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Strøm IF, Wentzel-Larsen T, Stensland S, Dyb G, Stene LE. Health care needs, experiences, and satisfaction after terrorism: a longitudinal study of parents of survivors of the Utøya attack. BMC Health Serv Res 2024; 24:277. [PMID: 38454472 PMCID: PMC10921612 DOI: 10.1186/s12913-024-10592-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Accepted: 01/11/2024] [Indexed: 03/09/2024] Open
Abstract
BACKGROUND There is scarce knowledge on the health care follow-up of parents of terror attack survivors. This study focused on the mothers and fathers of survivors and examined (1) their perceived health care needs relative to their psychological reactions, physical health problems (unmet health care needs), and adaptation to work; (2) whether sociodemographic characteristics, health problems and social support were associated with unmet health care needs; and (3) how unmet health care needs, sociodemographic characteristics, and experiences with health services associated with overall dissatisfaction during the health care follow-up. METHODS Interview and questionnaire data from three waves of the Utøya parent study were analyzed (n = 364). Chi-square tests and t- tests were used to compare unmet physical and psychological health care needs, sociodemographic factors and post-terror attack health reported by mothers and fathers. Logistic regression analyses were used to examine whether sociodemographic characteristics, unmet health care needs, and health care experiences were associated with overall dissatisfaction among mothers and fathers of the survivors during the health care follow-up. RESULTS Among the mothers, 43% reported unmet health care needs for psychological reactions, while 25% reported unmet health care needs for physical problems. Among the fathers, 36% reported unmet health care needs for psychological reactions, and 15% reported unmet health care needs for physical problems. Approximately 1 in 5 mothers and 1 in 10 fathers reported "very high/high" needs for adaptation to work. Poorer self-perceived health, higher levels of posttraumatic stress and anxiety/depression symptoms, and lower levels of social support were significantly associated with reported unmet psychological and physical health care needs in both mothers and fathers. Parents with unmet health care needs reported significantly lower satisfaction with the help services received compared to parents whose health care needs were met. Low accessibility of help services and not having enough time to talk and interact with health care practitioners were associated with overall dissatisfaction with the help received. CONCLUSIONS Our findings highlight that parents of terror-exposed adolescents are at risk of having unmet psychological and physical health care needs and thus need to be included in proactive outreach and health care follow-up programs in the aftermath of a terror attack.
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Affiliation(s)
- Ida Frugård Strøm
- Norwegian Centre for Violence and Traumatic Stress Studies, Pb 181 Nydalen, 0409, Oslo, Norway.
| | - Tore Wentzel-Larsen
- Norwegian Centre for Violence and Traumatic Stress Studies, Pb 181 Nydalen, 0409, Oslo, Norway
- Centre for Child and Adolescent Mental Health, Eastern and Southern Norway, Oslo, Norway
| | - Synne Stensland
- Norwegian Centre for Violence and Traumatic Stress Studies, Pb 181 Nydalen, 0409, Oslo, Norway
- Research and Communication Unit for Musculoskeletal Health (FORMI), Division of Clinical Neuroscience, Oslo University Hospital, Oslo, Norway
| | - Grete Dyb
- Norwegian Centre for Violence and Traumatic Stress Studies, Pb 181 Nydalen, 0409, Oslo, Norway
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Lise Eilin Stene
- Norwegian Centre for Violence and Traumatic Stress Studies, Pb 181 Nydalen, 0409, Oslo, Norway
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Cadamuro A, Bisagno E, Trifiletti E, Di Bernardo GA, Visintin EP. Parental Support during the COVID-19 Pandemic: Friend or Foe? A Moderation Analysis of the Association between Maternal Anxiety and Children's Stress in Italian Dyads. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 20:268. [PMID: 36612589 PMCID: PMC9819444 DOI: 10.3390/ijerph20010268] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Revised: 12/19/2022] [Accepted: 12/21/2022] [Indexed: 06/17/2023]
Abstract
There is evidence that parental psychological disorders in stressful situations increase the risk of disturbance in child development. This has been investigated in disasters but not in pandemics, which are sensibly different from other types of traumatic events. We investigated the relationship between mothers' anxiety and their children's (self-reported) stress and the boundary conditions of this association during the first full COVID-19 lockdown in Italy. During the COVID-19 pandemic, mothers might have increased their protective attitudes to secure and support their children; we tested whether the relationship between mothers' anxiety and children's stress was weaker (buffer effect) or stronger (over-protection effect) when perceived parental support was high. We measured mothers' anxiety, children's perceived parental support, and children's stress in a sample of 414 8- to 11-year-old primary school children (229 females, Mage = 9.44) and 395 mothers (Mage = 42.84). Results supported the over-protection scenario and provided the first evidence for the "helicopter-parent effect" during the COVID-19 pandemic: mothers' anxiety was positively associated with children's stress only when perceived support was high. Our finding highlights the importance of educating parents (for example, via emotional training) to prevent the worst consequences of adverse events in children and promote their mental health.
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Affiliation(s)
- Alessia Cadamuro
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, 41125 Modena, Italy
| | - Elisa Bisagno
- Surgical, Medical and Dental Department of Morphological Sciences Related to Transplant, Oncology and Regenerative Medicine, University of Modena and Reggio Emilia, 41124 Modena, Italy
| | - Elena Trifiletti
- Department of Human Sciences, University of Verona, 37129 Verona, Italy
| | - Gian Antonio Di Bernardo
- Department of Education and Human Sciences, University of Modena and Reggio Emilia, 42121 Reggio Emilia, Italy
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The Emergency of Prosociality: A Developmental Perspective on Altruism and Other Prosocial Behavior in the Face of Disaster. CURRENT DIRECTIONS IN PSYCHOLOGICAL SCIENCE 2022. [DOI: 10.1177/09637214221114090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
No two emergency situations are alike. A combination of human and contextual factors makes each emergency and disaster unique in its time line, its aftermath, and especially its impact on affected populations. In all of these situations, however, people engage in prosocial behavior that benefits others. We provide an overview of altruistic and other prosocial behavior in typical human development and of developmental distinctions between helping, sharing, and comforting. We focus on the expression of these behaviors in emergency situations, using the COVID-19 pandemic to illustrate how prosociality shifts and adapts in a specific context. Finally, we suggest that a developmental framework may help researchers and professionals in the field achieve a more comprehensive understanding of the many facets and underlying mechanisms of prosociality in emergency contexts.
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Gökyar M, Erdur-Baker Ö. Impacts of Urban Terror Attacks on Turkish Mothers' Daily Experiences. JOURNAL OF INTERPERSONAL VIOLENCE 2022; 37:NP10245-NP10270. [PMID: 33446009 DOI: 10.1177/0886260520985493] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
This phenomenological study aims to provide a deeper understanding of the day-to-day experiences of Turkish women with caregiving responsibilities in terms of (a) how they respond to and regulate their lives around the fear of terror, (b) how their caregiving roles affect their reactions, and (c) how they cope with terrorism induced distress in their day-to-day life. A total of 21 women were interviewed for the study about their daily experiences following terrorist attacks that occurred in their urban hometowns. The qualitative analysis program called Atlas.ti was utilized for the coding procedure. Four main themes (the nature of the terrorist attacks, reactions to the event, coping strategies, and the role of the media) and several subcategories emerged from the data. The participants were emotionally affected by these events as they were shocked and confused, their sense of security was shaken, and they felt anxious not only during the events but they also continued to perceive such danger days or weeks after the events. All participating mothers reported some degree of shock, anxiety, fear, threat, risk alertness, and a shaken sense of security even though none of the mothers themselves or their loved ones were direct victims of the events. Overall, the results reveal that Turkish mothers feel terror threat perception and security-related stress even around 6 months after the events. Having a caregiving responsibility exacerbates the women's distress level. The unpredictability, uncertainty, and physical proximity/familiarity of the location of the event appear to have vital impacts on participants' cognitive, emotional, and behavioral reactions as well as in their coping. Similarly, the media, including social media, play significant roles in meaning making and responses as well as the coping process. The results were discussed in the light of the related literature.
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Children and adolescents' emotional problems during the COVID-19 pandemic in Brazil. Eur Child Adolesc Psychiatry 2022; 32:1083-1095. [PMID: 35618973 PMCID: PMC9135594 DOI: 10.1007/s00787-022-02006-6] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2021] [Accepted: 05/04/2022] [Indexed: 11/21/2022]
Abstract
Brazil has been severely affected by the COVID-19 pandemic with one of the largest numbers of youth impacted by school closure globally. This longitudinal online survey assessed emotional problems in children and adolescents aged 5-17 years living in Brazil during the COVID-19 pandemic. Recruitment occurred between June to November 2020 and participants were invited for follow-up assessments every 15 days until June 2021. Participants were 5795 children and adolescents living across the country with mean age of 10.7 (SD 3.63) years at recruitment; 50.5% were boys and 69% of white ethnicity. Weighted prevalence rates of anxiety, depressive and total emotional symptoms at baseline were 29.7%, 36.1% and 36%, respectively. Longitudinal analysis included 3221 (55.6%) participants and revealed fluctuations in anxiety and depressive symptoms during one year follow-up, associated with periods of social mobility and mortality. Emotional problems significantly increased in July and September 2020 and decreased from December 2020 to February 2021 and then significantly increased in May 2021 relative to June 2020. Older age, feeling lonely, previous diagnosis of mental or neurodevelopmental disorder, previous exposure to traumatic events or psychological aggression, parental psychopathology, and sleeping less than 8/h a day were associated with increased rates of anxiety and depressive symptoms at baseline and over time. Food insecurity and less social contact with family and peers were associated with baseline anxiety and depressive symptoms, and lowest socio-economic strata, chronic disease requiring treatment and family members physically ill due to COVID-19 were associated with increasing rates over time. The pandemic severely affected youth, particularly those from vulnerable populations and in moments of increased mortality and decreased social mobility. Results underscore the need for allocation of resources to services and the continuous monitoring of mental health problems among children and adolescents.
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Zhao T, Su Q, Hu X. The Relationships Between Family Characteristics and Undergraduate Students' COVID-19 Responses: A Cross-Sectional Study in China. Front Public Health 2022; 10:873696. [PMID: 35586017 PMCID: PMC9108259 DOI: 10.3389/fpubh.2022.873696] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Accepted: 03/28/2022] [Indexed: 12/12/2022] Open
Abstract
The COVID-19 pandemic has dramatically threatened the post-secondary education setting. It is crucial to understand the factors that potentially affect college students' COVID-19 responses, such as risk awareness, knowledge of the disease, and pandemic preparedness. However, there is insufficient literature on whether family characteristics contribute to students' COVID-19 responses. Leveraging the data from self-administrated survey – titled College Students' Epidemic Preparedness in the Post-COVID-19 Era (CSEPPCE), we find that students from high-income families were more likely to have a greater awareness of risk and better knowledge of COVID-19. Additionally, students whose parents were employed by the government had a higher probability of knowing COVID-19 symptoms and wearing masks. However, the relationships among risk awareness, knowledge, and family income did not meaningfully vary by sex or ethnicity. Implications and future directions are discussed.
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Affiliation(s)
- Teng Zhao
- Zhejiang Academy of Higher Education, Hangzhou Dianzi University, Hangzhou, China
| | - Qiang Su
- Zhejiang Academy of Higher Education, Hangzhou Dianzi University, Hangzhou, China
- Institute of Higher Education, Wenzhou Medical University, Wenzhou, China
- *Correspondence: Qiang Su
| | - Xinye Hu
- Center for the Study of Higher and Postsecondary Education, University of Michigan, Ann Arbor, MI, United States
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A Safe Home? A Qualitative Study into the Experiences of Adolescents Growing Up in the Dutch Area Impacted by Earthquakes Induced by Gas Extraction. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19084716. [PMID: 35457580 PMCID: PMC9030444 DOI: 10.3390/ijerph19084716] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/16/2022] [Revised: 04/06/2022] [Accepted: 04/12/2022] [Indexed: 11/16/2022]
Abstract
For decades, the Netherlands has experienced minor earthquakes due to gas extraction. This study aims to obtain insight into the experiences of adolescents and the impact of these earthquakes on their well-being and living environment. Focus groups were held with 24 adolescents, and interviews were held with 3 adolescents (N = 27; M = 15 years). Through qualitative analysis, we identified six themes. The adolescents shared experiences of anxiety related to the earthquakes and their consequences and considered these to be a normal part of their life. Anxiety and feelings of endangerment not only related to their own experiences but were also connected to the impact of earthquakes on their social environment, such as the restoration of buildings. Several sources of support (e.g., talking, social cohesion) were mentioned to deal with the negative consequences of the earthquakes. A lack of trust in the government was an additional main theme, with adolescents mentioning several needs, potentially relevant to policymakers in the Netherlands. Growing up in the gas extraction area of Groningen had many consequences on the adolescents in the study, who felt inhibited from expressing feelings of anxiety and fear. To support their needs, interventions at the individual, family, educational, societal, and policy levels are recommended.
