Predicting Mothers' Reports of Children's Mental Health Three Years after Hurricane Katrin

Exposure to Multiple Natural Disasters and Externalising and Internalising Behavior: A Longitudinal Study of Adolescents

PURPOSE

As natural disasters become more frequent and more severe, there is a corresponding need to understand their relationship with child and adolescent mental health, and in particular, to understand exposure to multiple natural disasters. This study assesses the relationship between exposure to both single and multiple disasters and adolescent internalising and externalising behavior.

METHODS

The study used five waves of a nationally representative longitudinal Australian dataset. Exposure to sudden-onset (fires, floods, storms) and slow-onset (drought) disasters was collected across five waves. Adolescent internalising and externalising behavior collected in the final three waves using the self-reported Strengths and Difficulties Questionnaire. Random effects regressions assessed sudden- and slow-onset disasters and multiple disaster exposure, controlling for geographic and socioeconomic variables.

RESULTS

Exposure to multiple disasters was associated with adverse adolescent outcomes. Two or more sudden- and slow-onset disaster exposures in the last 12 months was related to more conduct problems. Exposure to multiple sudden-onset disasters in the current and previous waves was related to increased problems with peers. A single exposure to either sudden- or slow-onset disasters was not associated with Strengths and Difficulties Questionnaire outcomes.

DISCUSSION

The study findings suggest that multiple exposure to disasters has a negative association with adolescent wellbeing. These findings suggest that, rather than adapting to disasters, youth exposed to multiple disasters suffer more than their peers, including peers exposed to a single disaster.

The Impact of Caregivers on COVID-19 Fears, Behaviors, and Perceived Impact in a Majority Black American Sample of Children

Introduction

Caregivers may play an essential role in buffering and/or exacerbating COVID-19 fears and behaviors in youth. However, few studies have examined these associations in children from racial and ethnic minority groups, who have been historically marginalized and may be disproportionately susceptible to psychological consequences. Here, we examined the associations among caregivers and children for COVID-19-related fears, behaviors, and impact in a majority Black sample (71.9%) of children.

Methods

Children (N = 64, 24 females, ages 7-10 years) were recruited from three Detroit, Michigan-area schools during the 2019-2020 school year. Following school shutdowns in March 2020, children and their caregivers were invited to complete remote surveys in May and August 2020. We examined the associations among child and caregiver COVID-19-related fears, preventive behaviors, and perceived impact. We also examined whether aspects of the caregiver-child relationship (i.e., closeness, conflicts) moderated these associations.

Results

Caregiver-child fears about social distancing, preventive behaviors, and perceived impact of COVID-19 were positively correlated. The positive correlation between caregiver-child preventive behaviors strengthened over time and was moderated by caregiver-child closeness.

Conclusion

These findings suggest that caregivers may impact fear as well as preventive behaviors and perceived impact of the pandemic in marginalized youth.

Youth Suicidality in the Context of Disasters

PURPOSE OF REVIEW

The purpose of this review is to summarize the current literature regarding youth suicidality (suicidal ideation, suicidal behavior, and completed suicide) in the context of disasters.

RECENT FINDINGS

There are fewer studies that examine the effect of disasters on suicidality specifically in children and youth than studies that focus on adults or general population. Numerous studies have reported on the effect of disasters on youth mental health in general without zeroing in on suicide risk. Some variables that have shown to increase suicide risk in children and youth after disasters include female gender, age at the time of disaster exposure, dependence on adults, attachments to places and caregivers, family functioning, and vulnerability to mistreatment. Several studies have demonstrated that youth suicidality fluctuates in response to disasters, at times increasing immediately post-disaster and at other times decreasing immediately post-disaster followed by an increase later. Exposure to natural disasters (e.g., earthquakes, typhoons, hurricanes, wildfires, and extremes of temperature and humidity), man-made disasters (e.g., armed conflict, global warming, and pollution), and unique disasters (e.g., the COVID-19 pandemic) have had significant impact on suicidality in children and adolescents. Although there are several promising interventions to mitigate the post-disaster suicide risk among youth, there is no consensus on a single intervention that is superior to others. More research is needed to study youth suicide risk in the context of disasters and develop culturally appropriate and evidence-based interventions.

