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"Vernberg, Eric M"
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A Qualitative Analysis of Barriers, Challenges, and Successes in Meeting the Needs of Hurricane Katrina Evacuee Families
Hurricane Katrina caused many individuals to evacuate to towns and cities throughout the United States. Psychological First Aid (PFA) is a treatment program designed to help clinicians and other disaster relief workers address the needs of adults, youth, and families immediately following disasters. We conducted focus groups with disaster relief and evacuee service providers in the Kansas City Metro Area as an exploratory study to identify their perceptions of the needs of evacuees. Participants identified a number of mental health needs, as well as displacement-related challenges, including loss of social support, material loss, unemployment, and other stressful life events that were secondary to the hurricane. Many of these needs are consistent with principles presented in the PFA manual. We also found that service providers faced unique challenges when attempting to assist evacuees. We discuss implications of these findings for treatment programs and provide suggestions for addressing barriers to care.
Journal Article
The Use of Psychological First Aid in Children Exposed to Mass Trauma
Purpose of Review
Psychological first aid (PFA) has been widely disseminated and promoted as an intervention to support short-term coping and long-term functioning after disasters. Despite its popularity, earlier reviews cite a startling lack of empirical outcome studies. The current review explores recent studies of PFA, especially pertaining to its use with children.
Recent Findings
Initial studies of PFA show that it is well received by youth, families, and providers as well as being linked to decreases in depressive and posttraumatic stress symptoms, improved self-efficacy, increased knowledge about disaster preparedness and recovery, and enhanced feelings of safety and connection. The flexibility of the modular style of PFA and cultural adaptations emerged as significant themes.
Summary
Although the studies reviewed cast a favorable light on PFA, more research is needed regarding its use and outcomes. This review describes the challenges to conducting these studies as well as suggestions for paths forward.
Journal Article
Caregiver–adolescent co-reminiscing and adolescents’ individual recollections of a devastating tornado: Associations with enduring posttraumatic stress symptoms
Although disaster-related posttraumatic stress symptoms (PTSS) typically decrease in intensity over time, some youth continue to report elevated levels of PTSS many years after the disaster. The current study examines two processes that may help to explain the link between disaster exposure and enduring PTSS: caregiver emotion socialization and youth recollection qualities. One hundred and twenty-two youth (ages 12 to 17) and their female caregivers who experienced an EF-4 tornado co-reminisced about the event, and adolescents provided independent recollections between 3 and 4 years after the tornado. Adolescent individual transcripts were coded for coherence and negative personal impact, qualities that have been found to contribute to meaning making. Parent–adolescent conversations were coded for caregiver egocentrism, a construct derived from the emotion socialization literature to reflect the extent to which the caregiver centered the conversation on her own emotions and experiences. Egocentrism predicted higher youth PTSS, and this association was mediated by the coherence of adolescents’ narratives. The association between coherence and PTSS was stronger for youth who focused more on the negative personal impacts of the tornado event during their recollections. Results suggest that enduring tornado-related PTSS may be influenced in part by the interplay of caregiver emotion socialization practices and youth recollection qualities.
Journal Article
Talking with Children About Natural Disasters: Maternal Acknowledgment, Child Emotion Talk, and Child Posttraumatic Stress Symptoms
BackgroundTalking about past experiences with parents is generally thought to promote positive psychological adjustment in children. Less is known about parent–child co-reminiscing when discussing past traumatic experiences, such as natural disasters, a unique type of shared trauma that can have long-lasting, and variable, psychological impacts on children and families.ObjectiveThe current study examined the association between qualities of parent–child co-reminiscing and children’s posttraumatic stress symptoms (PTSS) following exposure to a devastating tornado.MethodForty-nine children ages 8–12 years (49% female; 78% White/Non-Hispanic) and their mothers who experienced a category EF-5 tornado in May 2011 participated in this study and provided joint recollections about their tornado experiences approximately 14–18 months post-tornado. Children also provided individual recollections about their tornado-related experiences. Individual recollections were coded for negative and positive emotion words and parent–child conversations were coded for maternal acknowledgement of child generated content.ResultsMaternal acknowledgement moderated the link between children’s use of both positive and negative emotion words and child tornado-related PTSS, such that children’s use of both positive and negative emotion words was associated with higher levels of PTSS but only at lower levels of maternal acknowledgment.ConclusionsMaternal acknowledgement of child expressions may be a protective factor for disaster-exposed children. Understanding how children and parents discuss trauma experiences, and how aspects of discussions are associated with youth mental health, may ultimately inform interventions to help children and parents communicate following disaster exposure in a way that promotes optimal growth and recovery.
Journal Article
Children’s Postdisaster Trajectories of PTS Symptoms: Predicting Chronic Distress
Background
There are no studies of the distinct trajectories of children’s psychological distress over the first year after a destructive natural disaster and the determinants of these trajectories.