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Parental Internalizing Psychopathology and PTSD in Offspring after the 2012 Earthquake in Italy. CHILDREN-BASEL 2021; 8:children8100930. [PMID: 34682196 PMCID: PMC8535087 DOI: 10.3390/children8100930] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/19/2021] [Revised: 10/13/2021] [Accepted: 10/15/2021] [Indexed: 11/16/2022]
Abstract
Post-traumatic stress disorder (PTSD) is common in youths after earthquakes, with parental psychopathology among the most significant predictors. This study investigated the contribution and the interactional effects of parental internalizing psychopathology, the severity of exposure to the earthquake, and past traumatic events to predict PTSD in offspring, also testing the reverse pattern. Two years after the 2012 earthquake in Italy, 843 children and adolescents (9-15 years) living in two differently affected areas were administered a questionnaire on traumatic exposure and the UCLA PTSD Reaction Index. Anxiety, depression, and somatization were assessed in 1162 parents through the SCL-90-R. General linear model showed that, for offspring in the high-impact area, predictors of PTSD were earthquake exposure, past trauma, and parental internalizing symptoms, taken individually. An interaction between earthquake exposure and parental depression or anxiety (not somatization) was also found. In the low-impact area, youth PTSD was only predicted by earthquake exposure. The reverse pattern was significant, with parental psychopathology explained by offspring PTSD. Overall, findings support the association between parental and offspring psychopathology after natural disasters, emphasizing the importance of environmental factors in this relationship. Although further research is needed, these results should be carefully considered when developing mental health interventions.
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9
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Changes in Depressive Symptoms, Stress and Social Support in Mexican Women during the COVID-19 Pandemic. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18168775. [PMID: 34444524 PMCID: PMC8394154 DOI: 10.3390/ijerph18168775] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Revised: 08/16/2021] [Accepted: 08/17/2021] [Indexed: 01/07/2023]
Abstract
The aim of this study was to examine changes in depression, stress and social support levels before and during the COVID-19 pandemic in women living in Mexico City. We studied 466 women enrolled in the Programming Research in Obesity, Growth, Environment and Social Stressors (PROGRESS) study who completed the Edinburgh Depression Scale (EDS) questionnaire prior (2018–2019) and during the lockdown period of the pandemic (May–November 2020). Psychosocial stress and social support for both time periods were ascertained using the Crisis in Family Systems (CRISYS) questionnaire and the Social Support Network (SSN) Scale, respectively. Associations between stress, social support and change in EDS score/depression were analyzed using generalized linear models adjusting for covariates. Higher stress (>median) during the pandemic was associated with an increase in EDS score (β: 2.13; 95% CI (1.06, 3.19), p < 0.001), and higher odds of depression (OR: 3.75; 95% CI (2.17, 6.50), p < 0.001), while social support was associated with lower odds of depression (OR: 0.56, 95% CI (0.32, 0.97), p = 0.037). Higher levels of stress during the pandemic were associated with depression. Social support may act as a buffer for the effects of psychosocial stress. Future studies should examine the long-term effects of stress associated with the pandemic on mental and overall health.
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Liang Z, Mazzeschi C, Delvecchio E. The Impact of Parental Stress on Italian Adolescents' Internalizing Symptoms during the COVID-19 Pandemic: A Longitudinal Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:8074. [PMID: 34360369 PMCID: PMC8345594 DOI: 10.3390/ijerph18158074] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Revised: 07/28/2021] [Accepted: 07/28/2021] [Indexed: 12/12/2022]
Abstract
The challenges and consequences of COVID-19 imposed massive changes in adolescents' daily routines (e.g., school closures, home confinement, and social distancing rules), which impacted their mental health. This longitudinal study aimed to better understand the changes in adolescents' internalizing symptoms and the underlying mechanisms of parental stress due to COVID-19. We asked 1053 parents of adolescents to complete an online survey during the second and fifth weeks and at the end of home confinement (i.e., four weeks later). Results showed that parents reported their adolescents' anxiety and depression symptoms were more severe at Time 2 than at the first administration. Anxiety symptoms slightly decreased at Time 3, while there was no significant change in depression symptoms. Moreover, parents' expressive suppression mediated the association between parental stress and adolescents' anxiety and depression symptoms, respectively. The findings suggest that as restriction increased, adolescents' anxiety and depression became more severe. Moreover, due to the link between parental stress and adolescents' internalizing disorders helping families to cope with the distress due to the pandemic may have a positive impact on parents, the child, and the family as a whole (i.e., the family climate).
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Affiliation(s)
| | | | - Elisa Delvecchio
- Department of Philosophy, Social Sciences and Education, University of Perugia, Piazza Ermini 1, 06123 Perugia, Italy; (Z.L.); (C.M.)
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Liang Z, Delvecchio E, Cheng Y, Mazzeschi C. Parent and Child's Negative Emotions During COVID-19: The Moderating Role of Parental Attachment Style. Front Psychol 2021; 12:567483. [PMID: 33746813 PMCID: PMC7973364 DOI: 10.3389/fpsyg.2021.567483] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2020] [Accepted: 02/10/2021] [Indexed: 12/26/2022] Open
Abstract
In February 2020, the coronavirus disease 2019 (COVID-19) appeared and spread rapidly in Italy. With the health emergency and social isolation, parents started spending more time with their children, and they might have experienced greater distress. Attachment style is considered as an effective emotion regulation strategy in the parent-child relationship. However, few empirical studies have addressed this issue. Based on attachment theory, this study aimed to find parental attachment style as a candidate to moderate the relation between parents' negative emotions and their perceptions of their children's negative emotions related to COVID-19. Parents (Mage = 42.55 ± 6.56, 88.2% female) of 838 Italian children and adolescents aged 3 to 18 years participated in an online survey. Results showed that parents with a fearful attachment style had significantly higher negative emotions when facing COVID-19 than those with other attachment styles. Moreover, parents with a dismissing attachment style perceived fewer negative emotions in their children than parents with fearful and preoccupied styles. At last, higher parents' negative emotions were associated with greater perception of children's negative emotions only in parents classified as secure and fearful. These findings suggest that parents with dismissing and fearful attachment styles and their children may be at higher risk during the COVID-19 pandemic and they should be given long-term attention.
