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Adu MK, Agyapong B, Agyapong VIO. Children's Psychological Reactions to Wildfires: a Review of Recent Literature. Curr Psychiatry Rep 2023; 25:603-616. [PMID: 37851204 DOI: 10.1007/s11920-023-01451-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/11/2023] [Indexed: 10/19/2023]
Abstract
PURPOSE OF REVIEW This review aims to synthesize currently available literature regarding the impact of wildfire on mental health, specifically the psychological reactions of children to wildfires. The information gathered from this review will help health experts understand and address the mental health needs of children during wildfire disasters and may serve as a base for future studies to evaluate evidence-based public health responses to mitigate adverse outcomes. RECENT FINDINGS The results identified post-traumatic stress disorder (PTSD), anxiety, depression, stress, alcohol/substance misuse, hopelessness, low resilience, reduced quality of life, and self-esteem as the psychological conditions manifesting in children and adolescent post-wildfire disaster. PTSD was the most evaluated psychological reaction in the participants (7 out of eight studies). This review highlights that deleterious mental health effects, such as PTSD, depression, anxiety, and suicidality, can persist in children for years post-wildfire disaster. Factors such as gender, direct exposure to the wildfire, re-traumatization, and resilience informed or ameliorated the severity of the impact of wildfire on children and adolescents. Our findings further emphasize the need for multi-year funding and programs to support children and adolescents' mental health, including children with disabilities in the communities that have experienced wildfire disasters.
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Affiliation(s)
- Medard K Adu
- Department of Psychiatry, Faculty of Medicine, Abbie J. Lane Memorial Building, Dalhousie University, QEII Health Sciences Centre, 5909 Veterans Memorial Lane, 8Th Floor, Halifax, NS, B3H 2E2, Canada
| | - Belinda Agyapong
- Department of Psychiatry, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, T6G 2B7, Canada
| | - Vincent I O Agyapong
- Department of Psychiatry, Faculty of Medicine, Abbie J. Lane Memorial Building, Dalhousie University, QEII Health Sciences Centre, 5909 Veterans Memorial Lane, 8Th Floor, Halifax, NS, B3H 2E2, Canada.
- Department of Psychiatry, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, T6G 2B7, Canada.
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2
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Rooney EE, Stewart RW, Ramachandran S, Orengo-Aguayo R, Young J. Psychometric properties of the Spanish Child PTSD Symptom Scale for DSM-5-Self-Report in El Salvador. J Trauma Stress 2022; 35:1559-1570. [PMID: 35460129 DOI: 10.1002/jts.22841] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2021] [Revised: 03/09/2022] [Accepted: 03/11/2022] [Indexed: 11/08/2022]
Abstract
Conducting research in global applied settings necessitates the use of easily administered, brief, and evidentiary measures. One widely used, brief self-report measure of posttraumatic stress disorder (PTSD) symptoms in children and adolescents is the Child PTSD Symptom Scale for DSM-5-Self-Report (CPSS-5-SR). The present study examined the factor structure, measurement invariance, reliability, and convergent validity of the Spanish translation of the CPSS-5-SR in a sample of 1,296 third- through 12th-graders in El Salvador (Mage = 12.73 years, SD = 2.67, 55.2% female, 100.0% Latinx). This sample was collected as part of a government-led initiative to conduct broad school-based psychopathology screening, with the wider goal of introducing trauma-informed services into El Salvador's school system. Consistent with prior research, confirmatory factor analysis indicated that the four-factor DSM-5 model displayed a strong fit with the data. Measurement invariance by gender was also examined, with results showing invariance at the configural, metric, and scalar levels, indicating strong evidence that participants' patterns of response did not differ by gender. The results also indicated strong reliability, Cronbach's α = .91, and convergent validity with measures of commonly comorbid psychopathology, rs = .43-.68. Total scale norms derived from the current sample are provided. These findings highlight the considerable levels of posttraumatic stress experienced by Salvadorian youth and the importance of establishing evidentiary measures of psychopathology that can be used in diverse global populations. In particular, psychometric research represents the first step in augmenting efforts to screen, refer, and treat youth impacted by violence across the globe.
