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Approaches to the Assessment of Children in the Context of Disasters

  • Child and Family Disaster Psychiatry (B Pfefferbaum, Section Editor)
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Abstract

Children exposed to disasters are a vulnerable population, making the assessment of children post-disaster an important issue. Utilizing a Multiple Gating Stepped Care framework, we highlight recent literature related to post-disaster assessment and intervention for children. In particular, we focus on screening, clinical evaluation, and feedback-informed service delivery. Screening allows large populations of children to be assessed at a relatively low cost. Children identified by screening as being at risk may then be assessed through more in-depth clinical evaluations, in order to assess clinical symptoms, strengths, and stressors, and to make determinations about appropriate interventions. Continued assessment during therapy provides important feedback for the delivery of appropriate care. New formats for assessment, as well as issues related to identifying sources for assessment, are discussed. Recommendations for future directions are provided.

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References

Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

  1. United Nations Office for Disaster Risk Reduction. UNISDR says the young are the largest group affected by disasters. 2011. Accessed 3 Aug 2015.

  2. Leaning J, Guha-Sapir D. Natural disasters, armed conflict, and public health. N Engl J Med. 2013;369(19):1836–42. doi:10.1056/NEJMra1109877. 7p.

    Article  CAS  PubMed  Google Scholar 

  3. National Commission on Children and Disasters. 2010 report to the President and congress 2010.

  4. Norris FH, Friedman MJ, Watson PJ. 60,000 disaster victims speak: part II. Summary and implications of the disaster mental health research. Psychiatry Interpersonal Biol Process. 2002;65(3):240–60. doi:10.1521/psyc.65.3.240.20169.

    Article  Google Scholar 

  5. Ronan K, Johnston D. Promoting community resilience in disasters: the role for schools, youth, and families. New York: Springer Science+Business Media, Inc.; 2005.

    Google Scholar 

  6. Bonanno GA, Brewin CR, Kaniasty K, La Greca AM. Weighing the costs of disaster: consequences, risks, and resilience in individuals, families, and communities. Psychol Sci Public Interest. 2010;11(1):1–49. doi:10.1177/1529100610387086.

    Article  PubMed  Google Scholar 

  7. Furr JM, Comer JS, Edmunds JM, Kendall PC. Disasters and youth: a meta-analytic examination of posttraumatic stress. J Consult Clin Psychol. 2010;78(6):765–80. doi:10.1037/a0021482.

    Article  PubMed  Google Scholar 

  8. Hoven CW, Duarte CS, Lucas CP, Wu P, Mandell DJ, Goodwin RD, et al. Psychopathology among New York City public school children 6 months after September 11. Arch Gen Psychiatry. 2005;62(5):545–51. doi:10.1001/archpsyc.62.5.545.

  9. Dyb G, Jensen TK, Nygaard E. Children’s and parents’ posttraumatic stress reactions after the 2004 tsunami. Clin Child Psychol Psychiatry. 2011;16(4):621–34. doi:10.1177/1359104510391048.

    Article  PubMed  Google Scholar 

  10. Alisic E, Jongmans MJ, van Wesel F, Kleber RJ. Building child trauma theory from longitudinal studies: a meta-analysis. Clin Psychol Rev. 2011;31(5):736–47. doi:10.1016/j.cpr.2011.03.001.

    Article  PubMed  Google Scholar 

  11. Fan F, Zhang Y, Yang Y, Mo L, Liu X. Symptoms of posttraumatic stress disorder, depression, and anxiety among adolescents following the 2008 Wenchuan earthquake in China. J Trauma Stress. 2011;24(1):44–53. doi:10.1002/jts.20599.

    Article  PubMed  Google Scholar 

  12. Lai BS, La Greca AM, Auslander BA, Short MB. Children’s symptoms of posttraumatic stress and depression after a natural disaster: comorbidity and risk factors. J Affect Disord. 2013;146(1):71–8. doi:10.1016/j.jad.2012.08.041.

    Article  PubMed  PubMed Central  Google Scholar 

  13. Weems CF, Scott BG, Taylor LK, Cannon MF, Romano DM, Perry AM. A theoretical model of continuity in anxiety and links to academic achievement in disaster-exposed school children. Dev Psychopathol. 2013;25(3):729–37. doi:10.1017/s0954579413000138.

    Article  PubMed  Google Scholar 

  14. Fothergill A, Peek L. Children of Katrina. Katrina Bookshelf. Austin, Texas: University of Texas Press; 2015.

    Google Scholar 

  15. Ekşi A, Braun KL. Over-time changes in PTSD and depression among children surviving the 1999 Istanbul earthquake. Eur Child Adolesc Psychiatry. 2009;18(6):384–91. doi:10.1007/s00787-009-0745-9.

