. PLoS One 2014; 9:e109342. [PMID: 25333762 PMCID: PMC4204852 DOI: 10.1371/journal.pone.0109342] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2014] [Accepted: 09/05/2014] [Indexed: 11/17/2022] Open
Abstract
Background On March 11, 2011, a massive undersea earthquake and tsunami struck East Japan. Few studies have investigated the impact of exposure to a natural disaster on preschool children. We investigated the association of trauma experiences during the Great East Japan Earthquake on clinically significant behavior problems among preschool children 2 years after the earthquake. Method Participants were children who were exposed to the 2011 disaster at preschool age (affected area, n = 178; unaffected area, n = 82). Data were collected from September 2012 to June 2013 (around 2 years after the earthquake), thus participants were aged 5 to 8 years when assessed. Severe trauma exposures related to the earthquake (e.g., loss of family members) were assessed by interview, and trauma events in the physical environment related to the earthquake (e.g. housing damage), and other trauma exposure before the earthquake, were assessed by questionnaire. Behavior problems were assessed by caregivers using the Child Behavior Checklist (CBCL), which encompasses internalizing, externalizing, and total problems. Children who exceeded clinical cut-off of the CBCL were defined as having clinically significant behavior problems. Results Rates of internalizing, externalizing, and total problems in the affected area were 27.7%, 21.2%, and 25.9%, respectively. The rate ratio suggests that children who lost distant relatives or friends were 2.36 times more likely to have internalizing behavior problems (47.6% vs. 20.2%, 95% CI: 1.10–5.07). Other trauma experiences before the earthquake also showed significant positive association with internalizing, externalizing, and total behavior problems, which were not observed in the unaffected area. Conclusions One in four children still had behavior problems even 2 years after the Great East Japan Earthquake. Children who had other trauma experiences before the earthquake were more likely to have behavior problems. These data will be useful for developing future interventions in child mental health after a natural disaster.
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Affiliation(s)
- Takeo Fujiwara
- Department of Social Medicine, National Research Institute for Child Health and Development, Tokyo, Japan
| | - Junko Yagi
- Department of Neuropsychiatry, Iwate Medical University, Iwate, Japan
| | - Hiroaki Homma
- Miyagi Prefectural Comprehensive Children's Center, Miyagi, Japan
| | - Hirobumi Mashiko
- Department of Neuropsychiatry, Fukushima Medical University, Fukushima, Japan
| | | | - Makiko Okuyama
- Department of Psychosocial Medicine, National Center for Child Health and Development, Tokyo, Japan
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Osofsky JD, Osofsky HJ, Weems CF, Hansel TC, King LS. Effects of Stress Related to the Gulf Oil Spill on Child and Adolescent Mental Health. J Pediatr Psychol 2014; 41:65-72. [DOI: 10.1093/jpepsy/jsu085] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2014] [Accepted: 09/09/2014] [Indexed: 11/13/2022] Open
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Mouchenik Y, Marty-Chevreuil A, Marquer C, Barry C, Gaboulaud V, Derivois D, Mathieu M, Jean-Jacques R, Falissard B, Baubet T, Moro MR. L'utilisation du PSYCa 3-6 pour l'évaluation indicative des difficultés psychologiques des jeunes enfants touchés par le séisme de janvier 2010 en Haïti. PSYCHIATRIE DE L ENFANT 2014. [DOI: 10.3917/psye.571.0237] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
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Santiago CD, Pears G, Baweja S, Vona P, Tang J, Kataoka SH. Engaging parents in evidence-based treatments in schools: Community perspectives from implementing CBITS. SCHOOL MENTAL HEALTH 2013; 5. [PMID: 24273613 DOI: 10.1007/s12310-012-9100-2] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
This study explored parent engagement in an evidence-based treatment, the Cognitive Behavioral Intervention for Trauma in Schools (CBITS), which was delivered in a school setting. To examine the successes and challenges in engaging parents in this school-based program, we conducted qualitative interviews by phone to obtain data from clinicians, parents, and other school personnel across eleven schools from 3 different regions of the United States. Almost all of these schools served low-income and ethnically diverse communities. We describe general impressions of parent engagement, parent reactions and preferences with regard to CBITS, barriers to parent engagement, and how to overcome barriers from multiple perspectives. Parent engagement across schools varied, with extensive outreach and relatively good parent engagement in CBITS described in some schools, while in other schools, efforts to engage parents were not as consistent. Implications for future efforts to engage parents in school-based treatments are discussed.