Pain, mental health and healthcare utilization: Impact of the COVID-19 pandemic on youth with chronic pain, parents and siblings

BACKGROUND

Paediatric chronic pain was a public health emergency before the novel coronavirus (COVID-19) pandemic, and this problem is predicted to escalate. Pain tends to occur intergenerationally in families, and youth with chronic pain and their parents have high rates of mental health issues, which can further exacerbate pain. Siblings of youth with chronic pain have been largely overlooked in research, as well as the impact of the pandemic on posttraumatic stress disorder (PTSD) symptoms and healthcare utilization.

METHODS

This cross-sectional study examined pain, mental health and healthcare utilization in three groups: youth with chronic pain (n = 357), parents of youth with chronic pain (n = 233) and siblings of youth with chronic pain (n = 156) during the COVID-19 pandemic in Canada.

RESULTS

More so than with pain symptoms, the results revealed high levels of mental health symptoms (i.e. anxiety, depressive, and PTSD), particularly in individuals more personally impacted by the pandemic. The largest effect was seen on PTSD symptoms for all groups. For parents with chronic pain, greater personal COVID-19 impact was related to worse pain interference. Reported rates of healthcare utilization were strikingly high, with youth with chronic pain, parents (reporting on behalf of their children with chronic pain), and siblings of youth with chronic pain reporting that most consultations were due to pain.

CONCLUSIONS

Longitudinal research assessing these outcomes across continued waves of the pandemic is needed to ensure timely, tailored and equitable access to pain and mental health assessment and treatment.

SIGNIFICANCE

This study examined pain, mental health, substance use and healthcare utilization in youth with chronic pain, siblings and parents during the COVID-19 pandemic. Greater personal impact of the pandemic was not largely associated with poorer pain outcomes; however, it was associated with mental health, with the largest effect on PTSD symptoms. The high rates and significant association of COVID-19 impact with PTSD symptoms underscore the importance of including PTSD assessment as part of routine screening practices in pain clinics.

Domestic violence towards children in Kenya and Zambia during the COVID-19 pandemic

OBJECTIVES

Although research has demonstrated that the COVID-19 pandemic has increased the likelihood of children experiencing domestic abuse, few empirical studies have focused on the most vulnerable communities in developing countries. This study aimed to evaluate the impact of the COVID-19 pandemic on domestic violence towards children in Kenya and Zambia.

STUDY DESIGN

In collaboration with an international non-governmental organisation (NGO), an original door-to-door survey of 842 children and their parents (or adult guardians) was conducted in Kenya and Zambia. The survey sites were carefully selected to target economically underprivileged communities with the presence of NGOs as well as those without.

METHODS

Using multivariate regression analysis of child and parent survey responses, we attempted to identify how parents' experiences of COVID-19 affected children's exposure to domestic violence. Our analysis of domestic violence included both emotional (psychological) and physical violence.

RESULTS

Children from households whose guardians perceived a strongly negative effect of COVID-19 were more likely to experience domestic violence. The correlation was statistically significant for both emotional and physical violence. In Kenya, children in communities with NGO presence were less likely to experience domestic violence.

CONCLUSIONS

The COVID-19 pandemic has exposed children to an increased risk of experiencing domestic violence. Children from underprivileged communities in developing countries are particularly vulnerable to such risk, as they tend to lack social support from communities and governments. International organisations must pay more attention to these children during the pandemic.

"We survived the pandemic together": The impact of the COVID-19 pandemic on Canadian families living with chronic pain

Introduction

Pediatric chronic pain is a significant problem in Canada, affecting one in five youth. This study describes the impact of the pandemic on the experiences of Canadian families living with chronic pain through interviews with youth living with chronic pain, parents, and siblings.

Methods

Employing a qualitative descriptive design, in-depth semistructured interviews were completed with Canadian youth living with pain, as well as parents and siblings. Participants were not required to be related. Interviews were analyzed using a reflexive thematic analysis approach.