    Article  PubMed  Google Scholar 

  16. Goenjian AK, Molina L, Steinberg AM, Fairbanks LA, Alvarez ML, Goenjian HA, et al. Posttraumatic stress and depressive reactions among Nicaraguan adolescents after Hurricane Mitch. Am J Psychiatry. 2001;158(5):788–94. doi:10.1176/appi.ajp.158.5.788.

    Article  CAS  PubMed  Google Scholar 

  17. Lai BS, Auslander BA, Fitzpatrick SL, Podkowirow V. Disasters and depressive symptoms in children: a review. Child Youth Care Forum. 2014;43(4):489–504. doi:10.1007/s10566-014-9249-y.

    Article  PubMed  PubMed Central  Google Scholar 

  18. Adams ZW, Danielson CK, Sumner JA, McCauley JL, Cohen JR, Ruggiero KJ. Comorbidity of PTSD, major depression, and substance use disorder among adolescent victims of the spring 2011 tornadoes in Alabama and Joplin, Missouri. Psychiatry: Interpersonal Biol Process. 2015;78(2):170–85.

    Google Scholar 

  19. Scheeringa MS. Untangling psychiatric comorbidity in young children who experienced single, repeated, or Hurricane Katrina traumatic events. Child Youth Care Forum. 2015;44(4):475–92. doi:10.1007/s10566-014-9293-7. New insights regarding comorbidity, suggesting that PTSD symptoms are driving comorbid symptoms.

    Article  PubMed  Google Scholar 

  20. McMillen C, North C, Mosley M, Smith E. Untangling the psychiatric comorbidity of posttraumatic stress disorder in a sample of flood survivors. Compr Psychiatry. 2002;43:478–85. doi:10.1053/comp.2002.34632.

    Article  PubMed  Google Scholar 

  21. Boer F, Smit C, Morren M, Roorda J, Yzermans J. Impact of a technological disaster on young children: a five-year postdisaster multiinformant study. J Trauma Stress. 2009;22(6):516–24. doi:10.1002/jts.20461.

    PubMed  Google Scholar 

  22. Comer JS, Fan B, Duarte CS, Wu P, Musa GJ, Mandell DJ, et al. Attack-related life disruption and child psychopathology in New York City public schoolchildren 6-months post-9/11. J Clin Child Adolesc Psychol. 2010;39(4):460–9. doi:10.1080/15374416.2010.486314.

    Article  PubMed  PubMed Central  Google Scholar 

  23. Piyasil V, Ketumarn P, Prubrukarn R, Pacharakaew S, Dumrongphol H, Rungsri S, et al. Psychiatric disorders in children at one year after the tsunami disaster in Thailand. J Med Assoc Thail. 2008;91 Suppl 3:S15–20.

    Google Scholar 

  24. Thienkrua W, Lopes Cardozo B, Chakkraband MLS, Guadamuz TE, Pengjuntr W, Tantipiwatanaskul P, et al. Symptoms of posttraumatic stress disorder and depression among children in tsunami-affected areas in southern Thailand. J Am Med Assoc. 2006;296(5):549–59. doi:10.1001/jama.296.5.549.

    Article  CAS  Google Scholar 

  25. Kronenberg ME, Hansel TC, Brennan AM, Osofsky HJ, Osofsky JD, Lawrason B. Children of Katrina: lessons learned about postdisaster symptoms and recovery patterns. Child Dev. 2010;81(4):1241–59. doi:10.1111/j.1467-8624.2010.01465.x.

    Article  PubMed  Google Scholar 

  26. La Greca AM, Lai BS, Llabre MM, Silverman WK, Vernberg EM, Prinstein MJ. Children’s postdisaster trajectories of PTS symptoms: predicting chronic distress. Child Youth Care Forum. 2013;42(4):351–69. doi:10.1007/s10566-013-9206-1.

    Article  PubMed  PubMed Central  Google Scholar 

  27. Self-Brown S, Lai BS, Thompson JE, McGill T, Kelley ML. Posttraumatic stress disorder symptom trajectories in Hurricane Katrina affected youth. J Affect Disord. 2013;147(1-3):198–204. doi:10.1016/j.jad.2012.11.002.