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Hansel TC, Osofsky JD, Osofsky HJ, Friedrich P. The effect of long-term relocation on child and adolescent survivors of Hurricane Katrina. J Trauma Stress 2013; 26:613-20. [PMID: 24115291 DOI: 10.1002/jts.21837] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
The current study is designed to increase knowledge of the effects of relocation and its association with longer-term psychological symptoms following disaster. Following clinical observations and in discussions held with school officials expressing concerns about relocated students, it was hypothesized that students who relocated to a different city following Hurricane Katrina in 2005 would have more symptoms of posttraumatic stress compared to students who returned to New Orleans. The effect of Hurricane Katrina relocation was assessed on a sample of child and adolescent survivors in 5th through 12th grades (N = 795). Students with Orleans Parish zip codes prior to Hurricane Katrina were categorized into relocation groupings: (a) relocated to Baton Rouge, (b) returned to prior zip code, and (c) moved to a different zip code within Orleans Parish. Overall results revealed more trauma symptoms for relocated students. Results also revealed that younger relocated students had fewer symptoms compared to older students. The opposite was found for students who returned to their same zip code, with older students having fewer symptoms. This study supports the need for school-based services not only in disaster areas, but also in schools where survivors tend to migrate.
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Affiliation(s)
- Tonya C Hansel
- Department of Psychiatry, Louisiana State University Health Sciences Center, New Orleans, Louisiana, USA
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Abstract
Education and training about immediate responses are important for all mental health providers of immediate and continuing services to assist children, adolescents, adults, and families in the aftermath of disasters. To sensitively help with evacuations and return to normalcy, responders must also be trained to understand the culture and traditions of affected communities. It is important to provide knowledge about available resources and to emphasize the need for routines and self-care for both victims and responders in an environment that, with recovery, will reflect a new normal.
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Affiliation(s)
- Howard J Osofsky
- Department of Psychiatry, LSU Health Sciences Center, New Orleans, LA, USA.
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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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Abstract
INTRODUCTION Social networks play an important role in disaster situations as they have become a new form of social convergence that provides collective information. The effect of social media on people who experienced disaster should be assessed. Hypothesis In this study, Twitter communication during the Great East Japan Earthquake of March 11, 2011 was assessed. The hypothesis of this study was that usage of Twitter had psychological effects on victims of the disaster. METHODS A cross-sectional questionnaire survey was carried out in cooperation with a major Japanese newspaper three months after the disaster, and 1,144 volunteer participants responded. They were asked about their health, area of residence, property damage they had experienced, information sources they used at the time of the disaster, and their usage of Twitter. Further, the Twitter users were divided into two groups-with and without disaster experience. Their psychological effects relating to feelings of relief, stress or anxiety that they experienced in using Twitter were compared between two groups, and Twitter's psychological risk of disaster experience was estimated as an odds ratio. RESULTS Twitter users in this study tended to reside in disaster-affected areas and thought Twitter was a credible information source during the time of the disaster. The psychological effect of Twitter differed based on participants' disaster experience and gender. Females with disaster experience reported more feelings of relief and stress as a result of using Twitter compared to females who did not experience the disaster. On the other hand, males with disaster experience only reported more stress experiences as a result of using Twitter compared to those without disaster experience. CONCLUSION Twitter users with disaster experience had a higher usage of Twitter than those without disaster experience. Social media might have had a material psychological influence on people who experienced disaster, and the effect differed by gender. Regardless of gender, negative feelings were transmitted easily among people who experienced the disaster. It was anticipated that the application of Twitter in a disaster situation will be expanded further by taking these findings into consideration.
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Rutkow L, Vernick JS, Wissow LS, Tung GJ, Marum F, Barnett DJ. Legal issues affecting children with preexisting conditions during public health emergencies. Biosecur Bioterror 2013; 11:89-95. [PMID: 23641730 DOI: 10.1089/bsp.2012.0066] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Among the millions of children in the United States exposed to public health emergencies in recent years, those with preexisting health conditions face particular challenges. A public health emergency may, for example, disrupt treatment regimens or cause children to be separated from caregivers. Ongoing shortages of pediatricians and pediatric subspecialists may further exacerbate the risks that children with preexisting conditions face in disaster circumstances. The US Department of Homeland Security recently called for better integration of children's needs into all preparedness activities. To aid in this process, multiple legal concerns relevant to pediatricians and pediatric policymakers must be identified and addressed. Obtaining informed consent from children and parents may be particularly challenging during certain public health emergencies. States may need to invoke legal protections for children who are separated from caregivers during emergencies. Maintaining access to prescription medications may also require pediatricians to use specific legal mechanisms. In addition to practitioners, recommendations are given for policymakers to promote effective pediatric response to public health emergencies.
