Child Trajectories of Posttraumatic Stress after Natural Disasters

自然灾害后儿童创伤后应激的轨迹

基本信息

批准号：
9729235
负责人：
Betty Sao-Hou Lai
金额：
$ 8.39万
依托单位：
BOSTON COLLEGE
依托单位国家：
美国
项目类别：
财政年份：
2018
资助国家：
美国
起止时间：
2018-08-01 至 2020-07-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/9729235
关键词：
Address Advocate Caring Characteristics Child Child Development Child Mental Health Child Rearing Child Welfare Clinical Data Data Analyses Data Set Databases Development Disasters Distress Early identification Early treatment Earthquakes Event Exposure to Floods Frequencies Future Goals Growth Health Health Policy Heterogeneity Hurricane Individual Intervention Longitudinal Studies Measurement Measures Mental Health Meta-Analysis Methodology Methods Modeling Natural Disasters Outcome Pattern Publishing Reaction Recording of previous events Reporting Reproducibility Research Resources Risk Risk Factors Sample Size Sampling Science Social support Source Testing Theoretical model Time Tornadoes Trauma Triage United States National Institutes of Health Weather Wildfire Work aged base child mental health service climate change clinical practice coping cost evidence base experience falls flexibility high risk knowledge base minority children novel post-traumatic stress psychological distress response stress symptom stressor

项目摘要

Project Summary/Abstract Natural disasters, including hurricanes, floods, earthquakes, tornadoes, and wildfires, present a significant threat to the health and wellbeing of children. Disaster management experts advocate that stepped care models of intervention are needed to address children’s mental health needs after disasters. The goal of stepped care models is to triage children so that those at highest risk for persistent distress (e.g., clinically elevated posttraumatic stress symptoms, PTSS, that endure beyond 3 – 6 months postdisaster) receive the most intense levels of intervention. However, a critical barrier to implementing stepped care models is that there is a paucity of information on how and why children differ in the PTSS patterns (i.e., trajectories) after disasters. Thus, it is not clear how to stratify children based on their risk for persistent PTSS. This proposal will utilize a novel methodological approach, Integrative Data Analysis (IDA), to overcome the limitations of drawing conclusions from the myriad of individual studies focused on children’s mental health outcomes after disasters. Individual studies, while valuable in informing future directions for research, are limited in terms of sample size, period of child development examined, postdisaster assessment time frame, frequency of assessments, risk factors studied, and sample diversity. IDA methods integrate individual level data from multiple studies, creating a pooled source of data that is more powerful and diverse than any individual study. The proposed study will integrate data from landmark studies of children’s reactions to four of the most costly disasters in U.S. history (Hurricanes Andrew, Charley, Katrina, and Ike), using 3,245 observations of 1,653 children aged 6 to 16 years, assessed from 3 to 25 months postdisaster. The objective of this proposal is to use IDA to build an empirical knowledge base of data to understand which factors characterize varying trajectories of PTSS. The Specific Aims include Aim 1: Develop an IDA methods framework to synthesize data across four studies of children’s mental health outcomes after devastating hurricanes; and Aim 2: Determine trajectories and associated risk factors of PTSS following the hurricanes. The long-term goal of this study is to develop risk models to more effectively use scarce postdisaster resources in stepped care models. Results will be directly applicable to clinical practice by providing guidance for early identification of children at higher risk of persistent PTSS.

项目概要/摘要自然灾害，包括飓风、洪水、地震、龙卷风和野火，造成了灾害管理专家倡导需要采取分级护理干预模式来满足儿童的心理健康需求灾难发生后，分级护理模式的目标是对儿童进行分类，以便那些处于最高风险的儿童。持续性痛苦（例如，临床上升高的创伤后应激症状，PTSS，灾后 3 至 6 个月）接受最强烈的干预。实施阶梯式护理模式的关键障碍是缺乏相关信息灾难后儿童的 PTSS 模式（即轨迹）如何以及为何有所不同因此，事实并非如此。明确如何根据儿童持续性 PTSS 的风险对他们进行分层。该提案将利用一个指标。新颖的方法论，综合数据分析（IDA），克服了以下局限性：从大量关注儿童心理健康的个体研究中得出结论灾难后的结果，同时对于指导未来的方向很有价值。研究的样本量、所检查的儿童发育时期、灾后情况均受到限制评估时间框架、评估频率、研究的风险因素和样本多样性。 IDA 方法整合了来自多项研究的个体水平数据，创建了一个汇总数据源拟议的研究将比任何单独的研究都更强大和多样化。来自对儿童对美国损失最惨重的四场灾难的反应的里程碑式研究的数据历史（飓风安德鲁、查理、卡特里娜和艾克），使用 1,653 名儿童的 3,245 次观察年龄为 6 至 16 岁，在灾后 3 至 25 个月内进行评估本提案的目标是。使用 IDA 构建数据的经验知识库，以了解哪些因素表征 PTSS 的不同轨迹具体目标包括目标 1：开发 IDA 方法。综合四项关于儿童心理健康结果研究的数据的框架毁灭性飓风；以及目标 2：确定 PTSS 的轨迹和相关风险因素这项研究的长期目标是为更多人开发风险模型。在分级护理模式中有效利用稀缺的灾后资源将产生直接的结果。适用于临床实践，为儿童的早期识别提供指导持续性 PTSS 的风险。

项目成果

期刊论文数量（7）

专著数量（0）

科研奖励数量（0）

会议论文数量（0）

专利数量（0）

Evaluation of a Tool to Identify Child Sex Trafficking Victims in Multiple Healthcare Settings.

对在多个医疗机构中识别儿童性贩运受害者的工具进行评估。

DOI：
发表时间：
2018-12
期刊：
影响因子：
0
作者：
Greenbaum, V Jordan;Livings, Michelle S;Lai, Betty S;Edinburgh, Laurel;Baikie, Peggy;Grant, Sophia R;Kondis, Jamie;Petska, Hillary W;Bowman, Mary Jo;Legano, Lori;Kas;Self
通讯作者：
Self

Trajectories of School Recovery After a Natural Disaster: Risk and Protective Factors.

自然灾害后学校恢复的轨迹：风险和保护因素。

DOI：
发表时间：
2019-03
期刊：
影响因子：
0
作者：
Lai, Betty S;Esnard, Ann;Wyczalkowski, Chris;Savage, Ryan;Shah, Hazel
通讯作者：
Shah, Hazel

Posttraumatic Stress Symptom Trajectories Among Children After Disaster Exposure: A Review.

DOI：
10.1002/jts.22242
发表时间：
2017-12-01
期刊：
Journal of traumatic stress
影响因子：
3.3
作者：
B. Lai;Rayleen Lewis;M. Livings;A. La Greca;A. Esnard
通讯作者：
A. Esnard

Sleep Problems and Posttraumatic Stress: Children Exposed to a Natural Disaster.

睡眠问题和创伤后应激：遭受自然灾害的儿童。

DOI：
10.1093/jpepsy/jsaa061
发表时间：
2020-09-04
期刊：
Journal of pediatric psychology
影响因子：
3.6
作者：
B. Lai;A. La Greca;Courtney A. Colgan;Whitney M. Herge;Sherilynn F Chan;Julia Medzhitova;M. Short;B. Ausl;er;er
通讯作者：
er

The relationship between social support and posttraumatic stress symptoms among youth exposed to a natural disaster.

遭受自然灾害的青少年的社会支持与创伤后应激症状之间的关系。