    Article  PubMed  PubMed Central  Google Scholar 

  28. Lilienfeld SO. Psychological treatments that cause harm. 2007:53.

  29. Ramirez M, Harland K, Frederick M, Shepherd R, Wong M, Cavanaugh JE. Listen protect connect for traumatized schoolchildren: a pilot study of psychological first aid. BMC Psychol. 2013;1(1):26. doi:10.1186/2050-7283-1-26.

    Article  PubMed  PubMed Central  Google Scholar 

  30. Forbes D, Fletcher S, Wolfgang B, Varker T, Creamer M, Brymer MJ, et al. Practitioner perceptions of skills for psychological recovery: a training programme for health practitioners in the aftermath of the Victorian bushfires. Aust N Z J Psychiatry. 2010;44(12):1105–11. doi:10.3109/00048674.2010.513674.

    Article  PubMed  Google Scholar 

  31. Davison GC. Stepped care: doing more with less? J Consult Clin Psychol. 2000;68(4):580–5. doi:10.1037/0022-006X.68.4.580.

    Article  CAS  PubMed  Google Scholar 

  32. Hansen B, Howe A, Sutton P, Ronan K. Impact of client feedback on clinical outcomes for young people using public mental health services: a pilot study. Psychiatry Res. 2015;229(1-2):617–9. doi:10.1016/j.psychres.2015.05.007.

    Article  PubMed  Google Scholar 

  33. Lambert MJ. Prevention of treatment failure: The use of measuring, monitoring, and feedback in clinical practice. Washington, D. C.: American Psychological Association; 2010.

    Book  Google Scholar 

  34. Lambert MJ. Yes, it is time for clinicians to routinely monitor treatment outcome. The heart and soul of change: delivering what works in therapy. 2nd ed. Washington: American Psychological Association; 2010. p. 239–66.

    Google Scholar 

  35. Pfefferbaum B, Weems C, Scott B, Nitiéma P, Noffsinger M, Pfefferbaum R, et al. Research methods in child disaster studies: a review of studies generated by the September 11, 2001, terrorist attacks; the 2004 Indian Ocean Tsunami; and Hurricane Katrina. Child Youth Care Forum. 2013;42(4):285–337. doi:10.1007/s10566-013-9211-4.

    Article  PubMed  PubMed Central  Google Scholar 

  36. Alisic E, Zalta AK, van Wesel F, Larsen SE, Hafstad GS, Hassanpour K, et al. Rates of post-traumatic stress disorder in trauma-exposed children and adolescents: meta-analysis. Br J Psychiatry. 2014;204(5):335–40. doi:10.1192/bjp.bp.113.131227. Meta-analysis of 43 independent samples regarding the incidence of PTSD in trauma-exposed children and adolescents, assessed with well-established diagnostic interviews. Provides benchmarks for DSM-5 and ICD revisions.

    Article  PubMed  Google Scholar 

  37. Foundation CaW. Children’s revised impact of event scale (CRIES-13). 2005.

  38. Pynoos R, Rodriguez N, Steinberg A, Stuber ML, Frederick C. The University of California at Los Angeles posttraumatic stress disorder reaction index (UCLA-PTSD RI) for DSM–IV (Revision 1). Los Angeles: UCLA Trauma Psychiatry Program; 1998.

    Google Scholar 

  39. Deeba F, Rapee R, Pryan T. Psychometric properties of the children’s revised impact of events scale (CRIES) with Bangladeshi children and adolescents. Peer J. 2014;2:e536.

    Article  PubMed  PubMed Central  Google Scholar 

  40. Bankoff G. Rendering the world unsafe: ‘vulnerability’ as western discourse. Disasters. 2001;25(1):19–35.

    Article  CAS  PubMed  Google Scholar 

  41. Ventevogel P, Komproe IH, Jordans MJ, Feo P, De Jong JTVM. Validation of the Kirundi versions of brief self-rating scales for common mental disorders among children in Burundi. BMC Psychiatry. 2014;14:36. doi:10.1186/1471-244X-14-36.

    Article  PubMed  PubMed Central  Google Scholar 

  42. Perrin S, Meiser-Stedman R, Smith P. The children’s revised impact of event scale (CRIES): validity as a screening instrument for PTSD. Behav Cogn Psychother. 2005;33(04):487–98. doi:10.1017/S1352465805002419.

    Article  Google Scholar 

  43. National Child Traumatic Stress Network. Administration and scoring of the UCLA PTSD reaction index for DSM-V. http://www.nctsn.org/products/administration-and-scoring-ucla-ptsd-reaction-index-dsm-v. Accessed 6 Jan 2016.