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Affiliation(s)
- Evan E Rooney
- Scientific Infusion that Helps (SITH) Lab, Department of Psychology, University of Mississippi, University, Mississippi, USA
| | - Regan W Stewart
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, South Carolina, USA
| | - Sujith Ramachandran
- Center for Pharmaceutical Marketing and Management, University of Mississippi School of Pharmacy, University, Mississippi, USA.,Department of Pharmacy Administration, University of Mississippi School of Pharmacy, University, Mississippi, USA
| | - Rosaura Orengo-Aguayo
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, South Carolina, USA
| | - John Young
- Scientific Infusion that Helps (SITH) Lab, Department of Psychology, University of Mississippi, University, Mississippi, USA
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3
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Mangold A, King AR, Herting NA. The Role of Children's PTSD Symptomatology in Non-Offending Caregivers' Secondary Traumatic Stress Symptomatology Following Disclosures of Sexual or Physical Abuse. JOURNAL OF CHILD & ADOLESCENT TRAUMA 2022; 15:553-565. [PMID: 35958711 PMCID: PMC9360266 DOI: 10.1007/s40653-021-00408-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 09/16/2021] [Indexed: 06/15/2023]
Abstract
This research examined factors influencing levels of secondary traumatic stress (STS) in non-offending caregivers (NOCs) of children with histories of sexual or physical abuse. These factors included the nature of the abuse, NOCs' relationships with the initiators of the abuse, children's ages and genders, NOCs' trauma histories, and the elapsed time between children's disclosures of abuse and their trauma assessments. As a secondary objective, this research examined the interactions between children's self-reports of their own posttraumatic stress disorder (PTSD) symptomatology, NOCs' estimates of their children's PTSD symptomatology, and NOCs' self-reports of their own STS symptomatology. Participants from a clinical sample (N = 300, children = 150, NOCs = 150; child age M = 9.89, SD = 4.08; NOC age M = 37.87, SD = 9.23) completed structured intake interviews, the PTSD Checklist for the DSM-5 (PCL-5) and the Child PTSD Symptom Scale (CPSS; Child-Report and NOC-Report). Analytic strategies included point-biserial correlation coefficient calculations, linear regression analyses, and Analyses of Covariance (ANCOVAs). NOCs' levels of STS were impacted by their relationships with the initiators of the abuse and their own trauma histories. NOCs' self-reported STS symptomatology mirrored their estimates of their children's PTSD symptomatology. The discrepancy scores between children's self-reports of their PTSD symptomatology and NOCs' estimates of children's PTSD symptomatology were impacted by children's ages and genders. Clinical practitioners should note the importance of examining children's PTSD symptomatology and NOCs' STS symptomatology concurrently when making recommendations for trauma-informed evidence-based treatments.
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Affiliation(s)
- Ani Mangold
- Department of Psychological Sciences, University of North Dakota, Grand Forks, ND USA
- Red River Children’s Advocacy Center, Fargo, ND USA
| | - Alan R. King
- Department of Psychological Sciences, University of North Dakota, Grand Forks, ND USA
| | - Nicola A. Herting
- Department of Psychological Sciences, University of North Dakota, Grand Forks, ND USA
- Red River Children’s Advocacy Center, Fargo, ND USA
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4
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Hermosilla S, Forthal S, Van Husen M, Metzler J, Ghimire D, Ager A. The Child PTSD Symptom Scale: Psychometric Properties among Earthquake Survivors. Child Psychiatry Hum Dev 2021; 52:1184-1193. [PMID: 33247347 PMCID: PMC8155094 DOI: 10.1007/s10578-020-01097-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/12/2020] [Indexed: 10/22/2022]
Abstract
Evidence for a single underlying factor structure of posttraumatic stress disorder (PTSD) in children remains elusive. We assessed the underlying factor structure of the Child PTSD Symptom Scale through exploratory (EFA) and confirmatory factor analyses (CFA) in 570 survivors of the 2015 Gorkha earthquake in Nepal. The EFA suggests that the three-factor DSM-IV model fit these data best. The CFA suggests that while the DSM-IV model adequately fit these data, the four-factor King model fit them better. There was no evidence of differential item functioning by age or gender, and internal consistency of the scale was high. PTSD (overall or by factor) was not correlated with functional impairment. Inconsistent psychometric results across contexts and methodologies suggest that our current theoretical conceptualizations and empirical models of posttraumatic stress are lacking. Future studies must both document the instrument properties to assure internal validity and cross-study comparisons and, bolstered by increased psychometric data and analyses, rework theoretical models of PTSD with improved cross-cultural validity.
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Affiliation(s)
- Sabrina Hermosilla
- Institute for Social Research, University of Michigan, 426 Thompson Street, 1006E, Ann Arbor, MI, 48104, USA.
| | - Sarah Forthal
- Columbia-WHO Center for Global Mental Health, Department of Psychiatry, Columbia University Irving Medical Center, New York, USA
| | - Madeline Van Husen
- Columbia-WHO Center for Global Mental Health, Department of Psychiatry, Columbia University Irving Medical Center, New York, USA
| | - Janna Metzler
- Department of Population and Family Health, Mailman School of Public Health, Columbia University, New York, USA
| | - Dirgha Ghimire
- Institute for Social Research, University of Michigan, 426 Thompson Street, 1006E, Ann Arbor, MI, 48104, USA
| | - Alastair Ager
- Department of Population and Family Health, Mailman School of Public Health, Columbia University, New York, USA
- Institute for Global Health and Development, Queen Margaret University, Edinburgh, Scotland, UK
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5
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Stewart RW, Villalobos BT, Dueweke AR, Rodriguez JH, Nicasio AV, Alto M, Orengo-Aguayo R. A Pilot Trial of Universal School-Based Mental Health Screening in El Salvador: Traumatic Stress in an Underresourced School Environment. J Trauma Stress 2021; 34:955-966. [PMID: 34297864 PMCID: PMC10019777 DOI: 10.1002/jts.22716] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2020] [Revised: 04/29/2021] [Accepted: 05/08/2021] [Indexed: 01/27/2023]
Abstract
Salvadoran youth have an elevated risk of trauma exposure and related mental health problems. However, investigations of childhood trauma exposure and mental health sequelae in El Salvador are limited. The present study aimed to (a) explore the prevalence of exposure to potentially traumatic events and symptoms of posttraumatic stress, anxiety, and depression and (b) evaluate the associations between specific trauma types and emotional functioning among Salvadoran youth. A total of 1,296 youth aged 8-21 years from seven public schools completed self-report measures of trauma exposure, posttraumatic stress symptoms (PTSS), anxiety, and depression. Participants reported high levels of trauma exposure, endorsing an average of 3.62 (SD = 2.32) trauma types. In total, 34.5% of participants reported clinically elevated PTSS; fewer youths reported elevated depressive (8.7%) and anxiety symptoms (8.6%). Although boys reported exposure to more trauma types than girls, d = 0.22, girls were more likely to endorse elevated PTSS, V = .11; anxiety, V = .06; and depression, V = .10. Adolescents reported exposure to more trauma types than younger children, d = 0.23, and were more likely to endorse elevated PTSS, V = .07; anxiety, V = .13; and depression, V = .16. Undergoing a frightening medical procedure, OR = 2.30; female sex, OR = 1.92; witnessing domestic violence, OR = 1.70; and experiencing war between gangs, OR = 1.61, were strong predictors of elevated PTSS. This broad, school-based screening was a critical step toward better understanding the rate of trauma exposure and trauma-related symptoms among Salvadoran youth.
