Adolescents' perspectives on the psychological effects of natural disasters in China and Nepal

Population-level effects of Hurricane Sandy on adolescent health

BACKGROUND

Disasters are increasing in frequency and intensity due to climate change. Youth are the largest and most vulnerable group exposed to disasters. More evidence is needed regarding how youth mental health and health behaviors vary based on disaster exposure, how mental health influences health behaviors, and how diverse groups of youth may be differentially affected.

METHODS

Using data from the Youth Risk Behavior Survey and Federal Emergency Management Agency, we examined the impact of Hurricane Sandy (2012) on mental health (sadness, suicidality) and health behaviors (substance use, physical activity, screen time, sexual behaviors) of 240,365 youth. Difference-in-differences regression analyses evaluated pre-disaster (2005-2011) and post-disaster (2013-2019) changes.

RESULTS

There were 83,442 (34.7 %) adolescents (51.2 % female, 18.1 % non-Hispanic White) located in 6 districts exposed to Hurricane Sandy and 156,923 (65.3 %) adolescents located in 13 non-exposed districts. Exposure was associated with differences in substance use, physical (in)activity, and risky sexual behaviors, but not mental health outcomes. Mental health did not moderate the association between disaster exposure and health behaviors. Hispanic adolescents and those identifying as Other races/ethnicities were most vulnerable to post-disaster negative health outcomes.

LIMITATIONS

Study limitations include questionnaire design, cross-sectional data, sampling, and possible response biases.

CONCLUSIONS

Findings provide critical information about youth mental health and health behaviors following disasters, as well as how youth may differ in their responses. Findings provide guidance for early identification and resource allocation for youth at higher risk for post-disaster health issues.

Experiences of adolescents affected by earthquakes: A qualitative study

PURPOSE

The aim of the study is to explore the experiences of adolescents affected by the earthquake.

DESIGN AND METHODS

This study was carried out in a descriptive phenomenological design, which is a qualitative research method. This research was conducted as a qualitative investigation utilizing a phenomenological approach to explore the experiences of 12 adolescents through the purposeful snowball sampling method. The interviews were conducted with adolescents who affected by the Kahramanmaraş earthquakes in a city located in the west of the country, between March 18, 2023 and June 30, 2023. Semistructured interviews were employed, and the data underwent inductive content analysis. COREQ reporting guidelines were used.

RESULTS

The participants in this study vividly recounted experiencing intense fear and panic during the earthquake. Subsequent challenges emerged from the lack of coordination in aid efforts, struggles to secure shelter and necessities, and the profound loss of relatives. These adversities posed considerable physical and psychological challenges. Notably, the adolescents' ability to reflect on their past lives and reshape their perspectives proved instrumental in facilitating their adaptation to a new life. However, witnessing the demise of loved ones, grappling with the fear of death and loss, and incessantly discussing the earthquake hindered their adjustment.

PRACTICE IMPLICATIONS

We found that adolescents experienced the quakes in three phases: in the moment, postquake, and adaptation to new life. The first theme underscores the limitations of current effectiveness of quake training. This finding has important implications for policy to better prepare the adolescent population for quake disasters. The second theme reveals that the communication and coordination problems experienced after the earthquake enable the weaknesses of the system to be noticed and political steps should be taken in this direction. The third theme focuses on the factors that increase or decrease the psychosocial adaptation of adolescents who have experienced this traumatic experience to the new life. This provides important clues to improve and support adolescent health.

Evaluation of system based psychological first aid training on the mental health proficiency of emergency medical first responders to natural disasters in China: a cluster randomised controlled trial

OBJECTIVE

To evaluate the effectiveness of a system based psychological first aid (PFA) training programme for emergency medical first responders in China.

DESIGN

Parallel-group, assessor-blinded, cluster randomised controlled trial.

SETTING

42 clusters of health workers from various health facilities in China.

PARTICIPANTS

1399 health workers who provide emergency service for survivors of disasters.

INTERVENTIONS

One-day system based PFA training programme (PFA) or training as usual (TAU).