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Affiliation(s)
- Ziqin Liang
- Department of Philosophy, Social Sciences and Education, University of Perugia, Perugia, Italy
| | - Elisa Delvecchio
- Department of Philosophy, Social Sciences and Education, University of Perugia, Perugia, Italy
| | - Yucong Cheng
- Department of Philosophy, Social Sciences and Education, University of Perugia, Perugia, Italy
| | - Claudia Mazzeschi
- Department of Philosophy, Social Sciences and Education, University of Perugia, Perugia, Italy
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Battistin T, Mercuriali E, Zanardo V, Gregori D, Lorenzoni G, Nasato L, Reffo ME. Distance support and online intervention to blind and visually impaired children during the pandemic COVID-19. RESEARCH IN DEVELOPMENTAL DISABILITIES 2021; 108:103816. [PMID: 33271446 PMCID: PMC7682482 DOI: 10.1016/j.ridd.2020.103816] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/15/2020] [Revised: 11/13/2020] [Accepted: 11/15/2020] [Indexed: 05/12/2023]
Abstract
The COVID-19 pandemic imposed dramatic changes to everyone's daily routines, but especially to children with developmental disabilities. The Robert Hollman Foundation decided not to interrupt its service to all the visually impaired children and initiated a Distance Support Project. It was an online process covering all aspects of support for the children and involving audio-video calls, videos and tailored-made multisensory material created specifically for each child. A questionnaire, carried out after the 5-month project duration, was created to collect feedback from parents and professionals to understand the impact this project had on everyone involved. Overall both parents and professionals indicated high levels of satisfaction, but in a significant number of questions parents reported consistently higher levels of satisfaction (p-value <0.001). It was shown that parents felt reassured at this otherwise very difficult time because their children were able to continue their treatment, even if in a very different way. This fact encourages us to consider enriching our existing programmes of support and care, integrating this online approach when necessary. At the same time, it seems clear that the responses of the professionals indicate their belief that the benefits of the traditional ways of working remain of unquestionable importance for children with sight deprivation.
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Affiliation(s)
- Tiziana Battistin
- Robert Hollman Foundation "Consultation and Support for the Development of Visually Impaired Children", Via Siena 1, Padova, Italy.
| | - Elena Mercuriali
- Robert Hollman Foundation "Consultation and Support for the Development of Visually Impaired Children", Via Siena 1, Padova, Italy
| | - Vincenzo Zanardo
- Robert Hollman Foundation "Consultation and Support for the Development of Visually Impaired Children", Via Siena 1, Padova, Italy
| | - Dario Gregori
- Unit of Biostatistics, Epidemiology and Public Health, Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padova, Italy
| | - Giulia Lorenzoni
- Unit of Biostatistics, Epidemiology and Public Health, Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padova, Italy
| | - Laura Nasato
- Unit of Biostatistics, Epidemiology and Public Health, Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padova, Italy
| | - Maria Eleonora Reffo
- Robert Hollman Foundation "Consultation and Support for the Development of Visually Impaired Children", Via Siena 1, Padova, Italy
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Whaley GL, Varma V, Hawks EM, Cowperthwaite R, Arlee L, Pfefferbaum B. Risk and Resilience in Children in the Context of Mass Trauma. Psychiatr Ann 2020. [DOI: 10.3928/00485713-20200812-02] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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14
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Fuchs R, Glaude M, Hansel T, Osofsky J, Osofsky H. Adolescent risk substance use behavior, posttraumatic stress, depression, and resilience: Innovative considerations for disaster recovery. Subst Abus 2020; 42:358-365. [PMID: 32813991 DOI: 10.1080/08897077.2020.1784357] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Natural and technological disasters cause long-term psychological trauma and increase substance use in adults. It is unclear whether these problems also occur in children and whether trauma influences long-term psychological outcomes due to developmental stages at the time of trauma. One community of interest is located in southeastern Louisiana, where, as children, many locals were exposed to Hurricane Katrina in 2005 and the Deepwater Horizon Oil Spill in 2010. We hypothesized individuals exposed to these disasters in early childhood would exhibit higher rates of anxiety, depression, and alcohol use as adolescents than the general population. To test this, we developed a questionnaire with a focus on severity of disaster exposure, indicators of psychological resilience, and current levels of anxiety, depression, and alcohol use. This survey was administered to over 1000 adolescents in local high schools throughout southeastern Louisiana. Structural equation modeling was performed to test correlations and moderation effects. We found disaster exposure was positively associated with trauma-like symptoms and substance use and psychological resilience was negatively related to these outcomes. These findings demonstrate childhood disaster exposure has the potential to cause chronic psychological distress and predispose individuals to substance use later in life. They also suggest resilience may be protective for disaster survivors. Future studies should expand these concepts to other age groups and types of disasters. Whether resilience-focused psychotherapy may be beneficial in these populations is also a relevant topic for exploration.
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Affiliation(s)
- Robert Fuchs
- Psychiatry, Louisiana State University Health Sciences Center, New Orleans, Louisiana, USA
| | - Maurya Glaude
- School of Social Work, Tulane University, New Orleans, Louisiana, USA
| | - Tonya Hansel
- School of Social Work, Tulane University, New Orleans, Louisiana, USA
| | - Joy Osofsky
- Psychiatry, Louisiana State University Health Sciences Center, New Orleans, Louisiana, USA
| | - Howard Osofsky
- Psychiatry, Louisiana State University Health Sciences Center, New Orleans, Louisiana, USA
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Mastnak W. Psychopathological problems related to the COVID-19 pandemic and possible prevention with music therapy. Acta Paediatr 2020; 109:1516-1518. [PMID: 32395840 PMCID: PMC7272822 DOI: 10.1111/apa.15346] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/02/2020] [Revised: 04/30/2020] [Accepted: 05/06/2020] [Indexed: 01/03/2023]
Affiliation(s)
- Wolfgang Mastnak
- Research Centre for Arts Therapies Beijing Normal University Beijing China
- University of Music and Performing Arts Munich Germany
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16
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Kaniasty K, de Terte I, Guilaran J, Bennett S. A scoping review of post-disaster social support investigations conducted after disasters that struck the Australia and Oceania continent. DISASTERS 2020; 44:336-366. [PMID: 31298760 DOI: 10.1111/disa.12390] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
This scoping review provides a summary of research findings on social support dynamics in the wake of disasters that occurred on the continent of Australia and Oceania between 1983 and 2013. Forty-one studies, quantitative and qualitative, were summarised, investigating different facets of post-disaster supportive interactions. All inquiries assessed disasters resulting from natural hazards, with the majority of them conducted following events in Australia and New Zealand. The review revealed similar patterns of post-disaster social support dynamics that routinely unfold after disastrous incidents all over the world. Consistent with the disaster mental health literature, the documentation of social support mobilisation and social support deterioration processes was common. Salutary direct effects of supportive behaviours on post-disaster psychological distress were also highly evident. Most studies, however, posed research questions or hypotheses that lacked empirical or theoretical grounding. In conclusion, the review offers several recommendations on how to advance research on post-disaster social support.
