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Associations between potential traumatic experience and mental health in adolescent refugee populations: A scoping review. CURRENT PSYCHOLOGY 2022. [DOI: 10.1007/s12144-022-03929-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Coulon N, Grenon M, Consigny M, Simson JP. PTSD in French Adolescent Victims Following the London Attack in March 2017: Data From the First Step of the AVAL Study. Front Psychiatry 2022; 13:728133. [PMID: 35280156 PMCID: PMC8907535 DOI: 10.3389/fpsyt.2022.728133] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/20/2021] [Accepted: 01/21/2022] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND The terrorist attack at Westminster Bridge on March 22nd, 2017 impacted on French high school students on a school trip in London. This terrorist attack was claimed by the Islamic State. The aim of the study was to assess the mental health consequences of the attack on the French adolescents who were directly exposed (criteria A for Post-Traumatic Stress Disorder, PTSD). This involved three dimensions, namely: (1) clinical; (2) epidemiological; and (3) prevention and therapeutic. MATERIAL AND METHOD The investigation was the first observational step of AVAL (Adolescents Victimes de l'Attentat de Londres) study, a cohort monitoring project and it was then a monocentric, cross sectional, non interventional survey, at only one-year post-trauma. The study was carried out utilizing self- and clinician-administered questionnaires. Volunteers from the medico-psychological emergency unit provided support for these victims during the study protocol. RESULTS From the target population (n = 53), 39 adolescents (73.6%) agreed to participate, with a median age 16.9 years. 12 months after the attack, 25.6% of teenagers suffered from current PTSD (p < 0.0001). Those with, vs. without, PTSD showed several significant differences: (1) heightened levels of major depressive episodes (p = 0.0266) and suicidality (p = 0.0164); (2) increased substance use, including tobacco (p = 0.0284) and cannabis (p = 0.0449); and (3) impaired functioning in school (p = 0.0203), social (p < 0.0001) and family (p < 0.0001) settings. Sixty four percentage of directly exposed teenagers also had a current psychiatric disorder other than PTSD. DISCUSSION The heightened levels of PTSD, psychiatric disorders, and substance use at 12 months highlight the importance of early intervention in adolescents exposed to terrorist-linked potentially traumatic events.
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Affiliation(s)
- Nathalie Coulon
- Department of Psychiatry, Brest University Hospital, Brest, France.,Assistance Publique des Hôpitaux de Paris APHP, DHU Pe-PSY, Medical University Department of Psychiatry and Addictology Henri Mondor, Schizophrenia Expert Center, Paris Est Créteil University, Créteil, France
| | - Marion Grenon
- Department of Psychiatry, Brest University Hospital, Brest, France.,Military Hospital, HIA Clermont-Tonnerre, Departement of Psychiatry, Brest, France
| | - Maëlys Consigny
- Brest University Hospital, Delegation for Clinical Research and Innovation, Clinical Investigation Center, INSERM 14 12, Brest, France
| | - J-P Simson
- Military Hospital, HIA Clermont-Tonnerre, Departement of Psychiatry, Brest, France
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Prieto S, Sanz J, García-Vera MP, Fausor R, Morán N, Cobos B, Gesteira C, Navarro R, Altungy P. Growing Up With Terrorism: The Age at Which a Terrorist Attack Was Suffered and Emotional Disorders in Adulthood. Front Psychol 2021; 12:700845. [PMID: 34220658 PMCID: PMC8249802 DOI: 10.3389/fpsyg.2021.700845] [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: 04/26/2021] [Accepted: 05/25/2021] [Indexed: 11/25/2022] Open
Abstract
Abundant scientific literature shows that exposure to traumatic situations during childhood or adolescence has long-term psychopathological consequences, for example, in the form of a higher prevalence of emotional disorders in adulthood. However, an evolutionary perspective suggests that there may be differential vulnerabilities depending on the age at which the trauma was suffered. As there are no studies on the psychopathological impact in adulthood of attacks suffered during childhood or adolescence, the objective of this study was to analyze the influence of the age at which a terrorist attack was suffered in the presence of emotional disorders many years after the attack. A sample of 566 direct and indirect victims of terrorist attacks in Spain was recruited, of whom 50 people were between the age of 3 and 9 when they suffered the attack, 46 were between 10 and 17 years old, and 470 were adults. All of them underwent a structured diagnostic interview (SCID-I-VC) an average of 21 years after the attacks. No significant differences were found between the three age groups at which the attack occurred in terms of the current prevalence of post-traumatic stress disorder, major depressive disorder, or anxiety disorders. The results of several multiple binary logistic regression analyses also indicated that, after controlling for the effect of sex, current age, the type of victims, and the time since the attack, the age at which the attack was suffered was not related to the current prevalence of those emotional disorders. The results are discussed concerning the differences between various types of trauma and in the context of the theories that propose that traumatic experiences are processed differently at different ages and can lead to differences in the likelihood of developing different emotional disorders.
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Affiliation(s)
- Sara Prieto
- Department of Personality, Assessment, and Clinical Psychology, Complutense University of Madrid, Madrid, Spain
| | - Jesús Sanz
- Department of Personality, Assessment, and Clinical Psychology, Complutense University of Madrid, Madrid, Spain
| | - María Paz García-Vera
- Department of Personality, Assessment, and Clinical Psychology, Complutense University of Madrid, Madrid, Spain
| | - Rocío Fausor
- Department of Personality, Assessment, and Clinical Psychology, Complutense University of Madrid, Madrid, Spain
| | - Noelia Morán
- Department of Personality, Assessment, and Clinical Psychology, Complutense University of Madrid, Madrid, Spain
| | - Beatriz Cobos
- Department of Personality, Assessment, and Clinical Psychology, Complutense University of Madrid, Madrid, Spain
| | - Clara Gesteira
- Department of Personality, Assessment, and Clinical Psychology, Complutense University of Madrid, Madrid, Spain
| | - Roberto Navarro
- Department of Personality, Assessment, and Clinical Psychology, Complutense University of Madrid, Madrid, Spain
| | - Pedro Altungy
- Department of Personality, Assessment, and Clinical Psychology, Complutense University of Madrid, Madrid, Spain
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The Association between Child and Parent Psychiatric Disorders in Families Exposed to Flood and/or Dioxin. Behav Sci (Basel) 2021; 11:bs11040046. [PMID: 33915718 PMCID: PMC8066693 DOI: 10.3390/bs11040046] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2020] [Revised: 03/05/2021] [Accepted: 03/26/2021] [Indexed: 01/27/2023] Open
Abstract
Associations of disaster mental health sequelae between children and their parents have been demonstrated, but not using full diagnostic assessment. This study examined children and their parents after a series of disasters in 1982 to investigate associations of their psychiatric outcomes. Members of 169 families exposed to floods and/or dioxin or no disaster were assessed in 1986–1987 with structured diagnostic interviews. This vintage dataset collected several decades ago provides new information to this field because of the methodological rigor that is unparalleled in this literature. Disaster-related PTSD and incident postdisaster disorders in children were associated, respectively with disaster-related PTSD and incident postdisaster disorders in the chief caregiver and mother. More flood-only than dioxin-only exposed parents reported great harm by the disaster, but neither children nor parents in these two groups differed in incident psychiatric disorders. Although this study did not determine the direction of causal influences, its findings suggest that clinicians working with disaster-exposed families should work with children and adult members together, as their mental health outcomes may be intertwined.