PRIMARY AND SECONDARY OUTCOME MEASURES

The primary outcome was the PFA skills, knowledge and attitude (SKA-PFA) score at 2 months postintervention. Secondary outcomes included post-traumatic growth, self-efficacy and professional quality of life.

RESULTS

The intervention group (n=690) had significantly higher SKA-PFA scores than the control group (n=709) at 2 months postintervention (adjusted mean difference=4.44; 95% CI 1.17 to 7.52; p=0.007; Cohen's d=0.35). The intervention group also had higher scores on post-traumatic growth (p=0.113, d=0.24), self-efficacy (p=0.032, d=0.20) and professional quality of life (p=0.281, d=0.04).

CONCLUSIONS

The system based PFA training programme was more effective than the TAU in enhancing the PFA knowledge and skills of the emergency medical first responders and in increasing their competence to provide emergency service for survivors in China.

TRIAL REGISTRATION NUMBER

ChiCTR2200060464.

Interactions among stress, behavioral inhibition, and delta-beta coupling predict adolescent anxiety during the COVID-19 pandemic

The COVID-19 pandemic brought about unprecedented changes and uncertainty to the daily lives of youth. The range of adjustment in light of a near-universal experience of COVID restrictions highlights the importance of identifying factors that may render some individuals more susceptible to heightened levels of anxiety during stressful life events than others. Two risk factors to consider are temperamental behavioral inhibition (BI) and difficulties in emotion regulation (ER). As such, the current paper focused on BI examined prior to COVID, because of its developmental link to anxiety and ER, as difficulties may be associated with differences in anxiety. We examined a neurocognitive marker of ER processes, delta-beta coupling (DBC). The current paper had two goals: (1) to examine BI in relation to COVID-related worry and social anxiety experienced during the pandemic, and (2) to explore the role of individual differences in early DBC in the relationship between BI and anxiety outcomes 6 months apart during COVID-19 (n = 86; T1 Mage  = 15.95, SD = 1.73; T6 Mage  = 16.43, SD = 1.73). We found support for the moderating role of DBC in the relationship between BI levels and social anxiety disorder (SAD) symptom severity during the pandemic. Here, high BI was predictive of increased SAD symptom levels in adolescents with stronger DBC.

Mineral solubilizing microorganisms and their combination with plants enhance slope stability by regulating soil aggregate structure

Introduction

The stability of exposed slopes is prone to natural disasters, seriously threatening socio-economic and human security. Through years of exploration and research, we proposed an active permanent greening (APG) method based on patented mineral solubilizing microorganisms (MSMs) as an improvement over the traditional greening method.

Methods

In this study, we selected two MSMs (Bacillus thuringiensis and Gongronella butleri) and a plant species (Lolium perenne L.) set up six treatments (T1, T2, T3, T4, T5, and T6) to investigate the effectiveness of the MSMs and their combinations with the plant species on the soil stability using APG method.

Results

We noted that both MSMs and the plant species significantly improved soil aggregate stability and organic matter content. Of all the treatments, the T1 treatment exhibited better results, with soil aggregate stability and organic matter content increased to 45.63% and 137.57%, respectively, compared to the control. Soil stability was significant positively correlated with macroaggregate content and negatively with microaggregates. Using structural equation modeling analysis, we further evaluated the mechanism underpinning the influence of organic matter content and fractions on the content of each graded agglomerates. The analysis showed that the macroaggregate content was influenced by the presence of the plant species, primarily realized by altering the content of organic matter and aromatic and amide compounds in the agglomerates, whereas the microaggregate content was influenced by the addition of MSMs, primarily realized by the content of organic matter and polysaccharide compounds. Overall, we observed that the effect of the co-action of MSMs and the plant species was significantly better than that of using MSMs or the plant species alone.

Discussion

The findings of this study provide reliable data and theoretical support for the development and practical application of the APG method to gradually develop and improve the new greening approach.

