Serious Emotional Disturbance Among Youths Exposed to Hurricane Katrina 2 Years Postdisaster

Harvard Medical School, 180 Longwood Avenue, Cambridge, MA 02115, USA.
Journal of the American Academy of Child and Adolescent Psychiatry (Impact Factor: 7.26). 09/2009; 48(11):1069-78. DOI: 10.1097/CHI.0b013e3181b76697
Source: PubMed


To estimate the prevalence of serious emotional disturbance (SED) among children and adolescents exposed to Hurricane Katrina along with the associations of SED with hurricane-related stressors, sociodemographics, and family factors 18 to 27 months after the hurricane.
A probability sample of prehurricane residents of areas affected by Hurricane Katrina was administered a telephone survey. Respondents provided information on up to two of their children (n = 797) aged 4 to 17 years. The survey assessed hurricane-related stressors and lifetime history of psychopathology in respondents, screened for 12-month SED in respondents' children using the Strengths and Difficulties Questionnaire, and determined whether children's emotional and behavioral problems were attributable to Hurricane Katrina.
The estimated prevalence of SED was 14.9%, and 9.3% of the youths were estimated to have SED that is directly attributable to Hurricane Katrina. Stress exposure was associated strongly with SED, and 20.3% of the youths with high stress exposure had hurricane-attributable SED. Death of a loved one had the strongest association with SED among prehurricane residents of New Orleans, whereas exposure to physical adversity had the strongest association in the remainder of the sample. Among children with stress exposure, parental psychopathology and poverty were associated with SED.
The prevalence of SED among youths exposed to Hurricane Katrina remains high 18 to 27 months after the storm, suggesting a substantial need for mental health treatment resources in the hurricane-affected areas. The youths who were exposed to hurricane-related stressors, have a family history of psychopathology, and have lower family incomes are at greatest risk for long-term psychiatric impairment.

Download full-text


Available from: John Fairbank, Oct 08, 2015
1 Follower
20 Reads
  • Source
    • "Further, existing research varies in the measures used, sample demographics, and the amount of time between the disaster and data collection. From a general psychopathology perspective, 9.3% of 4–17-year-old children were described as experiencing a “serious emotional disturbance” 18–27 months after Hurricane Katrina (McLaughlin et al., 2009). This is consistent with large sample cross-sectional research following a range of different disasters that has reported approximately 5–15% of children experience significant mental health symptoms following disaster exposure (McDermott & Palmer, 1999; Roussos et al., 2005; Shaw, Applegate, & Schorr, 1996; Thienkrua, Cardozo, Chakkraband, Guadamuz, & Thailand Post-Tsunami Mental Health Study Group, 2006; Vernberg, Silverman, La Greca, & Prinstein, 1996). "
    [Show abstract] [Hide abstract]
    ABSTRACT: BackgroundFrom a global perspective, natural disasters are common events. Published research highlights that a significant minority of exposed children and adolescents develop disaster-related mental health syndromes and associated functional impairment. Consistent with the considerable unmet need of children and adolescents with regard to psychopathology, there is strong evidence that many children and adolescents with post-disaster mental health presentations are not receiving adequate interventions.ObjectiveTo critique existing child and adolescent mental health services (CAMHS) models of care and the capacity of such models to deal with any post-disaster surge in clinical demand. Further, to detail an innovative service response; a child and adolescent stepped-care service provision model.MethodA narrative review of traditional CAMHS is presented. Important elements of a disaster response – individual versus community recovery, public health approaches, capacity for promotion and prevention and service reach are discussed and compared with the CAMHS approach.ResultsDifficulties with traditional models of care are highlighted across all levels of intervention; from the ability to provide preventative initiatives to the capacity to provide intense specialised posttraumatic stress disorder interventions. In response, our over-arching stepped-care model is advocated. The general response is discussed and details of the three tiers of the model are provided: Tier 1 communication strategy, Tier 2 parent effectiveness and teacher training, and Tier 3 screening linked to trauma-focused cognitive behavioural therapy.ConclusionIn this paper, we argue that traditional CAMHS are not an appropriate model of care to meet the clinical needs of this group in the post-disaster setting. We conclude with suggestions how improved post-disaster child and adolescent mental health outcomes can be achieved by applying an innovative service approach.
    European Journal of Psychotraumatology 07/2014; 5. DOI:10.3402/ejpt.v5.24294 · 2.40 Impact Factor
  • Source
    • "Hurricanes are among the costliest of WDs [Table 3]. Prior to Hurricane Katrina (preliminary cost, $100 billion), Hurricane Andrew was the most expensive disaster event in the United States ($35.6 billion).[1317] A recent menace along the eastern coast of the U.S., Hurricane Sandy, in 2012, was the largest reported hurricane arising in the Atlantic and was estimated to result in a cost of $60 billion, including $20 billion in property damages and with at least 110 fatalities.[18] "
    [Show abstract] [Hide abstract]
    ABSTRACT: Wind disasters are responsible for tremendous physical destruction, injury, loss of life and economic damage. In this review, we discuss disaster preparedness and effective medical response to wind disasters. The epidemiology of disease and injury patterns observed in the early and late phases of wind disasters are reviewed. The authors highlight the importance of advance planning and adequate preparation as well as prompt and well-organized response to potential damage involving healthcare infrastructure and the associated consequences to the medical response system. Ways to minimize both the extent of infrastructure damage and its effects on the healthcare system are discussed, focusing on lessons learned from recent major wind disasters around the globe. Finally, aspects of healthcare delivery in disaster zones are reviewed.
    04/2013; 3(2):130-42. DOI:10.4103/2229-5151.114273
  • Source
    • "Identification of factors that distinguish children who present serious symptoms from those who experience rather mild problems seems to be of great importance for developing post-disaster interventions. Female sex, younger age, and parent psychopathology have been also identified as predictors of more serious symptoms in children and adolescents after natural disasters (McLaughlin et al., 2009; Pynoos et al., 1993; Shannon et al., 1994). These symptoms may last for several months or years, interfering with children's and adolescents' growth and development. "
    [Show abstract] [Hide abstract]
    ABSTRACT: Aim: To evaluate the prevalence of symptoms of posttraumatic stress disorder (PTSD), depression and anxiety among children and adolescents exposed to the 2007 fire disaster in Greece along with the relationships of these symptoms with disaster-related stressors and sociodemographic characteristics four months after the fire. Methodology: A sample of 343 youths aged 9-18 years from schools in an area severely affected by the fire completed self-reported questionnaires. The Children's Post-Traumatic Stress Disorder-Reaction Index-Revised (CPTSD-RI-R), the Children's Depression Inventory (CDI) and the Screen for Child Anxiety Related Emotional Disorders (SCARED) were used to assess relative symptoms, while fire-related stressors were also examined in respondents. Results: The estimated prevalence rates of high levels of PTSD, depressive and anxiety symptoms four months after the disaster were approximately 45%, 34% and 32%, respectively. Staying without both parents after the fire was strongly associated with more PTSD symptoms, while housing adversity and loss of property were most strongly associated with elevated depressive symptoms. Life-threatening experience of a loved one and worry for a loved one predicted higher levels of PTSD symptomatology, whereas injury of a loved one was associated with high levels of depressive and anxiety Research Article British Journal of Medicine & Medical Research, 1(4): 320-332, 2011 321 symptoms. Conclusion: A significant proportion of children and adolescents exposed to 2007 Greek forest fires experienced mental health problems four months after the fire. Different types of stressors were associated with PTSD, depressive and anxiety symptoms. These findings highlight the importance of preventive and treatment mental health services in the aftermath of similar disasters.
Show more