The Pediatric Symptom Checklist-17 (PSC-17) is a widely used, briefer version of the PSC-35, a parent-completed measure of children's psychosocial functioning. Despite the extensive use of the PSC-17 over the past 15 years there has not been a large-scale replication of the original derivation study.
Untreated mental health problems are among the most disabling, persistent, and costly health conditions. Because they often begin in childhood and continue into adulthood, there has been growing interest in preventive mental health programs for children. In recent years, several such programs have been implemented at regional, state, or national scale, and although many experimental studies have documented positive outcomes of individual programs, this article represents the first attempt to systematically compare the largest programs in terms of scope, scale, and dose. The school-based mental health programs discussed in this review appear to have reached more than 27 million children over the last decade, and many of these programs have collected systematic outcomes data. The role that such programs can play in low- and middle-income countries (LMICs) is a secondary focus of this article. Until recently, wide-scaled, preventive, mental health interventions for children have been studied almost exclusively in high-income countries even though around 80% of the global population of children reside in LMICs. Since a number of programs are now operating on a large scale in LMICs, it has become possible to consider child mental health programs from a more global perspective. With both the increasing diversity of countries represented and the growing scale of programs, data sets of increasing quality and size are opening up new opportunities to assess the degree to which preventive interventions for child mental health, delivered at scale, can play a role in improving health and other life outcomes.
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.
Objective:The current study examined how severity of disaster exposure and predisaster individual and family characteristics predicted trajectories of disaster-related posttraumatic stress symptoms (PTSS) in children over 4 years following a devastating EF-4 tornado. Method: Participants (n ϭ 346; 65% male; 77.5% African American) were 4th-6th-graders and their caregivers, from predominantly low-income households, who were already participating in a longitudinal study of indicated prevention effects for externalizing outcomes when the tornado occurred in 2011. Latent class trajectory analyses were used to identify disaster-related PTSS trajectory groups across the 4-year postdisaster period. Results: Three groups were identified: (1) a group that declined (recovery) in PTSS over time (15.90%); (2) a group that was stable and low in PTSS over time (76.87%); and (3) a group that was stable and high (chronic) in PTSS over time (7.23%). Multinomial logistic regression analyses revealed that greater tornado exposure predicted membership in the declining trajectory group relative to the low-stable group. Positive parenting and pretornado caregiver trauma exposure also moderated how disaster exposure, particularly perceived life threat, predicted PTSS trajectories. Conclusions: Some youth reported elevated disasterrelated PTSS repeatedly for 4 years following a devastating tornado. Consistent with the concept of equifinality, results suggest that there are several pre-exposure risk factors that may increase risk for a chronic PTSS trajectory following disaster exposure.
What is the public health significance of this article?This study indicates that a portion of youth report chronically elevated disaster-related PTSS four years after a natural disaster. Severity of disaster exposure predicts initially high symptoms, but the effects of disaster exposure on persisting symptoms were moderated by pretornado caregiver trauma and the parenting styles of caregivers prior to the tornado. Thus, predisaster individual and family characteristics may help to identify those youth who are at most risk for enduring and elevated posttraumatic stress.
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