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Affiliation(s)
- Krzysztof Kaniasty
- Professor in the Department of Psychology, Indiana University of Pennsylvania, United States, and at the Institute of Psychology, Polish Academy of Sciences, Poland
| | - Ian de Terte
- Senior Lecturer in the School of Psychology, Massey University, Wellington, New Zealand
| | - Johnrev Guilaran
- Assistant Professor in the Division of Social Science at the University of the Philippines Visayas, Philippines
| | - Simon Bennett
- Senior Lecturer in the School of Psychology, Massey University, Wellington, New Zealand
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Morganstein JC, Ursano RJ. Ecological Disasters and Mental Health: Causes, Consequences, and Interventions. Front Psychiatry 2020; 11:1. [PMID: 32116830 PMCID: PMC7026686 DOI: 10.3389/fpsyt.2020.00001] [Citation(s) in RCA: 102] [Impact Index Per Article: 25.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2019] [Accepted: 01/02/2020] [Indexed: 12/13/2022] Open
Abstract
Ecological disasters highlight the importance of understanding natural disasters as they relate to a changing global climate. Such disasters often have a predictable pattern of evolving over time and anticipated psychological and behavioral problems and community disruptions. Various factors enhance transmission of these adverse effects beyond the geographic location of the ecological disaster, with certain populations being particularly vulnerable to these effects. Understanding the range and pattern of these effects can aid in optimizing interventions. The use of evidence-informed interventions can reduce distress, enhance well-being, and improve functioning for affected individuals and communities. Effective preparedness involves an understanding of these factors, incorporation of them at all stages of disaster management, and continuous education and training for disaster planners and responders.
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Affiliation(s)
- Joshua C. Morganstein
- Department of Psychiatry, School of Medicine, Uniformed Services University, Bethesda, MD, United States
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Kawahara K, Ushijima H, Usami M, Takebayashi M. No Associations of Psychological Symptoms and Suicide Risk with Disaster Experiences in Junior High School Students 5 Years After the 2011 Great East Japan Earthquake and Tsunami. Neuropsychiatr Dis Treat 2020; 16:2377-2387. [PMID: 33116537 PMCID: PMC7571580 DOI: 10.2147/ndt.s269835] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2020] [Accepted: 09/03/2020] [Indexed: 12/29/2022] Open
Abstract
INTRODUCTION Natural disasters such as earthquakes can cause substantial damage and trauma, especially to children. The aim of this study was to examine the effects of disaster experience on psychological symptoms, suicide risk, and associated factors in junior high school students 5 years after the Great East Japan Earthquake (GEJE). The hypothesis of this study was that psychological symptoms and suicide risk of junior high school students are associated with disaster experience. METHODS A cross-sectional survey consisting of questionnaires and face-to-face interviews with students at two junior high schools in Ishinomaki city, Miyagi Prefecture, Japan, about psychological symptoms, disaster situations, and their current environment 5 years after the GEJE was conducted. In total, data from 264 (117 boys [44.3%] and 147 girls [55.7%]) students were analyzed. RESULTS There were no associations between disaster experience and PTSSC-15, DSRS-C, and SCAS scores. Those with evacuation experience and still living in temporary housing had significantly higher scores on the oppositional defiant behavior inventory (ODBI). Of these students, 29 (11.0%) were considered to have suicide risk 5 years after the GEJE. The presence of depressive symptoms was the only factor related to suicide risk; no associations were found with sex, post-traumatic stress disorder (PTSD) symptoms, or other factors reported in previous studies, including disaster experience. CONCLUSIONS Disaster experience was not associated with psychological symptoms (PTSD, depression, anxiety) and suicide risk in junior high school students 5 years after the GEJE. The suicide risk appears to be the same as that in the general population in Japan. However, attention should be paid to externalization problems and depressive symptoms, an important suicide risk factor, even 5 years after the GEJE.
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Affiliation(s)
- Kazuhiro Kawahara
- Department of Neuropsychiatry, Graduate School of Medical Science, Kumamoto University, Kumamoto, Japan.,Department of Child and Adolescent Psychiatry, Kohnodai Hospital, National Center for Global Health and Medicine, Chiba, Japan
| | - Hirokage Ushijima
- Department of Child and Adolescent Psychiatry, Kohnodai Hospital, National Center for Global Health and Medicine, Chiba, Japan
| | - Masahide Usami
- Department of Child and Adolescent Psychiatry, Kohnodai Hospital, National Center for Global Health and Medicine, Chiba, Japan
| | - Minoru Takebayashi
- Department of Neuropsychiatry, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan
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School-based psychoeducation and storytelling: Associations with long-term mental health in adolescent survivors of the Wenchuan earthquake. Epidemiol Psychiatr Sci 2019; 29:e65. [PMID: 31640825 PMCID: PMC8061163 DOI: 10.1017/s2045796019000611] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
AIMS We explored the factors promoting long-term mental health among adolescent survivors of the 2008 Wenchuan earthquake in China. We examined the associations of their long-term mental health with disaster-related storytelling and school-based psychoeducation, and of school-based psychoeducation with disaster-related storytelling. METHODS A secondary school-based cross-sectional survey was conducted 6 years after the disaster. Participants with traumatic experiences such as injury, loss, witnessing someone's death/injury and home destruction (N = 1028, mean age 15, standard deviation 1.38, male 51%) were eligible. Mental health/disaster education (MHE/DE) was defined as taking one or more lessons in MHE and/or DE at school since the earthquake. Experiences of storytelling about the disaster involved expressing distressing memories and feelings regarding the earthquake since the disaster happened, according to four groups: never expressed distressing memories and feelings, expressed them through writing/drawing, expressed them through talking to lay supporters and expressed them through talking to health professionals. Analysis of covariance was used to compare mean scores on five selected subscales of the Symptom Checklist-90 (SCL-90), the Athens Insomnia Scale (AIS) and the Psychotic-Like Experiences (PLEs) scale among the four storytelling groups. Linear regression analysis was used to identify the relationships between MHE/DE and current mental health as measured by the SCL-90, AIS and PLEs. The relationship between education and storytelling was probed by χ2 test. RESULTS The talked-to-lay-supporters group showed better mental health on the SCL-90 (p ⩽ 0.001), AIS (p < 0.001) and PLEs (p = 0.004), while the consulted-health-professionals group showed worse mental health on the three dimensions of the SCL-90: depression (p = 0.05), anxiety (p = 0.02) and fear (p = 0.04), and on PLEs (p = 0.02) compared with the never-expressed group. MHE and DE were inversely associated with SCL-90, AIS and PLE scores. Participants who received these forms of education talked about their disaster experiences to lay supporters more than those who did not. CONCLUSIONS MHE and DE at school may promote adolescents' mental health after a disaster. Experience of storytelling about the disaster to lay supporters may be helpful for long-term psychological recovery, and may be a potential mediating factor for school-based education and better mental health. Because of the cross-sectional nature of this study, causality cannot be inferred; therefore, further prospective intervention studies are needed to elucidate the effect of these factors on adolescent survivors' mental health.
