Natural Disaster and Risk of Psychiatric Disorders in Puerto Rican Children

描述（由申请人提供）：从袭击波多黎各的乔治飓风灾难中，出现了一个具有独特潜力的数据库，可以解决以前许多儿童灾难心理健康研究的方法学缺陷。这两波流行病学研究的儿童和青少年精神疾病改善了许多以前的研究，儿童的灾后心理健康和恢复，通过其抽样策略，高质量的测量精神疾病，测量的社会生态风险和保护因素的广度和深度，并使用多个线人。这项二级数据分析研究的目的是研究如何恢复环境，在家庭，同伴，学校和社区微系统的域，影响灾害暴露和发展的内在障碍在18和30个月灾后的关系。讨论了关于每个微系统内结构的相对影响及其影响机制的具体假设。在家庭微系统中，这包括评估家庭关系质量的各个方面，随着时间的推移，它作为一个调解人的作用，在抑郁症的关系，和潜在的调解人的家庭关系质量。我们将研究同伴关系如何影响灾难后精神障碍的风险，特别关注越轨同伴的影响，以及同伴受害如何侵蚀同伴的支持。在学校微观系统方面，我们评估了学校暴力的影响和效能。我们还讨论了如何生活在社区内的特点是高水平的暴力和邻里质量差的影响恢复。年龄在4-17岁之间的儿童是从全岛概率家庭抽样中随机挑选的。对数据进行加权，以代表2000年美国人口普查显示的波多黎各儿童和青少年人口。在灾后18个月和30个月，利用训练有素的访谈人员，使用儿童诊断访谈时间表进行了结构化访谈，并采取了风险和保护措施。访谈完成了1,886个亲子配对，完成率为90.1%。在时间2，有94%的留存率。多层次结构方程模型将用于解决研究的目的。对灾后恢复环境中的风险和保护如何影响内化障碍的发展的彻底调查将有助于为多层次干预提供信息和目标，以减少灾难后不良心理健康结果的风险。公共卫生相关性：这项研究考察了灾难后儿童的长期心理健康状况。儿童，家庭和学校/社区的因素，增加或减少风险发展为精神疾病暴露于灾难进行了研究。

DESCRIPTION (provided by applicant): From the Hurricane Georges disaster that struck Puerto Rico, a database with unique potential to address many of the methodological short-comings of much of previous child disaster mental health research has emerged. This two-wave epidemiological study of child and adolescent psychiatric disorders improves upon many prior studies on children's post-disaster mental health and recovery through its sampling strategy, high quality measurement of psychiatric disorders, breadth and depth of measurement of socio-ecological risk and protective factors, and the use of multiple informants. The aims of this secondary data analysis study are examining how the recovery environment, within the domains of the family, peer, school, and community microsystems, influences the relationship between disaster exposure and the development of an internalizing disorder at 18 and 30 months post-disaster. Specific hypotheses about the relative influence of constructs within each microsystem and their mechanism of influence are addressed. Within the family microsystem, this includes assessing aspects of family relationship quality over time, its roles as a mediator in the exposure-disorder relationship, and potential moderators of family relationship quality. We will examine how peer relationships influence risk of psychiatric disorder following a disaster, with a specific focus on the influence of deviant peers and how peer victimization may erode peer support. In relation to the school microsystem, we assess the influence of school violence and efficacy. We also address how living within communities characterized by high levels of violence and poor neighborhood quality influence recovery. Children aged 4-17 years were randomly-selected from an island-wide probability household sample. Data were weighted to represent the child and adolescent population in Puerto Rico as indicated by the 2000 U.S. Census. Structured interviews using the Diagnostic Interview Schedule for Children and measures of risk and protection were conducted using highly trained interviewers at 18 and 30 months post-disaster. Interviews were completed with 1,886 parent-child dyads representing a completion rate of 90.1 percent. At time 2, there was a 94 percent retention rate. Multi-level structural equation modeling will be used to address the aims of the study. This thorough investigation of how risk and protection within the post-disaster recovery environment influences the development of an internalizing disorder will help inform and target multi-level interventions to reduce risk for adverse mental health outcomes following a disaster. PUBLIC HEALTH RELEVANCE: This study examines children's mental health in the long-term aftermath of a disaster. Child, family, and school/community factors that increase or decrease risk for developing a psychiatric disorder following exposure to a disaster are studied.