Natural Disaster and Risk of Psychiatric Disorders in Puerto Rican Children

描述(申请人提供)：从袭击波多黎各的飓风乔治灾难中，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在方法上的许多缺陷。这项关于儿童和青少年精神障碍的两波流行病学研究通过其抽样战略、精神障碍的高质量测量、社会生态风险和保护因素测量的广度和深度以及使用多种信息来源，改进了以往许多关于儿童灾后心理健康和康复的研究。这项次级数据分析研究的目的是考察家庭、同伴、学校和社区微系统领域内的恢复环境如何影响灾难暴露与灾后18个月和30个月内化性障碍发展之间的关系。提出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。在家庭微观系统内，这包括评估随着时间的推移家庭关系质量的各个方面，它在暴露-障碍关系中的中介作用，以及家庭关系质量的潜在调节因素。我们将研究同伴关系如何影响灾难后精神障碍的风险，特别关注离经叛道的同伴的影响，以及同伴受害可能如何侵蚀同伴的支持。在学校微观系统方面，我们评估了校园暴力的影响和效能。我们还讨论了生活在以暴力程度高和邻里质量差为特点的社区内如何影响恢复。4-17岁的儿童是从全岛概率家庭样本中随机挑选出来的。2000年美国人口普查表明，数据经过加权后代表了波多黎各的儿童和青少年人口。在灾后18个月和30个月，使用儿童诊断性面谈时间表以及风险和保护措施的训练有素的面谈人员进行了结构化面谈。共完成了1886名亲子二人组的访谈，完成率为90.1%。在时间2，有94%的保留率。将使用多层次结构方程模型来解决研究的目标。这项关于灾后恢复环境中的风险和保护如何影响内化性障碍发展的彻底调查，将有助于提供信息并有针对性地采取多层次干预措施，以降低灾难后不利心理健康后果的风险。公共卫生相关性：这项研究调查了灾难发生后长期儿童的心理健康状况。研究了儿童、家庭和学校/社区因素，这些因素增加或降低了在灾难中发生精神障碍的风险。

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.