01-05-2011 | Uitgave 4/2011 Open Access

Natural Disaster and Risk of Psychiatric Disorders in Puerto Rican Children
- Tijdschrift:
- Research on Child and Adolescent Psychopathology > Uitgave 4/2011
Introduction
Conceptual Model of Post-Disaster Trauma Reactions
Post-Disaster Distress Among Latino/as
Current Study
Methods
Participants
Demographics
|
Sample at T1
|
Sample at T2
|
2000 Census
|
||||
---|---|---|---|---|---|---|---|
n
|
Weighted%
|
n
|
Weighted%
|
n
|
%
|
||
Sex
|
Male
|
982
|
51.1
|
920
|
50.8
|
438,540
|
51.1
|
Female
|
915
|
48.9
|
868
|
49.2
|
419,202
|
48.9
|
|
Age
|
4–10
|
986
|
50.2
|
794
|
42.9
|
431,004
|
50.2
|
11–17
|
911
|
49.8
|
994
|
57.1
|
426,738
|
49.8
|
|
Poverty level
|
Live well
|
1,033
|
51.4
|
1,015
|
56.5
|
–
|
–
|
Chk to chk
|
618
|
33.7
|
546
|
30.55
|
–
|
–
|
|
Live poorly
|
266
|
15.0
|
227
|
12.95
|
–
|
–
|
Measures
Exposure events
|
n (%)
|
---|---|
Child separation from family due to the hurricane
|
53 (3.0%)
|
Staying overnight out of home
|
329 (21.3%)
|
Still living out of home at time of T1 interview
|
19 (1.1%)
|
Severe physical injury to the child
|
5 (0.7%)
|
Severe physical injury to a significant other
|
32 (1.9%)
|
Death of a person close to the child
|
23 (1.3%)
|
Death of a pet
|
92 (6.9%)
|
Child’s loss of objects (toys, books or other important belongings)
|
409 (25.5%)
|
Parent feeling afraid of dying or being hurt
|
407 (21.9%)
|
Parent becoming ill or injured
|
107 (6.8%)
|
Heavy loss due to the hurricane
|
812 (47.7%)
|
Trees falling on family home
|
182 (8.8%)
|
Flooding of home
|
492 (29.6%)
|
Roof falling
|
318 (20.8%)
|
Walls falling
|
101 (8.4%)
|
Breakage of windows or door
|
366 (23.0%)
|
Total loss of the house
|
142 (10.3%)
|
Procedures
Analytic Strategy
Results
Disaster Exposure
Demographics
|
Unexposed
|
Exposed
a
|
---|---|---|
n (%)
|
n (%)
|
|
Total
|
768 (39.8%)
|
1,082 (60.2%)
|
Sex
|
||
Male
|
401 (50.1%)
|
558 (52.1%)
|
Female
|
367 (49.9%)
|
524 (47.9%)
|
Age
|
||
4–10
|
403 (51.4%)
|
551 (48.8%)
|
11–17
|
365 (48.6%)
|
531(51.2%)
|
Poverty***
|
||
Live well
|
465 (60.0%)
|
521 (45.9%)
|
Check to check
|
245 (32.0%)
|
360 (34.7%)
|
Live poorly
|
58 (8.1%)
|
200 (19.4%)
|
Any psychiatric disorder**
|
97 (13.0%)
|
202 (18.5%)
|
Any externalizing disorder*
|
64 (8.7%)
|
144 (12.9%)
|
Any internalizing disorder**
|
44 (5.8%)
|
106 (11.0%)
|
The Influence of Disaster Exposure on Psychopathology
Predictors
|
Any psychiatric disorder
|
Any externalizing disorder
|
Any internalizing disorder
|
|||
---|---|---|---|---|---|---|
Time 1
|
Time 2
|
Time 1
|
Time 2
|
Time 1
|
Time 2
|
|
OR (CI)
|
OR (CI)
|
OR (CI)
|
OR (CI)
|
OR (CI)
|
OR (CI)
|
|
4–17 years total sample
|
||||||
Gender
|
0.89
|
0.70
+
|
0.64
*
|
0.56**
|
1.62*
|
0.92
|
Female
|
(0.63–1.25)
|
(0.48–1.01)
|
(0.42–0.99)
|
(0.37–0.84)
|
(1.03–2.54)
|
(0.52–1.61)
|
Age
|
1.03
|
1.01
|
0.99
|
0.96
|
1.08***
|
1.08**
|
(0.99–1.08)
|
(0.97–1.05)
|
(0.95–1.03)
|
(0.92–1.01)
|
(1.03–1.14)
|
(1.02–1.14)
|
|
Poverty
|
1.27
|
2.08***
|
1.52
+
