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Publications (318)
Purpose of Review
The goals of this analysis were to identify practice elements frequently used in child mass trauma interventions and to determine if these elements differed across interventions with respect to type of event addressed.
Recent Findings
The most frequent elements used were psychoeducation for the child, affect modulation, relaxatio...
Introduction
Terrorism and trauma survivors often experience changes in biomarkers of autonomic, inflammatory and hypothalamic-pituitary-adrenal (HPA) axis assessed at various times. Research suggests interactions of these systems in chronic stress.
Study Objective
This unprecedented retrospective study explores long-term stress biomarkers in thre...
Purpose of Review
The purpose of the current review was to detail changes in children’s diet, eating behavior, and weight in the context of the COVID-19 pandemic.
Recent Findings
Global changes in children’s diets and eating behavior occurred during the pandemic. Both undernutrition and obesity were prominent concerns. Obese children and those fro...
The COVID-19 pandemic has shown that all emergencies, major incidents and disease outbreaks can have substantial mental health consequences, and it has demonstrated the proven need for additional care for populations in the wake of disasters. This book brings together practice and recent developments in pre-hospital emergency care, emergency medici...
Purpose of Review
The COVID-19 pandemic and protracted home confinement required adjustments to schedules and routines generating concern about children’s sleep. This review describes general considerations regarding children’s sleep, changes and disturbances in their sleep during the pandemic, and the association of sleep measures with health and...
Purpose of Review
This review examines the challenges faced by parents in the context of the COVID-19 pandemic, their emotional reactions, and risk and protective factors in their adjustment. Clinical and policy implications are discussed, and recommendations for future study are offered.
Recent Findings
The literature reveals numerous stresses ex...
Purpose of Review
This paper examines children’s physical activity and sedentary behavior and associated psychological outcomes coincident with the COVID-19 pandemic.
Recent Findings
Generally, the research has found decreased physical activity and increased sedentary behavior, both of which are associated with various psychological outcomes. The...
Aims:
This study aimed to establish a cross-cultural adaptation of the Communities Advancing Resilience Toolkit (CART) assessment survey for Korean communities (K-CART) and evaluated its psychometric properties of K-CART.
Design:
A cross-sectional study design was used.
Methods:
A forward and backward translation of the CART was conducted. The...
Disaster mental health (MH) research has documented substantial MH consequences warranting targeted interventions. Little research has been conducted on MH assistance for employees in the postdisaster workplace. Conducted about 3 years after the September 11, 2001 (9/11), terrorist attacks, this study examined the services provided to and used by a...
Abstract Background Earthquakes are global natural disasters and can cause loss of property, livelihood and affect human health. A 5.4 magnitude earthquake, the Pohang earthquake, occurred in South Korea in 2017. In this study, based on a health-related quality of life (HRQOL) conceptual model, we examined the HRQOL and its associated factors among...
Purpose of Review
This paper reports a review of the empirical research examining the association between mass trauma media contact and depression in children, the factors that may influence the association, and the difficulties encountered in the study of media effects on depression.
Recent Findings
All of the included studies assessed general po...
With its global spread and protracted threat, mounting morbidity and mortality, pervasive social and economic ramifications, vital public health measures, and often compromised risk communication, the COVID-19 pandemic has increased the risk to children's emotional health relative to more common biological, natural, and man-made events. Posttraumat...
Purpose of Review
This paper reviews the literature on the psychological effects of the COVID-19 pandemic on children and the reactions of vulnerable children.
Recent Findings
Research reveals increases in clinically significant depression, suicidal ideation and behavior, and some anxiety symptoms. Substance use studies suggest an inadvertent decr...
Purpose of Review
The closure of schools during the COVID-19 pandemic has interrupted the education of children worldwide. This paper reviews the psychological effects of this action on children and the impact on school-based services.
Recent Findings
Emerging epidemiologic findings have generated an intense debate about the need for, and potentia...
Objective: The mental health effects of major terrorist attacks on diplomatic government personnel have not been well studied. This study examined the psychiatric and psychosocial effects of the 1998 terrorist bombing of the US Embassy in Nairobi, Kenya, on US government personnel exposed to the bombing. Method: At 8-10 months after the bombing, 17...
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...
Research has examined the association between contact with media coverage of mass trauma events and various psychological outcomes, including depression. Disaster-related depression research is complicated by the relatively high prevalence of the major depressive disorder in general populations even without trauma exposure. The extant research is i...