Objective
We examined these issues using an existing dataset of children exposed to Hurricane Andrew, one of the most devastating natural disasters in US history.
Methods
At 3-months postdisaster, 568 children (55 % girls; grades 3–5) residing in areas most directly affected by the hurricane completed measures of hurricane exposure and stressors, social support, coping, and general anxiety. Children also reported major life events occurring since the hurricane (at 7-months) and posttraumatic stress (PTS) symptoms at 3-, 7-, and 10-months postdisaster.
Results
Latent growth mixture modeling identified three trajectories of PTS reactions: resilient (37 %), recovering (43 %), and chronic distress (20 %). Predictors of the trajectories were examined. Odds ratios indicated that, compared to the resilient trajectory, girls were more likely to be in the recovering and chronically distressed trajectories, as were children reporting higher anxiety and greater use of coping strategies that reflected poor emotion regulation. Compared to the recovering trajectory, children in the chronically distressed trajectory had greater odds of reporting high anxiety, less social support, more intervening life events, and greater use of poor emotion regulation strategies.
Conclusions
Hurricane exposure may be less effective in identifying children who develop chronic postdisaster distress than other child (anxiety, coping) and contextual variables (social support, life events). Effective screening after disasters is critical for identifying youth most in need of limited clinical resources.
Journal Article
Youth Aggression and Peer Victimization as Predictors of Adolescent Alcohol and Marijuana Use: A Longitudinal Analysis of Youth with Aggressive Behavior Problems
Youth who are behaviorally aggressive and victimized by their peers comprise a significant population with specific risks and vulnerabilities relative to substance use. The goals of the current study were to examine the roles that youth aggression and peer victimization play in determining the timing of alcohol and marijuana use initiation and the frequency of use 5-years later in a sample of at-risk, aggressive youth. 360 youth (
M
age
= 10.17 years; 65% boys, 35% girls; 78.1% African American, 20.3% Caucasian, 1.4% Hispanic, and 0.3% other) recruited for a prevention program for at-risk youth were followed for 5 years (4th – 9th grade). Cox PH regressions were conducted to predict timing of alcohol and marijuana use initiation. Zero-inflated negative binomial regressions were used to predict frequency of alcohol and marijuana use 5 years later. Results showed that peer victimization inferred decreased risk of alcohol use initiation. However, this effect was only observed for youth with relatively moderate, and low levels of aggression. Findings suggest that differences in youth aggression and victimization interact to predict distinct outcomes, suggesting the need for a more comprehensive approach when working with aggressive youth who have experienced peer victimization.
Journal Article
Teacher Adherence and Its Relation to Teacher Attitudes and Student Outcomes in an Elementary School-Based Violence Prevention Program
This study examined variability in teachers' reported adherence to a school-based violence prevention program, Creating a Peaceful School Learning Environment, and investigated the relations of teacher adherence to teachers' attitudes related to the intervention and students' attitudes about and responses to bullying. The results provide evidence of variation in adherence among teachers and schools and that teachers' attitudes may have affected adherence. Prospective analyses demonstrated dose-effect relations of teacher adherence with students' attitudes about and responses to bullying, particularly their tendency to assist victims. Findings underscore the importance of assessing and promoting adherence for school-based programs, inform the use of self-report to assess teacher adherence, and provide evidence that teachers are important contributors to the success of school-based antibullying interventions.
Journal Article
Peer Deviance, Social Support, and Symptoms of Internalizing Disorders Among Youth Exposed to Hurricane Georges
This study examined the influence of peers in meeting DSM-IV symptom criteria for an internalizing disorder in adolescents exposed to Hurricane Georges. Participants included a representative community sample of 905 youth (n = 476 boys) ages 11-17, residing in Puerto Rico. Data were gathered on hurricane exposure, symptoms of internalizing disorders, peer social support, peer violence, and peer substance use through in-person structured interviews with adolescents and caretakers from 1999 to 2000 in Puerto Rico, 12-27 months after Hurricane Georges. Hurricane exposure, peer violence, and peer substance use predicted whether adolescents met DSM-IV symptom criteria for a measured internalizing disorder. An interaction was found between hurricane exposure and peer violence, which indicated that hurricane exposure was significantly related to meeting DSM-IV symptom criteria for an internalizing disorder among adolescents who do not report associating with violent peers. However, for participants who reported high levels of peer violence, hurricane exposure did not convey additional risk for meeting DSM-IV symptom criteria for an internalizing disorder. With the increasing role peers play in adolescents' lives, understanding the influence of peers on the development of internalizing symptoms following hurricane exposure may assist in planning developmentally sensitive response plans.
Journal Article