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Hind D, Allsopp K, Chitsabesan P, French P. The psychosocial response to a terrorist attack at Manchester Arena, 2017: a process evaluation. BMC Psychol 2021; 9:22. [PMID: 33531071 PMCID: PMC7852120 DOI: 10.1186/s40359-021-00527-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2019] [Accepted: 01/22/2021] [Indexed: 01/14/2023] Open
Abstract
BACKGROUND A 2017 terrorist attack in Manchester, UK, affected large numbers of adults and young people. During the response phase (first seven weeks), a multi-sector collaborative co-ordinated a decentralised response. In the subsequent recovery phase they implemented a centralised assertive outreach programme, 'The Resilience Hub', to screen and refer those affected. We present a process evaluation conducted after 1 year. METHODS Case study, involving a logic modelling approach, aggregate routine data, and semi-structured interviews topic guides based on the Inter-Agency Collaboration Framework and May's Normalisation Process Theory. Leaders from health, education and voluntary sectors (n = 21) and frontline Resilience Hub workers (n = 6) were sampled for maximum variation or theoretically, then consented and interviewed. Framework analysis of transcripts was undertaken by two researchers. RESULTS Devolved government, a collaborative culture, and existing clinical networks meant that, in the response phase, a collaboration was quickly established between health and education. All but one leader evaluated the response positively, although they were not involved in pre-disaster statutory planning. However, despite overwhelming positive feedback there were clear difficulties. (1) Some voluntary sector colleagues felt that it took some time for them to be involved. (2) Other VCSE organisations were accused of inappropriate, harmful use of early intervention. (3) The health sector were accused of overlooking those below the threshold for clinical treatment. (4) There was a perception that there were barriers to information sharing across organisations, which was particularly evident in relation to attempts to outreach to first responders and other professionals who may have been affected by the incident. (5) Hub workers encountered barriers to referring people who live outside of Greater Manchester. After 1 year of the recovery phase, 877 children and young people and 2375 adults had completed screening via the Resilience Hub, 79% of whom lived outside Greater Manchester. CONCLUSIONS The psychosocial response to terrorist attacks and other contingencies should be planned and practiced before the event, including reviews of communications, protocols, data sharing procedures and workforce capacity. Further research is needed to understand how the health and voluntary sectors can best collaborate in the wake of future incidents.
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Affiliation(s)
- Daniel Hind
- School of Health and Related Research, University of Sheffield, Regent Court, 30 Regent Street, Sheffield, S1 4DA, UK.
| | - Kate Allsopp
- Complex Trauma and Resilience Research Unit, Greater Manchester Mental Health NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK.,Division of Psychology and Mental Health, School of Health Sciences, University of Manchester, Manchester Academic Health Science Centre, Manchester, UK
| | - Prathiba Chitsabesan
- Young People's Mental Health Research Unit, Pennine Care NHS Foundation Trust, Manchester, UK.,Faculty of Health, Psychology and Social Care, Manchester Metropolitan University, Manchester, M15 6GX, UK
| | - Paul French
- Greater Manchester Mental Health NHS Foundation Trust, Manchester, UK.,Institute of Psychology, Health and Society, University of Liverpool, Liverpool, UK
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Hobfoll SE, Watson P, Bell CC, Bryant RA, Brymer MJ, Friedman MJ, Friedman M, Gersons BPR, de Jong J, Layne CM, Maguen S, Neria Y, Norwood AE, Pynoos RS, Reissman D, Ruzek JI, Shalev AY, Solomon Z, Steinberg AM, Ursano RJ. Five Essential Elements of Immediate and Mid-Term Mass Trauma Intervention: Empirical Evidence. Psychiatry 2021; 84:311-346. [PMID: 35061969 DOI: 10.1080/00332747.2021.2005387] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Given the devastation caused by disasters and mass violence, it is critical that intervention policy be based on the most updated research findings. However, to date, no evidence-based consensus has been reached supporting a clear set of recommendations for intervention during the immediate and the mid-term post mass trauma phases. Because it is unlikely that there will be evidence in the near or mid-term future from clinical trials that cover the diversity of disaster and mass violence circumstances, we assembled a worldwide panel of experts on the study and treatment of those exposed to disaster and mass violence to extrapolate from related fields of research, and to gain consensus on intervention principles. We identified five empirically supported intervention principles that should be used to guide and inform intervention and prevention efforts at the early to mid-term stages. These are promoting: 1) a sense of safety, 2) calming, 3) a sense of self- and community efficacy, 4) connectedness, and 5) hope.
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Psychological Well-Being Among Internally Displaced Adolescents and the Effect of Psychopathology on PTSD Scores Depends on Gender. Community Ment Health J 2020; 56:1489-1495. [PMID: 32124156 DOI: 10.1007/s10597-020-00594-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2019] [Accepted: 02/24/2020] [Indexed: 10/24/2022]
Abstract
The purpose of this cross-sectional study was to investigate the post-traumatic symptoms and psychological well-being among internally displaced (ID) adolescents in the early phase of the conflict in the southeast part of Turkey and clarify the effect of psychopathology on PTSD scores depends on gender. With the help of the results of our study, we aimed to enhance our understanding of adolescent mental health. Our study was completed with 102 ID adolescents (42 boys, 60 girls). Our results showed that ID adolescents flee from conflict had significantly higher levels of mental disorders and PTSD. Girls show higher rates of PTSD symptoms than boys and there was no significant interactive effect of gender and emotional, behavioral and peer problems on PTSD. However, boys with ADHD seem to be more prone to develop PTSD than girls. We aimed to highlight the challenges facing adolescents forced to flee from conflict zones who were temporarily relocated. These results may help us to enlighten our understanding of ID adolescents and may suggest more studies to provide beneficial gender-specific intervention program.
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Moore-Petinak N, Waselewski M, Patterson BA, Chang T. Active Shooter Drills in the United States: A National Study of Youth Experiences and Perceptions. J Adolesc Health 2020; 67:509-513. [PMID: 32693981 DOI: 10.1016/j.jadohealth.2020.06.015] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2020] [Revised: 05/27/2020] [Accepted: 06/02/2020] [Indexed: 11/19/2022]
Abstract
PURPOSE The purpose of this study was to understand youth experience and opinion surrounding active shooter drills. METHODS MyVoice is a national text message poll of the youth ages 14-24 years that collects youth opinion on salient policy issues. Participants are recruited to meet national benchmarks. Five open-ended probes were posed to participants on August 2, 2019. Qualitative data were analyzed using thematic analysis; quantitative data were summarized using descriptive statistics. RESULTS Among respondents (815 of 1283; 63.5%), the average age was 18.7 years (SD = 2.9). Most were girls (52.9%), non-white (42.8%), and with < high school diploma (56.9%). Responses centered around three themes: drill methods vary, active shooter drills cause emotional distress, and youth perceive drills to have questionable benefit. The majority (60.2%) mentioned that drills make them feel "scared and hopeless," but many (56.1%) also noted drills "teach kids on what to do." Others (24%) stated drills do not improve safety because they inform potential shooters or are ineffective because "people will likely panic, forgetting their drill." CONCLUSIONS Many youth report that active shooter drills have a negative effect on their emotional health and are conflicted on their effectiveness.
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Affiliation(s)
| | - Marika Waselewski
- Department of Family Medicine, University of Michigan, Ann Arbor, Michigan
| | | | - Tammy Chang
- Department of Family Medicine, Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor, Michigan.
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Van Overmeire R, Six S, Vesentini L, Deschepper R, Denys E, Vandekerckhove M, Bilsen J. Questions and Emotions of Minors After Terrorist Attacks: A Qualitative Study Using Data from a Belgian Youth-Helpline. Community Ment Health J 2020; 56:280-286. [PMID: 31571085 DOI: 10.1007/s10597-019-00482-w] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2019] [Accepted: 09/25/2019] [Indexed: 12/20/2022]
Abstract
Until now, there is little research on the experiences of indirectly exposed minors after terrorist attacks. This study sheds light on the emotions and questions of such indirectly exposed minors. A qualitative content analysis of secondary data gained from Awel, a youth-helpline, was performed until saturation. Data contained emotions and questions in chat conversations, with 30 minors (8-18 years old). Emotions included guilt, sadness, and especially fear of attacks on themselves, their family, or at school. Questions mostly focused on making sense of the attacks, and how to distinguish fantasy from reality. After an attack children and adolescents experienced a wide range of emotions, and seem to have difficulty to make sense of what happened. Teachers and parents can play an important role in buffering fears, and in offering contextual information and concrete answers.