  44. La Greca AM, Silverman WK, Wasserstein SB. Children’s predisaster functioning as a predictor of posttraumatic stress following Hurricane Andrew. J Consult Clin Psychol. 1998;66(6):883–92. doi:10.1037/0022-006X.66.6.883.

    Article  PubMed  Google Scholar 

  45. Weems CF, Pina AA, Costa NM, Watts SE, Taylor LK, Cannon MF. Predisaster trait anxiety and negative affect predict posttraumatic stress in youths after Hurricane Katrina. J Consult Clin Psychol. 2007;75(1):154–9. doi:10.1037/0022-006x.75.1.154.

    Article  PubMed  Google Scholar 

  46. Lai BS, La Greca AM, Llabre MM. Children’s sedentary activity after hurricane exposure. Psycholl Trauma Theory Res Pract Policy. 2014;6(3):280–9. doi:10.1037/a0033331.

    Article  Google Scholar 

  47. La Greca AM, Silverman WK, Lai B, Jaccard J. Hurricane-related exposure experiences and stressors, other life events, and social support: concurrent and prospective impact on children’s persistent posttraumatic stress symptoms. J Consult Clin Psychol. 2010;78(6):794–805. doi:10.1037/a0020775.

    Article  PubMed  Google Scholar 

  48. Kilmer RP, Gil-Rivas V, Griese B, Hardy SJ, Hafstad GS, Alisic E. Posttraumatic growth in children and youth: clinical implications of an emerging research literature. Am J Orthopsychiatry. 2014;84(5):506.

    Article  PubMed  Google Scholar 

  49. Trickey D, Siddaway AP, Meiser-Stedman R, Serpell L, Field AP. A meta-analysis of risk factors for post-traumatic stress disorder in children and adolescents. Clin Psychol Rev. 2012;32(2):122–38. doi:10.1016/j.cpr.2011.12.001.

    Article  PubMed  Google Scholar 

  50. Nader K, Kriegler JA, Blake DD, Pynoos RS, Newman E, Weathers FW. Clinician-administered PTSD scale, child and adolescent version. White River Junction: National Center for PTSD; 1996.

    Google Scholar 

  51. Silverman WK, Albano AM. ADIS: Anxiety disorders interview schedule for DSM-IV: child version. Psychological Corporation. 1996.

  52. Reich W, Leacock N, Shanfield C. Diagnostic interview for children and adolescents-revised (DICA-R). St. Louis, Missouri: Washington University; 1994.

    Google Scholar 

  53. Kaufman J, Birmaher B, Brent D, Rao U. Schedule for affective disorders and schizophrenia for school-age children-present and lifetime version (K-SADS-PL): initial reliability and validity data. J Am Acad Child Adolesc Psychiatry. 1997;36(7):980–8.

    Article  CAS  PubMed  Google Scholar 

  54. Saigh P, Yasik A, Oberfield R, Green B, Halamandaris P, Rubenstein H, et al. The children’s PTSD inventory: development and reliability. J Trauma Stress. 2000;13(3):369.

    Article  CAS  PubMed  Google Scholar 

  55. Ben-Ezra M, Palgi Y, Hamama-Raz Y, Soffer Y, Shrira A. Reactions to the 2011 Tohoku earthquake and tsunami: a preliminary matching study comparing nurses and civilians. J Nerv Ment Dis. 2013;201(6):534–6. doi:10.1097/NMD.0b013e318294828e.

    Article  PubMed  Google Scholar 

  56. Zhang MW, Ho C, Fang P, Lu Y, Ho RC. Usage of social media and smartphone application in assessment of physical and psychological well-being of individuals in times of a major air pollution crisis. JMIR mHealth uHealth. 2014;2(1), e16. doi:10.2196/mhealth.2827.

    Article  PubMed  PubMed Central  Google Scholar 

  57. Smyth JM, Heron KE. Ecological momentary assessment (EMA) in family research. In: McHale SM, Amato P, Booth A, editors. Emerging methods in family research, National symposium on family issues. Cham, Switzerland: Springer International Publishing; 2014. p. 145–61.

    Chapter  Google Scholar 

  58. Mehl MR, Pennebaker JW, Crow DM, Dabbs J, Price JH. The Electronically Activated Recorder (EAR): a device for sampling naturalistic daily activities and conversations. Behav Res Methods Instrum Comput. 2001;33(4):517–23.

    Article  CAS  PubMed  Google Scholar 

  59. Mehl MR, Robbins ML, Deters FG. Naturalistic observation of health-relevant social processes: the electronically activated recorder methodology in psychosomatics. Psychosom Med. 2012;74(4):410–7. doi:10.1097/PSY.0b013e3182545470. Key paper on the development, methodology, and potential of the Electronically Activated Recorder. Provides practical insights into use of this method in psychosocial research.