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Affiliation(s)
- Regan W Stewart
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, South Carolina, USA
| | - Bianca T Villalobos
- Department of Psychological Science, The University of Texas Rio Grande Valley, Edinburg, Texas, USA
| | - Aubrey R Dueweke
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, South Carolina, USA
| | | | - Andel V Nicasio
- PhD Clinical Psychology Program, Albizu University, San Juan Campus, San Juan, Puerto Rico, USA
| | - Michelle Alto
- Johns Hopkins University, Bloomberg School of Public Health, Department of Mental Health, Baltimore, Maryland, USA
| | - Rosaura Orengo-Aguayo
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, South Carolina, USA
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6
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Characterizing pain in long-term survivors of childhood cancer. Support Care Cancer 2021; 30:295-303. [PMID: 34278531 DOI: 10.1007/s00520-021-06386-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2020] [Accepted: 06/21/2021] [Indexed: 10/20/2022]
Abstract
Many long-term survivors of childhood cancer (LTSCC), individuals at least 5 years post-diagnosis or 2 years post-treatment, experience late- and long-term effects from their treatments, including pain. Yet, pain is poorly understood among LTSCC. The current study aimed to (1a) describe rates and multiple dimensions of pain; (1b) identify patterns of chronic pain; and (2) test correlates of chronic pain in LTSCC. Survivors (n = 140; 48.6% male, Mage = 17.3 years (range = 8-25)) were recruited from across Canada. Between 2017 and 2019, participants completed the Pain Questionnaire, Pain Catastrophizing Scale, Pediatric Quality of Life Inventory, Patient-Reported Outcome Measurement Information System (PROMIS)-Pain Interference, Anxiety, and Depression scales, Child Posttraumatic Stress Scale, the Posttraumatic Stress Disorder Checklist for the DSM-V, and the Cancer Worry Scale. RESULTS: Twenty-six percent of LTSCC reported experiencing chronic pain. Exploratory cluster analysis showed 20% of survivors had moderate to severe chronic pain based on measures of pain intensity and interference. The combination of higher posttraumatic stress symptoms, older current age, more pain catastrophizing, and sex (being female) significantly predicted the presence of chronic pain in logistic regression, χ2 (4, N = 107) = 28.10, p < .001. Higher pain catastrophizing (OR = 1.09; 95% CI = 1.02-1.16), older current age (OR = 1.20; 95% CI = 1.07-1.34), and higher posttraumatic stress (OR = 1.92; 95% CI = 1.01-3.63) were significant predictors of chronic pain. LTSCC should be screened for the presence and magnitude of chronic pain during long-term follow-up visits so appropriate interventions can be offered and implemented. Future research should investigate pain interventions tailored for this population. RELEVANCE: Findings support regular screening for the presence and magnitude of chronic pain in survivors of childhood cancer in long-term follow-up care.
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Pazderka H, Brown MRG, Agyapong VIO, Greenshaw AJ, McDonald-Harker CB, Noble S, Mankowski M, Lee B, Drolet JL, Omeje J, Brett-MacLean P, Kitching DT, Silverstone PH. Collective Trauma and Mental Health in Adolescents: A Retrospective Cohort Study of the Effects of Retraumatization. Front Psychiatry 2021; 12:682041. [PMID: 34248717 PMCID: PMC8267583 DOI: 10.3389/fpsyt.2021.682041] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Accepted: 05/31/2021] [Indexed: 12/18/2022] Open
Abstract
In the wake of the massive Canadian wildfire of May 2016 in the area of Fort McMurray Alberta, we observed increased rates of mental health problems, particularly post-traumatic stress disorder (PTSD), in school-aged adolescents (ages 11-19). Surprisingly, we did not see these rates decline over the 3.5-year follow-up period. Additionally, our research suggested that the impact of this mass incident resulted in other unanticipated effects, including the finding that children who were not present for and relatively unaffected by the wildfire showed a similar PTSD symptom profile to children more directly involved, suggesting some degree of spillover or stress contagion. A potential explanation for these high rates in individuals who were not present could be undiagnosed retraumatization in some of the students. To investigate this possibility, we compared two groups of students: those who reported the wildfire as their most significant trauma (n = 740) and those who had their most significant trauma prior to the wildfire (n = 295). Those with significant pre-existing trauma had significantly higher rates of both depression and PTSD symptoms, although, unexpectedly the groups exhibited no differences in anxiety level. Taken together, this evidence suggests retraumatization is both longer-lasting and more widespread than might be predicted on a case-by-case basis, suggesting the need to reconceptualize the role of past trauma history in present symptomatology. These findings point to the need to recognize that crises instigated by natural disasters are mass phenomena which expose those involved to numerous unanticipated risks. New trauma-informed treatment approaches are required that incorporate sensitivity to the collective impact of mass crises, and recognize the risk of poorer long-term mental health outcomes for those who experienced trauma in the past.