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Affiliation(s)
- Roel Van Overmeire
- Department of Public Health, Mental Health and Wellbeing Research Group, Vrije Universiteit Brussel, Laarbeeklaan 103, 1090, Jette, Belgium.
| | - Stefaan Six
- Department of Public Health, Mental Health and Wellbeing Research Group, Vrije Universiteit Brussel, Laarbeeklaan 103, 1090, Jette, Belgium
| | - Lara Vesentini
- Department of Public Health, Mental Health and Wellbeing Research Group, Vrije Universiteit Brussel, Laarbeeklaan 103, 1090, Jette, Belgium
| | - Reginald Deschepper
- Department of Public Health, Mental Health and Wellbeing Research Group, Vrije Universiteit Brussel, Laarbeeklaan 103, 1090, Jette, Belgium
| | | | - Marie Vandekerckhove
- Department of Psychology, Biological Psychology, Vrije Universiteit Brussel, Pleinlaan 2, 1050, Elsene, Belgium
| | - Johan Bilsen
- Department of Public Health, Mental Health and Wellbeing Research Group, Vrije Universiteit Brussel, Laarbeeklaan 103, 1090, Jette, Belgium
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Bensimon M. Perceptions of music therapists regarding their work with children living under continuous war threat: Experiential reframing of trauma through songs. NORDIC JOURNAL OF MUSIC THERAPY 2020. [DOI: 10.1080/08098131.2019.1703210] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Affiliation(s)
- Moshe Bensimon
- Department of Criminology, Bar-Ilan University, Ramat-Gan, Israel
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Tynes BM, Willis HA, Stewart AM, Hamilton MW. Race-Related Traumatic Events Online and Mental Health Among Adolescents of Color. J Adolesc Health 2019; 65:371-377. [PMID: 31196779 DOI: 10.1016/j.jadohealth.2019.03.006] [Citation(s) in RCA: 102] [Impact Index Per Article: 20.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/30/2018] [Revised: 03/14/2019] [Accepted: 03/14/2019] [Indexed: 10/26/2022]
Abstract
PURPOSE Viral videos of the detainment of undocumented immigrants in cages and police killings of unarmed citizens are two of the most pressing traumatic events facing adolescents of color. However, little is known about whether these online experiences are linked to mental health outcomes. This study examines the association between exposure to such events online and mental health in a sample of African American and Latinx adolescents. METHODS Data were collected from a national sample of 302 African American and Latinx adolescents aged 11-19 years. Participants reported their exposure to traumatic events online (TEO), depressive symptoms, post-traumatic stress disorder (PTSD) symptoms, and other sociodemographics. Multiple regression analyses were conducted. RESULTS Analyses indicated a significant association between TEO and both PTSD symptoms and depressive symptoms, indicating that more frequent experiences of TEO were associated with higher levels of PTSD symptoms and depressive symptoms. In addition, regression analyses further indicated that girls reported higher PTSD and depressive symptoms than boys. Latinx participants also reported increased depressive symptoms. CONCLUSIONS This study extends recent research that suggests police killings, as well as viewing distressing news directed at members of one's own racial-ethnic group or those who share the same immigration status, are related to poor mental health outcomes. Researchers should also explore what protective factors may buffer youth against the outcomes typically associated with these events.
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Affiliation(s)
- Brendesha M Tynes
- Center for Empowered Learning and Development with Technology, Rossier School of Education, University of Southern California, Los Angeles, California.
| | - Henry A Willis
- Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Ashley M Stewart
- Center for Empowered Learning and Development with Technology, Rossier School of Education, University of Southern California, Los Angeles, California
| | - Matthew W Hamilton
- Center for Empowered Learning and Development with Technology, Rossier School of Education, University of Southern California, Los Angeles, California
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Parent-Reported Child Reactions to the September 11, 2001 World Trade Center Attacks (New York USA) in Relation to Parent Post-Disaster Psychopathology Three Years After the Event. Prehosp Disaster Med 2018; 33:558-564. [PMID: 30295206 DOI: 10.1017/s1049023x18000869] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
IntroductionParents are a primary support for children following disasters, even though they face numerous challenges in addressing the physical and social consequences of an event. Parents who are directly exposed to a disaster and those who develop psychiatric disorders post-event are likely to be especially challenged and may be limited in their ability to support their children. This Brief Report describes a pilot study of survivors of the September 11, 2001 World Trade Center (New York USA) attacks who reported their own psychosocial consequences and the reactions of their children three years post-event.HypothesesThe primary hypothesis of the study was that children's September 11th reactions would be associated with their parents' psychiatric status. Secondary hypotheses were that the children's disaster reactions would be associated with direct exposure to the disaster in children and/or their parents, parent-child separation due to the disaster, and disaster-related school absence. METHODS Approximately three years after the 2001 World Trade Center attacks, 116 parents recruited from disaster-affected or disaster-related organizations were assessed using structured diagnostic interviews and queried about their children's (188 youths, aged three to 17 years at the time of the attacks) posttraumatic stress symptoms and behavioral changes. RESULTS Almost one-half of the parents had a post-disaster psychiatric disorder, including major depression in 27% and disaster-related posttraumatic stress disorder (PTSD) in 11%. More than three-fourths of the children had at least one disaster-related posttraumatic stress symptom, and more than one-half experienced at least one post-disaster behavior change. A minority of the children were reported to have increased school behavior problems or a decline in their grades. Key correlates of children's disaster-related posttraumatic stress symptoms and post-disaster behavior changes were parent-child separation due to the disaster and parental post-disaster psychiatric disorders. CONCLUSION Because parents provide primary caretaking and support for children post-disaster, addressing the needs of parents is critical to their ability to assist their children. Reducing parents' symptoms should increase their emotional availability and enhance their ability to address the needs of their children. Given the challenges in providing disaster interventions directly to children, especially when resources are limited, addressing parent psychopathology and distress (even in the absence of focusing on children's symptoms) may benefit children. PfefferbaumB, SimicZ, NorthCS. Parent-reported child reactions to the September 11, 2001, World Trade Center attacks (New York USA) in relation to parent post-disaster psychopathology three years after the event. Prehosp Disaster Med. 2018;33(5):558-564.
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Singer MJ, Humphreys KL, Lee SS. Coping Self-Efficacy Mediates the Association Between Child Abuse and ADHD in Adulthood. J Atten Disord 2016. [PMID: 23204062 DOI: 10.1177/1087054712465337] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE To investigate whether individual differences in coping self-efficacy mediated the association of child abuse and symptoms of ADHD in young adults. METHOD Self-reported measures of coping self-efficacy, child abuse, and ADHD were obtained from 66 adults. RESULTS Adults who reported childhood physical or sexual abuse (prior to the age of 17) had significantly higher levels of ADHD than those who did not. Individual differences in coping self-efficacy fully mediated the association between child abuse and ADHD symptoms in adulthood, such that individuals who endorsed child abuse had lower coping self-efficacy, and coping self-efficacy negatively predicted ADHD symptoms. DISCUSSION The findings suggest a potential causal mechanism by which childhood physical and sexual abuse may result in ADHD symptoms later in life. Interventions that improve coping skills may be useful in preventing later ADHD symptoms among adults with a childhood history of physical and sexual abuse.
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Affiliation(s)
| | | | - Steve S Lee
- University of California, Los Angeles, CA, USA
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Shoshani A, Slone M. The Resilience Function of Character Strengths in the Face of War and Protracted Conflict. Front Psychol 2016. [PMID: 26793139 DOI: 10.3389/fpsyg.2015.02006.] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
This study investigated the role of character strengths and virtues in moderating relations between conflict exposure and psychiatric symptoms among 1078 adolescents aged 13-15 living in southern Israel, who were exposed to lengthy periods of war, terrorism and political conflict. Adolescents were assessed for character strengths and virtues, political violence exposure using the Political Life Events (PLE) scale, and psychiatric symptoms using the Brief Symptom Inventory and the UCLA PTSD Index. Results confirmed that political violence exposure was positively correlated with psychiatric symptoms. Interpersonal, temperance and transcendence strengths were negatively associated with psychiatric symptoms. Moderating effects of the interpersonal strengths on the relation between political violence exposure and the psychiatric and PTSD indices were confirmed. The findings extend existing knowledge about the resilience function of character strengths in exposure to protracted conflict and have important practical implications for applying strength-building practices for adolescents who grow up in war-affected environments.
