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害中，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害心理健康研究在方法上的许多缺陷。这项儿童和青少年精神疾病的两波流行病学研究通过其抽样策略、高质量的精神疾病测量、社会生态风险和保护因素测量的广度和深度以及多信息者的使用，改进了先前许多关于儿童灾后心理健康和恢复的研究。这项二级数据分析研究的目的是研究在家庭、同伴、学校和社区微系统领域内的恢复环境如何影响灾后18个月和30个月灾害暴露与内化障碍发展之间的关系。具体假设的相对影响的结构在每个微系统和他们的影响机制进行了讨论。在家庭微系统中，这包括随着时间的推移评估家庭关系质量的各个方面，其在暴露障碍关系中的中介作用，以及家庭关系质量的潜在调节因子。我们将研究同伴关系如何影响灾难后精神障碍的风险，特别关注异常同伴的影响以及同伴受害如何侵蚀同伴支持。在学校微系统方面，我们评估了学校暴力的影响和效能。我们还讨论了生活在暴力程度高、社区质量差的社区中如何影响康复。4-17岁的儿童从全岛概率家庭样本中随机选择。根据2000年美国人口普查，数据被加权以代表波多黎各的儿童和青少年人口。在灾后18个月和30个月，使用儿童诊断访谈时间表和风险和保护措施进行结构化访谈，并由训练有素的访谈者进行。对1,886对亲子二人的访谈完成，完成率为90.1%。时间2时，保留率为94%。多层次结构方程模型将用于解决研究的目的。这项关于灾后恢复环境中的风险和保护如何影响内化障碍发展的深入调查将有助于提供信息并确定多层次干预措施的目标，以减少灾后不良心理健康结果的风险。公共卫生相关性：本研究考察了灾难后儿童的长期心理健康状况。研究了儿童、家庭和学校/社区因素增加或减少灾害暴露后发展为精神障碍的风险。

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.