|
2.49***
|
1.23
|
1.69
|
Chk to Chk
|
(0.88–1.83)
|
(1.37–3.14)
|
(1.00–2.30)
|
(1.55–4.01)
|
(0.79–1.92)
|
(0.89–3.21)
|
Live poorly
|
1.72*
|
1.73*
|
2.41
***
|
2.52**
|
0.98
|
1.02
|
(1.11–2.67)
|
(1.04–2.88)
|
(1.51–3.84)
|
1.39–4.60
|
(0.53–1.80)
|
(0.53–1.96)
|
|
Exposure
a
|
1.05
|
1.01
|
1.02
|
0.97
|
1.14***
|
1.07
+
|
(0.99–1.11)
|
(0.96–1.07)
|
(0.96–1.08)
|
(0.87–1.08)
|
(1.06–1.22)
|
(0.99–1.16)
|
|
4–10 years subsample
|
||||||
Sex:
|
0.57
*
|
0.44**
|
0.58
|
0.47*
|
0.74
|
0.33*
|
Female
|
(0.34–0.94)
|
(0.26–0.75)
|
(0.33–1.04)
|
(0.27–0.84)
|
(0.36–1.54)
|
(0.12–0.91)
|
Age
|
1.03
|
0.92
|
1.01
|
0.90
|
1.13
|
1.04
|
(0.92–1.14)
|
(0.80–1.06)
|
(0.90–1.14)
|
(0.77–1.06)
|
(0.93–1.38)
|
(0.85–1.29)
|
|
Poverty
|
1.52
|
1.80
+
|
1.69
*
|
2.33**
|
1.43
|
0.77
|
Chk to Chk
|
(0.95–2.42)
|
(0.96–3.38)
|
(1.01–2.85)
|
(1.26–4.32)
|
(0.71–2.88)
|
(0.25–2.36)
|
Live poorly
|
2.84
*** (1.58–5.11)
|
2.17
+ (0.92–5.10)
|
3.23
*** (1.75–5.97)
|
3.26** (1.40–7.62)
|
1.22 (0.49–3.07)
|
0.79 (0.17–3.60)
|
Exposure
a
|
1.01
|
0.98
|
1.01
|
0.93
|
1.11*
|
1.06
|
(0.95–1.07)
|
(0.84–1.14)
|
(0.94–1.08)
|
(0.79–1.10)
|
(1.02–1.21)
|
(0.89–1.25)
|
|
11–17 years subsample
|
||||||
Sex
|
1.30
|
0.90
|
0.71
|
0.62
|
2.75***
|
1.27
|
Female
|
(0.83–2.03)
|
(0.56–1.46)
|
(0.40–1.27)
|
(0.35–1.10)
|
(1.53–4.93)
|
(0.64–2.49)
|
Age
|
1.08
|
0.91
|
1.03
|
0.86
|
1.04
|
0.95
|
(0.96–1.22)
|
(0.81–1.02)
|
(0.89–1.20)
|
(0.75–0.98)
|
(0.91–1.20)
|
(0.79–1.12)
|
|
Poverty
|
1.04
|
2.17**
|
1.33
|
2.50
|
1.06
|
2.10
+
|
Chk to Chk
|
(0.63–1.73)
|
(1.28–3.68)
|
(0.71–2.48)
|
(1.31–4.78)
|
(0.59–1.92)
|
(0.97–4.57)
|
Live poorly
|
1.16
|
1.52
|
1.76
|
2.03
|
0.81
|
1.12
|
(0.58–2.34)
|
(0.79–2.95)
|
(0.79–3.95)
|
(0.84–4.91)
|
(0.34–1.94)
|
(0.54–2.33)
|
|
Exposure
|
1.08
+
|
1.03
|
1.02
|
1.00
|
1.17**
|
1.08
|
(0.99–1.18)
|
(0.95–1.13)
|
(0.92–1.13)
|
(0.90–1.11)
|
(1.05–1.29)
|
(0.95–1.24)
|
|
Exposure
|
0.97*
|
0.94**
|
–
|
–
|
0.97+
|
–
|
X Age
|
(0.94–1.00)
|
0.90–0.97
|
(0.93–1.00)
|
Assessment of Age Influences on the Exposure-Disorder Relationship
Moderators of Exposure
Rates of Specific Internalizing Disorders
Disorders
|
Time 1
|
Time 2
|
||
---|---|---|---|---|
Unexposed
|
Exposed
|
Unexposed
|
Exposed
|
|
n (w%) CI
|
n w% (CI)
|
n w% (CI)
|
n w% (CI)
|
|
PTSD
|
3 (0.8%)
|
8 (0.8%)
|
2 (0.2%)
|
6 (0.5%)
|
0.2–2.8%
|
0.3–2.0%
|
0.1–0.8%
|
0.2–1.2%
|
|
Major depression
|
9 (1.3%)*
|
30 (4.0%)*
|
14 (1.7%)
|
22 (2.2%)
|
06.–2.7%
|
2.5–6.3%
|
0.9–3.1%
|
1.4–3.5%
|
|
Dysthimia
|
4 (0.5%)
|
7 (0.5%)
|
0
|
1
|
0.2–1.4%
|
0.2–1.4%
|
–
|
–
|
|
Generalized anxiety
|
12 (1.4%)
|
22 (2.8%)
|
5 (0.4%)
|
10 (1.0%)
|
0.7–2.7%
|
1.7–4.8%
|
0.2–0.9%
|
0.5–1.9%
|
|
Social phobia
|
10 (1.4%)*
|
32 (3.3%)*
|
7 (0.7%)
a
|
18 (1.9%)
a
|
0.7–2.8%
|
2.2–4.9%
|
0.3–1.4%
|
1.0–3.4%
|
|
Separation anxiety
|
19 (1.9%)*
|
46 (3.9%)*
|
12 (1.7%)
|
28 (2.7%)
|
1.1–3.2%
|
2.7–5.6%
|
0.9–3.4%
|
1.7–4.4%
|
|
Panic
|
2 (0.2%)
|
6 (0.7%)
|
3 (0.4%)
|
3 (0.3%)
|
0.0–0.8%
|
0.3–1.9%
|
0.1–1.4%
|
0.1–1.3%
|