Psychological Risk & Resiliency: Children’s Adjustment Post-Katrina

DEPARTMENT OF PSYCHOLOGY

Psychological Risk & Resiliency:Children’s Adjustment Post-Katrina

Mary Lou Kelley, Ph.D.USPHS Scientific & Training

SymposiumJune 21, 2011

Presented by the National Center for the Study of Coastal Hazards, A Department of Homeland Security Science and Technology Center of Excellence. This material is based upon work supported by the U.S. Department of Homeland Security under Award Number: 2008-ST-061-ND0001. The views and conclusions contained in this document are those of the authors and should not be interpreted as necessarily representing the official policies, either expressed or implied, of the US Department of Homeland Security.

Hurricane Katrina

August 29, 2005

Levee breach flooded 80% of the city

1000 lives were lost

500,000 homes were destroyed

Families lost homes, possessions, social support, and schools

Disaster-Related Mental Health Impact

Short-Term Distress

Short-Term Mental Disorders

Persistent Psychological

Disorders

Mild Transitory Distress

Num

ber o

f Affe

cted

Indi

vidu

als Greater

Fewer

IntroductionFactors Related to Negative Outcomes in Children Post-

Disaster- Degree of Disaster Exposure (loss and threat)- Female Gender- Pre-Disaster Anxiety- Low Socioeconomic Status- Parent PTSD symptoms- Parent Psychopathology

Predicting PTSD in Children Post-Katrina: A Longitudinal Analysis

Limitations of the Research- Minimal focus on parenting behavior- Minimal focus on contextual variables- Lack of longitudinal studies- Use of measures with inadequate psychometric support - Limited treatment outcome studies


Purpose1. To evaluate the adjustment of children and their mothers post-

Katrina over a two year time span.

2. To examine variables impacting children from a family and community perspective.

3. To examine the effect of parent distress and lack of social support on parenting behavior and children’s PTSD symptom severity.

Kelley, M.L., Self-Brown, S., Le, B., Vigna, J.F., Hernandez, B. C., & Gordon, A.T. (2010). Predicting Post-Traumatic Stress Symptoms in Children Following Hurricane Katrina: A Longitudinal Analysis of Child and Family Variables. Journal of Traumatic Stress.


Diagnostic Criteria for PTSD

Must present with at least: – 3 Symptoms of Avoidance

• Avoidance of places or persons, and feelings of detachment

– 2 Symptoms of Arousal • Sleep problems, irritability, or outbursts of anger

– 1 Re-experiencing Symptom• Recurring distressful recollection and/or dreams

Participants381 Katrina affected mother-child dyads from New Orleans and

surrounding parishes. The majority were from New Orleans and 74% were displaced by the storm.

Sample primarily African American (68%) with 24% Caucasian and 8% other ethnicities.

Average reported household income was under $25,000.


ProcedureParticipants were solicited from six reopened schools that served

the entire parish. Children brought home flyers asking for participation and parent consent.

Children completed questionnaires at their schools under the supervision of researchers. Parents completed questionnaires at home and returned them by mail.

Families were compensated for participation.


Child Measures1. Hurricane Threat and Loss (HURTE) 2. Community Violence Exposure (SAVE)3. PTSD (UCLA PTSD Reaction Index)

Mother Measures4. Negative Coping (Brief Cope)5. Social Support (ISEL)6. Global Distress (SCL-90, Global Distress Index)

Parenting Measures7. Corporal Punishment (Alabama Parenting Questionnaire)8. Family Routines (Family Routine Questionnaire)


1. Exogenous Variables (Hurricane and Violence Exposure) equally predictive of child PTSD.

2. Exogenous Variables indirectly associated with higher levels of PTSD at T1 through the parenting distress and parenting variables.

3. Low Social Support and Negative Coping predicted parent distress.

4. Parent Distress positively related to corporal punishment and routines.

5. Parents’ use of Corporal Punishment predicted child PTSD at T1 & T2.

6. Children with severe PTSD symptoms at T1, 12 times more likely to have severe PTSD at T2. 13% had severe PTSD symptoms at T1.


Public Health Implications1. Findings indicate that parents’ maladaptive coping is related

to negative parenting and exacerbates risk for psychopathology.