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Abstract
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 to PTG. RECENT FINDINGS Guided by PTG theory and the literature on PTG in adults, research has revealed relationships between PTG and child, environmental, and family and social factors among youth though the results are mixed. Youth's subjective exposure to disasters, their level of posttraumatic stress following the disaster, and the type of psychological processes they employ to cope with the disaster appear to be associated with PTG. Research has garnered preliminary support for PTG in children exposed to natural disasters but additional research is needed to fully explicate these relationships and to understand how these relationships change over time.
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Affiliation(s)
- Melissa Bernstein
- University of Oklahoma Health Sciences Center, 920 Stanton L. Young Blvd., Oklahoma City, OK, 73104, USA.
| | - Betty Pfefferbaum
- University of Oklahoma Health Sciences Center, 920 Stanton L. Young Blvd., Oklahoma City, OK, 73104, USA
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21
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North CS, Mendoza S, Simic Z, Pfefferbaum B. Parent-reported behavioral and emotional responses of children to disaster and parental psychopathology. JOURNAL OF LOSS & TRAUMA 2018; 23:303-316. [PMID: 30745859 DOI: 10.1080/15325024.2018.1443710] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
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 children had ≥1 postdisaster behavior change or disaster-related posttraumatic stress symptom. The children's postdisaster behavioral and emotional problems were associated with parental postdisaster psychopathology. The results underscore the importance of asking disaster survivors about their children's disaster reactions and considering parental disaster experiences and reactions in addressing their children's reactions.
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Affiliation(s)
- Carol S North
- Medical Director, The Altshuler Center for Education & Research, Metrocare Services, 1250 Mockingbird Lane, Suite 330, Dallas, Texas 75247-4914, 214-743-1200, The Nancy and Ray L. Hunt Chair in Crisis Psychiatry and Professor of Psychiatry, The University of Texas Southwestern Medical Center, 6363 Forest Park Rd., Room BL6.226, Dallas, Texas 75390-8828, 214-648-5375
| | - Steffi Mendoza
- Child and Adolescent Psychiatry Fellow, The University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd., Dallas, Texas 75390
| | - Zorica Simic
- Clinical Research Coordinator, The University of Texas Southwestern Medical Center, 6363 Forest Park Rd., Room BL6.310, Dallas, Texas 75390-8828, 214-648-4447
| | - Betty Pfefferbaum
- George Lynn Cross Research Professor Emeritus, Department of Psychiatry and Behavioral Sciences, College of Medicine, University of Oklahoma Health Sciences Center, 920 Stanton L. Young Blvd., WP3217, Oklahoma City, OK 73104, (405) 271-5251 x47639
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22
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Lai BS, Osborne MC, Piscitello J, Self-Brown S, Kelley ML. The relationship between social support and posttraumatic stress symptoms among youth exposed to a natural disaster. Eur J Psychotraumatol 2018; 9:1450042. [PMID: 29696072 PMCID: PMC5912434 DOI: 10.1080/20008198.2018.1450042] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2017] [Accepted: 02/25/2018] [Indexed: 11/22/2022] Open
Abstract
Background: Children are a vulnerable population following a natural disaster, due to their age and dependence on adults. The primary presenting problem children report after disasters is posttraumatic stress symptoms (PTSS). Prior research suggests that PTSS is inversely related to social support, which is often disrupted after a disaster. Objective: This study examined the relationship between social support (from parents, teachers, and peers) and PTSS in children affected by Hurricane Katrina. The research contributes to the literature by examining the mechanisms that drive this relationship over time. Methods: In this study, 426 children were followed over four timepoints, beginning 3-7 months after Hurricane Katrina and concluding 25-27 months post-hurricane. Three path models analysed the relationship between social support (from parents, teachers, and peers, measured by the Social Support Scale for Children) and PTSS (measured by the UCLA PTSD Reaction Index). Covariates included child age, minority status, gender, perceived life threat, and actual life threat. Nonsignificant paths were trimmed from the final models. Global fit indices were examined to determine model fit. Results: In the parent and peer social support models, PTSS exhibited statistically significant effects on social support from one wave to the next. In the teacher model, this was only true between Waves 2 and 3. Social support showed a statistically significant effect on PTSS between Wave 2 and Wave 3 in the peer model (standardized estimate = -0.26, p < .0001). No paths from social support to PTSS were significant in the parent and teacher models. Conclusion: Findings support a social selection model in which PTSS undermine social support, particularly in the first two years post-disaster. If these findings are replicated, this suggests that, in cases of limited funding, PTSS should be prioritized, given their cascading effects on social support.
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Affiliation(s)
- Betty S Lai
- School of Public Health, Georgia State University, Atlanta, GA, USA
| | | | | | | | - Mary Lou Kelley
- Department of Psychology, Louisiana State University, Baton Rouge, LA, USA
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23
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Abstract
PURPOSE OF REVIEW This paper reviews youth outcomes following exposure to natural disaster, with a focus on three relatively understudied outcomes: externalizing behavior problems, physical health, and posttraumatic growth. Recent, high-impact studies focusing on each outcome are summarized. RECENT FINDINGS Studies highlighted in this review utilize innovative and comprehensive approaches to improve our current understanding of youth broad-based physical and mental health outcomes beyond PTSD. The review concludes with recommendations to advance the field of youth disaster research by exploring how disasters may impact children across multiple domains, as well as using cutting edge ecobiological approaches and advanced modeling strategies to better understand how youth adjust and thrive following natural disaster.