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Affiliation(s)
- Anat Shoshani
- Baruch Ivcher School of Psychology, Interdisciplinary Center Herzliya Herzliya, Israel
| | - Michelle Slone
- School of Psychological Sciences, Tel Aviv University Tel Aviv, Israel
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15
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Shoshani A, Slone M. The Resilience Function of Character Strengths in the Face of War and Protracted Conflict. Front Psychol 2016; 6:2006. [PMID: 26793139 PMCID: PMC4709440 DOI: 10.3389/fpsyg.2015.02006] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2015] [Accepted: 12/16/2015] [Indexed: 11/23/2022] Open
Abstract
This study investigated the role of character strengths and virtues in moderating relations between conflict exposure and psychiatric symptoms among 1078 adolescents aged 13–15 living in southern Israel, who were exposed to lengthy periods of war, terrorism and political conflict. Adolescents were assessed for character strengths and virtues, political violence exposure using the Political Life Events (PLE) scale, and psychiatric symptoms using the Brief Symptom Inventory and the UCLA PTSD Index. Results confirmed that political violence exposure was positively correlated with psychiatric symptoms. Interpersonal, temperance and transcendence strengths were negatively associated with psychiatric symptoms. Moderating effects of the interpersonal strengths on the relation between political violence exposure and the psychiatric and PTSD indices were confirmed. The findings extend existing knowledge about the resilience function of character strengths in exposure to protracted conflict and have important practical implications for applying strength-building practices for adolescents who grow up in war-affected environments.
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Affiliation(s)
- Anat Shoshani
- Baruch Ivcher School of Psychology, Interdisciplinary Center Herzliya Herzliya, Israel
| | - Michelle Slone
- School of Psychological Sciences, Tel Aviv University Tel Aviv, Israel
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16
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Wolmer L, Hamiel D, Versano-Eisman T, Slone M, Margalit N, Laor N. Preschool Israeli Children Exposed to Rocket Attacks: Assessment, Risk, and Resilience. J Trauma Stress 2015; 28:441-7. [PMID: 26401837 DOI: 10.1002/jts.22040] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Preschool children are among the most vulnerable populations to adversity. This study described the effects of 4 weeks of daily exposure to rocket attacks on children living on Israel's southern border. Participants enrolled in this study were 122 preschool children (50% boys) between the ages 3 and 6 years from 10 kindergartens. We assessed mothers' report of children's symptoms according to the DSM-IV and alternative criteria resembling the DSM-5 criteria for posttraumatic stress disorder (PTSD), general adaptation, traumatic exposure, and stressful life events 3 months after the war. The prevalence of PTSD was lower when the diagnosis was derived from the DSM-IV (4%) than from the DSM-5 criteria (14%). Mothers of children with 4 or more stressful life events reported more functional impairment in social, occupational, and other important areas of functioning compared to children with 0 or 1 stressful life event. Children with more severe exposure showed more severe symptoms and mothers had more concerns about the child's functioning (η(p)(2) = .09-.25). Stressful life events and exposure to traumatic experiences accounted for 32% of the variance in PTSD and 19% of the variance in the adaptation scale. Results were explored in terms of risk and resilience factors.
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Affiliation(s)
- Leo Wolmer
- Donald J. Cohen & Irving B. Harris Resilience Center, Israel.,School of Psychology, Interdisciplinary Center (IDC) Herzliya, Israel
| | - Daniel Hamiel
- Donald J. Cohen & Irving B. Harris Resilience Center, Israel.,School of Psychology, Interdisciplinary Center (IDC) Herzliya, Israel.,Tel Aviv-Brull Community Mental Health Center, Tel-Aviv, Israel
| | | | - Michelle Slone
- School of Psychological Sciences, Tel-Aviv University, Israel
| | - Nitzan Margalit
- Donald J. Cohen & Irving B. Harris Resilience Center, Israel
| | - Nathaniel Laor
- Donald J. Cohen & Irving B. Harris Resilience Center, Israel.,Tel Aviv-Brull Community Mental Health Center, Tel-Aviv, Israel.,Sackler Faculty of Medicine, Tel-Aviv University, Israel.,Child Study Center, Yale University, New Haven, Connecticut, USA
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17
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Fossion P, Leys C, Kempenaers C, Braun S, Verbanck P, Linkowski P. Beware of multiple traumas in PTSD assessment: the role of reactivation mechanism in intrusive and hyper-arousal symptoms. Aging Ment Health 2015; 19:258-63. [PMID: 24927132 DOI: 10.1080/13607863.2014.924901] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
OBJECTIVES Post-traumatic stress disorder (PTSD) is a major public health problem defined by three symptom clusters: intrusion thoughts, avoidance mechanisms and hyper-arousal. Several authors have emphasized, that some or all of these symptoms related to a past traumatic experience could be reactivated, even after long asymptomatic periods. This study investigates the role of an additional trauma in the reactivation of a childhood trauma among a group of former hidden children (n = 65), the Jewish youths who spent World War II in various hideaway shelters in Nazi-occupied Europe. They were compared with a control group. METHOD The presence or absence of an additional trauma in adulthood was assessed and PTSD symptoms were measured by using the Impact of Event Scale-Revised. RESULTS An additional trauma reactivates PTSD symptoms of intrusion thoughts and, marginally, symptoms of hyper-arousal. At the opposite, symptoms of avoidance were not reactivated. CONCLUSION Our results confirm the role of an additional trauma in the reactivation of traumatic memories, related to an earlier trauma, in later life. Clinical and theoretical implications are discussed and perspectives are proposed.
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Affiliation(s)
- Pierre Fossion
- a CHU Brugmann , Université Libre de Bruxelles , Brussels , Belgium
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18
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Rousseau C, Jamil U, Bhui K, Boudjarane M. Consequences of 9/11 and the war on terror on children's and young adult's mental health: a systematic review of the past 10 years. Clin Child Psychol Psychiatry 2015; 20:173-93. [PMID: 24068751 DOI: 10.1177/1359104513503354] [Citation(s) in RCA: 50] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
This mixed method systematic review appraises the individual, familial and systemic effect of 9/11 and the war on terror for majority and minority children and youth in North America. The results highlight the broad social consequences of the socio-political transformations associated with the terror context, which cannot be understood only through a trauma focus analysis. The social stereotypes transformed youth experiences of belonging and exclusion. The difference between the consequences for majority and minority youth suggests the need for a broader appraisal of this societal context to support the development of prevention and intervention intersectorial programs.
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Affiliation(s)
| | - Uzma Jamil
- University of South Australia, Australia
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19
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Rousseau C, Moreau N, Dumas MP, Bost I, Lefebvre S, Atlani-Duault L. Public media communications about H1N1, risk perceptions and immunization behaviours: A Quebec-France comparison. PUBLIC UNDERSTANDING OF SCIENCE (BRISTOL, ENGLAND) 2015; 24:225-240. [PMID: 23942830 DOI: 10.1177/0963662513495149] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
During the H1N1 pandemic, governments tailored their communications plans in order to influence risk perception and promote public compliance with the public health plan measures. Considering the volume and the content of calls to flu information centres as indicators of the public risk perception, this mixed method study compares the relation between public communications, risk perception and immunization behaviour in Quebec and France. Results suggest that advocating for clear information and coordination between health authorities and the media promotes adherence to preventive behaviour. However, over-exaggerating the risks and minimizing the population's agency may undermine health authority credibility.
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Affiliation(s)
| | | | | | - Ida Bost
- CNRS Laboratoire d'Ethnologie et de Sociologie comparative, France
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20
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Helping youth immediately following war exposure: a randomized controlled trial of a school-based intervention program. J Prim Prev 2014; 34:293-307. [PMID: 23868708 DOI: 10.1007/s10935-013-0314-3] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
This study evaluates a school-based primary prevention intervention designed to promote adolescents' coping in the immediate aftermath of war exposure in Operation Cast Lead. Participants were 179 adolescents from two demographically similar schools in Ashkelon in south Israel. The intervention incorporated two previously proven resilience factors-mobilization of support and self-efficacy. In a repeated measures design, the study assessed pre- to post-test changes in intervention (n=94) and control (n=85) conditions among adolescents exposed to high or low political life events (PLE). Findings showed significant pre-test differences in self-efficacy and psychological symptoms between participants with low and high PLE. For both PLE groups, the intervention strengthened support mobilization and self-efficacy and reduced psychological distress and emotional symptoms. Findings reinforce the importance of offering appropriate evidence-based interventions for school staff to restore security and well-being to adolescents in a crisis context immediately following war. Despite the apparent return to a school routine after war, school staff should be aware of the risk to youth for development of psychological symptoms and disorders, and the need for preventative intervention.