Results

Forty-four interviews were completed with 14 parents, 19 youth with chronic pain, and 11 siblings from across the country. Three key themes were developed: (1) absorbing and shifting: the toll of the pandemic on the family system (e.g., loss of coping mechanisms, shifting roles to respond to the pandemic), (2) social ambiguity and abandonment (e.g., social sacrifice and abandonment by the health care system), and (3) building community resilience: familial adaptation to the pandemic (e.g., family cohesion, confidence, and self-management).

Discussion/Conclusions

Youth, parents, and siblings reported that the pandemic impacted coping strategies across the family system. These results outline the challenges youth experienced managing their pain and overall health throughout the pandemic and the resilience built within families during this time. Going forward, it would be relevant to examine how racialized and structurally marginalized youth with chronic pain and their families experienced the pandemic. Future research should examine how unexpected benefits of the pandemic (e.g., increased confidence and self-management) may be sustained into the future.

The Effects of Maternal Disaster Exposure on Adolescent Mental Health 12 Years Later

Natural disasters adversely impact children's mental health, with increased parent or child exposure and subsequent parental distress predicting poorer outcomes. It remains unknown, however, whether the psychological consequences of disasters for children persist long-term, and if so, why and for whom. We therefore examined the effects of mothers' exposure to Hurricane Katrina on adolescent children's mental health 12 years later, distinguishing between direct effects of disaster exposure and effects mediated by maternal distress, and evaluating moderation by child age and gender. Data were from a 2003-2018 study of young, low-income, primarily African American mothers living in New Orleans when Hurricane Katrina occurred in 2005 (n = 328). Mothers rated their mental health about one year pre-Katrina and one, four, and 12 years afterwards. They reported on an adolescent child's (ages 10-17, mean = 14.46) internalizing and externalizing symptoms 12 years post-Katrina using the Strengths and Difficulties Questionnaire. Path analytic models adjusting for mothers' pre-disaster distress showed that, whereas the direct effects of maternal hurricane exposures on child mental health were not significant, the indirect effects were. Specifically, mothers who experienced more Katrina-related stressors had higher distress thereafter, which predicted poorer child outcomes. Results did not differ significantly by child age. Gender differences are discussed. Findings suggest that disasters can affect child mental health for many years, even for those who were very young or not yet born at the time, due to parents' disaster-related distress. Addressing parents' mental health needs in the aftermath of disasters may improve child well-being long-term.

The Mental Health Consequences of Hurricane Matthew on Haitian Children and Youth: An Exploratory Study

Haiti has experienced many major natural disasters in the past decade that included Hurricane Matthew which led to mass damage to property, a depletion of basic resources, human fatalities and injuries, and mental health consequences that affected the poorest. The current study focused on the psychological effects of Hurricane Matthew on Haitian children and adolescents. Children display heightened depression, and PTSD symptoms in the aftermath of disasters (Hausman et al., Journal of Family Psychology 34:836-845, 2020), however, the researchers anticipated that children living in orphanages would display more severe mental health symptoms than those living with their families, because of their additional stressor of family loss. Using a convenience sample, quantitative data was collected using several instruments, in a survey format, that were individually administered to a sample of 77 adolescents. Participants had high depressive scores and reported multiple adverse events and limited access to basic needs. In comparing subgroups, we found children who were in orphanages reported significantly fewer adverse childhood experiences than those living with their families. This is likely because orphanages in Haiti consistently provide children with a safe and stable environment, buffering them against the traumatic effects of disasters. In contrast, children living with their families reported witnessing or experiencing interpersonal violence, neglect and abuse in addition to disaster-related stress. Before addressing the issues faced by disaster-affected children in Haiti, the systemic issues that maintain the socio-economic deprivation of so many citizens must be addressed. An important step is for policymakers to collaborate with mental health providers to develop community interventions that are low-cost and easily accessible. These interventions must consider and incorporate the social context and cultural patterns of help-seeking and treatment utilization in Haiti.