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Affiliation(s)
- Hannah Pazderka
- Department of Psychiatry, University of Alberta, Edmonton, AB, Canada
| | - Matthew R G Brown
- Department of Psychiatry, University of Alberta, Edmonton, AB, Canada.,Department of Computing Science, University of Alberta, Edmonton, AB, Canada
| | | | | | | | - Shannon Noble
- Fort McMurray Public School District, Fort McMurray, AB, Canada
| | - Monica Mankowski
- Fort McMurray Catholic School District, Fort McMurray, AB, Canada
| | - Bonnie Lee
- Faculty of Health Sciences, University of Lethbridge, Lethbridge, AB, Canada
| | - Julie L Drolet
- Faculty of Social Work, University of Calgary, Edmonton, AB, Canada
| | - Joy Omeje
- Department of Psychiatry, University of Alberta, Edmonton, AB, Canada
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8
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Pazderka H, Brown MR, McDonald-Harker CB, Greenshaw AJ, Agyapong VI, Noble S, Mankowski M, Lee B, Omeje J, Brett-MacLean P, Kitching DT, Hayduk LA, Silverstone PH. Model of Post-traumatic Growth in Newly Traumatized vs. Retraumatized Adolescents. Front Psychiatry 2021; 12:682055. [PMID: 34658943 PMCID: PMC8514981 DOI: 10.3389/fpsyt.2021.682055] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Accepted: 09/06/2021] [Indexed: 11/24/2022] Open
Abstract
Background: In our analysis of adolescents affected by the 2016 Fort McMurray wildfire, we observed many negative mental health effects in individuals with a prior history of psychological trauma. Elevated rates of depression and markers of post-traumatic stress disorder (PTSD) were observed, consistent with the hypothesis that prior trauma may reduce sensitivity thresholds for later psychopathology (stress sensitization). Surprisingly, levels of anxiety did not differ based on prior trauma history, nor were retraumatized individuals at increased risk for recent (past month) suicidal ideation. These results are more suggestive of inoculation by prior trauma than stress sensitization. This led us to consider whether individuals with a prior trauma history showed evidence of Post-Traumatic Growth (PTG), a condition in which the experience of a previous trauma leads to areas of sparing or even improvement. Method: To investigate this issue, we generated a structural equation model (SEM) exploring the role of anxiety in previously traumatized (n = 295) and wildfire trauma alone (n = 740) groups. Specifically, models were estimated to explore the relationship between hopelessness, anxiety, PTSD symptoms, self-efficacy and potential protective factors such as friend and family support in both groups. The model was tested using a cross-sectional sample of affected youth, comparing effects between the two groups. Results: While both models produced relatively good fit, differences in the effects and chi-squared values led us to conclude that the groups are subject to different causal specifications in a number of areas, although details warrant caution pending additional investigation. Discussion: We found that adolescents with a prior trauma history appear to have a more realistic appraisal of potential difficulties associated with traumatic events, and seem less reactive to potentially unsettling PTSD symptoms. They also seemed less prone to overconfidence as they got older, an effect seen in the adolescents without a history of trauma. Our findings provide preliminary evidence that the construct of anxiety may work differently in newly traumatized and retraumatized individuals, particularly in the context of mass trauma events.