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Fujiwara T, Yagi J, Homma H, Mashiko H, Nagao K, Okuyama M. Suicide risk among young children after the Great East Japan Earthquake: A follow-up study. Psychiatry Res 2017; 253:318-324. [PMID: 28412615 DOI: 10.1016/j.psychres.2017.04.018] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2016] [Revised: 02/06/2017] [Accepted: 04/07/2017] [Indexed: 11/26/2022]
Abstract
On 11 March 2011, the Great East Japan Earthquake and subsequent tsunami hit East Japan. We aim to investigate the impact of trauma experiences related to the earthquake on suicide risk among young children, stratified by child sex. Participants at baseline were children who were exposed to the 2011 disaster at preschool age (affected area, n=198; unaffected area, n=82, total n=280). From July 2013 to May 2014, suicide risk was assessed using the Mini International Neuropsychiatric Interview for Children and Adolescents (MINI-KID) in a follow-up interview conducted by a child psychiatrist or psychologist (N=210, follow-up rate: 75%). Among young girls in the affected area, 12 out of 65 (18.5%) showed suicidal ideation, which is significantly higher than girls in the unaffected area (4.7%, p for chi-square=0.036). In the multivariate model adjusted for potential confounders and mediators, the odds ratio for 4 or more trauma experiences related to the earthquake was 5.74 (95% confidence interval: 0.83-39.6, p=0.076) compared to no trauma experience related to the earthquake. Among young boys, trauma exposure was not associated with suicidal ideation. Our findings showed that young girls who experienced earthquake-related trauma at preschool age had a higher suicidal ideation 3 years after the earthquake.
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Affiliation(s)
- Takeo Fujiwara
- Department of Global Health Promotion, Tokyo Medical and Dental University, Tokyo, Japan.
| | - Junko Yagi
- Department of Neuropsychiatry, Iwate Medical University,, Iwate, Japan
| | - Hiroaki Homma
- Miyagi Prefectural Comprehensive Children's Center, Miyagi, Japan
| | - Hirobumi Mashiko
- Department of Neuropsychiatry, Fukushima Medical University, Fukushima, Japan
| | | | - Makiko Okuyama
- Department of Psychosocial Medicine, National Center for Child Health and Development, Japan
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Addressing the Needs of Preschool Children in the Context of Disasters and Terrorism: Assessment, Prevention, and Intervention. Curr Psychiatry Rep 2017; 19:40. [PMID: 28536808 DOI: 10.1007/s11920-017-0792-8] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
PURPOSE OF REVIEW The goal of this paper is to review the research literature regarding the needs of preschoolers in the context of disasters and terrorism with the aim of understanding the existing methods for assessment, prevention, and intervention to provide recommendations and point out required research and development. RECENT FINDINGS We differentiate between screening tools that provide initial evaluation and assessment tools for diagnosing preschooler children's pathology and review possible interventions that address the preschool child's needs before, during, and after the incident itself. We also emphasize the lack of dissemination and research of prevention programs and mass interventions for preschoolers. Programs for community mass prevention and intervention for preschoolers should be developed and evaluated and interventions should be adapted for individual and group delivery. Moreover, the increase in the number of children refugees requires cultural adaptations of assessment measures and interventions.
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26
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Lai BS, Esnard AM, Lowe SR, Peek L. Schools and Disasters: Safety and Mental Health Assessment and Interventions for Children. Curr Psychiatry Rep 2016; 18:109. [PMID: 27778233 DOI: 10.1007/s11920-016-0743-9] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
This article draws on experiences and lessons from global disasters and utilizes the United Nations Comprehensive School Safety Framework to highlight the necessary role of safe schools in protecting children, as well as adult staff, from the immediate threats and long-term implications of disasters. Specifically, we focus on three well-established pillars of school safety: Pillar I: Safe Learning Facilities; Pillar II: Disaster Management; and Pillar III: Risk Reduction and Resilience Education. In addition, we propose a potential fourth pillar, which underscores the function of schools in postdisaster mental health assessment and intervention for children. We argue that schools offer a central location and trusted institutional space for mental health assessment and intervention after disasters. We also examine the important linkages between schools, child mental health, and household and family recovery. We conclude with recommendations for filling gaps in research and practice related to ensuring the safety of schools and the associated health and well-being of children in the face of future disasters.
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Affiliation(s)
- Betty S Lai
- School of Public Health, Georgia State University, 1 Park Place, Atlanta, GA, 30303, USA.
| | - Ann-Margaret Esnard
- Andrew Young School of Policy Studies, Georgia State University, 14 Marietta Street, NW, Atlanta, GA, 30303, USA
| | - Sarah R Lowe
- Department of Psychology, Montclair State University, 1 Normal Avenue, Montclair, NJ, 07043, USA
| | - Lori Peek
- Department of Sociology, Colorado State University, B-237 Clark Building, Fort Collins, CO, 80523, USA
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Cherewick M, Tol W, Burnham G, Doocy S, Glass N. A structural equation model of conflict-affected youth coping and resilience. Health Psychol Behav Med 2016. [DOI: 10.1080/21642850.2016.1228458] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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Abstract
This paper reviews the impact of exposure to man-made or natural disasters on adolescent substance use. It covers empirical studies published from 2005 to 2015 concerning (a) the scope of the problem, (b) vulnerable groups and risk and protective factors, and (c) evidence-based interventions. The review suggests a strong link between adolescent substance use and exposure to either man-made or natural disaster. Vulnerable groups include adolescents with previous exposure to traumatic events, living in areas that are continually exposed to disasters, and ethnic minorities. Risk and protective factors at the individual, familial, community, and societal levels are described based on the bioecological model of mass trauma. Given that mass trauma is unfortunately a global problem, it is important to establish international interdisciplinary working teams to set gold standards for comparative studies on the etiology for adolescent substance use in the context of disasters.
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Affiliation(s)
- Miriam Schiff
- Hebrew University School of Social Work and Social Welfare, Mount Scopus, 91905, Jerusalem, Israel.
| | - Lin Fang
- Factor-Inwentash Faculty of Social Work, University of Toronto, 246 Bloor Street W, Toronto, ON, M5S1V4, Canada
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Child Disaster Mental Health Services: a Review of the System of Care, Assessment Approaches, and Evidence Base for Intervention. Curr Psychiatry Rep 2016; 18:5. [PMID: 26719308 DOI: 10.1007/s11920-015-0647-0] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
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 children to appropriate services. To assess the evidence base for disaster interventions, recent reviews of numerous child disaster mental health interventions are summarized.