Over the last 20 years, numerous interventions have been developed and evaluated for use with children exposed to mass trauma with six publications reporting meta-analyses of randomized controlled trials of child mass trauma interventions using inactive controls to examine intervention effects on posttraumatic stress, depression, anxiety, and funct...
Background:
This study assesses long-term physical and emotional symptoms and unmet needs in direct survivors of the 1995 Oklahoma City terrorist bombing 18 ½ years after the event.
Methods:
A telephone questionnaire assessed psychiatric symptoms, health problems and coping strategies in 138 terrorism survivors (of whom 80% were physically injur...
Background
Meta-analyses have documented a small positive association of mass trauma media consumption with posttraumatic stress outcomes but have not examined the association of media contact with depression or anxiety.
Methods
From an initial search of 2194 papers, 157 were identified for review leading to a meta-analysis of 20 studies on depres...
Background:
Disaster studies establishing an association between parent and child disaster reactions usually discuss results in terms of the influence of parents on their children. This study explores a complementary interpretation of this association by focusing on the potential influence of children on their parents.
Methods:
Investigations of...
Objective:
The objective of this study was to examine associations between media contact and posttraumatic stress in a sample with a large number of individuals who were directly exposed to the September 11, 2001 (9/11) attacks and to compare outcomes in exposed and unexposed participants.
Methods:
Structured interviews and questionnaires were a...
This article explores the extant literature on outcomes of mass trauma in children as well as factors that predict risk and interventions used to enhance resilience and promote recovery. Many children display acute stress reactions after a mass trauma and some will develop chronic symptoms, but most will recover or demonstrate resilience. Children'...
Purpose of review:
This paper reviews research on the effects of contact with war media coverage on psychological outcomes in children.
Recent findings:
Children's contact with media coverage of war is pervasive and is associated with numerous outcomes and with their parents' reactions. Younger children are more affected by news stories with vis...
Purpose of review:
This paper traces advances in our knowledge about children's exposure and reactions to terrorist events over the last 25 years, beginning with the 1995 Oklahoma City bombing, and offers observations about cross-cutting issues including implications for services.
Recent findings:
Direct and indirect interpersonal exposures have...
This study examined the benefit of psychosocial interventions on functional impairment in youth exposed to mass trauma. A random effects meta-analysis was used to estimate the overall effect in 15 intervention trials identified through a literature review. The moderator analysis examined how the effect of intervention differed across types of popul...
Objective
Survivors of natural disasters are at risk for mental health sequela, including deficits in neurocognitive functioning. This study explores links between hurricane exposure and resulting psychiatric symptoms and deficits in cognitive processing, attention, learning, and memory.
Methods
Relocated Katrina survivors and demographically matc...
Background:
The increase in terrorism worldwide has stimulated research on directly and indirectly exposed survivors, but there have been few investigations of the children of highly exposed survivors. This study examined the relationship between parental psychopathology and outcomes in their children who were exposed indirectly to a terrorist inc...
Numerous interventions to address posttraumatic stress (PTS) in youth exposed to mass trauma have been delivered and evaluated. It remains unclear, however, which interventions work for whom and under what conditions. This report describes a meta-analysis of the effect of youth mass-trauma interventions on PTS to determine if interventions were sup...
Background
Meta-analyses of youth mass trauma intervention studies have focused primarily on posttraumatic stress even though depression and anxiety are common maladaptive outcomes that require intervention.
Objective
This meta-analysis examined youth mass trauma intervention effects on depression and anxiety relative to natural recovery and chara...
Purpose of Review
This paper reviews the extant research on the effects of contact with terrorism media coverage on psychological outcomes in youth in the context of chronic threat and conflict in Israel.
Recent Findings
The extant research is inconclusive with respect to the relationship between media contact and a variety of psychological outcom...
This study presents the findings of meta-analyses examining the association between viewing mass trauma television coverage and posttraumatic stress (PTS) outcomes as well as acute stress reactions (ASR) among adults and youth. A literature search identified 43 (N = 31,162) studies assessing the association between viewing mass trauma television co...
Background: Millions of children are affected by disasters every year. Children need not be passive victims, however, but instead may contribute to disaster risk reduction activities.
Objective: This paper provides a theoretical foundation for children’s involvement in disaster risk reduction activities.
Method: The paper reviews and analyses the l...
Introduction
Parents 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 thei...