Parenting stress, maternal depression and child mental health in a Melbourne cohort before and during the COVID-19 pandemic

AIM

This paper aims to examine the maternal and child mental health and parenting outcomes in the context of COVID-19 pandemic conditions using a sample from Melbourne, Australia - a city exposed to one of the longest lockdowns world-wide in response to the pandemic.

METHODS

This study utilises observational data from a prospective, pregnancy cohort, Mercy Pregnancy Emotional Wellbeing Study and includes 468 women and their children followed up in Melbourne to 3-4 years postpartum pre-COVID pandemic and compared to those followed up during the COVID-19 pandemic.

RESULTS

When compared to mothers followed up at 3-4 years postpartum pre-pandemic, those followed up during the COVID-19 pandemic showed higher depressive symptoms with a steep incline in their symptom trajectory (EMM_difference  = 1.72, Bonferroni-corrected P < 0.01, d = 0.35) and had a three times higher risk of scoring 13 or above on the EPDS (aRR = 3.22, Bonferroni-corrected P < 0.01). Although this increase was not associated with the variation in the duration of exposure to pandemic conditions, the steep increase in depressive symptoms was more pronounced in those with pre-existing depressive disorders. There was no difference in parenting stress or adjusted childhood mental health symptoms or disorder.

CONCLUSIONS

Our findings highlight the vulnerability of those with pre-existing clinical mental health disorders and the need for adequate clinical care for this vulnerable group. Equally, our study indicates the possibility that  parenting and early childhood mental health outcomes, at least in the short term, may be resilient.

Longitudinal transactional relationships between caregiver and child mental health during the COVID-19 global pandemic

BACKGROUND

Emerging work examining the psychological impact of COVID-19 on children and families suggests that the relationship between pandemic-related stress, child psychosocial functioning, and caregiver mental health are interrelated. However, much of this research is unidirectional and thus little is known about the bidirectional cascading effects children and caregivers may experience. The current study examined the transactional relationships between caregiver and child mental health over time during the COVID-19 pandemic.

METHODS

Linguistically, racially, and ethnically diverse caregivers (N = 286) of young children completed measures of caregiver mental health, caregiver pandemic-related stress, and child mental health (i.e., externalizing, internalizing, prosocial behavior) across three time points in the spring of 2020.

RESULTS

Using autoregressive cross-lagged analyses, impaired caregiver mental health at Time 1 (April 2020) predicted increased caregiver pandemic-related stress at Time 2 (May 2020). Caregiver pandemic-related stress at Time 1 predicted increased child internalizing symptoms at Time 2 which, in turn, predicted increased caregiver pandemic-related stress at Time 3 (July 2020). Lastly, impaired caregiver mental health at Time 2 (May 2020) predicted increased child externalizing symptoms at Time 3 (July 2020).

CONCLUSIONS

Assessing transactional relationships between child and caregiver mental health during the COVID-19 pandemic is important to inform models of risk and resilience. Interventions at the level of the caregiver, the child, and/or the family should be considered as a way to interrupt potential negative developmental cascades.

Psychological effects of the 2017 California wildfires on children and youth with disabilities

The psychological effects of disasters on children with disabilities are understudied, despite evidence towards increased risk for complications after other types of trauma exposure. This study investigated the experience of children and youth with disabilities exposed to the 2017 Northern California wildfires, with a particular focus on psychological reactions. In-depth interviews were conducted with parents of 14 children and youth with disabilities one year post-disaster. Thematic analysis was used to analyze the interviews. Parents described the wildfires as traumatic events for both themselves and their children. Children and youth exhibited stress, grief, and other emotional and behavioral reactions during evacuation, in the immediate aftermath, and one year post-disaster. Navigating disability-related needs, such as accessible housing, contributed to parent stress post-disaster. School and community-based mental health efforts are described, along with a call for increased attention to disaster-related reactions in children with developmental disabilities. Suggestions for improving preparedness and response efforts that better support children with disabilities and their families post-disaster are given.

