Structure and prevalence of PTSD symptomology in children who have experienced a severe tornado

Evans, Linda; Oehler-Stinnett, Judy

doi:10.1002/pits.20150

Cited by 40 publications

(36 citation statements)

References 50 publications

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“…The United States experiences the most tornadoes worldwide, with over 1,000 tornadoes recorded each year (Evans and Oehler-Stinnett, 2006), but little research has studied how posttraumatic psychopathology manifests in youth exposed to these disasters. To our knowledge, this study is the first to examine the structure of PTSD symptoms in tornado-exposed adolescents and investigate potential moderators of this structure and associations between underlying dimensions of PTSD with developmentally-informed functional correlates that have been understudied in the youth disaster mental health literature.…”

Section: Discussionmentioning

confidence: 99%

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Elucidating dimensions of posttraumatic stress symptoms and their functional correlates in disaster-exposed adolescents

Sumner

Pietrzak

Danielson

et al. 2014

Journal of Psychiatric Research

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The aim of this study was to elucidate the dimensional structure of posttraumatic stress disorder (PTSD) and potential moderators and functional correlates of this structure in disaster-affected adolescents. A population-based sample of 2,000 adolescents aged 12–17 years (M=14.5 years; 51% female) completed interviews on post-tornado PTSD symptoms, substance use, and parent-adolescent conflict between 4 and 13 months (M=8.8, SD=2.6) after tornado exposure. Confirmatory factor analyses revealed that all models fit well but a 5-factor dysphoric arousal model provided a statistically significantly better representation of adolescent PTSD symptoms compared to 4-factor dysphoria and emotional numbing models. There was evidence of measurement invariance of the dysphoric arousal model across gender and age, although girls and older adolescents aged 15–17 years had higher mean scores than boys and younger adolescents aged 12–14 years, respectively, on some PTSD dimensions. Differential magnitudes of association between PTSD symptom dimensions and functional correlates were observed, with emotional numbing symptoms most strongly positively associated with problematic substance use since the tornado, and dysphoric arousal symptoms most strongly positively associated with parent-adolescent conflict; both correlations were significantly larger than the corresponding correlations with anxious arousal. Taken together, these results suggest that the dimensional structure of tornado-related PTSD symptomatology in adolescents is optimally characterized by five separate clusters of re-experiencing, avoidance, numbing, dysphoric arousal, and anxious arousal symptoms, which showed unique associations with functional correlates. Findings emphasize that PTSD in disaster-exposed adolescents is not best conceptualized as a homogeneous construct and highlight potential differential targets for post-disaster assessment and intervention.

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Section: Discussionmentioning

confidence: 99%

“…Our results extend work on the dysphoric arousal model in disaster-exposed youth to both a new cultural context and natural disaster. Earthquakes and tornadoes are similar in that they strike quickly with little warning, although tornadoes occur more frequently than other natural disasters (Evans and Oehler-Stinnett, 2006). …”

Section: Discussionmentioning

confidence: 99%

Elucidating dimensions of posttraumatic stress symptoms and their functional correlates in disaster-exposed adolescents

Sumner

Pietrzak

Danielson

et al. 2014

Journal of Psychiatric Research

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“…Within studies of traumatic stress, such posttrauma cognitions are referred to as "a sense of foreshortened future," indicating that following traumatic experiences some individuals have persistent thoughts that their life will be cut short, whether by the experience of another trauma or by some other means (American Psychiatric Association, 2000;Evans & Oehler-Stinnett, 2006). Belief about a foreshortened future is an understudied area of PTSD, but such beliefs might help to account for higher rates of suicidal ideation and behaviors (e.g., Allwood, Dyl, Hunt, & Spirito, 2008;Lipschitz, Winegar, Hartnick, Foote, & Southwick, 1999;Mazza, 2000) and other self-harm behaviors (e.g., substance use, Kilpatrick et al, 2003;self injury, Weierich & Nock, 2008) seen in the aftermath of trauma exposure.…”

Section: The Effect Of Past Events On Outlook On the Futurementioning

confidence: 99%

Depressive Symptoms, Including Lack of Future Orientation, as Mediators in the Relationship between Adverse Life Events and Delinquent Behaviors

