Natural disaster effects on aggressive children and their caretakers: Outcomes ac

说明(申请人提供)：这项研究将审查龙卷风相关的自然灾害对参加正在进行的药物使用预防试验的儿童和父母的影响，并将提供一个独特的机会，在已经处于危险之中的样本中检查儿童和父母在全面的生物心理-社会指标以及药物滥用和精神健康服务使用方面的灾前和灾后功能变化。关于自然灾害对儿童及其照顾者的服务使用、物质使用、行为和情感影响的研究得到的经验关注有限，尽管由于情感和行为功能紊乱以及服务使用需求的增加，此类灾难具有相当大的公共卫生意义。现有关于自然灾害对儿童影响的研究由于不知道灾难在多大程度上改变了儿童的灾前功能而受到限制。这将是第一个灾难研究 包括广泛的数据，包括儿童在灾难暴露前后的行为、情感、心理(教师、家长、同伴和自我报告)、社会(基于同伴、教师和自我报告的儿童的同伴关系)和心理生理(皮肤电导、心率、呼吸窦性心律失常)的运作情况。这项拟议研究的另一项重要创新是，它将跟踪在灾难发生前被确定为有风险的青春期前儿童的样本。因此，样本很可能更严重地受到灾难的影响(Kaminer等人，2005年；Resnick，1995；Weems等人，2010年)，因为摧毁研究地区的龙卷风为本已脆弱的儿童增加了另一组风险因素。该项目的具体目标是：1探索龙卷风前后儿童(情绪、行为、社会、学业和自主神经系统功能和物质使用)和主要照顾者(情绪功能和育儿做法)的功能变化；2)探索龙卷风暴露程度、龙卷风前儿童(性别、种族、气质焦虑)和家庭(社会经济状况、龙卷风后负面生活事件、家庭社会支持水平、育儿做法)特征和基因与环境(龙卷风暴露程度)影响对儿童和照顾者功能变化的调节；3)通过龙卷风暴露程度和龙卷风前儿童和家庭特征以及照顾者和儿童的功能变化，探索龙卷风后药物滥用、精神卫生服务使用和诊断结果的适度性；4)确定龙卷风后提供的认知行为干预(应对能力)是否以跨诊断方式减少龙卷风后行为和情绪问题的增加(队列3与队列1和2)。这里寻求的资金将支持在更频繁和更长期的时间点对现有干预抽样进行评估，并支持对与具体目标有关的额外措施进行评估，从而实现这些目标。

DESCRIPTION (provided by applicant): This study will examine the effects of a tornado-related natural disaster on children and parents participating in an ongoing substance use prevention trial and will allow a unique opportunity to examine changes in children's and parents' predisaster and postdisaster functioning on a comprehensive range of biopsychic- social indicators and on substance abuse and mental health service use in an already at-risk sample. Research on the service use, substance use, behavioral and emotional effects of natural disasters on children and their caretakers has received limited empirical attention, even though such disasters have considerable public health significance due to increases in disordered emotional and behavioral functioning and service use demands. Existing studies of the aftereffects of natural disasters on children are limited by not knowing how much the disaster changed the children's predisaster functioning. This will be the first disaster study that includes extensive data on children's behavioral, emotional, (teacher, parent, peer, and self reports), social (children's peer relations based on peer, teacher and self report) and psycho- physiological (skin conductance, heart rate, respiratory sinus arrhythmia) functioning both before and after disaster exposure. Another important innovation of the proposed study is that it will follow a sample of preadolescent children identified as being at-risk prior to the disaster. Thus, the sample is likely to be more heavily influenced by the disaster (Kaminer et al., 2005; Resnick, 1995; Weems et al., 2010), because the tornado that devastated the study area adds another set of risk factors to already vulnerable children. The specific aims of the project are: 1 To explore changes in functioning pre-to-post tornado in children (emotional, behavioral, social, academic, and autonomic nervous system functioning and substance use) and primary caretakers (emotional functioning and parenting practices); 2) To explore moderation of changes in child and caretaker functioning pre-to-post tornado by degree of tornado exposure, by pre- tornado child (sex, ethnicity, temperamental anxiety) and family (socioeconomic status, post-tornado negative life events, levels of family social support, parenting practices) characteristics and by gene-by- environment (degree of exposure to the tornado) effects; 3) To explore moderation of post-tornado rates of substance abuse, mental health service use and diagnostic outcomes by degree of tornado exposure and pre-tornado child and family characteristics and by caretakers' and children's changes in functioning; 4) To determine whether cognitive behavioral intervention (Coping Power) delivered after the tornado (Cohort 3 versus Cohorts 1 and 2) attenuates increases in behavioral and emotional problems after the tornado in a transdiagnostic fashion. The funding sought here would make it possible to address these aims by supporting the assessment of the existing intervention sample at more frequent and longer-term time points and on additional measures linked to the specific aims.