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Trends in Serious Emotional Disturbance Among Youths Exposed to Hurricane Katrina

https://doi.org/10.1016/j.jaac.2010.06.012Get rights and content

Objective

To examine patterns and predictors of trends in DSM-IV serious emotional disturbance (SED) among youths exposed to Hurricane Katrina.

Method

A probability sample of adult pre-hurricane residents of the areas affected by Katrina completed baseline and follow-up telephone surveys 18 to 27 months post-hurricane and 12 to 18 months later. Baseline adult respondents residing with children and adolescents (4-17 years of age) provided informant reports about the emotional functioning of these youths (n = 576) with the Strengths and Difficulties Questionnaire (SDQ). The surveys also assessed hurricane-related stressors and ongoing stressors experienced by respondent families.

Results

SED prevalence decreased significantly across survey waves from 15.1% to 11.5%, although even the latter prevalence was considerably higher than the pre-hurricane prevalence of 4.2% estimated in the US National Health Interview Survey. Trends in hurricane-related SED were predicted by both stressors experienced in the hurricane and ongoing stressors, with SED prevalence decreasing significantly only among youths with moderate stress exposure (16.8% versus 6.5%). SED prevalence did not change significantly between waves among youths with either high stress exposure (30.0% versus 41.9%) or low stress exposure (3.5% versus 3.4%). Pre-hurricane functioning did not predict SED persistence among youths with high stress exposure, but did predict SED persistence among youth with low-moderate stress exposure.

Conclusions

The prevalence of SED among youths exposed to Hurricane Katrina remains significantly elevated several years after the storm despite meaningful decrease since baseline. Youths with high stress exposure have the highest risk of long-term hurricane-related SED and consequently represent an important target for mental health intervention.

Section snippets

Sample

We recruited English-speaking adults (≥18 years of age) for the initial survey either by random-digit–dial telephone calls of households in the FEMA-defined disaster area or from a random selection of families applying for assistance from the American Red Cross database. The initial CAG interviews were carried out in three waves (Table 1). The first wave was collected 5 to 7 months after the hurricane (n = 1,043; 41.9% cooperation rate); the second wave was carried out 7 to 10 months

Estimated prevalence and trends in SED

The estimated prevalence of SED decreased significantly from 15.1% at the baseline survey (18-27 months post-hurricane) to 11.5% at the follow-up survey (36-39 months post-hurricane) (t = 2.1, p = .03). (Table 2) The estimated prevalence of H-SED decreased from baseline (9.3%) to the follow-up (7.5%). A similar decrease was observed for the estimated prevalence of NH-SED (5.7% and 4.1%, respectively), although this decrease was not statistically significant for either H-SED or NH-SED.

Discussion

The estimated prevalence of SED among children and adolescents exposed to Hurricane Katrina decreased significantly from 15.1% at our baseline assessment 18 to 27 months after the storm to 11.5% at our assessment 12 to 18 months later. This reduction is not surprising, given that the prevalence of youth mental health problems following natural disasters tends to decrease over time.6, 17 However, the prevalence of SED among youths exposed to Katrina continues to be considerably greater than the

References (37)

  • A. Bokszczanin

    PTSD symptoms in children and adolescents 28 months after a flood: Age and gender differences

    J Trauma Stress

    (2007)
  • A. Eksi et al.

    Risk factors for the development of PTSD and depression among child and adolescent victims following a 7.4 magnitude earthquake

    Int J Psychiatry Clin Pract

    (2007)
  • A.M. LaGreca et al.

    Symptoms of posttraumatic stress in children after Hurricane Andrew: A prospective study

    J Consult Clin Psychol

    (1996)
  • F. Neuner et al.

    Post-tsunami stress: A study of posttraumatic stress disorder in children living in three severely affected regions in Sri Lanka

    J Trauma Stress

    (2006)
  • C.V. Russoniello et al.

    Childhood posttraumatic stress disorder and efforts to cope after Hurricane Floyd

    Behav Med

    (2002)
  • D. Abramson et al.

    On the Edge: Children and Families Displaced by Hurricanes Katrina and Rita Face a Looming Medical and Mental Health Crisis

    (2006)
  • L. Hensley et al.

    PTSD symptoms and somatic complaints following Hurricane Katrina: The roles of trait anxiety and anxiety sensitivity

    J Clin Child Adolesc Psychol

    (2008)
  • H.J. Osofsky et al.

    Posttraumatic stress symptoms in children after Hurricane Katrina: Predicting the need for mental health services

    Am J Orthopsychiatry

    (2009)

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    This study is supported by National Institutes of Health (NIH) Research Grants R01 MH070884-01A2 and R01 MH081832 from the US Department of Health and Human Services, NIH, the Office of the Assistant Secretary of Planning and Evaluation, the Federal Emergency Management Agency, and the Administration for Children and Families.

    Supplemental material cited in this article is available online.

    Disclosure: Dr. Kessler has served as a consultant for GlaxoSmithKline, Inc., Kaiser Permanente, Pfizer Inc., Sanofi-Aventis, Shire Pharmaceuticals, and Wyeth-Ayerst. He has served on the advisory boards for Eli Lilly and Co., and Wyeth-Ayerst. He has received research support from Bristol-Myers Squibb, Eli Lilly and Co., GlaxoSmithKline, Inc., Johnson and Johnson Pharmaceuticals, Ortho-McNeil Pharmaceuticals, Inc., Pfizer Inc., and Sanofi-Aventis. Drs. McLaughlin, Fairbank, Jones, Osofsky, and Pfefferbaum, and Mr. Gruber, and Mrs. Sampson report no biomedical financial interests or potential conflicts of interest.

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    Copyright © 2010 American Academy of Child and Adolescent Psychiatry. Published by Elsevier Inc. All rights reserved.