Objective:
Inflammatory and immunologic cytokines and vagal activity have important roles in health and mental health, and may influence each other. The authors assessed relationships of representative biomarkers linked to disaster exposure-heart rate variability (HRV) with Interleukin-2 (IL-2, cell-medicated immunity) and Interleukin-6 (IL-6, pro...
Purpose of review:
This review examines factors thought to be associated with posttraumatic growth (PTG) (demographic variables, exposure, and family and social processes) among youth exposed to natural disasters, describes the relationship between PTG and posttraumatic stress, and discusses psychological processes (rumination and coping) linked t...
Little is known about whether, compared to terrorism survivors who relocated to another area, better long-term outcome occurs in terrorism survivors who remain in the community, which may offer social support and formal services as well as ongoing trauma reminders and adversities. A cross-sectional telephone survey of OKC bombing survivors 19 years...
Purpose of review:
This paper reviews the evidence on the relationship between contact with media coverage of terrorist incidents and psychological outcomes in children and adolescents while tracing the evolution in research methodology.
Recent findings:
Studies of recent events in the USA have moved from correlational cross-sectional studies ex...
Child disaster mental health research has been largely limited by investigation of one disaster at a time and inconsistent methods across different studies. This study assessed 160 survivors of 3 disasters with structured diagnostic interviews, asking about the behavioral and emotional disaster reactions their 266 children of ages 3-17. Most childr...
There is compelling evidence of the potential negative effects of disasters on children’s adjustment and functioning. Although there is an increasing base of evidence supporting the effectiveness of some interventions for trauma following disaster, more research is needed, particularly on interventions that can be delivered in the early aftermath o...
Background
The need to establish an evidence base for early child disaster interventions has been long recognized. Objective
This paper presents a descriptive analysis of the empirical research on early disaster mental health interventions delivered to children within the first 3 months post event. Methods
Characteristics and findings of the includ...
Objectives
Despite the frequency of disasters in Africa, almost nothing is known about ethnic affiliations in relation to psychopathology after such incidents. This study examined the mental health outcomes of members of 7 major ethnic groups exposed to the 1998 terrorist bombing of the US Embassy in Nairobi, Kenya.
Methods
Approximately 8 to 10 m...
Background:
Cytokines are of increasing interest as markers for stress responses, mental disorders and general health. We assessed associations of two cytokines with several factors among relocated hurricane survivors and controls.
Methods:
We examined 40 relocated hurricane survivors and 40 demographically matched (frequency matching) Oklahoma...
Helping children, adolescents, and families displaced following a natural disaster is a daunting task made more challenging by the relatively small research base to inform services and interventions. This paper describes the current literature pertaining to intervention practices used with displaced youth. Where gaps in the literature exist, we pul...
Mass shootings are complex and confusing situations that pose many methodological challenges for researchers who aim to promote knowledge that may help future impacted communities. This chapter examines ethical issues that are pertinent to research in the aftermath of mass shootings and relevant findings from research on trauma-affected populations...
Objective:
The purpose of this pilot study was to evaluate the Resilience and Coping Intervention (RCI) with college students.
Participants:
College students (aged 18-23) from a large Midwest US university who volunteered for a randomized controlled trial during the 2015 spring semester.
Methods:
College students were randomly assigned to an i...
The literature on children’s responses to disasters is well developed with increasing attention to the confounding experiences of displacement. This paper presents an overview of the emotional and behavioral effects of displacement on children and adolescents and describes their educational adjustment in terms of both academic achievement and schoo...
Opinion statement
The field of child disaster mental health has seen remarkable growth over the last several decades, and awareness of the needs of children in the context of disasters has translated into the creation and evaluation of multiple interventions. The sheer volume of intervention studies and the systematic attention to examining the evi...
This article describes an application of the Communities Advancing Resilience Toolkit (CART) Assessment Survey which has been recognized as an important community tool to assist communities in their resilience-building efforts. Developed to assist communities in assessing their resilience to disasters and other adversities, the CART survey can be u...
As societies become more complex and interconnected, the global risk for catastrophic disasters is increasing. Demand for expertise to mitigate the human suffering and damage these events cause is also high. A new field of disaster medicine is emerging, offering innovative approaches to optimize disaster management. Much of the information needed t...
A growing literature has begun to address the cognitions that influence children's disaster reactions as well as the effects of disasters on children's cognitions. These cognitions must be viewed in the context of developmental and cultural considerations as well as disaster-related factors such as exposure and secondary stressors. This review exam...