Risk and resilience of well-being in caregivers of young children in response to the COVID-19 pandemic

The COVID-19 pandemic is impacting communities worldwide, with direct effects of illness and mortality, and indirect effects on economies, workplaces, schools/daycares, and social life. However, we understand very little about the effects of this pandemic on families of young children. We used a risk and resilience model to evaluate the effects of the pandemic on mental health in diverse caregivers (N = 286) with children ages birth to 5. We evaluated the hypotheses that (a) pandemic stress and caregiver-reported child psychosocial concerns correlate with caregivers' mental health symptoms and (b) caregivers' pandemic-related self-efficacy and coping mediate these relationships. Caregivers completed surveys in April-May 2020 assessing pandemic stress (e.g., health, finances, and housing), child psychosocial problems, coping strategies, and self-efficacy to manage family needs. Our primary outcome was caregivers' self-reported changes in mental health symptoms since the outbreak. Path analysis revealed that higher pandemic stress was associated with caregivers' reduced confidence in meeting their family's needs related to COVID-19, which correlated with worse caregiver mental health symptoms. Greater child psychosocial problems also predicted worse caregiver mental health symptoms. Findings suggest that pandemic stress, child psychosocial problems, and caregiver self-efficacy are interrelated in their influence on caregivers' mental health. While further research is needed to examine strategies to foster resilience and buffer the pandemic's effects on caregiver mental health, this is a first step in evaluating the psychosocial effects of this pandemic in families of young children. Clinical implications are discussed for a tiered response to mitigate the pandemic's impacts on family functioning.

The effects of cumulative natural disaster exposure on adolescent psychological distress

Natural disasters are becoming more frequent and destructive due to climate change and have been shown to be associated with a variety of adverse mental health outcomes in children and adolescents. This study utilizes data from three cohort studies of Hurricane Katrina survivors-including low-income mothers from New Orleans; displaced and highly impacted families from Louisiana and Mississippi; and Vietnamese immigrants in New Orleans-to examine the relationship between cumulative natural disaster exposure and adolescent psychological distress approximately 13 years after Katrina. Among 648 respondents with children ages 10-17, 112 (17.2%) reported that their child had exhibited one or more symptoms of psychological distress in the past month. Overall, respondents had experienced an average of 0.6 (SD 1.0) natural disasters following Hurricane Katrina. Each additional natural disaster experienced by the respondent was associated with 1.41 (95% CI 1.05, 1.88) greater odds of his or child experiencing psychological distress in the past month. This relationship was not significantly moderated by any measures of family resilience or vulnerability, nor by race/ethnicity or socioeconomic status, although family functioning, parental coping, and caregiver mental health were independently associated with adolescent psychological distress. The results of this analysis suggest that natural disasters have cumulative, detrimental impacts on adolescent mental health.

Mitigating Health Disparities After Natural Disasters: Lessons From The RISK Project

Climate change exacerbates the severity of natural disasters, which disproportionately affect vulnerable populations. Mitigating disasters' health consequences is critical to promoting health equity, but few studies have isolated the short- and long-term effects of disasters on vulnerable groups. We filled this gap by conducting a fifteen-year (2003-2018) prospective study of low-income, predominantly Black parents who experienced Hurricane Katrina: the Resilience in Survivors of Katrina (RISK) Project. Here we describe this project and synthesize lessons from work that has resulted from it. Our findings can guide policy makers, service providers, and health officials in disaster planning and response. We synthesize them into an organizational schema of five priorities: Primary efforts should be aimed at preventing exposure to trauma through investments in climate resilience and by eliminating impediments to evacuation, health care policies should promote uninterrupted and expanded access to care, social services should integrate and strive to reduce the administrative burden on survivors, programs should aid survivors in forging or strengthening connections to their communities, and policy makers should fund targeted long-term services for highly affected survivors.

Long-Lasting Effects of the 2013 Yolanda Typhoon on Overall Health of Mothers and Children

OBJECTIVES

Three years after the 2013 Yolanda Typhoon, this study sought to determine the factors associated with the stress of the affected mothers and the health of the children on Leyte island, and the preparedness of the community to mitigate future potential disasters.