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21
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Tyrer RA, Fazel M. School and community-based interventions for refugee and asylum seeking children: a systematic review. PLoS One 2014; 9:e89359. [PMID: 24586715 PMCID: PMC3933416 DOI: 10.1371/journal.pone.0089359] [Citation(s) in RCA: 135] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2013] [Accepted: 01/21/2014] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Research for effective psychological interventions for refugee and asylum-seeking children has intensified. The need for interventions in environments more easily accessed by children and families is especially relevant for newly arrived populations. This paper reviews the literature on school and community-based interventions aimed at reducing psychological disorders in refugee and asylum-seeking children. METHODS AND FINDINGS Comprehensive searches were conducted in seven databases and further information was obtained through searching reference lists, grey literature, and contacting experts in the field. Studies were included if they reported on the efficacy of a school or community-based mental health intervention for refugee or asylum-seeking children. Two independent reviewers made the final study selection, extracted data, and reached consensus on study quality. Results were summarized descriptively. The marked heterogeneity of studies excluded conducting a meta-analysis but study effect-sizes were calculated where possible. Twenty one studies met inclusion criteria for the review reporting on interventions for approximately 1800 refugee children. Fourteen studies were carried out in high-income countries in either a school (n = 11) or community (n = 3) setting and seven studies were carried out in refugee camps. Interventions were either primarily focused on the verbal processing of past experiences (n = 9), or on an array of creative art techniques (n = 7) and others used a combination of these interventions (n = 5). While both intervention types reported significant changes in symptomatology, effect sizes ranged from 0.31 to 0.93 and could mainly be calculated for interventions focusing on the verbal processing of past experiences. CONCLUSIONS Only a small number of studies fulfilled inclusion criteria and the majority of these were in the school setting. The findings suggest that interventions delivered within the school setting can be successful in helping children overcome difficulties associated with forced migration.
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Affiliation(s)
- Rebecca A. Tyrer
- Oxford University Department of Psychiatry, Warneford Hospital, Oxford, United Kingdom
| | - Mina Fazel
- Oxford University Department of Psychiatry, Warneford Hospital, Oxford, United Kingdom
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22
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Afectaciones psicológicas de niños y adolescentes expuestos al conflicto armado en una zona rural de Colombia. ACTA COLOMBIANA DE PSICOLOGIA 2014. [DOI: 10.14718/acp.2014.17.1.9] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
Abstract
Se determinaron las afectaciones psicológicas de 284 niños y adolescentes expuestos al conflicto armado en una zona rural colombiana, seleccionados mediante un muestreo aleatorio por afijación proporcional. Los instrumentos aplicados fueron: la Lista de chequeo de comportamiento infantil, el Auto-reporte de comportamientos de jóvenes, la Lista de síntomas postraumáticos, la Escala de estrategias de afrontamiento para adolescentes y la Escala de resiliencia para escolares. El 72% de la población presentó afectaciones psicológicas: el 64.4%, conductas internalizadas, el 47%, conductas externalizadas en rango clínico. El 32%, problemas somáticos; el 56%, se encontraba en riesgo de estrés postraumático, y el 93% consumía alcohol en grado moderado. La estrategia de afrontamiento más utilizada era dejar que las cosas se arreglaran solas. Se encontró una alta necesidad de atención en salud. Ser hombre constituyó un factor de riesgo de depresión, agresión y problemas sociales en los niños. A su vez, tener hasta doce años y estar cursando un grado escolar bajo, lo fue para los síntomas somáticos en adolescentes. Los resultados evidenciaron la afectación en la salud mental de los participantes.
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23
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Sarro EC, Sullivan RM, Barr G. Unpredictable neonatal stress enhances adult anxiety and alters amygdala gene expression related to serotonin and GABA. Neuroscience 2013; 258:147-61. [PMID: 24240029 DOI: 10.1016/j.neuroscience.2013.10.064] [Citation(s) in RCA: 54] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2013] [Revised: 10/21/2013] [Accepted: 10/28/2013] [Indexed: 12/18/2022]
Abstract
Anxiety-related disorders are among the most common psychiatric illnesses, thought to have both genetic and environmental causes. Early-life trauma, such as abuse from a caregiver, can be predictable or unpredictable, each resulting in increased prevalence and severity of a unique set of disorders. In this study, we examined the influence of early unpredictable trauma on both the behavioral expression of adult anxiety and gene expression within the amygdala. Neonatal rats were exposed to unpaired odor-shock conditioning for 5 days, which produces deficits in adult behavior and amygdala dysfunction. In adulthood, we used the Light/Dark box test to measure anxiety-related behaviors, measuring the latency to enter the lit area and quantified urination and defecation. The amygdala was then dissected and a microarray analysis was performed to examine changes in gene expression. Animals that had received early unpredictable trauma displayed significantly longer latencies to enter the lit area and more defecation and urination. The microarray analysis revealed over-represented genes related to learning and memory, synaptic transmission and trans-membrane transport. Gene ontology and pathway analysis identified highly represented disease states related to anxiety phenotypes, including social anxiety, obsessive-compulsive disorders, post-traumatic stress disorder and bipolar disorder. Addiction-related genes were also overrepresented in this analysis. Unpredictable shock during early development increased anxiety-like behaviors in adulthood with concomitant changes in genes related to neurotransmission, resulting in gene expression patterns similar to anxiety-related psychiatric disorders.
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Affiliation(s)
- E C Sarro
- Child Study Center, Center for Early Childhood Health & Development, Child & Adolescent Psychiatry, New York University School of Medicine, New York, NY 10010, United States; Emotional Brain Institute, Nathan Kline Institute, 140 Old Orangeburg Road, Orangeburg, NY 10962, United States.
| | - R M Sullivan
- Child Study Center, Center for Early Childhood Health & Development, Child & Adolescent Psychiatry, New York University School of Medicine, New York, NY 10010, United States; Emotional Brain Institute, Nathan Kline Institute, 140 Old Orangeburg Road, Orangeburg, NY 10962, United States
| | - G Barr
- The Children's Hospital of Philadelphia, Department of Anesthesiology and Critical Care Medicine, Perelman School of Medicine at the University of Pennsylvania, United States
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Conway A, McDonough SC, MacKenzie MJ, Follett C, Sameroff A. Stress-related changes in toddlers and their mothers following the attack of September 11. THE AMERICAN JOURNAL OF ORTHOPSYCHIATRY 2013; 83:536-44. [PMID: 24164525 DOI: 10.1111/ajop.12055] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Unlike other forms of disaster, terrorism is not confined to a particular place or time, and recent evidence indicates that the 9/11 terrorist attack was a significant macrolevel stressor affecting the health and mental health of United States citizens. No studies, however, have reported symptoms in toddlers and their mothers both before and after the attacks. To address this gap, we examined the effects of the 9/11 terrorist attacks on mothers and their 33-month-old toddlers. The attacks occurred during data collection at 33 months of a longitudinal study. Thirty-three-month-old toddlers and mothers who were assessed after the attacks were compared with those assessed before the attacks. When changes were examined from a previous wave of data collected at 15 months, those in the after-attack group showed poorer health, lower child acceptance, and marginally more anxiety, and their toddlers cried more and slept less, whereas the before-attack group showed no changes. Our findings contribute to research documenting widespread effects of the 9/11 terrorist attack on stress-related symptoms and suggest that greater attention must be placed on the needs of our youngest citizens and their caregivers.
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25
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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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26
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Abstract
It has long been recognized that human beings exposed to severe stress may develop psychological symptoms. With recent terrorist acts around the world including the New York City World Trade Center September 11, 2001 atrocity, there has been a growing interest in the specific impact of terrorist acts on the victims and witnesses. One area that has received less study is the specific impact on children. This paper reviews some of the general effects of traumatic stress on children and the history of the research in this area including a specific discussion of post-traumatic stress disorder in children. This is followed by a review of how children might react to the trauma of a terrorist attack differentiating between three different subgroups of children (preschool age children, school-age children, and adolescents). Then there is a review of what a comprehensive evaluation of childhood victims of terrorism should entail. Finally, treatment modalities that have been shown to be effective are reviewed.