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30
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Thordardottir EB, Valdimarsdottir UA, Hansdottir I, Hauksdóttir A, Dyregrov A, Shipherd JC, Elklit A, Resnick H, Gudmundsdottir B. Sixteen-year follow-up of childhood avalanche survivors. Eur J Psychotraumatol 2016; 7:30995. [PMID: 27534741 PMCID: PMC4989177 DOI: 10.3402/ejpt.v7.30995] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2016] [Revised: 07/19/2016] [Accepted: 07/22/2016] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Every year a substantial number of children are affected by natural disasters worldwide. However, data are scarce on long-term psychological impact of natural disasters on children's health. Identifying risk factors and outcomes associated with the long-term sequelae of posttraumatic stress disorder (PTSD) can provide a gateway to recovery as well as enhancement of preventive measures. OBJECTIVE Among childhood avalanche survivors, we aimed to investigate risk factors for PTSD symptoms and the relationship between socioeconomic status (SES) and PTSD symptoms in adulthood. METHODS Childhood survivors (aged 2-19 at the time of exposure) of two avalanches were identified through nationwide registers 16 years later. The Posttraumatic Diagnostic Scale was used to assess current PTSD symptoms. One-way ANOVA was used to explore PTSD symptoms by background and trauma-specific factors, as well as associations with current SES. Predictors of PTSD symptoms were examined by multivariable regression analysis. RESULTS Response rate was 66% (108/163). Results from univariate ANOVA analysis revealed that female sex was associated with PTSD symptoms (F=5.96, p<0.05). When adjusted for age and sex, PTSD symptoms were associated with lower education (F=7.62, p<0.001), poor financial status (F=12.21, p<0.001), and unemployment and/or disability (F=3.04, p<0.05). In a multivariable regression model, when adjusting for age and sex, lack of social support (t=4.22, p<0.001) and traumatic reactions of caregivers (t=2.49, p<0.05) in the aftermath of the disaster independently predicted PTSD 16 years post-trauma. CONCLUSIONS Lingering PTSD symptoms after childhood exposure to a disaster may negatively influence socioeconomic development in adulthood. Strengthening children's support systems post-disaster may prevent the long-term sequelae of symptoms.
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Affiliation(s)
- Edda Bjork Thordardottir
- Centre of Public Health Sciences, Faculty of Medicine, School of Health Sciences, University of Iceland, Reykjavik, Iceland;
| | - Unnur Anna Valdimarsdottir
- Centre of Public Health Sciences, Faculty of Medicine, School of Health Sciences, University of Iceland, Reykjavik, Iceland.,Department of Epidemiology, Harvard School of Public Health, Boston, MA, USA.,Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Ingunn Hansdottir
- Faculty of Psychology, School of Health Sciences, University of Iceland, Reykjavik, Iceland
| | - Arna Hauksdóttir
- Centre of Public Health Sciences, Faculty of Medicine, School of Health Sciences, University of Iceland, Reykjavik, Iceland
| | - Atle Dyregrov
- Center for Crisis Psychology, Bergen, Norway.,Department of Clinical Psychology, Faculty of Psychology, University of Bergen, Bergen, Norway
| | - Jillian C Shipherd
- National Center for PTSD, VA Boston Healthcare System, Boston, MA, USA.,Department of Psychiatry, Boston University School of Medicine, Boston, MA, USA
| | - Ask Elklit
- Department of Psychology, University of Southern Denmark, Odense, Denmark.,Department of Psychology, University of Ulster, Londonderry, Northern Ireland
| | - Heidi Resnick
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC, USA
| | - Berglind Gudmundsdottir
- Mental Health Services, Landspitali - The National University Hospital of Iceland, Reykjavik, Iceland.,Faculty of Medicine, School of Health Sciences, University of Iceland, Reykjavik, Iceland
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Houston JB, Spialek ML, Stevens J, First J, Mieseler VL, Pfefferbaum B. 2011 Joplin, Missouri Tornado Experience, Mental Health Reactions, and Service Utilization: Cross-Sectional Assessments at Approximately 6 Months and 2.5 Years Post-Event. PLOS CURRENTS 2015; 7:ecurrents.dis.18ca227647291525ce3415bec1406aa5. [PMID: 26579331 PMCID: PMC4639320 DOI: 10.1371/currents.dis.18ca227647291525ce3415bec1406aa5] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
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 Joplin adults at approximately 6 months post-disaster (Survey 1) and a purposive convenience sample (N = 438) of Joplin adults at approximately 2.5 years post-disaster (Survey 2). For both surveys we assessed tornado experience, posttraumatic stress, depression, mental health service utilization, and sociodemographics. For Survey 2 we also assessed social support and parent report of child strengths and difficulties. Results. Probable PTSD relevance was 12.63% at Survey 1 and 26.74% at Survey 2, while current depression prevalence was 20.82% at Survey 1 and 13.33% at Survey 2. Less education and more tornado experience was generally related to greater likelihood of experiencing probable PTSD and current depression for both surveys. Men and younger participants were more likely to report current depression at Survey 1. Low levels of social support (assessed only at Survey 2) were related to more probable PTSD and current depression. For both surveys, we observed low rates of mental health service utilization, and these rates were also low for participants reporting probable PTSD and current depression. At Survey 2 we assessed parent report of child (ages 4 to 17) strengths and difficulties and found that child difficulties were more frequent for younger children (ages 4 to 10) than older children (ages 11 to 17), and that parents reporting probable PTSD reported a greater frequency of children with borderline or abnormal difficulties. Discussion. Overall our results indicate that long-term (multi-year) community disaster mental health monitoring, assessment, referral, outreach, and services are needed following a major disaster like the 2011 Joplin tornado.
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Affiliation(s)
- J Brian Houston
- Disaster and Community Crisis Center, Department of Communication, University of Missouri, Columbia, Missouri, USA
| | - Matthew L Spialek
- Disaster and Community Crisis Center, Department of Communication, University of Missouri, Columbia, Missouri, USA
| | - Jordan Stevens
- Department of Psychology, University of Missouri, Columbia, Missouri, USA
| | - Jennifer First
- Disaster and Community Crisis Center, School of Social Work, University of Missouri, Columbia, Missouri, USA
| | | | - Betty Pfefferbaum
- Department of Psychiatry and Behavioral Health Sciences, University of Oklahoma College of Medicine, Oklahoma City, Oklahoma, USA
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Pfefferbaum B, Jacobs AK, Griffin N, Houston JB. Children's disaster reactions: the influence of exposure and personal characteristics. Curr Psychiatry Rep 2015; 17:56. [PMID: 25980513 DOI: 10.1007/s11920-015-0598-5] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
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 recently, traumatic grief and posttraumatic growth have been explored. New research has delineated trajectories of children's posttraumatic stress reactions and offered insight into the long-term consequences of their disaster experiences. Risk factors for adverse outcomes include pre-disaster vulnerabilities, perception of threat, and loss and life disruptions post-disaster. Areas in need of additional research include studies on the timing and course of depression and anxiety post-event and their interactions with other disorders, disaster-related functional and cognitive impairment, positive outcomes, and coping.
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Affiliation(s)
- Betty Pfefferbaum
- Department of Psychiatry and Behavioral Sciences, College of Medicine, University of Oklahoma Health Sciences Center, P.O. Box 26901, WP3217, Oklahoma City, OK, 73126-0901, USA,
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