Abstract
BackgroundIt has been asserted that psychological responses to disasters in children and adolescents vary widely across cultures, but this has rarely been investigated. The objectives of the study were to clinically evaluate the construct of traumatic stress symptoms and disorder in children and adolescents after a super-cyclone in Orissa, India; to find out the prevalence at one year; compare the effect in high and low exposure areas and study the factors associated with it.MethodsClinical examination of children and adolescents (n = 447) was done, supplemented by a symptoms checklist based on International Classification of Mental and Behavioural Disorders, Diagnostic Criteria for Research and a semi-structured questionnaire for disaster related experiences.ResultsA majority of children had post-traumatic symptoms. Post-traumatic stress disorder (PTSD) was present in 30.6% (95% confidence interval: 26.4 to 34.9), and an additional 13.6% had sub-syndromal PTSD. Parents or teachers reported mental health concerns in 7.2% subjects, who were a minor proportion (12.8%) of subjects with any syndromal diagnosis (n = 196). Significantly more (43.7%) children in high exposure areas had PTSD than that (11.2%) in low exposure areas (p < 0.001). Depression was significantly associated with PTSD. Binary logistic regression analysis indicated that high exposure, lower educational level and middle socioeconomic status significantly predicted the outcome of PTSD. Extreme fear and perceived threat to life during the disaster, death in family, damage to home, or staying in shelters were not significantly associated with PTSD.ConclusionFollowing natural disaster PTSD is a valid clinical construct in children and adolescents in Indian set up; and though highly prevalent it may be missed without clinical screening. Its manifestation and associated factors resembled those in other cultures.
Highlights
It has been asserted that psychological responses to disasters in children and adolescents vary widely across cultures, but this has rarely been investigated
Binary logistic regression suggested that high exposure, lower educational level and middle socioeconomic status significantly predicted the outcome of post-traumatic stress disorder (PTSD)
The results suggest that post-traumatic symptoms and the syndrome in children and adolescents in this culture resembled those noted in western societies
Summary
It has been asserted that psychological responses to disasters in children and adolescents vary widely across cultures, but this has rarely been investigated. Current literature suggests that there are wide variations of prevalence figures for PTSD in children and adolescents after natural disasters. As one can not generalize the adult findings to children [12,24], it becomes imperative to study prevalence of and associated risk factors for PTSD in children and adolescents after disasters in different socio-cultural settings. Such evaluation is important for the assessment of mental health, but for intervention and prevention issues as well, especially as trauma in childhood and adolescence is suggested to bring in prolonged vulnerability [25]
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