Allwood

Baetz

DeMarco

et al. 2012

Journ Child Adol Trauma

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The present study provided a cross-sectional examination of associations among adverse life events, depressive symptoms, and delinquency in a community sample of 123 early adolescent boys and girls. We also examined whether depressive cognitions, including hopelessness, differentially mediated the relations between exposure to adverse events and delinquent behaviors. Depressive cognitions, especially lack of future orientation, were associated with delinquent behaviors and partially mediated the relationship between adverse events and delinquent behaviors. Findings highlight the importance of future orientation among adversity-exposed youth, and suggest that interventions for trauma should focus on instilling optimism and hope as a means of reducing risk for negative outcomes, including delinquency.Adverse life events in childhood and adolescence have been consistently linked to juvenile delinquency (Kerig, this issue). However, much of the research in this area has focused on exposure to violence or abuse; far less is known about the associations between nonviolent, nonabusive negative life events and delinquent behaviors. Theories such as frustrationaggression theory (Felson, 1992) and general strain theory (Agnew, 2001) suggest that nonviolent negative life events should be associated with delinquency and that negative emotions are the mechanism through which these constructs are related. According to general strain theory, individuals engage in criminal behavior in response to the negative emotions associated with experiencing adverse events. Similarly, frustration-aggression theory posits that adverse events, including the inability to achieve a desired goal, lead to negative affect, which in turn leads to aggression. Taken together, these theories suggest that violent and nonviolent stressful life events lead to negative emotions, which increases the likelihood of adolescent involvement in aggression and delinquency.

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“…Tornadoes occur more frequently than other disasters, and are unique in that they can strike with little warning, specific paths are largely unpredictable, patterns of damage are selective, and they have a devastating impact (Evans & Oehler-Stinnett, 2006; NOAA, 2013). …”

Section: Rationale For Selection Of Disaster-affected Areasmentioning

confidence: 99%

“…To date, there have only been a handful of studies examining mental health outcomes post-tornado (Polusny et al, 2011; Evans & Oehler-Stinnett, 2006; Houlihan et al, 2008). Optimally, Bounce Back Now is designed for the 1–6 month period after disasters.…”

Section: Rationale For Selection Of Disaster-affected Areasmentioning

confidence: 99%

Bounce Back Now! Protocol of a population-based randomized controlled trial to examine the efficacy of a Web-based intervention with disaster-affected families

Ruggiero

Davidson

McCauley³

et al. 2015

Contemporary Clinical Trials

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Disasters have far-reaching and potentially long-lasting effects on youth and families. Research has consistently shown a clear increase in the prevalence of several mental health disorders after disasters, including depression and posttraumatic stress disorder. Widely accessible evidence-based interventions are needed to address this unmet need for youth and families, who are underrepresented in disaster research. Rapid growth in Internet and Smartphone access, as well as several web based evaluation studies with various adult populations has shown that web-based interventions are likely to be feasible in this context and can improve clinical outcomes. Such interventions also are generally cost-effective, can be targeted or personalized, and can easily be integrated in a stepped care approach to screening and intervention delivery. This is a protocol paper that describes an innovative study design in which we evaluate a self-help web-based resource, Bounce Back Now, with a population-based sample of disaster affected adolescents and families. The paper includes description and justification for sampling selection and procedures, selection of assessment measures and methods, design of the intervention, and statistical evaluation of critical outcomes. Unique features of this study design include the use of address-based sampling to recruit a population-based sample of disaster-affected adolescents and parents, telephone and web-based assessments, and development and evaluation of a highly individualized web intervention for adolescents. Challenges related to large-scale evaluation of technology-delivered interventions with high-risk samples in time-sensitive research are discussed, as well as implications for future research and practice.

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Structure and prevalence of PTSD symptomology in children who have experienced a severe tornado

Cited by 40 publications

References 50 publications

Elucidating dimensions of posttraumatic stress symptoms and their functional correlates in disaster-exposed adolescents

Elucidating dimensions of posttraumatic stress symptoms and their functional correlates in disaster-exposed adolescents

Depressive Symptoms, Including Lack of Future Orientation, as Mediators in the Relationship between Adverse Life Events and Delinquent Behaviors

Bounce Back Now! Protocol of a population-based randomized controlled trial to examine the efficacy of a Web-based intervention with disaster-affected families

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