Health Issues Among Nepalese Youth: A Literature Review

Nepal is one of the world's least-developed countries. Nepalese children are often vulnerable to a lack of resources which leads to suboptimal levels of health in turn. This review article aims to identify health issues and inequities faced by school-aged children greater than five years old in Nepal. A comprehensive search of the literature was conducted in PubMed and Global Health databases to gather relevant studies. Inclusion and exclusion criteria were applied to select appropriate articles, and 35 full-length articles were reviewed in-depth. The literature supports the association between inadequate resource distribution among Nepalese children and poorer health outcomes compared to youth in developed countries. The key health issues of Nepalese youth identified in the literature consist of diarrheal illness, stunted growth, dental caries, visual impairment, poor mental health, and low health literacy. This review article aims to identify key health issues affecting Nepalese youth as well as propose interventions that can lead to an enhanced quality of life in this population.

"That Was the Happiest Time of My Life": Understanding Childhood Eco-Connections in Appalachian Communities

The goal of this study was to explore facets of childhood eco-connections, using retrospective qualitative data from adults. One hundred and forty-five adults from predominantly rural and small-town communities in southern Appalachia (71.7% female), average age 36.23 years (SD = 12.08) participated in semi-structured qualitative interviews on key life experiences and the places they grew up. Mentions about place-related childhood memories or interactions were grouped into four themes based on exploratory thematic content analysis: nature nostalgia (positive reminiscences about nature experiences); nature immersion (extensive contact with the natural world during childhood); formative experiences with nature (nature interactions that taught a skill or life lesson); and rhythms of nature (appreciation of seasonal or cyclical patterns). Childhood eco-connections are multifaceted and often emerge from early impactful or intense experiences. Pro-environmentalism messages to youth may benefit from more references to childhood eco-connections.

Daily stressors and mental health following disaster: A school-based assessment of adolescent disaster survivors in China and Nepal

Postdisaster daily stressors, the economic and social challenges caused or exacerbated by disasters, have significant consequences for mental health but are rarely investigated in child and adolescent populations. We assessed posttraumatic stress symptoms (PTSS), depression, and anxiety among adolescents affected by disasters in China and Nepal and examined the specific contributions of disaster-related trauma exposure and daily stressors across mental health outcomes. A school-based, cross-sectional study was conducted with a stratified random sampling design. Adolescents living in disaster-affected areas of southern China and Nepal (N = 4,215, 52.7% female, age range: 15-19 years) completed translated, validated measures. Mixed effects logistic regression analyses were conducted using a priori risk factors. PTSS were reported by 22.7% of participants and were higher among Nepali adolescents but did not differ between genders. Depressive symptoms were reported by 45.2% of the sample and were higher among Nepali adolescents and girls in both countries. Across all settings, disaster-related trauma exposure was a significant risk factor for PTSS, depressive, and anxiety symptoms, China: odds ratios (ORs) = 1.44-2.06, Nepal, ORs = 1.21-2.53. High levels of household and interpersonal daily stressors further improved the models and contributed significantly to all mental health difficulties, China: ORs = 1.77-1.98, Nepal: ORs = 1.49-1.90. Postdisaster economic insecurity and interpersonal stressors are thus, likely to worsen adolescent mental health outcomes. Programs that identify and address structural inequalities for adolescents in disaster-affected settings will have cascading effects for mental health.

Cultural Factors in Disaster Response Among Diverse Children and Youth Around the World

PURPOSE OF REVIEW

Disasters and traumatic events are ever present globally but disproportionally impact culturally diverse low resource environments. Culture is an important context through which people experience disasters, develop adaptive strategies, and process external aid and support. This is even more critical for children and youth who are in the process of forming their cultural/ethnic identities. This review identifies literature on these important aspects of culture in disaster response.

RECENT FINDINGS

The literature supports that culture influences the experience of disasters, the development of coping and adaptational approaches, and the acceptability of external aid and support, especially mental health services. Cultural humility, awareness, and sensitivity are crucial in addressing the traumatic impact of disasters in children and youth, especially in the areas of the world that are most at risk for them.