Evidence-based practice requires the use of data grounded in theory with clear conceptualization and reliable and valid measurement. Unfortunately, developing a knowledge base regarding children’s coping in the context of disasters, terrorism, and war has been hampered by a lack of theoretical consensus and a virtual absence of rigorous test constr...
Background:
To examine the prevalence of psychopathology in 52 male rescue workers responding to the 1998 U.S. Embassy bombing in Nairobi, Kenya, comparing them with 176 male rescue workers responding to the 1995 Oklahoma City, Oklahoma, bombing and with 105 directly exposed male civilian survivors of the Nairobi bombing.
Methods:
The Diagnostic...
In this study, we explore directly exposed terrorism survivors' mental health and health status, healthcare utilization, alcohol and tobacco use, and posttraumatic growth 18½ years postdisaster. Telephone surveys compared terrorism survivors and nonexposed community control subjects, using Hopkins Symptom Checklist, Breslau's PTSD screen, Posttraum...
Several decades of research have informed our knowledge of children’s reactions to disasters and the factors that influence their reactions. This article describes the system of care for child disaster mental health services using population risk to determine needed services and a stepped care approach built on assessment and monitoring to advance...
Introduction. On May 22, 2011 the deadliest tornado in the United States since 1947 struck Joplin, Missouri killing 161 people, injuring approximately 1,150 individuals, and causing approximately $2.8 billion in economic losses.
Methods. This study examined the mental health effects of this event through a random digit dialing sample (N = 380) of J...
Community resilience has been recognized and promoted as both a vision and a strategy for disaster management. This paper establishes the importance of community resilience in disaster management, describes disaster management phases and the disaster system of care, reviews definitions and dimensions of community resilience and related foundational...
Abstract
Background
The hypothalamic–pituitary–adrenal (HPA) axis constitutes an important biological component of the stress response commonly studied through the measurement of cortisol. Limited research has examined HPA axis dysregulation in youth exposed to disasters.
Objective
This study examined HPA axis activation in adolescent Hurricane Kat...
This study evaluated the Resilience and Coping Intervention for Children (RCI), a group intervention to increase coping skills and resilience in children and adolescents. RCI was delivered to children and adolescents residing in five at-risk neighborhoods in a southern U.S. city. Children's and adolescent's self-report of coping strategies, strengt...
This paper reviews children's reactions to disasters and the personal and situational factors that influence their reactions. Posttraumatic stress disorder (PTSD) and posttraumatic stress reactions are the most commonly studied outcomes, though other conditions also occur including anxiety, depression, behavior problems, and substance use. More rec...
This review examines family (demographics, parent reactions and interactions, and parenting style) and social (remote effects, disaster media coverage, exposure to secondary adversities, and social support) factors that influence children's disaster reactions. Lower family socioeconomic status, high parental stress, poor parental coping, contact wi...
The debate over the use of psychological debriefing in the early aftermath of a traumatic event has raged for decades, yet little attention has been paid to its use with perhaps the most vulnerable of victims, children and adolescents. While recommendations against the use of group debriefing with adults seem to have been made based on research of...
Introduction Debriefing, a controversial crisis intervention delivered in the early aftermath of a disaster, has not been well evaluated for use with children and adolescents. This report constitutes a review of the child debriefing evidence base.
A systematic search of selected bibliographic databases (EBM Reviews, EMBASE, ERIC, Medline, Ovid, PIL...
Studies of survivors of the September 11, 2001 attacks on the World Trade Center in New York City suggest that postdisaster depressive disorders may be at least as prevalent, or even more prevalent, than posttraumatic stress disorder (PTSD), unlike findings from most other disaster studies. The relative prevalence and incidence of major depressive...
This article describes an application of the Communities Advancing Resilience Toolkit Assessment Survey using a sample of affiliated volunteer responders. The Communities Advancing Resilience Toolkit Assessment Survey is a theory-based, evidence-informed instrument. Early applications of the survey identified four domains: Connection and Caring, Re...
This article compares six interventions to enhance community resilience. In this review, underlying principles for community resilience interventions are (a) use a multihazard approach relevant to the local context, (b) utilize community assessment, (c) focus on community engagement, (d) adhere to bioethical principles, (e) emphasize both assets an...
Children face innumerable challenges following exposure to disasters. To address trauma sequelae, researchers and clinicians have developed a variety of mental health interventions. While the overall effectiveness of multiple interventions has been examined, few studies have focused on the individual components of these interventions. As a prelimin...