Screen for distress and negative coping soon but not immediately after a disaster.

2. Routines employed by distressed parents may be implemented more harshly or differently than non-distressed parents.

The recommendation to reestablish routines to aid in disaster recovery may need to be looked at more closely.


Public Health Implications3. Parents who reported less social support and use of negative

coping had more psychological distress.Re-establishing social support systems should be a paramount priority for aiding disaster victims.

4. Children with significant PTSD symptoms several months after a disaster were 12 times more likely to have significant symptoms one year later.

Screen for PTSD symptoms several months after a disaster and offer treatment to those with

significant symptoms.


Adapting well in the face of adversity or trauma: – Positive outcome despite high risk status– Sustained functioning under threat– Recovery from trauma

Multidimensional, dynamic construct: – Displayed in one environment but not another – Displayed in one psychological domain but not another

Sources: (American Psychological Association; Luthar & Crachetti, 2000;Masten, Best, & Garmezy, 1990; O’Donnell, Schwab-Stone, & Muyeed, 2002; Watson et al., 2006)

Psychological Resiliency

Background– Lack of research on children’s post-disaster positive adjustment– Positive adjustment: Possessing attributes such as interpersonal

skills, self-reliance, and self-esteem– Maternal and child coping and social support related to adjustment

in non-disaster literature and act as buffers against PTSD symptom severity post-disaster

Purpose – To examine possible predictors of positive adjustment post-Katrina,

emphasizing personal and maternal factors

Vigna, J. F., Hernandez, B. C., Paasch, V., Gordon, A.T., & Kelley, M. L. (2009). Positive Adjustment in Youth Post-Katrina: The Impact of Child and Maternal Social Support and Coping. K. E. Cherry (Ed), Lifespan Perspectives on Natural Disasters: Coping with Katrina, Rita and other Storms. NY: Springer.

Vigna, J. F., Hernandez, B. C., Paasch, V., Gordon, A.T., & Kelley, M. L. (2009). Positive Adjustment in Youth Post-Katrina: The Impact of Child and Maternal Social Support and Coping. K. E. Cherry (Ed), Lifespan Perspectives on Natural Disasters: Coping with Katrina, Rita and other Storms. NY: Springer.

Positive Adjustment in Youth Post-Katrina: Impact of Child & Maternal Social Support and Coping


Hypotheses1. Heightened hurricane and violence exposure will predict fewer

positive outcomes

2. Children’s positive coping strategies will predict greater positive adjustment; negative coping strategies will predict less positive adjustment

3. Mothers reporting greater social support will have children with greater positive adjustment

4. Mothers using positive coping strategies will have children with greater positive adjustment

Participants142 mother-child dyads from Orleans, Jefferson, and EBR parishes(Mean child age = 11.67 years; 58% female; 59% African American)

ProcedureYouth completed measures of hurricane (HURTE) and community violence exposure (SAVE) 3 – 7 months post-Katrina.

Youth completed measures of social support (SSSC), coping (YCRI), and positive adjustment (BASC-2) 25 – 28 months post-Katrina.

Parents completed measures of social support (ISEL), coping (COPE), and their perception of their children’s positive adjustment (BASC-2) 25 -28 months post-Katrina.


Results 1. Hurricane-related life-threatening experiences were positively

related to positive adjustment2. Parent-provided social support was the strongest predictor of

child-reported positive adjustment3. Coping style using Diversion (re-establishing routines, alternate

activities, and spirituality) was the second strongest predictor of positive adjustment

4. Destructive coping negatively predicted positive adjustment5. Ameliorative coping was not associated with positive outcomes


Conclusions1. Parent support is paramount in youths’ positive adjustment post-

disaster.

2. Programming should emphasize to parents their critical role in determining their children’s long-term adjustment in times of crisis.

3. Providing children distracting activities may be integral to post- disaster adjustment. Problem-focused coping may not be helpful to children in situations in which they cannot control the outcome.


Psychological Risk & Resiliency:Children’s Adjustment Post-Katrina

Thank you!

Mary Lou Kelley, Ph.D.236 Audubon HallDepartment of PsychologyLouisiana State UniversityBaton Rouge LA 70803

[email protected]

Psychological Risk & Resiliency: Children’s Adjustment Post-Katrina

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