Children as Bellwethers of Recovery: Dysfunctional Systems and the Effects of Parents, Households, and Neighborhoods on Serious Emotional Disturbance in Children After Hurricane Katrina
Children as Bellwethers of Recovery: Dysfunctional Systems and the Effects of Parents, Households, and Neighborhoods on Serious Emotional Disturbance in Children After Hurricane Katrina
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DOI：
10.1001/dmp.2010.7
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发表时间：
2010-09-01
影响因子：
2.7
通讯作者：
Redlener, Irwin
中科院分区：
文献类型：
--
作者：
Abramson, David M.;Park, Yoon Soo;Redlener, Irwin
背景：卡特里娜飓风过后，超过16万名儿童流离失所。成千上万的这些儿童经历了持续的混乱和流离失所和短暂的不确定性，以及他们生活中严重的社会混乱。本研究的目的是估计这种暴露对儿童心理健康的长期影响，并阐明灾难效应运作的系统途径。方法：对路易斯安那州和密西西比州283名学龄儿童进行严重情绪障碍患病率评估。这些儿童是墨西哥湾沿岸儿童和家庭健康研究的一部分，该研究涉及两个州的1079个随机抽样家庭的纵向队列，共包括427名儿童，自2006年1月以来，在每年四次的数据收集中对这些儿童进行了采访。本分析的大部分数据来自第四轮数据。结果：尽管自2005年以来，在受卡特里娜飓风影响的地区，儿童获得医疗保健的机会大大增加，但根据家长报告，超过37%的儿童接受了抑郁、焦虑或行为障碍的临床心理健康诊断。经历过卡特里娜飓风的儿童表现出严重情绪障碍的可能性几乎是卡特里娜飓风前儿童的5倍。通径分析证实了邻里社会障碍、家庭压力源和父母限制对儿童情绪和行为功能的影响。结论：儿童和青年特别容易受到灾害的影响。他们独立调动资源以帮助自己适应灾后压力环境的能力有限，而是依赖他人做出影响其家庭、社区、学校和更大社会环境的选择。灾后儿童的心理健康恢复可以作为成功恢复的风向标，也可以作为系统功能障碍和恢复失败的滞后指标。（灾害医学和公共卫生准备。2010;4:S17-S27）
Background: Over 160 000 children were displaced from their homes after Hurricane Katrina. Tens of thousands of these children experienced the ongoing chaos and uncertainty of displacement and transiency, as well as significant social disruptions in their lives. The objectives of this study were to estimate the long-term mental health effects of such exposure among children, and to elucidate the systemic pathways through which the disaster effect operates.Methods: The prevalence of serious emotional disturbance was assessed among 283 school-aged children in Louisiana and Mississippi. These children are part of the Gulf Coast Child & Family Health Study, involving a longitudinal cohort of 1079 randomly sampled households in the two states, encompassing a total of 427 children, who have been interviewed in 4 annual waves of data collection since January 2006. The majority of data for this analysis was drawn from the fourth round of data.Results: Although access to medical care for children has expanded considerably since 2005 in the region affected by Hurricane Katrina, more than 37% of children have received a clinical mental health diagnosis of depression, anxiety, or behavior disorder, according to parent reports. Children exposed to Hurricane Katrina were nearly 5 times as likely as a pre-Katrina cohort to exhibit serious emotional disturbance. Path analyses confirm the roles played by neighborhood social disorder, household stressors, and parental limitations on children's emotional and behavioral functioning.Conclusions: Children and youth are particularly vulnerable to the effects of disasters. They have limited capacity to independently mobilize resources to help them adapt to stressful postdisaster circumstances, and are instead dependent upon others to make choices that will influence their household, neighborhood, school, and larger social environment. Children's mental health recovery in a postdisaster setting can serve as a bellwether indicator of successful recovery or as a lagging indicator of system dysfunction and failed recovery. (Disaster Med Public Health Preparedness. 2010;4:S17-S27)