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Affiliation(s)
- Hannah Pazderka
- Department of Psychiatry, University of Alberta, Edmonton, AB, Canada.,Be Brave Ranch, Centre for Treatment of Child Sexual Abuse, Edmonton, AB, Canada
| | - Matthew Rg Brown
- Department of Psychiatry, University of Alberta, Edmonton, AB, Canada.,Department of Computing Science, University of Alberta, Edmonton, AB, Canada
| | | | | | | | - Shannon Noble
- Fort McMurray Public School District, Fort McMurray, AB, Canada
| | - Monica Mankowski
- Fort McMurray Catholic School District, Fort McMurray, AB, Canada
| | - Bonnie Lee
- Addictions Counselling Program, Faculty of Health Sciences, University of Lethbridge, Lethbridge, AB, Canada
| | - Joy Omeje
- Department of Psychiatry, University of Alberta, Edmonton, AB, Canada
| | | | | | - Leslie A Hayduk
- Department of Sociology, University of Alberta, Edmonton, AB, Canada
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Brown MRG, Pazderka H, Agyapong VIO, Greenshaw AJ, Cribben I, Brett-MacLean P, Drolet J, McDonald-Harker CB, Omeje J, Lee B, Mankowsi M, Noble S, Kitching DT, Silverstone PH. Mental Health Symptoms Unexpectedly Increased in Students Aged 11-19 Years During the 3.5 Years After the 2016 Fort McMurray Wildfire: Findings From 9,376 Survey Responses. Front Psychiatry 2021; 12:676256. [PMID: 34093284 PMCID: PMC8172807 DOI: 10.3389/fpsyt.2021.676256] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2021] [Accepted: 04/15/2021] [Indexed: 01/01/2023] Open
Abstract
In Fort McMurray, Alberta, Canada, the wildfire of May 2016 forced the population of 88,000 to rapidly evacuate in a traumatic and chaotic manner. Ten percentage of the homes in the city were destroyed, and many more structures were damaged. Since youth are particularly vulnerable to negative effects of natural disasters, we examined possible long-term psychological impacts. To assess this, we partnered with Fort McMurray Public and Catholic Schools, who surveyed Grade 7-12 students (aged 11-19) in November 2017, 2018, and 2019-i.e., at 1.5, 2.5, and 3.5 years after the wildfire. The survey included validated measurement scales for post-traumatic stress disorder (PTSD), depression, anxiety, drug use, alcohol use, tobacco use, quality of life, self-esteem, and resilience. Data analysis was done on large-scale anonymous surveys including 3,070 samples in 2017; 3,265 samples in 2018; and 3,041 samples in 2019. The results were unexpected and showed that all mental health symptoms increased from 2017 to 2019, with the exception of tobacco use. Consistent with this pattern, self-esteem and quality of life scores decreased. Resilience scores did not change significantly. Thus, mental health measures worsened, in contrast to our initial hypothesis that they would improve over time. Of note, we observed higher levels of mental health distress among older students, in females compared to male students, and in individuals with a minority gender identity, including transgender and gender-non-conforming individuals. These findings demonstrate that deleterious mental health effects can persist in youth for years following a wildfire disaster. This highlights the need for multi-year mental health support programs for youth in post-disaster situations. The indication that multi-year, post-disaster support is warranted is relatively novel, although not unknown. There is a need to systematically investigate factors associated with youth recovery following a wildfire disaster, as well as efficacy of psychosocial strategies during later phases of disaster recovery relative to early post-disaster interventions.
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Affiliation(s)
- Matthew R G Brown
- Department of Computing Science, University of Alberta, Edmonton, AB, Canada.,Department of Psychiatry, University of Alberta, Edmonton, AB, Canada
| | - Hannah Pazderka
- Department of Psychiatry, University of Alberta, Edmonton, AB, Canada
| | | | | | - Ivor Cribben
- Department of Accounting and Business Analytics, Alberta School of Business, University of Alberta, Edmonton, AB, Canada
| | | | - Julie Drolet
- Faculty of Social Work, University of Calgary, Calgary, AB, Canada
| | | | - Joy Omeje
- Department of Psychiatry, University of Alberta, Edmonton, AB, Canada
| | - Bonnie Lee
- Faculty of Health Sciences, University of Lethbridge, Lethbridge, AB, Canada
| | - Monica Mankowsi
- Fort McMurray Catholic School District, Fort McMurray, AB, Canada
| | - Shannon Noble
- Fort McMurray Public School District, Fort McMurray, AB, Canada
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10
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Patton M, Stokoe M, Forbes C, Nwaroh C, Noel M, Reynolds K, Schulte F. The Intergenerational Transmission of Chronic Pain from Parents to Survivors of Childhood Cancer. CHILDREN (BASEL, SWITZERLAND) 2020; 7:E246. [PMID: 33233437 PMCID: PMC7700439 DOI: 10.3390/children7110246] [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: 10/31/2020] [Revised: 11/16/2020] [Accepted: 11/19/2020] [Indexed: 11/26/2022]
Abstract
BACKGROUND Among youth with chronic non-cancer pain, 50% have parents with chronic pain. These youth report significantly more pain interference and posttraumatic stress symptoms (PTSS), and worse health-related quality of life (HRQL) than youth whose parents do not have chronic pain. Additionally, parent chronic pain is linked to increased child anxiety and depressive symptoms. Survivors of childhood cancer (SCCs) are at risk of pain and negative psychosocial outcomes and therefore may be especially vulnerable if their parents have chronic pain. Thus, the aims of the current study were to (1) identify rates of chronic pain among parents of SCCs, (2) test group differences in psychological symptoms in parents with chronic pain versus without, and (3) test group differences in pain interference, HRQL, anxiety, depression, and PTSS in SCCs with parents with chronic pain versus without. METHODS 122 SCCs (Mean age = 15.8, SD = 4.8, 45.7% male, Mean age at diagnosis = 5.9, SD = 4.7) and their parents were recruited from across Canada to complete online questionnaires. Parents were asked if they have had pain for at least three consecutive months and completed the brief symptom inventory (BSI) as a measure of psychological symptomatology. Survivors completed the pain questionnaire, patient reported outcomes measurement information system (PROMIS)-pain interference, anxiety, and depression measures, child posttraumatic stress scale, posttraumatic stress disorder checklist for the Diagnostic and Statistical Manual of Mental Disorders, and the pediatric quality of life inventory. RESULTS Forty-three (39%) parents of SCCs reported having chronic pain. Of the 29 survivors who had chronic pain, 14 (48%) also had parents with chronic pain. Parents with chronic pain reported significantly higher scores on the BSI than parents without chronic pain, F(1, 116) = 5.07, p = 0.026. SCCs with parents with versus without chronic pain reported significantly higher PTSS F(1, 105) = 10.53, p = 0.002 and depressive symptoms F(1, 102) = 6.68, p = 0.011. No significant differences were found across the other variables tested. CONCLUSIONS Findings suggest that survivors' parents' own pain is prevalent and is related to survivors' increased depressive symptoms and PTSS, but not anxiety, pain interference, or HRQL. Future research should explore whether parents may benefit from psychological intervention after their child has been diagnosed with cancer and how this could improve outcomes for their child.