METHODS

Three hundred mothers with children from 0 to 7 years old were selected through convenience sampling, structured interviews conducted using the Hurricane-Related Traumatic Experiences questionnaire and the PTSD (post-traumatic stress disorder) Checklist 5 (PCL5), and the children's weights and heights were measured.

RESULTS

The provisional PTSD prevalence was found to be 53.3% 3 y after Yolanda. The multiple regression analysis with multiple imputation for the missing values found that housing and childcare attitudes were significantly associated with preparedness.

CONCLUSIONS

This study concluded that living in multistoried houses was useful for disaster mitigation and that the caregiving responsibility for their children could be a disaster preparedness motivation for mothers.

Statistical analysis of childhood and early adolescent externalizing behaviors in a middle low income country

The article show the pattern of externalizing behavior across age, gender, school type, and school level, with reference to aggression, delinquency, and hyperactivity. The study samples were primary school pupils and secondary school students from three selected Local Government Areas (LGA) in Ogun State, Nigeria [Ado-Odo/Ota, Ifo, and Yewa South]. Their ages ranged from 10 to 20 years. The student/pupil sample was 1770 in all. The instrument used was an adapted version of Achenbach's child behavior checklist and youth self-report. Basic descriptive statistics like frequency, percentage, mean, standard deviation, as well as non-parametric statistics like Phi-coefficient, Chi-square, Goodman and Kruskal's gamma, Mann Whitney U test and Kruskal Wallis H test were utilized. Inferential parametric statistics like Pearson r, analysis of variance and simple regression were also utilized. Four major findings were reported. Firstly, the private schools irrespective of age, gender and level, scored higher than the public school in aggression, delinquency, and hyperactivity. Secondly, aggression is higher in secondary schools, while delinquency and hyperactivity are more prevalent in primary schools. Thirdly, school level and school type are the strongest predictors of externalizing behavior. Lastly, correspondence analysis showed a similar behavioral pattern for the three behaviors and three distinct behavioral patterns. i). Respondents aged 10 and below and those in primary schools (ii). Male, public and between 16 and 20. iii). Private, secondary, female and between 11 and 15. Implications of the study are discussed.

Behavioral Responses in Youth Exposed to Natural Disasters and Political Conflict

PURPOSE OF REVIEW

The aim of this review was to focus solely on youths' behavioral responses to natural disasters and political conflicts in order to fully understand their impact and scope.

RECENT FINDINGS

Recent studies in the field of trauma have shown that theoretical conceptions have moved away from a narrow focus on the individual and towards wider ecological perspectives and from a narrow focus on negative responses to trauma exposure towards positive prosocial responses. Although there is a distinction between youths' behavioral responses towards natural disasters vs. towards political conflicts, in both of these adverse situations, behavioral responses exist alongside emotional responses. Adolescents exposed to either type of adverse scenario are often able to turn their negative experiences into positive ones, take greater responsibility for themselves and others, contribute to recovery processes, and engage in prosocial behaviors. These responses must be investigated in the context of the trauma field's recent understandings regarding psychological, biological, environmental, and cultural factors.

A Meta-Analysis of the Impact of Natural Disasters on Internalizing and Externalizing Problems in Youth

Although exposure to natural disasters can lead to diverse mental health (MH) outcomes in youth, most child disaster MH research has focused on posttraumatic stress symptoms (PTSS). To highlight the likelihood of other MH outcomes, we meta-analyzed studies that have examined other (non-PTSS) internalizing and externalizing behavior problems in youth exposed to natural disasters. We used PRISMA guidelines to systematically gather studies that have examined the association between natural disaster exposure and non-PTSS internalizing and/or externalizing problems in samples of children and adolescents. Analyses of random effects models of 62 studies examining non-PTSS internalizing problems and 26 studies examining externalizing problems showed exposure to natural disasters was significantly associated with non-PTSS internalizing, r_mean = .18, k = 70, and externalizing problems, r_mean = .08; k = 31, in youth. Moderator analyses revealed a stronger association between disaster exposure and non-PTSS internalizing problems in countries with a "medium" Human Development Index (HDI) ranking, r = .56, than in countries with "high," r = .15, and "very high," r = .16, HDI rankings. We also found a stronger association between disaster exposure and externalizing problems in countries with a medium HDI ranking, r = .54, versus high, r = .05, and very high, r = .04, HDI rankings, and based on parent, r = .16, compared to child, r = -.01, report. Results support the need for assessment of multiple postdisaster MH outcomes to inform comprehensive interventions. We also include a discussion of the state of the disaster MH research.

