Tornado Exposure Research Articles

Examining tornado exposure, post-tornado distress, and gender following the March 2020 tornado in Nashville, Tennessee

ABSTRACT Extreme weather events, such as tornadoes, disproportionately impact socially vulnerable individuals and communities across the U.S. The current study utilised a survey to examine gender-based vulnerability to tornado exposure and adverse mental health among 412 participants following a tornado in Nashville, Tennessee in March 2020. Structural equation modelling results indicated that both men and women exhibited high rates of post-traumatic stress and depression symptoms. However, tornado exposure mediated a higher risk of post-traumatic stress and depression symptoms among female participants. These findings contribute to bridging the gap in research explaining underlying mechanisms that contribute to gender disparities in post-disaster mental health.

Risk and Protective Factors Associated with Post-Tornado Distress among Persons with Disabilities

This study examined the direct effects of tornado exposure and protective resources on post-disaster distress among (N = 209) persons with disabilities following a tornado outbreak in the Midwest and Southeast on December 10–11, 2021 using structural equation modeling. Results found the degree of tornado exposure (e.g., injury, loss of loved ones, property damage, etc.) increased the likelihood of experiencing higher levels of PTSD and depression. Results also found that higher levels of protective resources (physical, social, and emotional) were found to protect against post-tornado PTSD and depression. Findings can inform future post-disaster mental health services for persons with disabilities.

Protecting infants from natural disasters: The case of vitamin A supplementation and a tornado in Bangladesh

Environmental disasters have increased in frequency and intensity as a result of climate change. Can timely intervention help protect against the health impacts of these disasters? We study this question by leveraging data from a double-blind cluster-randomized controlled trial of at-birth vitamin A supplementation, which boosts immune system functioning, in Bangladesh. During the trial, a large tornado swept through the study area, affecting both treatment and control clusters. Tornado exposure in infancy decreased physical growth and increased the incidence of severe fevers. But infants who received supplementation were protected from these negative effects.

Effects of Autonomic Nervous System Functioning and Tornado Exposure on Long-Term Outcomes of Aggressive Children.

This study examined whether pre-disaster indicators of sympathetic and parasympathetic activity moderated the relation between degree of disaster exposure from an EF-4 tornado and changes in the externalizing and internalizing behavior problems of children at-risk for aggression. Participants included 188 children in 4th-6th grades (65% male; 78% African American; ages 9-13) and their parents from predominantly low-income households who were participating in a prevention study when the tornado occurred in 2011. Fourth-grade children who exhibited elevated levels of aggressive behavior were recruited in three annual cohorts. Parent-rated externalizing and internalizing problems were assessed prior to the tornado (Wave 1; W1), and at 4-12months (W2), 16-24months (W3), 42-28months (W4) and 56-60months (W5) post-tornado. Children's pre-tornado Skin Conductance Level (SCL) reactivity and Respiratory Sinus Arrhythmia (RSA) withdrawal were assessed at W1 using SCL and RSA measured during resting baseline and during the first 5min of the Iowa Gambling Task (IGT). Children and parents reported their exposure to tornado-related trauma and disruptions at Wave 3. Children displayed less reduction in externalizing problems if there had been higher child- or parent-reported tornado exposure and less RSA withdrawal, or if they had lower parent-reported TORTE and less SCL reactivity or lower SCL baseline. Highlighting the importance of children's pre-disaster arousal, higher levels of disaster exposure negatively affected children's level of improvement in externalizing problems when children had less vagal withdrawal, and when tornado exposure disrupted the protective effects of higher SCL reactivity and higher SCL baseline.

Tornado and hail exposure

Tornado and hail exposure

A preliminary investigation of rare variants associated with genetic risk for PTSD in a natural disaster-exposed adolescent sample

ABSTRACT Background: Posttraumatic stress disorder (PTSD) involves a complex interaction of biological, psychological, and social factors. Numerous studies have demonstrated genetic variation associated with the development of PTSD, primarily in adults. However, the contribution of low frequency and rare genetic variants to PTSD is unknown to date. Moreover, there is limited work on genetic risk for PTSD in child and adolescent populations. Objective: This preliminary study aimed to identify the low frequency and rare genetic variation that contributes to PTSD using an exome array. Method: This post-disaster, adolescent sample (n = 707, 51% females, M age = 14.54) was assessed for PTSD diagnosis and symptom count following tornado exposure. Results: Gene-based models, covarying for ancestry principal components, age, sex, tornado severity, and previous trauma identified variants in four genes associated with diagnosis and 276 genes associated with symptom count (at p adj < .001). Functional class analyses suggested an association with variants in the nonsense class (nonsynonymous variant that results in truncation of, and usually non-functional, protein) with both outcomes. An exploratory gene network pathway analysis showed a great number of significant genes involved in brain and immune function, illustrating the usefulness of downstream examination of gene-based findings that may point to relevant biological processes. Conclusions: While further investigation in larger samples is warranted, findings align with extant PTSD literature that has identified variants associated with biological conditions such as immune function.