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Affiliation(s)
- Ankur Saraiya
- New York University School of Medicine, 200 West 70th Street, Suite 16R, New York, NY 10023, USA
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Elklit A, Nielsen LH, Lasgaard M, Duch C. A Cartoon-Based Measure of PTSD Symptomatology in Children Exposed to a Disaster. JOURNAL OF LOSS & TRAUMA 2013. [DOI: 10.1080/15325024.2012.679125] [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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Nilsson DK, Gustafsson PE, Svedin CG. Polytraumatization and trauma symptoms in adolescent boys and girls: interpersonal and noninterpersonal events and moderating effects of adverse family circumstances. JOURNAL OF INTERPERSONAL VIOLENCE 2012; 27:2645-2664. [PMID: 22366475 DOI: 10.1177/0886260512436386] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
The objective of this study was to investigate the cumulative effect of interpersonal and noninterpersonal traumatic life events (IPEs and nIPEs, respectively) on the mental health of adolescents and to determine if the adverse impacts of trauma were moderated by adverse family circumstances (AFC). Adolescents (mean age 16.7 years) from the normative population (n = 462) completed the questionnaire, the Linköping Youth Life Experience Scale (LYLES), together with Trauma Symptom Checklist for Children (TSCC). The lifetime accumulation of interpersonal, noninterpersonal, and AFC was independently related to trauma-related symptoms in both boys and girls. The number of AFCs moderated the mental health impact of both IPEs and nIPEs in boys but not in girls. Cumulative exposure to both interpersonal and noninterpersonal traumatic events is important for the mental health of adolescents, and, at least for boys, family circumstances seem to be relevant for the impact of trauma. Our results suggest that broader approaches to the study, prevention, and treatment of trauma, including consideration of cumulative exposure, different types of trauma, and additional social risk factors, could be fruitful.
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Priya KR. Trauma Reactions, Suffering, and Healing among Riot-Affected Internally Displaced Children of Gujarat, India: A Qualitative Inquiry. QUALITATIVE RESEARCH IN PSYCHOLOGY 2012. [DOI: 10.1080/14780887.2010.500353] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Tol WA, Patel V, Tomlinson M, Baingana F, Galappatti A, Silove D, Sondorp E, van Ommeren M, Wessells MG, Panter-Brick C. Relevance or excellence? Setting research priorities for mental health and psychosocial support in humanitarian settings. Harv Rev Psychiatry 2012; 20:25-36. [PMID: 22335180 PMCID: PMC3335084 DOI: 10.3109/10673229.2012.649113] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2011] [Revised: 07/18/2011] [Accepted: 07/11/2011] [Indexed: 12/21/2022]
Abstract
BACKGROUND Humanitarian crises are associated with an increase in mental disorders and psychological distress. Despite the emerging consensus on intervention strategies in humanitarian settings, the field of mental health and psychosocial support (MHPSS) in humanitarian settings lacks a consensus-based research agenda. METHODS From August 2009 to February 2010, we contacted policymakers, academic researchers, and humanitarian aid workers, and conducted nine semistructured focus group discussions with 114 participants in three locations (Peru, Uganda, and Nepal), in both the capitals and remote humanitarian settings. Local stakeholders representing a range of academic expertise (psychiatry, psychology, social work, child protection, and medical anthropology) and organizations (governments, universities, nongovernmental organizations, and U.N. agencies) were asked to identify priority questions for MHPSS research in humanitarian settings, and to discuss factors that hamper and facilitate research. RESULTS Thematic analyses of transcripts show that participants broadly agreed on prioritized research themes in the following order: (1) the prevalence and burden of mental health and psychosocial difficulties in humanitarian settings, (2) how MHPSS implementation can be improved, (3) evaluation of specific MHPSS interventions, (4) the determinants of mental health and psychological distress, and (5) improved research methods and processes. Rather than differences in research themes across countries, what emerged was a disconnect between different groups of stakeholders regarding research processes: the perceived lack of translation of research findings into actual policy and programs; misunderstanding of research methods by aid workers; different appreciation of the time needed to conduct research; and disputed universality of research constructs. CONCLUSIONS To advance a collaborative research agenda, actors in this field need to bridge the perceived disconnect between the goals of "relevance" and "excellence." Research needs to be more sensitive to questions and concerns arising from humanitarian interventions, and practitioners need to take research findings into account in designing interventions.
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Affiliation(s)
- Wietse A Tol
- Global Health Initiative, Yale University, New Haven, CT 06520-8206, USA.
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31
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Kramer DN, Landolt MA. Characteristics and efficacy of early psychological interventions in children and adolescents after single trauma: a meta-analysis. Eur J Psychotraumatol 2011; 2:EJPT-2-7858. [PMID: 22893820 PMCID: PMC3402147 DOI: 10.3402/ejpt.v2i0.7858] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2011] [Revised: 10/05/2011] [Accepted: 10/15/2011] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND Single traumatising events are associated with an elevated rate of psychological disorders in children and adolescents. To date, it remains unclear whether early psychological interventions can reduce longer term psychological maladjustment. OBJECTIVE To systematically review the literature to determine the characteristics and efficacy of early psychological interventions in children and adolescents after a single, potentially-traumatising event. DESIGN Systematic searches were conducted of all relevant bibliographic databases. Studies on early psychological interventions were included if the first session was conducted within 1 month of the event. Two independent observers assessed each study for eligibility, using pre-determined inclusion and exclusion criteria, and rated the study's methodological quality. A meta-analysis was conducted on the group effects between individuals allocated to intervention versus control groups. Hence, effect sizes (ES) and confidence intervals were computed as well as heterogeneity and analogue-to-the ANOVA analyses. RESULTS Seven studies (including four randomised controlled trials) met the inclusion criteria. Depending on the specific outcome variable (e.g., dissociation, anxiety and arousal), small to large beneficial ES were noted. Although the meta-analysis revealed unexplained heterogeneity between the ES of the included studies, and although studies varied greatly with regards to their methodological quality and the interventions tested, findings suggest that early interventions should involve psycho-education, provide individual coping-skills and probably involve some kind of trauma exposure. Also, a stepped procedure that includes an initial risk screen and the provision of multiple sessions to those children at risk may be a promising strategy. CONCLUSIONS To date, research on the effectiveness of early interventions in children after a potentially traumatising event remains scarce. However, our review suggests that early interventions may be helpful.
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Affiliation(s)
| | - Markus A. Landolt
- Department of Psychosomatics and Psychiatry and Children's Research Center, University Children's Hospital Zürich, Zürich, Switzerland
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Abstract
Terrorism has dominated the domestic and international landscape since 9/11. Like other fields, psychiatry was not well prepared. With the 10th anniversary of the 9/11 attack approaching, it is timely to consider what can be done to prepare before the next event. Much has been learned to provide knowledge and resources. The roles of psychiatrists are challenged by what is known of the causes of, consequences of, and responses to terrorism. Reflecting on knowledge from before and since 9/11 introduces concepts, how individuals become terrorists, how to evaluate the psychiatric and behavioral effects of terrorism, and how to expand treatments, behavioral health interventions, public policy initiatives, and other responses for its victims. New research, clinical approaches, and policy perspectives inform strategies to reduce fear and cope with the aftermath. This article identifies the psychiatric training, skills and services, and ethical considerations necessary to prevent or reduce terrorism and its tragic consequences and to enhance resilience.
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Haravuori H, Suomalainen L, Berg N, Kiviruusu O, Marttunen M. Effects of media exposure on adolescents traumatized in a school shooting. J Trauma Stress 2011; 24:70-7. [PMID: 21268117 DOI: 10.1002/jts.20605] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
This study analyzes the impact of the media on adolescents traumatized in a school shooting. Participants were trauma-exposed students (n = 231) and comparison students (n = 526), aged 13-19 years. A questionnaire that included the Impact of Event Scale and a 36-item General Health Questionnaire was administered 4 months after the shooting. Being interviewed was associated with higher scores on the Impact of Event Scale (p = .005), but posttraumatic symptoms did not differ between those who refused to be interviewed and those not approached by reporters. Following a higher number of media outlets did not affect symptoms.
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Affiliation(s)
- Henna Haravuori
- Department of Mental Health and Substance Abuse Services, National Institute for Health and Welfare, Helsinki, Finland.