Long term mental health trajectories after disasters and pandemics: A multilingual systematic review of prevalence, risk and protective factors

The patterns of long-term psychological response after disasters and pandemics remain unclear. We aimed to determine the trajectories for post-traumatic stress symptoms (PTSS), depression and anxiety prevalence following disasters and pandemic exposure; and identify associated risk and protective factors. A systematic review of the English, Chinese, and Japanese longitudinal mental health literature was conducted. We searched Cochrane, MEDLINE, ProQuest, PsycINFO, PubMed, Web of Science, and CINAHL (English), CNKI and SINOMED (Chinese) and CiNii (Japanese) for studies published between January 2000 and May 2022. Following a pre-specified protocol (PROSPERO: CRD42020206424), conditional linear growth curve models and ANOVA analyses were conducted. The search identified 77,891 papers, with a final sample of 234: 206 English, 24 Chinese, and 4 Japanese-language papers. PTSS rates improved for all ages (p = .018, eta² = 0.035). In contrast, depression and anxiety prevalence remained elevated for years following exposure (p = .424, eta² = 0.019 and p = .051, eta² = 0.064, respectively), with significantly higher rates for children and adolescents (p < .005, eta² > 0.056). Earthquakes and pandemics were associated with higher prevalence of PTSS (p < .019, eta² > 0.019). Multi-level risk and protective factors were identified. The chronicity of mental health outcomes highlights a critical need for tailored, sustainable mental health services, particularly for children and adolescents, in disaster- and pandemic-affected settings.

Cyclone Idai–related losses and the coping strategies of adolescent survivors in the Odzi community of Manicaland Province, Zimbabwe

Climate change has been identified as one of the leading threats to human health in Southern Africa. Climate change–induced natural disasters often leave behind a trail of destruction characterized by multidimensional losses such as loss of infrastructure, physical health, and psychological health. Adolescents are among the most vulnerable groups during and after a natural disaster. This article presents findings of a research whose aim was to establish cyclone Idai–related losses and postdisaster coping strategies among adolescent survivors. Based on qualitative data collected from 15 participants in the Odzi community of Manicaland Province in Zimbabwe, the article reveals that participants experienced diverse disaster-related losses, such as loss of independence and sense of control over their lives and general life satisfaction. The study notes that the impact of disaster-related losses had a toll on adolescents’ psychological, social, and physical well-being. From the study, it is established that in the aftermath of natural disasters, adolescents adopted two-pronged coping strategies, namely, personal coping strategies that include positive thinking and self-talk, and the utilization of social support such as instrumental and counseling support. This study suggests, among other recommendations, school-based training to equip adolescents with personal coping strategies.

Intersecting Vulnerabilities: The Impacts of COVID-19 on the Psycho-emotional Lives of Young People in Low- and Middle-Income Countries

Across diverse contexts, emerging evidence suggests that the COVID-19 pandemic is increasing levels of anxiety and stress. In calling for greater attention to people's psychosocial and emotional well-being, global actors have paid insufficient attention to the realities of the pandemic in low- and middle-income countries, where millions of people are already exposed to intersecting vulnerabilities. Chronic poverty, protracted violence, conflict and displacement, coupled with weak health, education and protection systems, provide the backdrop of many adolescents' lives. Drawing on qualitative in-country telephone interviews with over 500 adolescents in Ethiopia, Côte d'Ivoire and Lebanon, this article unpacks the age and gendered dimensions of COVID-19 and its response. We conclude by discussing the implications for COVID-19 recovery efforts, arguing that embedding adolescent-centred, inclusive approaches in education, community-based health and social protection responses, has the potential to mitigate the psycho-emotional toll of the pandemic on young people and promote resilience.

Global Mental Health: Interdisciplinary challenges for a field in motion

In recent years, efforts in Global Mental Health (GMH) have evolved alongside critical engagement with the field's claims and interventions. GMH has shifted its agenda and epistemological underpinnings, increased its evidence base, and joined other global policy platforms such as the Sustainable Development Goals. This editorial introduction to a thematic issue traces the recent shifts in the GMH agenda and discusses the changing construct of "mental health" as GMH moves away from a categorical biomedical model toward dimensional and transdiagnostic approaches and embraces digital technologies. We highlight persistent and emerging lines of inquiry and advocate for meaningful interdisciplinary engagement. Taken together, the articles in this special issue of Transcultural Psychiatry provide a snapshot of current interdisciplinary work in GMH that considers the socio-cultural and historical dimensions of mental health important and proposes reflexive development of interventions and implementation strategies.