Trajectories of tornado-related posttraumatic stress symptoms and pre-exposure predictors in a sample of at-risk youth.

The current study examined how severity of disaster exposure and predisaster individual and family characteristics predicted trajectories of disaster-related posttraumatic stress symptoms (PTSS) in children over 4 years following a devastating EF-4 tornado. Participants (n = 346; 65% male; 77.5% African American) were 4th-6th-graders and their caregivers, from predominantly low-income households, who were already participating in a longitudinal study of indicated prevention effects for externalizing outcomes when the tornado occurred in 2011. Latent class trajectory analyses were used to identify disaster-related PTSS trajectory groups across the 4-year postdisaster period. Three groups were identified: (1) a group that declined (recovery) in PTSS over time (15.90%); (2) a group that was stable and low in PTSS over time (76.87%); and (3) a group that was stable and high (chronic) in PTSS over time (7.23%). Multinomial logistic regression analyses revealed that greater tornado exposure predicted membership in the declining trajectory group relative to the low-stable group. Positive parenting and pretornado caregiver trauma exposure also moderated how disaster exposure, particularly perceived life threat, predicted PTSS trajectories. Some youth reported elevated disaster-related PTSS repeatedly for 4 years following a devastating tornado. Consistent with the concept of equifinality, results suggest that there are several pre-exposure risk factors that may increase risk for a chronic PTSS trajectory following disaster exposure. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Implications of Prenatal Exposure to the Spring 2011 Alabama and Missouri Tornadoes on Birth Outcomes.

Despite emerging evidence of the detrimental effects of natural disasters on maternal and child health, little is known about exposure to tornadoes during the prenatal period and its impact on birth outcomes. We examined the relationship between prenatal exposure to the spring 2011 tornado outbreak in Alabama and Joplin (Missouri) and adverse birth outcomes. We conducted a retrospective, cross-sectional cohort study using the 2010-2012 linked infant births and deaths data set from the National Center for Health Statistics for tornado-affected counties in Alabama (n=126,453) and Missouri (Joplin, n=6,897). Chi-square and logistic regression analyses were performed to estimate associations between prenatal exposure to tornadoes and birth outcomes. Prenatal exposure to the tornado incidents did not influence birth weight outcomes. Women exposed to Alabama tornadoes were less likely to have a preterm birth compared to unexposed mothers (OR: 0.93, 95% CI: 0.91, 0.96). Preterm births among Joplin-tornado exposed mothers were slightly higher (13%) compared with unexposed mothers (11.2%). Exposed mothers from Joplin were also more likely to have a cesarean section compared to their counterparts (OR: 1.14, 95% CI: 1.02, 1.26). We found no association between tornado exposure and adverse birth weight and infant mortality rates. Our findings suggest that prenatal exposure can amplify the odds for a cesarean section. (Disaster Med Public Health Preparedness. 2019;13:279-286).

Prevalence and predictors of PTSD and depression among adolescent victims of the Summer 2016 tornado in Yancheng City

The aim of this study was to investigate the prevalence rate of probable posttraumatic stress disorder (PTSD) and depression in the adolescents who experienced the 2016 Yancheng tornado 3 months ago, as well as to analyze the related risk factors. A total of 247 tornado adolescent survivors were recruited to complete child PTSD symptom scale and Center for Epidemiologic Studies Depression Scale for Children. Results showed that 57.5% and 58.7% of the participants reported suspected symptoms of PTSD and depression respectively. PTSD is highly comorbid with depression. Risk factors of these two disorders were age and tornado exposure. Finally, the implications of intervention and prevention of mental health problems among adolescents who experienced tornado were discussed.

Post-traumatic growth 2.5 years after the 2011 Joplin, Missouri tornado

ABSTRACTIn 2011 a major tornado struck Joplin, Missouri, killing 158 and injuring 1,150 individuals. Approximately 2.5 years after this disaster, an online survey of Joplin adult residents (N = 438) was conducted to examine the relationship between disaster experience, post-traumatic stress (PTS) symptoms, communication with family, friends, and neighbors, and post-traumatic growth (PTG). Results indicate that more tornado exposure and tornado PTS symptoms were related to more PTG. In addition, engaging in more communication about the tornado with family, friends, and neighbors was related to more perceived PTG. Implications for social work practice in long-term post-disaster communities include building upon areas of growth and promoting positive interpersonal connections among survivors.