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Tibon S, Rothschild L, Appel L, Zeligman R. Assessing Effects of National Trauma on Adaptive Functioning of Mentally Healthy Adults: An Exploratory Rorschach Study. ACTA ACUST UNITED AC 2011. [DOI: 10.4236/psych.2011.29144] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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36
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Scrimin S, Moscardino U, Capello F, Altoè G, Steinberg AM, Pynoos RS. Trauma reminders and PTSD symptoms in children three years after a terrorist attack in Beslan. Soc Sci Med 2010; 72:694-700. [PMID: 21255892 DOI: 10.1016/j.socscimed.2010.11.030] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2010] [Revised: 10/18/2010] [Accepted: 11/24/2010] [Indexed: 11/19/2022]
Abstract
As a consequence of a terrorist attack, children may experience trauma-related internal and external reminders that are directly linked to their physical and psychological health. We assessed PTSD and trauma reminders in 58 school-age children three years after the terrorist attack in Beslan, Russia in 2004, as well as their association with degree of exposure, psychological distress and coping. Findings revealed a prevalence of situational trauma reminders associated with high levels of distress in more exposed children. The presence of PTSD was predicted by level of exposure to the attack, frequency of exposure to trauma reminders, and support seeking as a coping strategy. Findings are discussed in light of the socio-political climate in Beslan and distress experienced by the population three years after the attack.
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Affiliation(s)
- Sara Scrimin
- Department of Developmental Psychology, University of Padova, Via Venezia 8, 35131 Padova, Italy.
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Chemtob CM, Nomura Y, Rajendran K, Yehuda R, Schwartz D, Abramovitz R. Impact of maternal posttraumatic stress disorder and depression following exposure to the September 11 attacks on preschool children's behavior. Child Dev 2010; 81:1129-41. [PMID: 20636686 DOI: 10.1111/j.1467-8624.2010.01458.x] [Citation(s) in RCA: 83] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
To evaluate whether conjoined maternal posttraumatic stress disorder (PTSD) and depression are associated with increased behavioral problems among terrorism-exposed preschool children (N = 116; 18-54 months), this study compared clinically significant child behavioral problem rates among the preschool children of mothers with PTSD and depression, depression alone, and neither disorder. Behavioral problems were independently rated by mothers and preschool teachers. Maternal depression and PTSD, relative to maternal depression alone, and to neither disorder, were associated with substantially increased child problems. Notably, maternal depression and PTSD were associated with increased emotional reactivity (relative risk [RR] = 5.9 by mother's and 3.4 by teacher's reports) and aggressive behavior problems (RR = 11.0 by mother's and RR = 5.9 by teacher's reports). This was corroborated by teacher ratings. Implications for intervening with terrorism-exposed preschool children are discussed.
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Suomalainen L, Haravuori H, Berg N, Kiviruusu O, Marttunen M. A controlled follow-up study of adolescents exposed to a school shooting--psychological consequences after four months. Eur Psychiatry 2010; 26:490-7. [PMID: 20933371 DOI: 10.1016/j.eurpsy.2010.07.007] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2010] [Revised: 07/01/2010] [Accepted: 07/16/2010] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND In November 2007, a student shot eight people and himself at Jokela High School, Finland. This study aims to evaluate the long-term effects of exposure to a school shooting among adolescents. METHOD Associations between psychological outcomes and background factors were analysed and compared with "comparison students" four months after the incident. A questionnaire including Impact of Event Scale (IES) and General Health Questionnaire (GHQ-36) was used. RESULTS Half of the females and a third of the males suffered from posttraumatic distress. High level of posttraumatic distress (IES≥35), predicting PTSD, was observed in 27% of the females and 7% of the males. The odds ratio was 6.4 (95% confidence interval 3.5-10.5) for having high levels of posttraumatic distress. Severe or extreme exposure and female gender were found to increase the risk. Forty-two percent of the females and 16% of the males had psychiatric disturbance (GHQ≥9). Severe or extreme exposure, older age and female gender increased the risk. Perceived support from family and friends was found to be protective. CONCLUSIONS The observed risk and protective factors were similar to earlier studies. Follow-up will be essential in identifying factors predicting persisting trauma-related symptoms in adolescence.
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Affiliation(s)
- L Suomalainen
- Department of Mental Health and Substance Abuse Services, National Institute for Health and Welfare (MIPO/LAMI), P.O. Box 30, 00271 Helsinki, Finland.
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Wainryb C. Resilience and risk: How teens experience their violent world, and what they learn–and lose–in the process. JOURNAL OF APPLIED DEVELOPMENTAL PSYCHOLOGY 2010. [DOI: 10.1016/j.appdev.2010.05.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Wainryb C, Pasupathi M. Political Violence and Disruptions in the Development of Moral Agency. CHILD DEVELOPMENT PERSPECTIVES 2010. [DOI: 10.1111/j.1750-8606.2009.00117.x] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
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41
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Cohen E, Chazan S, Lerner M, Maimon E. Posttraumatic play in young children exposed to terrorism: An empirical study. Infant Ment Health J 2010; 31:159-181. [DOI: 10.1002/imhj.20250] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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Social support, sense of community, collectivistic values, and depressive symptoms in adolescent survivors of the 2004 Beslan terrorist attack. Soc Sci Med 2010; 70:27-34. [DOI: 10.1016/j.socscimed.2009.09.035] [Citation(s) in RCA: 50] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2009] [Indexed: 11/20/2022]
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Scrimin S, Moscardino U, Capello F, Axia G. Attention and memory in school-age children surviving the terrorist attack in Beslan, Russia. JOURNAL OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY 2009; 38:402-14. [PMID: 19437300 DOI: 10.1080/15374410902851689] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Little is known about the impact of terrorism on children's cognitive functioning and school learning. The primary purpose of this study was to report on cognitive functioning among school-age children 20 months after a terrorist attack against their school. Participants included 203 directly and indirectly exposed children from Beslan and 100 nonexposed children from another town of the Russian Federation. All children were tested using nonverbal neuropsychological measures of attention, memory, and visual-spatial performance. Predisaster traumatic events and terrorism-related exposure factors were evaluated. Findings revealed that overall, directly and indirectly exposed children performed significantly less well than controls in all domains. In addition, direct exposure and loss of a family member were associated with poor memory performance.
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Affiliation(s)
- Sara Scrimin
- Department of Developmental and Social Psychology, University of Padova, Via Venezia 8, Padova 35131, Italy.
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Polytraumatization and psychological symptoms in children and adolescents. Eur Child Adolesc Psychiatry 2009; 18:274-83. [PMID: 19156354 DOI: 10.1007/s00787-008-0728-2] [Citation(s) in RCA: 62] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/05/2008] [Accepted: 09/10/2008] [Indexed: 10/21/2022]
Abstract
Previous research on the impact of traumatic experiences in children and adolescents has focused almost entirely on the effect of single trauma. Research on cumulative traumas has been lacking, but Finkelhor (Child Abuse Negl 31:7-26, 2007) has recently directed the attention to the concept of polyvictimization. As an extension of this concept, this study examined the impact of polytraumatization, operationalized as the number of different potentially traumatic events. The study population comprised two cross-sectional samples of school-aged children (n = 270) and adolescents (n = 400). Information of life-time incidence of traumatic events was collected by the life incidence of traumatic events (LITE), and psychological symptoms by the parent version of the strengths and difficulties questionnaire (SDQ) for the school children and the self-report trauma symptom checklist for children (TSCC) for the adolescents. We found that exposure to at least one traumatic event was common in both the samples (63% of the children and 89.5% of the adolescents). The number of different traumatic events, polytraumatization, was highly predictive of symptoms in both samples, and with a few exceptions surpassed the impact of specific events in exploratory analyses. We furthermore replicated previous findings of the important impact of interpersonal over non-interpersonal events on symptoms in both samples, and found an indication that this effect differed by gender in different manners in the two samples. This study emphasizes the significance of both the quantity of traumatic events, polytraumatization, as well as the quality, interpersonal events.
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Ellis AA, Nixon RDV, Williamson P. The effects of social support and negative appraisals on acute stress symptoms and depression in children and adolescents. BRITISH JOURNAL OF CLINICAL PSYCHOLOGY 2009; 48:347-61. [PMID: 19254448 DOI: 10.1348/014466508x401894] [Citation(s) in RCA: 42] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
OBJECTIVES To investigate the impact of social support on both acute stress symptoms and depression in children and adolescents following a single-incident trauma as well as the potential mediating effects of negative appraisals. DESIGN A cross-sectional concurrent design was used. METHOD Ninety-seven children (aged 7-17 years) and a parent of each were recruited through the emergency department or in-patient ward of two metropolitan hospitals. Negative appraisals, child perception of social support, parent availability to provide social support, prior trauma and psychological difficulties, depression and acute stress symptoms were measured within 4 weeks of trauma. RESULTS Negative appraisals about the trauma were highly correlated with both acute stress and depression symptoms. Social support was negatively correlated with depression symptoms, but not acute stress symptoms. There was a trend for social support to be negatively correlated with negative appraisals. There was no evidence that negative appraisals mediated the social support-symptoms relationships. CONCLUSIONS The findings lend support to recent cognitive and developmental models of the aetiology of post-traumatic stress disorder, and the possible shared cognitive vulnerability between trauma symptoms and depression. Clinically, the results indicate that, appraisals, social support, and depression symptoms should be assessed in addition to trauma symptoms following single-incident traumatic events. The findings also suggest that when depression symptoms are present following trauma exposure, it may be useful to ensure children have adequate social support. Future research should also develop trauma specific measures of social support.