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Affiliation(s)
- Michaela Patton
- Department of Psychology, University of Calgary, Calgary, AB T2N 1N4, Canada; (M.P.); (M.N.)
| | - Mehak Stokoe
- Hematology, Oncology, and Bone Marrow Transplant Program, Alberta Children’s Hospital, Calgary, AB T3B 6A8, Canada; (M.S.); (C.F.); (K.R.)
| | - Caitlin Forbes
- Hematology, Oncology, and Bone Marrow Transplant Program, Alberta Children’s Hospital, Calgary, AB T3B 6A8, Canada; (M.S.); (C.F.); (K.R.)
| | - Chidera Nwaroh
- Cumming School of Medicine, University of Calgary, Calgary, AB T2N 1N4, Canada;
| | - Melanie Noel
- Department of Psychology, University of Calgary, Calgary, AB T2N 1N4, Canada; (M.P.); (M.N.)
| | - Kathleen Reynolds
- Hematology, Oncology, and Bone Marrow Transplant Program, Alberta Children’s Hospital, Calgary, AB T3B 6A8, Canada; (M.S.); (C.F.); (K.R.)
| | - Fiona Schulte
- Department of Psychology, University of Calgary, Calgary, AB T2N 1N4, Canada; (M.P.); (M.N.)
- Cumming School of Medicine, University of Calgary, Calgary, AB T2N 1N4, Canada;
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Hasson RG, Easton SD, Iriarte ADV, O’Dwyer LM, Underwood D, Crea TM. Examining the Psychometric Properties of the Child PTSD Symptom Scale Within a Sample of Unaccompanied Immigrant Children in the United States. JOURNAL OF LOSS & TRAUMA 2020. [DOI: 10.1080/15325024.2020.1777760] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Affiliation(s)
| | - Scott D. Easton
- Boston College School of Social Work, Boston College, Chestnut Hill, MA, USA
| | | | - Laura M. O’Dwyer
- Boston College Lynch School of Education and Human Development, Boston College, Chestnut Hill, MA, USA
| | | | - Thomas M. Crea
- Boston College School of Social Work, Boston College, Chestnut Hill, MA, USA
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12
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Brown MRG, Agyapong V, Greenshaw AJ, Cribben I, Brett-MacLean P, Drolet J, McDonald-Harker C, Omeje J, Mankowsi M, Noble S, Kitching D, Silverstone PH. After the Fort McMurray wildfire there are significant increases in mental health symptoms in grade 7-12 students compared to controls. BMC Psychiatry 2019; 19:18. [PMID: 30630501 PMCID: PMC6329184 DOI: 10.1186/s12888-018-2007-1] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2018] [Accepted: 12/27/2018] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND In order to examine the impact of disasters on adolescent mental health, this study compared population mental health survey data from two communities in Alberta, Canada: Fort McMurray, which experienced a major natural disaster, and Red Deer, which did not. METHODS Data from 3070 grade 7-12 students from Fort McMurray, Alberta, Canada (collected in 2017, 18 months after the 2016 wildfire) was compared with data from 2796 grade 7-12 students from Red Deer, Alberta, Canada (collected in 2014). The same measurement scales were used for both surveys. Both of these cities have populations of approximately 100,000, and both cities are located in Alberta, Canada. For this reason, Red Deer is an appropriate non-disaster impacted community to compare to the disaster impacted community of Fort McMurray. RESULTS The results of this comparison demonstrate that mental health symptoms were statistically significantly elevated in the Fort McMurray population when compared to the control population in Red Deer. This occurred for scores consistent with a diagnosis of depression (31% vs. 17%), moderately severe depression (17% vs. 9%), suicidal thinking (16% vs. 4%), and tobacco use (13% vs. 10%). Consistent with there being major mental health impacts from the 2016 Fort McMurray wildfire, self-esteem scores and quality of life scores were also statistically significantly lower in Fort McMurray. While the rates of anxiety disorder were similar (15% vs. 16%), the mean scores on the anxiety scale were slightly higher, with this difference reaching statistical significance. There were no statistical differences in the rates or scores for alcohol or substance use. CONCLUSIONS Our results are consistent with previous findings showing a significant negative impact of disasters on many aspects of adolescent mental, with a particular increase in symptoms related to depression and suicidal thinking. These findings highlight first, the need to identify adolescents most at risk of developing psychiatric symptoms after experiencing the trauma of disaster and second, the importance and necessity of implementing short and long term mental health intervention programs specifically aimed at adolescents, in order to help mitigate the negative effects of disasters on their mental health.