Observed and Projected Changes in United States Tornado Exposure

AbstractThis study examines how tornado risk and societal exposure interact to create tornado disaster potential in the United States. Finescale historical and projected demographic data are used in a set of region-specific Monte Carlo tornado simulations to reveal how societal development has shaped, and will continue to shape, tornado disaster frequency and consequences. Results illustrate that although the U.S. Midwest contains the greatest built-environment exposure and the central plains experience the most significant tornadoes, the midsouth contains the greatest tornado disaster potential. This finding is attributed to the relatively elevated tornado risk and accelerated growth in developed land area that characterizes the midsouth region. Disaster potential is projected to amplify in the United States due to increasing built-environment development and its spatial footprint in at-risk regions. In the four regions examined, both average annual tornado impacts and associated impact variability are projected to be as much as 6 to 36 times greater in 2100 than 1940. Extreme annual tornado impacts for all at-risk regions are also projected to nearly double during the twenty-first century, signifying the potential for greater tornado disaster potential in the future. The key lesson is that it is the juxtaposition of both risk and societal exposure that drive disaster potential. Mitigation efforts should evaluate changes in tornado hazard risk and societal exposure in light of land-use planning, building codes, and warning dissemination strategies in order to reduce the effects of tornadoes and other environmental hazards.

Projected 21st century changes in tornado exposure, risk, and disaster potential

While risk and associated hazard characteristics are important components of disaster formation, the consequences of hazards are often driven by underlying human and built-environment vulnerabilities. Yet, there has been little research conducted on how the evolving contributors of risk and vulnerability commingle to produce disaster potential. In this study, we assess the interaction of risk and vulnerability by investigating a single hazard, the tornado. How future changes in risk and vulnerability influence tornado disaster probability is estimated by integrating, for the first time, projected residential built environment data and modeled future severe weather environments. Results suggest that, although the projected twenty-first century escalation in tornado risk will play a role in increasing disaster consequences and frequency, growth in the human-built environment is projected to outweigh the effects of increased risk on future tornado disaster potential. While changes in societal exposure are projected to overshadow potential climate change-driven alterations in tornado risk, the combination of both an increase in risk and exposure may lead to a threefold increase in median annual tornado impact magnitude and disaster potential from 2010 to 2100.

Interview and recollection-based research with child disaster survivors: Participation-related changes in emotion and perceptions of participation.

Research suggests that some types of trauma research can be conducted safely with children ages 10 and older. The aim of this project was to learn more about potential risks or benefits of conducting research with younger children and with child disaster survivors, specifically about research that includes children providing trauma recollections. Fifty 8- to 12-year-old children who experienced a devastating tornado participated in an in-person interview that included both individual and joint (mother-child) recollections of their tornado experiences 1 year after exposure. These 50 children also rated 3 emotions at 3 time points and rated their perceptions (e.g., benefit and regret) of research post-participation. Children (N = 28) also participated in phone surveys 3 months later to assess persistent participation-related emotions and perceptions. Child reported that emotions worsened from pre- to during participation; however, reports of emotions returned to preparticipation levels post-participation and remained so at the 3-month follow-up. Sixty-four percent of children reported at least some participation benefit and no participation regret immediately postparticipation, as did 89.3% at the 3-month follow-up. Four percent of children reported some participation regret (no benefit) postparticipation, and 0% 3 months later. No children requested to stop participating, and none required postresearch connection with crisis services. Posttraumatic stress symptom severity, tornado exposure, and age were largely unrelated to child-reported emotions and perceptions of research. Results indicate that carefully planned and executed disaster-related research that includes children providing recollections can be conducted with preadolescents with little risk and some benefit.

Adolescent Substance Use Following a Deadly U.S. Tornado Outbreak: A Population-Based Study of 2,000 Families

Despite conceptual links between disaster exposure and substance use, few studies have examined prevalence and risk factors for adolescent substance use and abuse in large, population-based samples affected by a recent natural disaster. We addressed this gap using a novel address-based sampling methodology to interview adolescents and parents who were affected by the 4th deadliest tornado outbreak in U.S. history. Postdisaster interviews were conducted with 2,000 adolescent–parent dyads living within a 5-mile radius of the spring 2011 U.S. tornadoes. In addition to descriptive analyses to estimate prevalence, hierarchical linear and logistic regression analyses were used to examine a range of protective and risk factors for substance use and abuse. Approximately 3% reported substance abuse since the tornado. Greater number of prior traumatic events and older age emerged as consistent risk factors across tobacco and alcohol use and substance abuse since the tornado. Tornado incident characteristics, namely, greater loss of services and resources after the tornado and posttraumatic stress disorder since the tornado, were associated with greater alcohol consumption. Service loss increased risk for binge drinking, whereas, for substance abuse, posttraumatic stress disorder increased risk and parent presence during the tornado decreased risk. Greater family tornado exposure was associated with a greater number of cigarettes smoked in female but not male teen participants. Both trauma and non-trauma-related factors are relevant to postdisaster substance abuse among adolescents. Future research should examine the role of broader ecological systems in heightening or curtailing substance use risk for adolescents following disaster exposure.

