Posttraumatic Stress, Anxiety, and Depression Symptoms Among Children After Hurricane Katrina: A Latent Profile Analysis
This study utilized latent profile analysis to identify typologies of distress [i.e., patterns of posttraumatic stress (PTS), anxiety, and depression symptoms] among children exposed to Hurricane Katrina. Outcomes and risk factors for these pattern groups were examined. Participants were children (n = 353; ages 8–15 years) affected by Hurricane Katrina. Children were assessed at 3–7 months (Time 1) and 14–17 months (Time 2) post-Katrina. Results identified three pattern groups (No Disturbance, PTS Only, and Mixed Internalizing) at Time 1. Children in the No Disturbance group reported the lowest levels of internal distress, while the Mixed Internalizing group reported the highest levels of internal distress at Time 2. The Mixed Internalizing and the PTS Only groups reported greater school problems than the No Disturbance group at Time 2. Perceived life threat and community violence exposure were risk factors associated with higher likelihood of falling in the PTS Only and Mixed Internalizing groups, compared to the No Disturbance group. Immediate loss and disruption was also a risk factor associated with a higher likelihood of falling in the PTS Only group, compared to the No Disturbance group. Finally, social support from parents or a classmate/friend was a significant protective factor associated with a lower likelihood of falling into a symptomatic pattern group.
KeywordsPosttraumatic stress symptoms Anxiety Depression Children Disasters Latent profile analysis
This material is based upon work supported by the US Department of Homeland Security under Award Number: 2008-ST-061-ND 0001 and a research grant from the National Institute of Mental Health (RMH-078148A). We would like to thank Constance Ogokeh and Brooke Beaulieu for their administrative assistance with this article.
- Aderka, I. M., Foa, E. B., Applebaum, E., Shafran, N., & Gilboa-Schechtman, E. (2011). Direction of influence between posttraumatic and depressive symptoms during prolonged exposure therapy among children and adolescents. Journal of Consulting and Clinical Psychology, 79(3), 421. doi: 10.1037/a0023318.PubMedCentralPubMedCrossRefGoogle Scholar
- Asparouhov, T., & Muthen, B. (2012). Auxiliary variables in mixture modeling: A 3-step approach using Mplus. Mplus web notes: No. 15. Retrieved March 20, 2013 from http://www.statmodel.com/examples/webnotes/webnote15.pdf.
- Au, T. M., Dickstein, B. D., Comer, J. S., Salters-Pedneault, K., & Litz, B. T. (2013). Co-occurring posttraumatic stress and depression symptoms after sexual assault: A latent profile analysis. Journal of Affective Disorders, 149(1–3), 209–216. doi: 10.1016/j.jad.2013.01.026.PubMedCrossRefGoogle Scholar
- Clark, S. L., & Muthen, B. (2009). Relating latent class analysis results to variables not included in the analysis. Retrieved March 21, 2013 from http://www.statmodel.com/download/relatinglca.pdf.
- Goenjian, A. K., Molina, L., Steinberg, A. M., Fairbanks, L. A., Alvarez, M. L., Goenjian, H. A., et al. (2001). Posttraumatic stress and depressive reactions among Nicaraguan adolescents after Hurricane Mitch. The American Journal of Psychiatry, 158(5), 788–794. doi: 10.1176/appi.ajp.158.5.788.PubMedCrossRefGoogle Scholar
- Harter, S. (1985). Manual for the social support scale for children. Denver, CO: University of Denver.Google Scholar
- Jaycox, L. H., Cohen, J. A., Mannarino, A. P., Walker, D. W., Langley, A. K., Gegenheimer, K. L., et al. (2010). Children’s mental health care following Hurricane Katrina: A field trial of trauma-focused psychotherapies. Journal of Traumatic Stress, 23(2), 223–231. doi: 10.1002/jts.20518.PubMedCentralPubMedGoogle Scholar
- Kelley, M. L., Self-Brown, S., Le, B., Bosson, J. V., Hernandez, B. C., & Gordon, A. T. (2010). Predicting posttraumatic stress symptoms in children following Hurricane Katrina: A prospective analysis of the effect of parental distress and parenting practices. Journal of Traumatic Stress, 23(5), 582–590. doi: 10.1002/jts.20573.PubMedCentralPubMedCrossRefGoogle Scholar
- Knabb, R. D., Rhome, J. R., & Brown, D. P. (2005). Tropical cyclone report: Hurricane Katrina, 23–30 August 2005. Miami, FL: National Hurricane Center.Google Scholar
- La Greca, A. M., Lai, B. S., Joormann, J., Auslander, B. B., & Short, M. A. (2013a). Children’s risk and resilience following a natural disaster: Genetic vulnerability, posttraumatic stress, and depression. Journal of Affective Disorders, 151(3), 860–867. doi: 10.1016/j.jad.2013.07.024.PubMedCrossRefGoogle Scholar
- La Greca, A. M., & Silverman, W. K. (2011). Interventions for youth following disasters and acts of terrorism. In P. C. Kendall (Ed.), Child and adolescent therapy: Cognitive-behavioral procedures (4th ed.). New York: Guilford Press.Google Scholar