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Affiliation(s)
- Matthew R. G. Brown
- grid.17089.37Department of Computing Science, University of Alberta, Edmonton, Canada ,grid.17089.37Department of Psychiatry, University of Alberta, Edmonton, AB T6G 2B7 Canada
| | - Vincent Agyapong
- grid.17089.37Department of Psychiatry, University of Alberta, Edmonton, AB T6G 2B7 Canada
| | - Andrew J. Greenshaw
- grid.17089.37Department of Psychiatry, University of Alberta, Edmonton, AB T6G 2B7 Canada
| | - Ivor Cribben
- grid.17089.37Alberta School of Business, University of Alberta, Edmonton, Canada
| | - Pamela Brett-MacLean
- grid.17089.37Department of Psychiatry, University of Alberta, Edmonton, AB T6G 2B7 Canada
| | - Julie Drolet
- 0000 0004 1936 7697grid.22072.35Faculty of Social Work, University of Calgary, Calgary, Canada
| | - Caroline McDonald-Harker
- 0000 0000 9943 9777grid.411852.bDepartment of Sociology and Anthropology, Mount Royal University, Calgary, Canada
| | - Joy Omeje
- grid.17089.37Department of Psychiatry, University of Alberta, Edmonton, AB T6G 2B7 Canada
| | - Monica Mankowsi
- Fort McMurray Catholic School District, Fort McMurray, Canada
| | - Shannon Noble
- Fort McMurray Public School District, Fort McMurray, Canada
| | | | - Peter H. Silverstone
- grid.17089.37Department of Psychiatry, University of Alberta, Edmonton, AB T6G 2B7 Canada
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13
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Brown MRG, Agyapong V, Greenshaw AJ, Cribben I, Brett-MacLean P, Drolet J, McDonald-Harker C, Omeje J, Mankowsi M, Noble S, Kitching DT, Silverstone PH. Significant PTSD and Other Mental Health Effects Present 18 Months After the Fort Mcmurray Wildfire: Findings From 3,070 Grades 7-12 Students. Front Psychiatry 2019; 10:623. [PMID: 31543839 PMCID: PMC6728415 DOI: 10.3389/fpsyt.2019.00623] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/22/2019] [Accepted: 08/05/2019] [Indexed: 11/13/2022] Open
Abstract
Background: The May 2016 wildfire in Fort McMurray, Alberta, Canada forced evacuation of the population of 88,000 individuals and destroyed 10% of the homes. Youth are particularly impacted by disaster. Methods: Eighteen months after the wildfire, Fort McMurray Public and Catholic Schools surveyed 3,252 of the 4,407 students in Grades 7-12 to determine possible long-term psychological impacts. The survey included validated measurement scales for post-traumatic stress disorder (PTSD), depression, anxiety, use of drugs, alcohol, and tobacco, quality of life, self-esteem, and resilience. Data analysis was possible for only 3,070 students, i.e., 70% of the total student population. Anonymized data were analyzed to compare students who directly experienced lesser or greater impact from the wildfire, with greater impact defined as personally seeing the fire or having one's home destroyed. Also, students with greater or lesser scores on the Child and Youth Resilience Measure (CYRM-12) were compared. Results: Of the 3,070 students, 37% met criteria for probable PTSD; 31% met criteria for probable depression, and 17% for probable depression of at least moderate severity; 27% of students met criteria for probable anxiety, and 15% for probable alcohol or substance use disorder; 46% of all students met criteria for one or more probable diagnosis of PTSD, depression, anxiety, or alcohol/substance abuse, and this included students who were both present and not present in Fort McMurray at the time of the wildfire. Students with greater impact from the wildfire exhibited significantly higher scores on measures of PTSD, depression, anxiety, and alcohol/substance use. They also had lower self-esteem and quality of life scores. Students with lower resilience scores exhibited a similar pattern. Conclusions: These findings highlight first the negative impact of disasters on youth mental health, particularly for those who directly experience wildfire, and second the role of resilience on youth mental health, with lower resilience associated with substantially lower mental health outcomes. These results emphasize the need for long-term mental health supports for youth post-disaster, with specific focus on increasing youth resilience, which may serve as a protective factor against effects of disaster on mental health.
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Affiliation(s)
- Matthew R G Brown
- Department of Computing Science, University of Alberta, Edmonton, AB, Canada.,Department of Psychiatry, University of Alberta, Edmonton, AB, Canada
| | - Vincent Agyapong
- Department of Psychiatry, University of Alberta, Edmonton, AB, Canada
| | | | - Ivor Cribben
- Alberta School of Business, University of Alberta, Edmonton, AB, Canada
| | | | - Julie Drolet
- Faculty of Social Work, University of Calgary, Calgary, AB, Canada
| | | | - Joy Omeje
- Department of Psychiatry, University of Alberta, Edmonton, AB, Canada
| | - Monica Mankowsi
- Fort McMurray Catholic School District, Fort McMurray, AB, Canada
| | - Shannon Noble
- Fort McMurray Public School District, Fort McMurray, AB, Canada
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14
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Schwind JS, Formby CB, Santangelo SL, Norman SA, Brown R, Hoffman Frances R, Koss E, Karmacharya D. Earthquake exposures and mental health outcomes in children and adolescents from Phulpingdanda village, Nepal: a cross-sectional study. Child Adolesc Psychiatry Ment Health 2018; 12:54. [PMID: 30598695 PMCID: PMC6300918 DOI: 10.1186/s13034-018-0257-9] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/25/2018] [Accepted: 12/06/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Mental health issues can reach epidemic proportions in developed countries after natural disasters, but research is needed to better understand the impact on children and adolescents in developing nations. METHODS A cross-sectional study was performed to examine the relationship between earthquake exposures and depression, PTSD, and resilience among children and adolescents in Phulpingdanda village in Nepal, 1 year after the 2015 earthquakes, using the Depression Self-Rating Scale for Children, Child PTSD Symptom Scale, and the Child and Youth Resilience Measure, respectively. To quantify exposure, a basic demographic and household questionnaire, including an earthquake exposure assessment tool for children and adolescents, was created. RESULTS Of the 62 respondents interviewed, 3.23% and 4.84% displayed symptomatology of depression and PTSD. A large number of respondents interviewed scored high for resiliency (80.65%). All 62 respondents were displaced from their household and witnessed severe damage of both their homes and village. The number of earthquake exposures had a strong, positive correlation with PTSD symptomatology. CONCLUSIONS Although the number of respondents who showed signs of depression and PTSD symptomatology was lower than anticipated, resilience scores were considerably higher. Future research should explore which protective factors may contribute to high resiliency in Nepali children and adolescents.