    Article  PubMed  PubMed Central  Google Scholar 

  60. Alisic E, Barrett A, Bowles P, Conroy R, Mehl MR. Topical review: families coping with child trauma: a naturalistic observation methodology. J Pediatr Psychol. 2015. doi:10.1093/jpepsy/jsv016.

    PubMed  Google Scholar 

  61. Brown TH, Mellman TA, Alfano CA, Weems CF. Sleep fears, sleep disturbance, and PTSD symptoms in minority youth exposed to Hurricane Katrina. J Trauma Stress. 2011;24(5):575–80. doi:10.1002/jts.20680.

    Article  PubMed  Google Scholar 

  62. Scheeringa MS. PTSD in children younger than the age of 13: toward developmentally sensitive assessment and management. J Child Adolesc Trauma. 2011;4(3):181–97. doi:10.1080/19361521.2011.597079. 17p.

    Article  Google Scholar 

  63. Verlinden E, van Laar YL, van Meijel EPM, Opmeer BC, Beer R, de Roos C, et al. A parental tool to screen for posttraumatic stress in children: first psychometric results. J Trauma Stress. 2014;27(4):492–5. doi:10.1002/jts.21929. 4p.

    Article  PubMed  Google Scholar 

  64. Muris P, Merckelbach H, Körver P, Meesters C. Screening for trauma in children and adolescents: the validity of the traumatic stress disorder scale of the screen for child anxiety related emotional disorders. J Clin Child Psychol. 2000;29(3):406–13. doi:10.1207/S15374424JCCP2903_11.

    Article  CAS  PubMed  Google Scholar 

  65. Lai BS, Beaulieu B, Ogokeh CE, Self-Brown S, Kelley ML. Mother and child reports of hurricane related stressors: data from a sample of families exposed to Hurricane Katrina. Child Youth Care Forum. 2015;44(4):549–65. doi:10.1007/s10566-014-9289-3. Paper examining concordance between child and parent reports of disaster experiences.

    Article  PubMed  Google Scholar 

  66. Lai BS, Kelley ML, Harrison KM, Thompson JE, Self-Brown S. Posttraumatic stress, anxiety, and depression symptoms among children after Hurricane Katrina: a latent profile analysis. J Child Fam Stud. 2015;24(5):1262–70. doi:10.1007/s10826-014-9934-3.

    Article  PubMed  Google Scholar 

  67. Honkanen M, Määttä H, Hurtig T, Ebeling H, Taanila A, Koivumaa-Honkanen H. Teachers’ assessments of children’s mental problems with respect to adolescents’ subsequent self-reported mental health. J Adolesc Health. 2014;54(1):81–7.

    Article  PubMed  Google Scholar 

  68. Anker MG, Duncan BL, Sparks JA. Using client feedback to improve couple therapy outcomes: a randomized clinical trial in a naturalistic setting. J Consult Clin Psychol. 2009;77(4):693–704. doi:10.1037/a0016062.

    Article  PubMed  Google Scholar 

  69. Ronan K. Goals tracking form. Rockhampton (QLD) 2009.

  70. Miller S, Duncan B, Johnson L. The session rating scale V.3.0. Chicago, IL 2002.

  71. Ronan KR, Alisic E, Towers B, Johnson VA, Johnston DM. Disaster preparedness for children and families: a critical review. Curr Psychiatry Rep. 2015;17(7):1–9.

    Article  Google Scholar 

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Acknowledgments

The funding support of Australia’s Bushfire and Natural Hazards Cooperative Research Centre is gratefully acknowledged.

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Authors and Affiliations

  1. Georgia State University, 1 Park Place, Atlanta, GA, 30303, USA

    Betty S. Lai & Rayleen Lewis

  2. Monash University Accident Research Centre, Monash University, Clayton Campus, 21 Alliance Lane, Clayton, Victoria, 3800, Australia

    Eva Alisic

  3. School of Human, Health, and Social Sciences, CQUniversity Australia, Bruce Highway, Rockhampton, Queensland, 4701, Australia

    Kevin R. Ronan

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  1. Betty S. Lai
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Correspondence to Betty S. Lai.

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This article is part of the Topical Collection on Child and Family Disaster Psychiatry

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Lai, B.S., Alisic, E., Lewis, R. et al. Approaches to the Assessment of Children in the Context of Disasters. Curr Psychiatry Rep 18, 45 (2016). https://doi.org/10.1007/s11920-016-0683-4

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