This review of the literature on disaster media coverage describes the events, samples, and forms of media coverage (television, newspapers, radio, internet) studied and examines the association between media consumption and psychological outcomes. A total of 36 studies representing both man-made and natural events met criteria for review in this a...
Although many post-disaster interventions for children and adolescent survivors of disaster and terrorism have been created, little is known about the effectiveness of such interventions. Therefore, this meta-analysis assessed PTSD outcomes among children and adolescent survivors of natural and man-made disasters receiving psychological interventio...
Children are especially vulnerable to the effects of disasters. The coming tornado season raises concerns about enduring problems and anniversary reactions related to the May 2013 tornadoes as well as anxiety about the possibility of new events.
This article describes common emotional and behavioral disaster reactions in children and also identifie...
Members of Muslim and Arab-American communities were publicly targeted as suspects and perpetrators of this terrorism. One to two years after the attacks, 145 participants from 6 affected agencies in New York City participated in 22 focus groups to discuss post-disaster psychosocial issues. Ethnic prejudice was reflected in 2% of the comments emerg...
This study explored television viewing of the September 11 attacks in 99 survivors of the Oklahoma City bombing and examined the relationships of event-related television viewing with concerns about safety and danger in survivors with and without bombing-related posttraumatic stress disorder. The number of hours of viewing September 11 television c...
This review addresses universal disaster and terrorism services and preventive interventions delivered to children before and after an event. The article describes the organization and structure of services used to meet the needs of children in the general population (practice applications), examines screening and intervention approaches (tools for...
Objective:
The study assessed survivors of Oklahoma City's 1995 bombing seven years postdisaster to identify long-term mental health service use.
Methods:
Psychiatric disorders and disaster-related variables were assessed for 99 survivors at seven years postdisaster with the Diagnostic Interview Schedule for DSM-IV and its Disaster Supplement....
Disasters and terrorism present significant and often overwhelming challenges for children and families worldwide. Individual, family, and social factors influence disaster reactions and the diverse ways in which children cope. This article links conceptualizations of stress and coping to empirical knowledge of children's disaster reactions, identi...
Objective:
The purpose of this review is to describe interventions used with children who are exposed to disasters and terrorism and to present information about the potential benefits of these interventions.
Methods:
A literature search conducted in January 2013 using relevant databases and literature known to the authors that was not generated...
The aim of this study was to examine psychiatric illness and physiological indicators in the children of Oklahoma City bombing survivors seven years after the event.
A study of 17 Oklahoma City bombing survivors and their 21 adolescent and young-adult children conducted seven years after the disaster used structured diagnostic interviews to examine...
This review summarizes current knowledge on the timing of child disaster mental health intervention delivery, the settings for intervention delivery, the expertise of providers, and therapeutic approaches. Studies have been conducted on interventions delivered during all phases of disaster management from pre event through many months post event. M...
This review of child disaster mental health intervention studies describes the techniques used in the interventions and the outcomes addressed, and it provides a preliminary evaluation of the field. The interventions reviewed here used a variety of strategies such as cognitive behavioral approaches, exposure and narrative techniques, relaxation, co...
While building community resilience to disasters is becoming an important strategy in emergency management, this is a new field of research with few available instruments for assessing community resilience. This article describes the development of the Communities Advancing Resilience Toolkit (CART) survey instrument. CART is a community interventi...
This Practice Parameter identifies best approaches to the assessment and management of children and adolescents across all phases of a disaster. Delivered within a disaster system of care, many interventions are appropriate for implementation in the weeks and months after a disaster. These include psychological first aid, family outreach, psychoedu...
Exposure to a disaster is common, and one-third or more of individuals severely exposed may develop posttraumatic stress disorder or other disorders. A systematic approach to the delivery of timely and appropriate disaster mental health services may facilitate their integration into the emergency medical response.
To review and summarize the eviden...
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...
Community resilience has emerged as a construct to support and foster healthy individual, family, and community adaptation to mass casualty incidents. The Communities Advancing Resilience Toolkit (CART) is a publicly available theory-based and evidence-informed community intervention designed to enhance community resilience by bringing stakeholders...
Research on the relationship of alcohol and disasters has yielded mixed conclusions. Some studies investigate alcohol consumption but others examine alcohol use disorders in relation to disaster. Alcohol consumption and alcohol use disorders have not be studied concurrently in relation to specific disaster trauma exposures. A volunteer sample of 37...