Abstract
The objectives of this study were to ascertain behavioral outcomes 10-11 years after 9/11 in adolescents ages 11-18 years (0-8 years old at the time of 9/11) enrolled in the World Trade Center Health Registry (Registry), and relate these outcomes to their 9/11-exposures and to parent health. Behavioral difficulties among adolescents were assessed using the adolescent-reported Strengths and Difficulties Questionnaire (SDQ). Parental post-traumatic stress disorder (PTSD) was assessed using a 9/11-specific PTSD Checklist-Civilian Version, a cut-off score of 44 or greater was considered probable PTSD. Multivariable logistic regression was used to estimate associations of 9/11-exposure and parental health with abnormal/borderline SDQ scores, adjusting for demographic variables that were significantly associated with the SDQ score in bivariate analyses. Of the 449 adolescents, 12.5% (n=56) had abnormal/borderline SDQ scores. In the multivariable model, adolescents with severe/ moderate 9/11-exposures were 2.4 times more likely to have abnormal/borderline SDQ scores compared to adolescents with mild 9/11-exposures (95% Confidence Interval (CI): 1.1-6.4). Adolescents who had a parent with 9/11-related PTSD and at least one comorbid chronic condition were 4.2 times more likely to have abnormal/borderline SDQ scores compared to adolescents with a parent who had no reported chronic health conditions. Adolescents whose parent reported 14 or more poor mental health days in the preceding 30 days were 3.4 times more likely to have abnormal/borderline SDQ scores (95% CI: 1.2-9.5) The finding that parents' health appears to influence adolescent behavior problems 10-11 years following a disaster may have implications for healthcare practitioners and disaster response planners.
Highlights
Mental health disorders like depression or anxiety and physical health conditions such as asthma, other respiratory diseases, diabetes, or heart disease are becoming increasingly recognized for their importance in long-term health and quality of life among those who were affected by the terrorist attacks on the World Trade Center in New York City (NYC) on
We found that the number of poor mental health days reported by parents, but not physical health days, was associated with adolescent behavior problems
In this study we found that parents with post-traumatic stress disorder (PTSD) co-morbid with one or more other chronic condition were at increased risk of having an adolescent with behavior problems
Summary
Mental health disorders like depression or anxiety and physical health conditions such as asthma, other respiratory diseases, diabetes, or heart disease are becoming increasingly recognized for their importance in long-term health and quality of life among those who were affected by the terrorist attacks on the World Trade Center in New York City (NYC) on September 11, 2001 (9/11) (Caramanica et al, 2014; Jordan et al, 2011; Li et al, 2011; Miller-Archie et al, 2014; Shiratori & Samuelson, 2012). There is a wide range of serious 9/11-related mental health and behavioral outcomes affecting children and adolescents who were directly exposed to the disaster The collection of 9/11-exposures experienced by children often included one in which one or both parents suffered 9/11-related physical or mental health outcomes. This in turn may influence children’s own mental health and behavior
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