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Affiliation(s)
- Alicia A Ellis
- School of Psychology, Flinders University, Adelaide, Australia
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Slone M, Shoshani A. Efficacy of a school-based primary prevention program for coping with exposure to political violence. INTERNATIONAL JOURNAL OF BEHAVIORAL DEVELOPMENT 2008. [DOI: 10.1177/0165025408090976] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
A paradigm conceptualizing resilience as factors moderating between political violence exposure and psychological distress administered in a 7-year research project yielded a profile of factors promoting Israeli children's coping in conflict conditions. Three factors — social support mobilization, selfefficacy, and meaning attribution — were incorporated into a school-based primary intervention program. In a repeated measures design, the study assessed pre to post-test modifications in the three resilience factors and psychological distress in a primary and control intervention condition and the interaction of actual political violence exposure on distress reduction. Results validated modification only of the mobilization of support factor, but nonetheless confirmed the primary program's efficacy in moderating psychological distress particularly among children with low actual political violence exposure, who showed greater distress increases in the control condition. Findings reinforce the educational system's role in promoting resilience among children in conflict environments.
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Affiliation(s)
- Michelle Slone
- Adler Center for the Study of Development and Psychopathology,
Tel Aviv University, Israel
| | - Anat Shoshani
- Adler Center for the Study of Development and Psychopathology,
Tel Aviv University, Israel,
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KARAM ELIEG, FAYYAD JOHN, NASSER KARAM AIMEE, CORDAHI TABET CAROLINE, MELHEM NADINE, MNEIMNEH ZEINA, DIMASSI HANI. Effectiveness and specificity of a classroom-based group intervention in children and adolescents exposed to war in Lebanon. World Psychiatry 2008; 7:103-9. [PMID: 18560511 PMCID: PMC2430518 DOI: 10.1002/j.2051-5545.2008.tb00170.x] [Citation(s) in RCA: 77] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
Abstract
The purpose of this study was to examine the effectiveness and specificity of a classroom-based psychosocial intervention after war. All students (n=2500) of six villages in Southern Lebanon designated as most heavily exposed to war received a classroom-based intervention delivered by teachers, consisting of cognitive-behavioural and stress inoculation training strategies. A random sample of treated students (n=101) and a matched control group (n=93) were assessed one month post-war and one year later. Mental disorders and psychosocial stressors were assessed using the Diagnostic Interview for Children and Adolescents - Revised with children and parents. War exposure was measured using the War Events Questionnaire. The prevalence of major depressive disorder (MDD), separation anxiety disorder (SAD) and post-traumatic stress disorder (PTSD) was examined pre-war, one month post-war (pre-intervention), and one year post-war. Specificity of treatment was determined by rating teachers' therapy diaries. The rates of disorders peaked one month post-war and decreased over one year. There was no significant effect of the intervention on the rates of MDD, SAD or PTSD. Post-war MDD, SAD and PTSD were associated with pre-war SAD and PTSD, family violence parameters, financial problems and witnessing war events. These findings have significant policy and public health implications, given current practices of delivering universal interventions immediately post-war.
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Affiliation(s)
- ELIE G. KARAM
- Department of Psychiatry and Clinical Psychology, St. George Hospital University Medical Center and Balamand University Medical School, P.O. Box 166378, Beirut-Achrafieh 1100-2807, Lebanon,Institute for Development, Research, Advocacy and Applied Care (IDRAAC), Lebanon
| | - JOHN FAYYAD
- Department of Psychiatry and Clinical Psychology, St. George Hospital University Medical Center and Balamand University Medical School, P.O. Box 166378, Beirut-Achrafieh 1100-2807, Lebanon,Institute for Development, Research, Advocacy and Applied Care (IDRAAC), Lebanon
| | - AIMEE NASSER KARAM
- Department of Psychiatry and Clinical Psychology, St. George Hospital University Medical Center and Balamand University Medical School, P.O. Box 166378, Beirut-Achrafieh 1100-2807, Lebanon,Institute for Development, Research, Advocacy and Applied Care (IDRAAC), Lebanon
| | - CAROLINE CORDAHI TABET
- Department of Psychiatry and Clinical Psychology, St. George Hospital University Medical Center and Balamand University Medical School, P.O. Box 166378, Beirut-Achrafieh 1100-2807, Lebanon,Institute for Development, Research, Advocacy and Applied Care (IDRAAC), Lebanon
| | - NADINE MELHEM
- Institute for Development, Research, Advocacy and Applied Care (IDRAAC), Lebanon,Western Psychiatric Institute and Clinic, University of Pittsburgh, PA, USA
| | - ZEINA MNEIMNEH
- Institute for Development, Research, Advocacy and Applied Care (IDRAAC), Lebanon,Program in Survey Methodology, Institute for Social Research, University of Michigan, Ann Arbor, MI, USA
| | - HANI DIMASSI
- Institute for Development, Research, Advocacy and Applied Care (IDRAAC), Lebanon,School of Nursing, Faculty of Medicine, American University of Beirut, Lebanon
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Becker-Blease KA, Finkelhor D, Turner H. Media exposure predicts children's reactions to crime and terrorism. J Trauma Dissociation 2008; 9:225-48. [PMID: 19042776 DOI: 10.1080/15299730802048652] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
In this study we examined reactions to 3 news events (September 11 terrorist attacks, Summer 2002 kidnappings, and Fall 2002 sniper shootings) in a national, representative sample of children aged 2 to 17. Media exposure was related to increased worry and changes in activities, with September 11 creating the most concern and shootings the least. More signs of stress were apparent among 10- to 13-year-olds, minority children and those of low socioeconomic status, children with prior adversities, and children who lived in close geographical proximity. Girls aged 10 to 17 had more reaction to the kidnappings, suggesting that other features of target similarity may heighten a sense of risk. The results support moderating exposure for both younger and older youth.
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Sadeh A, Hen-Gal S, Tikotzky L. Young children's reactions to war-related stress: a survey and assessment of an innovative intervention. Pediatrics 2008; 121:46-53. [PMID: 18166556 DOI: 10.1542/peds.2007-1348] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE The goal was to assess stress reactions in young children during and after war and the effects of a new brief intervention. METHODS Two separate studies were conducted. In study I, we assessed war exposure and stress reactions of 74 children (2-7 years of age) in a sheltered camp during the second Israel-Lebanon war (July to August 2006). Their exposure to war experiences and their stress reactions were assessed through parental reports during the last week of the war. In addition to standard care, 35 children received a brief intervention (Huggy-Puppy intervention) aimed at encouraging them to care for a needy Huggy-Puppy doll that was given to them as a gift. The effects of the Huggy-Puppy intervention were assessed in a follow-up interview 3 weeks after the war. Study II assessed the efficacy of group administration of the Huggy-Puppy intervention to 191 young children, compared with 101 control subjects. The effects of the intervention on stress-related symptoms after the war were assessed in telephone interviews with the parents. RESULTS Study I indicated that, during the war, most children had significant exposure to war-related experiences and had severe stress reactions. The Huggy-Puppy intervention was associated with significant reductions in stress reactions in the postwar assessment. A higher level of attachment and involvement with the doll was associated with better outcomes. The results of study II indicated that group administration of the Huggy-Puppy intervention was associated with significant reductions in stress reactions. CONCLUSION These studies suggest that the Huggy-Puppy intervention may offer pediatricians and other child health care professionals a promising, cost-effective intervention for children during stressful times.
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Affiliation(s)
- Avi Sadeh
- Adler Center for Research in Child Development and Psychopathology, Department of Psychology, Tel Aviv University, Ramat Aviv 69978, Israel.
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