- La Greca, A. M., Silverman, W. K., Lai, B. S., & Jaccard, J. (2010). Hurricane-related exposure experiences and stressors, other life events, and social support: Concurrent and prospective impact on children’s persistent posttraumatic stress symptoms. Journal of Consulting and Clinical Psychology, 78(6), 794–805. doi: 10.1037/a0020775.PubMedCrossRefGoogle Scholar
- Lai, B. S., Auslander, B. A., Fitzpatrick, S. L., & Podkowirow, V. (in press). Disasters and depressive symptoms in children: A systematic review. Child and Youth Care Forum.Google Scholar
- Lai, B. S., La Greca, A. M., Auslander, B. A., & Short, M. B. (2013). Children’s symptoms of posttraumatic stress and depression after a natural disaster: Comorbidity and risk factors. Journal of Affective Disorders, 146(1), 71–78. doi: 10.1016/j.jad.2012.08.041.PubMedCentralPubMedCrossRefGoogle Scholar
- Lai, B. S., La Greca, A. M., & Llabre, M. M. (in press). Children’s sedentary activity after hurricane exposure. Psychological Trauma: Theory, Research, Practice and Policy.Google Scholar
- McDermott, B. M., & Palmer, L. J. (2002). Postdisaster emotional distress, depression and event-related variables: Findings across child and adolescent developmental stages. Australian and New Zealand Journal of Psychiatry, 36(6), 754–761. doi: 10.1046/j.1440-1614.2002.01090.x.PubMedCrossRefGoogle Scholar
- Muthen, B., & Muthen, L. (1998–2007). Mplus user’s guide (5th ed.). Los Angeles, CA: Muthen & Muthen.Google Scholar
- Pynoos, R., Rodriguez, N., Steinberg, A., Stuber, M. L., & Frederick, C. (1998). UCLA PTSD index for DSM-IV (Revision 1). Los Angeles, CA: UCLA Trauma Psychiatric Program.Google Scholar
- Reynolds, C. R., & Kamphaus, R. W. (2004). Behavior assessment system for children (BASC-2) (2nd ed.). Circle Pines, MN: AGS.Google Scholar
- Salloum, A., Carter, P., Burch, B., Garfinkel, A., & Overstreet, S. (2011). Impact of exposure to community violence, Hurricane Katrina, and Hurricane Gustav on posttraumatic stress and depressive symptoms among school age children. Anxiety Stress Coping, 24(1), 27–42. doi: 10.1080/10615801003703193.PubMedCrossRefGoogle Scholar
- Scheeringa, M. S., & Zeanah, C. H. (2008). Reconsideration of harm’s way: Onsets and comorbidity patterns of disorders in preschool children and their caregivers following Hurricane Katrina. Journal of Clinical Child and Adolescent Psychology, 37(3), 508–518. doi: 10.1080/15374410802148178.PubMedCrossRefGoogle Scholar
- Seballos, F., Tanner, T., Tarazona, M., & Gallegos, J. (2011). Children and disasters: Understanding impact and enabling agency (p. 12). Brighton: Institute of Development Studies.Google Scholar
- Thienkrua, W., Lopes Cardozo, B., Chakkraband, M. L. S., Guadamuz, T. E., Pengjuntr, W., Tantipiwatanaskul, P., et al. (2006). Symptoms of posttraumatic stress disorder and depression among children in tsunami-affected areas in southern Thailand. Journal of the American Medical Association, 296(5), 549–559. doi: 10.1001/jama.296.5.549.PubMedCrossRefGoogle Scholar
- Varni, J. W., & Katz, E. R. (1997). Stress, social support and negative affectivity in children with newly diagnosed cancer: A prospective transactional analysis. Psycho-Oncology, 6(4), 267–278. doi: 10.1002/(SICI)1099-1611(199712)6:4<267:AID-PON277>3.0.CO;2-O.PubMedCrossRefGoogle Scholar
- Warheit, G. J., Zimmerman, R. S., Khoury, E. L., Vega, W. A., & Gil, A. G. (1996). Disaster related stresses, depressive signs and symptoms, and suicidal ideation among a multi-racial/ethnic sample of adolescents: A longitudinal analysis. The Journal of Child Psychology and Psychiatry and Allied Disciplines, 37(4), 435–444. doi: 10.1111/1469-7610.ep11837542.CrossRefGoogle Scholar
- Weems, C. F., & Overstreet, S. (2008). Child and adolescent mental health research in the context of Hurricane Katrina: An ecological needs-based perspective and introduction to the special section. Journal of Clinical Child and Adolescent Psychology, 37(3), 487–494. doi: 10.1080/15374410802148251.PubMedCrossRefGoogle Scholar
- Weems, C. F., Pina, A. A., Costa, N. M., Watts, S. E., Taylor, L. K., & Cannon, M. F. (2007). Predisaster trait anxiety and negative affect predict posttraumatic stress in youths after Hurricane Katrina. Journal of Consulting and Clinical Psychology, 75(1), 154–159. doi: 10.1037/0022-006x.75.1.154.PubMedCrossRefGoogle Scholar
- Weems, C. F., Taylor, L. K., Cannon, M. F., Marino, R. C., Romano, D. M., Scott, B. G., et al. (2010). Post traumatic stress, context, and the lingering effects of the Hurricane Katrina disaster among ethnic minority youth. Journal of Abnormal Child Psychology, 38(1), 49–56. doi: 10.1007/s10802-009-9352-y.PubMedCrossRefGoogle Scholar