Psychological evaluations, referrals, and follow-up of adolescents after their exposure to Hurricane Hugo.

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There is little understanding of adolescent appraisal of stress and crisis intervention for adolescents who are exposed to major stress such as that of a natural disaster. A description of the psychological evaluations, referrals, and follow-up assessments made by nurse practitioners (NPs) and a nurse psychotherapist (NPT) of adolescents (N = 507) in two South Carolina high schools who experienced Hurricane Hugo. The NPs' evaluations concluded that 63 adolescents (12%) exhibited symptoms of psychological distress. The NPs referred 36 of these adolescents to high school counselors for minor distress or school-related problems and 27 for more intensive clinical evaluation by an NPT. Of the 27 adolescents who were referred to the NPT, 10 had symptoms associated with adolescent adjustment reaction, 8 showed symptoms of depression, 5 revealed symptoms of posttraumatic stress disorder, and 4 complained of serious family problems. Based on these data and the mental processes described by these adolescents, the authors propose a model and suggest adolescent appraisal of stress and crisis is a critical issue to consider when intervening with adolescents who are exposed to major stressors, including those associated with a disaster.