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Affiliation(s)
- Lainie Rutkow
- Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, 624 N. Broadway, Room 513, Baltimore, MD 21205, USA.
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Ghazali SR, Elklit A, Yaman K, Ahmad M. Symptoms of PTSD Among Adolescents in Malaysia 4 Years Following the 2004 Tsunami. JOURNAL OF LOSS & TRAUMA 2013. [DOI: 10.1080/15325024.2012.688703] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Abstract
OBJECTIVE This study examined trajectories of posttraumatic stress disorder symptoms in Hurricane Katrina affected youth. METHOD A total of 426 youth (51% female; 8-16 years old; mean age=11 years; 75% minorities) completed assessments at 4 time points post-disaster. Measures included Hurricane impact variables (initial loss/disruption and perceived life threat); history of family and community violence exposure, parent and peer social support, and post-disaster posttraumatic stress symptoms. RESULTS Latent class growth analysis demonstrated that there were three distinct trajectories of posttraumatic stress disorder symptoms identified for this sample of youth (resilient, recovering, and chronic, respectively). Youth trajectories were associated with Hurricane-related initial loss/disruption, community violence, and peer social support. CONCLUSIONS The results suggest that youth exposed to Hurricane Katrina have variable posttraumatic stress disorder symptom trajectories. Significant risk and protective factors were identified. Specifically, youth Hurricane and community violence exposure increased risk for a more problematic posttraumatic stress disorder symptom trajectory, while peer social support served as a protective factor for these youth. Identification of these factors suggests directions for future research as well as potential target areas for screening and intervention with disaster exposed youth. LIMITATIONS The convenience sample limits the external validity of the findings to other disaster exposed youth, and the self-report data is susceptible to response bias.
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Gil-Rivas V, Kilmer RP. Children's adjustment following Hurricane Katrina: the role of primary caregivers. THE AMERICAN JOURNAL OF ORTHOPSYCHIATRY 2013; 83:413-21. [PMID: 23889031 PMCID: PMC3752914 DOI: 10.1111/ajop.12016] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Hurricane Katrina severely disrupted the lives of many children and families in the central Gulf Coast of the United States. Face-to-face interviews with child-caregiver dyads were conducted at approximately 1 year posthurricane (T1) and 6-10 months later (T2). The contribution of several factors-caregiver's self-reported symptomatology and coping advice and child perceptions of caregiver distress, unavailability, warmth, and caregiver-child conflict-to child-reported posttraumatic stress symptoms (PTSS) and depressive symptoms was examined. Findings provide partial support for the importance of the caregiving context to children's adjustment. Specifically, higher levels of caregiver-child conflict at T1 were associated with more PTSS at T2, controlling for baseline symptoms. In contrast, higher levels of caregiver education were negatively related to child PTSS at T2. After adjusting for objective hurricane exposure and symptoms at T1, none of the caregiving variables was related to child-reported depressive symptoms at T2. The implications of these findings for efforts to promote children's adjustment after disaster are discussed.
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Affiliation(s)
- Virginia Gil-Rivas
- Department of Psychology, University of North Carolina at Charlotte, 9201 University City Blvd., Charlotte, NC 28223-0001, USA.