The Impact of Natural Disasters on Youth: A Focus on Emerging Research beyond Internalizing Disorders

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.

Life after Hurricane Katrina: The Resilience in Survivors of Katrina (RISK) Project

This article presents an overview of the findings to date of the Resilience in Survivors of Katrina (RISK) Project, a longitudinal study of 1,019 young, predominantly female and African American community college students who were surveyed a year before Hurricane Katrina in New Orleans and then two to three times afterward. This study combines a multidisciplinary, multimethod approach to understanding the immediate and long-term effects of the Katrina disaster on physical and mental health, economic and social functioning, and neighborhood attainment. I discuss what we can learn from the rare inclusion of predisaster data and our unusual ability to follow participants for years after the disaster. I argue that it is important to follow the recovery of individuals and communities as well as the recovery of the city, as these are often not the same, especially in Katrina where a large proportion of the city never returned.

Event-Related Household Discussions Following the Boston Marathon Bombing and Associated Posttraumatic Stress Among Area Youth

Despite research documenting the scope of disaster-related posttraumatic stress (PTS) in youth, less is known about how family processes immediately postdisaster might associate with child outcomes. The 2013 Boston Marathon bombing affords a unique opportunity to assess links between immediate family discussions about community trauma and child mental health outcomes. The present study examined associations between attack-related household discussions and child PTS among Boston-area youth ages 4 to 19 following the Marathon bombing (N = 460). Caregivers completed surveys 2 to 6 months postattack about immediate household discussions about the events, child exposure to potentially traumatic attack-related experiences, and child PTS. During the Marathon bombing and manhunt, there was considerable heterogeneity in household discussions across area families, and several discussion items were differentially predictive of variability in children's PTS. Specifically, after controlling for children's direct exposure to the potentially traumatic attack/manhunt events, children showed lower PTS when it was their caregivers who informed them about the attack and manhunt, and when their caregivers expressed confidence in their safety and discussed their own feelings about the manhunt with their child. Children showed higher PTS when their caregivers did not discuss the events in front of them, asked others to avoid discussing the events in front of them, and expressed concern at the time that their child might not be safe. Child age and traumatic attack/manhunt exposure moderated several links between household discussions and child PTS. Findings underscore the importance of family communication and caregiver modeling during times of community threat and uncertainty.

Mother and Child Reports of Hurricane Related Stressors: Data from a Sample of Families Exposed to Hurricane Katrina

BACKGROUND

Families exposed to disasters such as Hurricane Katrina are at risk for numerous adverse outcomes. While previous literature suggests that the degree of disaster exposure corresponds with experiencing negative outcomes, it is unclear if parents and children report similar levels of disaster exposure.

OBJECTIVE

The purpose of this paper was to examine levels of disaster stressor agreement among mother-child dyads affected by Hurricane Katrina, and to examine whether discrepancies in disaster stressor reports are associated with higher levels of posttraumatic stress (PTS) symptoms.

METHODS

Participants in this study consisted of 353 dyads of mothers (age M = 38.79 years, SD = 7.52; 68% African American) and children (52% girls; age M = 11.61 years, SD = 1.57) exposed to Hurricane Katrina. Parents and children were assessed at two timepoints, 3 - 7 months and 14 - 17 months postdisaster. Parent and child responses to items regarding hurricane related stressor exposure and PTS symptoms were analyzed.

