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.

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    • "Studies show that disasters and the resulting losses and ongoing stressors negatively impact young children's psychological outcomes (Osofsky 2011a; Devoe et al. 2011). While children's symptoms of posttraumatic stress generally decrease over time, level of exposure, loss, and ongoing stress affects the severity and longevity of children's symptoms (McLaughlin et al. 2009). As demonstrated in a study by Swenson et al. (1996), while the majority of two to six-year-old children's hurricane-related distress decreased over time, children who had lost their homes as a result of the hurricane or who experienced ongoing life stressors such as a marriage or a death in the family were more likely to have increased levels of posttraumatic stress 14 months after the hurricane. "
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    ABSTRACT: Background Research suggests that young childhood is a dynamic developmental phase during which risks to attachment figures as well as traumatic events may be particularly important. The loss and disruption associated with Hurricane Katrina highlighted the vulnerabilities and special needs of young children exposed to natural disaster. Objective The current study explored ways in which multiple stressors associated with Hurricane Katrina contributed to adverse outcomes. We hypothesize overall decreases in trauma symptoms over time. We further hypothesize that increased attachment and hurricane related risk factors will negatively influence longitudinal symptom patterns. Methods Data was collected from families of preschool-aged children (ages 3-5) during the school year following Hurricane Katrina (2005-2006) and each subsequent school year (2006-2007, 2007-2008, and 2008-2009). Latent growth curve modeling was used to assess trauma symptoms overtime and the effect of risk indices on these trauma symptoms. Results Results suggest an overall decrease in trauma distress symptoms over time and further indicate that attachment and trauma related risks of caregiver disruption, other non-human losses, trauma prior to and subsequent to the storm, as well as Katrina exposure are significant predictors of symptoms over time. Conclusions Given the rapid physical, cognitive, and emotional development that occurs in early childhood, these findings support the importance of providing intervention with preschool age children post-disaster. Further, the findings also suggest that a relationship based treatment including both caregiver and child is most likely to be effective.
    No preview · Article · Jan 2015 · Child and Youth Care Forum
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    • "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). "
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    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.
    Full-text · Article · Jul 2014 · European Journal of Psychotraumatology
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    • "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] "
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    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.
    Full-text · Article · Apr 2013
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