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Affiliation(s)
- Jessica S. Schwind
- 0000 0001 0657 525Xgrid.256302.0Department of Biostatistics, Epidemiology, and Environmental Health Sciences, Jiann-Ping Hsu College of Public Health, Georgia Southern University, P.O. Box 8015, Statesboro, Georgia 30460 USA ,0000 0001 2284 9329grid.410427.4Medical College of Georgia, Augusta University, 1120 15th Street, Augusta, GA 30912 USA
| | - Clara B. Formby
- 0000 0001 2284 9329grid.410427.4Medical College of Georgia, Augusta University, 1120 15th Street, Augusta, GA 30912 USA
| | - Susan L. Santangelo
- 0000 0004 0433 3945grid.416311.0Maine Medical Research Institute, 509 Forest Ave, Suite 200B, Portland, ME 04101 USA ,0000 0000 8934 4045grid.67033.31Tufts University School of Medicine, 136 Harrison Avenue, Boston, MA 02111 USA
| | - Stephanie A. Norman
- 0000 0001 2284 9329grid.410427.4Medical College of Georgia, Augusta University, 1120 15th Street, Augusta, GA 30912 USA
| | - Rebecca Brown
- St. Joseph’s College of Maine, 278 Whites Bridge Road, Standish, ME 04084 USA
| | - Rebecca Hoffman Frances
- 0000 0000 8934 4045grid.67033.31Tufts University School of Medicine, 136 Harrison Avenue, Boston, MA 02111 USA ,Maine Behavioral Healthcare, 165 Lancaster Street, Portland, ME 04101 USA
| | | | - Dibesh Karmacharya
- grid.428196.0Center for Molecular Dynamics Nepal, GPO Box 21049, Kathmandu, Nepal
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15
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Impact of Borderline Personality Pathology on Treatment Outcomes in Adolescents in Residential Treatment: The Role of Emotion Regulation. J Psychiatr Pract 2018; 24:388-398. [PMID: 30395546 DOI: 10.1097/pra.0000000000000349] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Despite growing research on the impact of borderline personality pathology (BPP) on treatment outcomes for emotional disorders among adults, no studies have examined this question in adolescents. Moreover, no studies have examined mediators of the relation between BPP and changes in mood and anxiety symptoms during treatment. This study examined the impact of BPP on treatment outcomes in 141 adolescents in psychiatric residential treatment, as well as the mediating role of change in emotion regulation (ie, adaptive responses to emotions) in the relation between baseline BPP and improvements in psychiatric symptoms during treatment. Participants completed questionnaires assessing emotion regulation and depression, anxiety, and posttraumatic stress disorder symptoms at baseline and posttreatment. Although BPP was not directly associated with the magnitude of change in psychiatric symptoms from baseline to posttreatment, it was positively associated with greater improvement in emotion regulation during treatment. Furthermore, results revealed significant indirect effects of BPP on improvements in all psychiatric symptoms through improvement in emotion regulation.
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Murray SM, Bolton P, Kane JC, Lakin DP, Skavenski Van Wyk S, Paul R, Murray LK. Measuring Symptoms of Psychopathology in Zambian Orphans and Vulnerable Children: Scale Validation and Psychometric Evaluation. Assessment 2018; 27:1335-1348. [PMID: 29871499 DOI: 10.1177/1073191118780455] [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: 11/16/2022]
Abstract
There is a paucity of validated mental health measures for assessing psychological well-being among HIV-affected youth. We sought to explore the psychometric properties and validity of the Achenbach Youth Self-Report and Child Posttraumatic Stress Disorder Symptom Scale among orphans and vulnerable children (OVC) living in Lusaka, Zambia. These scales were administered to 210 OVC aged 13 to 17 years via audio computer-assisted self-interview. Confirmatory factor analysis was used to assess scale structure, Cronbach's alpha for internal consistency, and correlations between scales related to mental or psychosocial health for construct validity. A known-groups validation was conducted using local identifications of youth with and without significant psychosocial problems, and test-retest reliability was assessed. Scales exhibited good internal reliability (α > .80), adequate criterion validity (area under the curve > .70), and moderate test-retest reliability (.62-.68). Findings support the utility of these symptom scales for identifying OVC experiencing significant psychosocial problems in Zambia.
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Affiliation(s)
| | - Paul Bolton
- Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Jeremy C Kane
- Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Daniel P Lakin
- Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | | | - Ravi Paul
- University of Zambia School of Medicine, Lusaka, Zambia
| | - Laura K Murray
- Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
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