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Osofsky JD, Osofsky HJ. Lessons Learned About the Impact of Disasters on Children and Families and Post-disaster Recovery. ISSUES IN CLINICAL CHILD PSYCHOLOGY 2013. [DOI: 10.1007/978-1-4614-7456-2_7] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
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Pervanidou P, Chrousos GP. Posttraumatic stress disorder in children and adolescents: neuroendocrine perspectives. Sci Signal 2012. [PMID: 23047921 DOI: 10.1007/978-1-4614-9608-3_38] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/10/2023]
Abstract
Posttraumatic stress disorder (PTSD) is a syndrome of distress that develops after exposure to traumatic life experiences. Dysregulation of both the hypothalamic-pituitary-adrenal (HPA) axis and the locus caeruleus/norepinephrine-sympathetic nervous system (LC/NE-SNS) is associated with the pathophysiology of the disorder. Studies have demonstrated a neuroendocrine profile unique to adults with PTSD, with centrally elevated corticotropin-releasing hormone (CRH), low cortisol in the periphery, and elevated catecholamines. Traumatic stress experiences in early life are strong predisposing factors for later PTSD development. In addition, early life stress programs the developing brain to overreact to future stressors. In children and adolescents involved in motor vehicle accidents, we found that high evening salivary cortisol and morning serum interleukin 6 concentrations were predictive of PTSD development 6 months later. We demonstrated a progressive divergence of the HPA and LC/NE-SNS axes of the stress system, which may be part of the pathophysiologic mechanism responsible for PTSD maintenance. An initial elevation of cortisol in the aftermath of the trauma, followed by a gradual normalization and finally low cortisol secretion, together with a gradual elevation of catecholamines over time, may represent the natural history of neuroendocrine changes in pediatric PTSD. Thus, the low cortisol concentrations found in adults with PTSD may reflect prior trauma and might represent a biologic vulnerability factor for later PTSD development.
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Affiliation(s)
- Panagiota Pervanidou
- Unit of Developmental and Behavioral Pediatrics, First Department of Pediatrics, University of Athens Medical School, Aghia Sophia Children's Hospital, 115 27 Athens, Greece.
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Framework for research on children's reactions to disasters and terrorist events. Prehosp Disaster Med 2012; 27:567-76. [PMID: 23034149 DOI: 10.1017/s1049023x12001343] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
Clinical work and research relative to child mental health during and following disaster are especially challenging due to the complex child maturational processes and family and social contexts of children's lives. The effects of disasters and terrorist events on children and adolescents necessitate diligent and responsible preparation and implementation of research endeavors. Disasters present numerous practical and methodological barriers that may influence the selection of participants, timing of assessments, and constructs being investigated. This article describes an efficient approach to guide both novice and experienced researchers as they prepare to conduct disaster research involving children. The approach is based on five fundamental research questions: "Why?, Who?, When?, What?, and How?" Addressing each of the "four Ws" will assist researchers in determining "How" to construct and implement a study from start to finish. A simple diagram of the five questions guides the reader through the components involved in studying children's reactions to disasters. The use of this approach is illustrated with examples from disaster mental health studies in children, thus simultaneously providing a review of the literature.
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Osofsky HJ, Osofsky JD, Hansel TC. Deepwater horizon oil spill: mental health effects on residents in heavily affected areas. Disaster Med Public Health Prep 2012; 5:280-6. [PMID: 22146666 DOI: 10.1001/dmp.2011.85] [Citation(s) in RCA: 77] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
BACKGROUND Mental health issues are a significant concern after disasters such as the Deepwater Horizon oil spill in the Gulf of Mexico in 2010. This study was designed to assess the mental health effects on residents of areas of southeastern Louisiana affected by the oil spill. METHODS Telephone and face-to-face interviews were conducted with residents (N = 452) assessing concerns and direct impact. RESULTS The results show that the greatest effect on mental health related to the extent of disruption to participants' lives, work, family, and social engagement, with increased symptoms of anxiety, depression, and posttraumatic stress. Given the location of the oil spill affecting communities that had been devastated by Hurricane Katrina, results also revealed that losses from Hurricane Katrina were highly associated with negative mental health outcomes. Conversely, the ability to rebound after adversity and place satisfaction were highly associated with better mental health outcomes. CONCLUSIONS Enhanced understanding of mental health effects after the Deepwater Horizon oil spill will help in determining directions for much-needed mental health services after the disaster and in contributing to the knowledge of complex traumatization and the ability to rebound after adversity.
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Affiliation(s)
- Howard J Osofsky
- Department of Pediatrics and Psychiatry, Louisiana State University Health Sciences Center, 1542 Tulane Ave, 2nd Floor, New Orleans, LA 70112, USA.
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Jaycox LH, Kataoka SH, Stein BD, Langley AK, Wong M. Cognitive Behavioral Intervention for Trauma in Schools. JOURNAL OF APPLIED SCHOOL PSYCHOLOGY 2012. [DOI: 10.1080/15377903.2012.695766] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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