RESULTS

Agreement on hurricane related exposures was predominately slight to moderate, with kappas ranging from κ = .19 to κ = .83. Polynomial regression analyses revealed that when mothers reported low levels of Immediate Loss/Disruption stressors and children reported high levels of these stressors, children reported higher levels of Time 2 PTS symptoms, b = -.72 (.33), p = .03.

CONCLUSIONS

Overall, levels of mother-child response agreement were low. Discrepancies in mother and child reports predicted higher levels of child PTS symptoms. Clinicians may want to query both parents and children about their disaster experiences when working with families postdisaster.

Clinically significant behavior problems among young children 2 years after the Great East Japan Earthquake

Background

On March 11, 2011, a massive undersea earthquake and tsunami struck East Japan. Few studies have investigated the impact of exposure to a natural disaster on preschool children. We investigated the association of trauma experiences during the Great East Japan Earthquake on clinically significant behavior problems among preschool children 2 years after the earthquake.

Method

Participants were children who were exposed to the 2011 disaster at preschool age (affected area, n = 178; unaffected area, n = 82). Data were collected from September 2012 to June 2013 (around 2 years after the earthquake), thus participants were aged 5 to 8 years when assessed. Severe trauma exposures related to the earthquake (e.g., loss of family members) were assessed by interview, and trauma events in the physical environment related to the earthquake (e.g. housing damage), and other trauma exposure before the earthquake, were assessed by questionnaire. Behavior problems were assessed by caregivers using the Child Behavior Checklist (CBCL), which encompasses internalizing, externalizing, and total problems. Children who exceeded clinical cut-off of the CBCL were defined as having clinically significant behavior problems.

Results

Rates of internalizing, externalizing, and total problems in the affected area were 27.7%, 21.2%, and 25.9%, respectively. The rate ratio suggests that children who lost distant relatives or friends were 2.36 times more likely to have internalizing behavior problems (47.6% vs. 20.2%, 95% CI: 1.10–5.07). Other trauma experiences before the earthquake also showed significant positive association with internalizing, externalizing, and total behavior problems, which were not observed in the unaffected area.

Conclusions

One in four children still had behavior problems even 2 years after the Great East Japan Earthquake. Children who had other trauma experiences before the earthquake were more likely to have behavior problems. These data will be useful for developing future interventions in child mental health after a natural disaster.

Maternal exposure to neighborhood soil Pb and eclampsia risk in New Orleans, Louisiana (USA): evidence from a natural experiment in flooding

BACKGROUND

Previous studies link maternal blood lead (Pb) levels and pregnancy-related hypertensive disorders.

OBJECTIVE

Assess the relationship between neighborhood soil Pb and maternal eclampsia risk.

METHODS

Zip code summarized high density soil survey data of New Orleans collected before and after Hurricanes Katrina and Rita (HKR) were merged with pregnancy outcome data on 75,501 mothers from the Louisiana office of public health. Cross-sectional logistic regression analyses are performed testing the association between pre-HKR accumulation of Pb in soils in thirty-two neighborhoods and eclampsia risk. Then we examine whether measured declines in soil Pb following the flooding of the city resulted in corresponding reductions of eclampsia risk.

RESULTS

Cross-sectional analyses show that a one standard deviation increase in soil Pb increases the odds of eclampsia by a factor of 1.48 (95% CI: 1.31, 1.66). Mothers in zip code areas with soil Pb>333 mg/kg were 4.00 (95% CI: 3.00, 5.35) times more likely to experience eclampsia than mothers residing in neighborhoods with soil Pb<50mg/kg. Difference-in-differences analyses capturing the exogenous reduction in soil Pb following the 2005 flooding of New Orleans indicate that mothers residing in zip codes experiencing decrease in soil Pb (-387.9 to -33.6 mg/kg) experienced a significant decline in eclampsia risk (OR=0.619; 95% CI: 0.397, 0.963).

CONCLUSIONS

Mothers residing in neighborhoods with high accumulation of Pb in soils are at heightened risk of experiencing eclampsia.