Serious emotional disturbance among youths exposed to Hurricane Katrina 2 years postdisaster.
OBJECTIVE
To estimate the prevalence of serious emotional disturbance (SED) among children and adolescents exposed to Hurricane Katrina along with the associations of SED with hurricane-related stressors, sociodemographics, and family factors 18 to 27 months after the hurricane.


METHODS
A probability sample of prehurricane residents of areas affected by Hurricane Katrina was administered a telephone survey. Respondents provided information on up to two of their children (n = 797) aged 4 to 17 years. The survey assessed hurricane-related stressors and lifetime history of psychopathology in respondents, screened for 12-month SED in respondents' children using the Strengths and Difficulties Questionnaire, and determined whether children's emotional and behavioral problems were attributable to Hurricane Katrina.


RESULTS
The estimated prevalence of SED was 14.9%, and 9.3% of the youths were estimated to have SED that is directly attributable to Hurricane Katrina. Stress exposure was associated strongly with SED, and 20.3% of the youths with high stress exposure had hurricane-attributable SED. Death of a loved one had the strongest association with SED among prehurricane residents of New Orleans, whereas exposure to physical adversity had the strongest association in the remainder of the sample. Among children with stress exposure, parental psychopathology and poverty were associated with SED.


CONCLUSIONS
The prevalence of SED among youths exposed to Hurricane Katrina remains high 18 to 27 months after the storm, suggesting a substantial need for mental health treatment resources in the hurricane-affected areas. The youths who were exposed to hurricane-related stressors, have a family history of psychopathology, and have lower family incomes are at greatest risk for long-term psychiatric impairment.
Drs. McLaughlin and Kessler, Mr. Gruber, Mr. Lakoma, and Ms. Sampson are with Harvard Medical School; Dr. Fairbank is with the National Center for Child Traumatic Stress, Duke University Medical Center, and the Mid-Atlantic Mental Illness Research, Education and Clinical Center (MIRECC), Durham VA Medical Center; Dr. Jones is with Virginia Tech University; and Dr. Pfefferbaum is with the University of Oklahoma College of Medicine.
Katie A
KA
Mclaughlin
Drs. McLaughlin and Kessler, Mr. Gruber, Mr. Lakoma, and Ms. Sampson are with Harvard Medical School; Dr. Fairbank is with the National Center for Child Traumatic Stress, Duke University Medical Center, and the Mid-Atlantic Mental Illness Research, Education and Clinical Center (MIRECC), Durham VA Medical Center; Dr. Jones is with Virginia Tech University; and Dr. Pfefferbaum is with the University of Oklahoma College of Medicine.
John A
JA
Fairbank
Drs. McLaughlin and Kessler, Mr. Gruber, Mr. Lakoma, and Ms. Sampson are with Harvard Medical School; Dr. Fairbank is with the National Center for Child Traumatic Stress, Duke University Medical Center, and the Mid-Atlantic Mental Illness Research, Education and Clinical Center (MIRECC), Durham VA Medical Center; Dr. Jones is with Virginia Tech University; and Dr. Pfefferbaum is with the University of Oklahoma College of Medicine.
Michael J
MJ
Gruber
Drs. McLaughlin and Kessler, Mr. Gruber, Mr. Lakoma, and Ms. Sampson are with Harvard Medical School; Dr. Fairbank is with the National Center for Child Traumatic Stress, Duke University Medical Center, and the Mid-Atlantic Mental Illness Research, Education and Clinical Center (MIRECC), Durham VA Medical Center; Dr. Jones is with Virginia Tech University; and Dr. Pfefferbaum is with the University of Oklahoma College of Medicine.
Russell T
RT
Jones
Drs. McLaughlin and Kessler, Mr. Gruber, Mr. Lakoma, and Ms. Sampson are with Harvard Medical School; Dr. Fairbank is with the National Center for Child Traumatic Stress, Duke University Medical Center, and the Mid-Atlantic Mental Illness Research, Education and Clinical Center (MIRECC), Durham VA Medical Center; Dr. Jones is with Virginia Tech University; and Dr. Pfefferbaum is with the University of Oklahoma College of Medicine.
Matthew D
MD
Lakoma
Drs. McLaughlin and Kessler, Mr. Gruber, Mr. Lakoma, and Ms. Sampson are with Harvard Medical School; Dr. Fairbank is with the National Center for Child Traumatic Stress, Duke University Medical Center, and the Mid-Atlantic Mental Illness Research, Education and Clinical Center (MIRECC), Durham VA Medical Center; Dr. Jones is with Virginia Tech University; and Dr. Pfefferbaum is with the University of Oklahoma College of Medicine.
Betty
B
Pfefferbaum
Drs. McLaughlin and Kessler, Mr. Gruber, Mr. Lakoma, and Ms. Sampson are with Harvard Medical School; Dr. Fairbank is with the National Center for Child Traumatic Stress, Duke University Medical Center, and the Mid-Atlantic Mental Illness Research, Education and Clinical Center (MIRECC), Durham VA Medical Center; Dr. Jones is with Virginia Tech University; and Dr. Pfefferbaum is with the University of Oklahoma College of Medicine.
Nancy A
NA
Sampson
Drs. McLaughlin and Kessler, Mr. Gruber, Mr. Lakoma, and Ms. Sampson are with Harvard Medical School; Dr. Fairbank is with the National Center for Child Traumatic Stress, Duke University Medical Center, and the Mid-Atlantic Mental Illness Research, Education and Clinical Center (MIRECC), Durham VA Medical Center; Dr. Jones is with Virginia Tech University; and Dr. Pfefferbaum is with the University of Oklahoma College of Medicine. Electronic address: kessler@hcp.med.harvard.edu.
Ronald C
RC
Kessler
D000293:Adolescent; D000342:Affective Symptoms / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology; D000407:Alabama; D002648:Child; D002653:Child Behavior Disorders / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology; D016241:Child of Impaired Parents / Q000523:psychology; D002675:Child, Preschool; D019955:Conduct Disorder / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology; D003430:Cross-Sectional Studies; D055867:Cyclonic Storms; D004190:Disasters; D005260:Female; D005500:Follow-Up Studies; D006306:Health Surveys; D006801:Humans; D008016:Life Change Events; D008145:Louisiana; D008297:Male; D008403:Mass Screening; D008922:Mississippi; D055820:New Orleans; D010552:Personality Assessment; D011203:Poverty / Q000523:psychology / Q000706:statistics & numerical data; D013313:Stress Disorders, Post-Traumatic / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology