Impact of conjoined exposure to the World Trade Center attacks and to other traumatic events on the behavioral problems of preschool children.
ABSTRACT To examine the long-term behavioral consequences of exposure to the World Trade Center (WTC) attacks in preschool children and to evaluate whether conjoined exposure to disaster and to other traumatic events has additive effects.
Retrospective cohort study.
Lower Manhattan, New York.
A total of 116 preschool children directly exposed to the WTC attacks. Main Exposures High-intensity WTC attack-related trauma exposure indexed by the child experiencing 1 or more of the following: seeing people jumping out of the towers, seeing dead bodies, seeing injured people, witnessing the towers collapsing, and lifetime history of other trauma exposure. Main Outcome Measure Clinically significant behavioral problems as measured using the Child Behavioral Checklist.
Preschool children exposed to high-intensity WTC attack-related events were at increased risk for the sleep problems and anxious/depressed behavioral symptom clusters. Conjoined exposure to high-intensity WTC attack-related events and to other trauma was associated with clinically significant emotionally reactive, anxious/depressed, and sleep-related behavioral problems. Children without a conjoined lifetime history of other trauma did not differ from nonexposed children. Risk of emotionally reactive, anxious/depressed, and attention problems in preschool children exposed to conjoined high-intensity WTC attack-related events and other trauma increased synergistically.
Conjoined other trauma exposure seems to amplify the impact of high-intensity WTC attack-related events on behavioral problems. Preschool children exposed to high-intensity events who had no other trauma exposure did not have increased clinically significant behavioral problems. The additive effects of trauma exposure are consistent with an allostatic load hypothesis of stress. More vigorous outreach to trauma-exposed preschool children should become a postdisaster public health priority.
SourceAvailable from: Masahide Usami[Show abstract] [Hide abstract]
ABSTRACT: Background: The 2011 Japan massive tsunami traumatized many children. The aim of this study was to assess changes in strengths and difficulties experienced in home and school by among surviving children after the 2011 tsunami, in comparison with published normal Japanese data. Methods: In November 2012 (20 months after the disaster) and September 2013 (30 months after the disaster), the Strengths and Difficulties Questionnaire (SDQ), a questionnaire on children's strengths and difficulties in home and school activities, were distributed to 12,193 and 11,819 children, respectively. An effective response of children 20 months and 30 month after the disaster was obtained in 10,597 children (86.9%), and 10,812 children (91.4%), respectively. The SDQ scores evaluated by parents and teachers were compared with published normal Japanese SDQ scores. Results: The SDQ scores (emotional problems, conduct problems, hyperactivity/ inattention, peer relationship problems, and total difficulty score) evaluated by parents of children in the 4th to 9th grade who were evaluated after 30 and 20 months were significantly high compared with the published normal data of children without traumatic experiences (all P,0.001). The SDQ scores (prosocial behavior) evaluated by teachers of children in the 4th to 9th grade who were evaluated after 30 and 20 months were significantly low compared with the published normal data of children without traumatic experiences (all P,0.001).PLoS ONE 11/2014; 9(11). DOI:10.1371/journal.pone.0113709 · 3.53 Impact Factor
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ABSTRACT: Background On March 11, 2011, a massive undersea earthquake and tsunami struck East Japan. Few studies have investigated the impact of exposure to a natural disaster on preschool children. We investigated the association of trauma experiences during the Great East Japan Earthquake on clinically significant behavior problems among preschool children 2 years after the earthquake. Method Participants were children who were exposed to the 2011 disaster at preschool age (affected area, n = 178; unaffected area, n = 82). Data were collected from September 2012 to June 2013 (around 2 years after the earthquake), thus participants were aged 5 to 8 years when assessed. Severe trauma exposures related to the earthquake (e.g., loss of family members) were assessed by interview, and trauma events in the physical environment related to the earthquake (e.g. housing damage), and other trauma exposure before the earthquake, were assessed by questionnaire. Behavior problems were assessed by caregivers using the Child Behavior Checklist (CBCL), which encompasses internalizing, externalizing, and total problems. Children who exceeded clinical cut-off of the CBCL were defined as having clinically significant behavior problems. Results Rates of internalizing, externalizing, and total problems in the affected area were 27.7%, 21.2%, and 25.9%, respectively. The rate ratio suggests that children who lost distant relatives or friends were 2.36 times more likely to have internalizing behavior problems (47.6% vs. 20.2%, 95% CI: 1.10–5.07). Other trauma experiences before the earthquake also showed significant positive association with internalizing, externalizing, and total behavior problems, which were not observed in the unaffected area. Conclusions One in four children still had behavior problems even 2 years after the Great East Japan Earthquake. Children who had other trauma experiences before the earthquake were more likely to have behavior problems. These data will be useful for developing future interventions in child mental health after a natural disaster.PLoS ONE 10/2014; 9(10):e109342. DOI:10.1371/journal.pone.0109342 · 3.53 Impact Factor
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ABSTRACT: The Project for Mothers, Infants, and Young Children of September 11, 2001, is described in this issue. This group of articles represents 10 years of involvement of a group of eight core therapists, working originally with approximately 40 families who suffered the loss of husbands and fathers on September 11, 2001. We focused our efforts on the families of women who were pregnant and widowed in the disaster, or of women who were widowed with an infant born in the previous year. These therapists are Beatrice Beebe, Phyllis Cohen, Anni Bergman, Sally Moskowitz, K. Mark Sossin, Rita Reiswig, Suzi Tortora, and Donna Demetri Friedman. This highly trained group of therapists specializes in adult, child, mother-infant, and family treatment, as well as in nonverbal communication. Two of Dr. Beebe's former students, Dr. Sara Markese and Adrianne Lange, were intimately involved in running the Project and contributed two key articles. We also invited Dr. Andrea Remez to co-author and Dr. Susan Coates to discuss one of the mother-child treatments, and we invited Dr. Marsha Kaitz of Hebrew University, Israel to discuss the project. The demands of the crisis led us to expand our psychoanalytic training, fostering new approaches to meeting the needs of these families. We sought out these families, offering support groups for mothers and their infants and young children in the mothers' own neighborhoods, and bringing the families to mother-child filming sessions at Columbia University, New York State Psychiatric Institute, courtesy of Dr. Joseph Jaffe. In 2011, marking the 10th anniversary of the World Trade Center tragedy, our Project continues to provide free services for these mothers who lost their husbands, for their infants who are now approximately 10 years old, and for the siblings of these children.Journal of Infant Child and Adolescent Psychotherapy 04/2011; 10(2-3):145-155. DOI:10.1080/15289168.2011.599716