Mental Health Among Adolescents Exposed to a Tornado: The Influence of Social Support and Its Interactions With Sociodemographic Characteristics and Disaster Exposure.

Approximately 25% of youths experience a natural disaster and many experience disaster-related distress, including symptoms of posttraumatic stress disorder (PTSD) and depression. This study contributes to the literature by examining PTSD and depressive symptoms among 2,000 adolescents (50.9% female, 70.5% White) assessed after exposure to tornadoes in 2011. The authors hypothesized that greater tornado exposure, female sex, and younger age would be associated with distress, and that social support would interact with these associations. Analyses showed that PTSD symptoms were associated with lower levels of social support (β = -.28, p < .001), greater tornado exposure (β = .14, p < .001), lower household income (β = -.06, p = .013, female sex (β = -.10, p < .001), and older age (β = .07, p = .002), with a 3-way interaction between tornado exposure, sex, and social support (β = -.06, p = .017). For boys, the influence of tornado exposure on PTSD symptoms increased as social support decreased. Regardless of level of tornado exposure, low social support was related to PTSD symptoms for girls; depressive symptom results were similar. These findings were generally consistent with the literature and provide guidance for intervention development focused on strengthening social support at the individual, family, and community levels.

Spatiotemporal analysis of tornado exposure in five US metropolitan areas

Weather-related disasters and affiliated losses in the USA have amplified over time. However, prior research using normalization schemes on damage tallies suggests that weather hazard losses are not necessarily rising when inflation, changes in wealth, and growth in population are accounted. This study evaluates the latter factor, assessing if population changes and a sprawling development mode have led to increasing potential for tornado disasters in the USA. Specifically, this research shows where and how quickly tornado exposure is growing by appraising spatiotemporal trends in gridded population and housing unit data for five metropolitan statistical areas (MSAs). The macroscale risk to tornadoes is represented by tornado day climatology and is related to the exposure of the five MSAs, which include Atlanta, GA; Chicago, IL; Dallas/Fort Worth, TX; Oklahoma City, OK; and St. Louis, MO. Supplementing the macroscale investigation, an observationally derived, hypothetical violent tornado track is transposed on various development types in each MSA to determine the microscale changes in human and built-environment exposure. Results demonstrate increased exposure in all MSAs at both the macro- and microscale. Of the five MSAs studied, Dallas, TX, had the greatest potential for a tornado disaster due to the higher risk for tornado occurrence comingling with the amount of MSA exposure. These results reveal further that amplifying exposure is a major impetus behind intensifying severe weather impacts and losses.

Elucidating dimensions of posttraumatic stress symptoms and their functional correlates in disaster-exposed adolescents

The aim of this study was to elucidate the dimensional structure of posttraumatic stress disorder (PTSD) and potential moderators and functional correlates of this structure in disaster-affected adolescents. A population-based sample of 2000 adolescents aged 12–17 years (M = 14.5 years; 51% female) completed interviews on post-tornado PTSD symptoms, substance use, and parent–adolescent conflict between 4 and 13 months (M = 8.8, SD = 2.6) after tornado exposure. Confirmatory factor analyses revealed that all models fit well but a 5-factor dysphoric arousal model provided a statistically significantly better representation of adolescent PTSD symptoms compared to 4-factor dysphoria and emotional numbing models. There was evidence of measurement invariance of the dysphoric arousal model across gender and age, although girls and older adolescents aged 15–17 years had higher mean scores than boys and younger adolescents aged 12–14 years, respectively, on some PTSD dimensions. Differential magnitudes of association between PTSD symptom dimensions and functional correlates were observed, with emotional numbing symptoms most strongly positively associated with problematic substance use since the tornado, and dysphoric arousal symptoms most strongly positively associated with parent–adolescent conflict; both correlations were significantly larger than the corresponding correlations with anxious arousal. Taken together, these results suggest that the dimensional structure of tornado-related PTSD symptomatology in adolescents is optimally characterized by five separate clusters of re-experiencing, avoidance, numbing, dysphoric arousal, and anxious arousal symptoms, which showed unique associations with functional correlates. Findings emphasize that PTSD in disaster-exposed adolescents is not best conceptualized as a homogenous construct and highlight potential differential targets for post-disaster assessment and intervention.

Prevalence and predictors of PTSD and depression among adolescent victims of the Spring 2011 tornado outbreak

Relatively few studies have examined prevalence and predictors of posttraumatic stress disorder (PTSD) or major depressive episode (MDE) in disaster-affected adolescents. Fewer still have administered diagnostic measures or studied samples exposed to tornadoes, a common type of disaster. Further, methodologic problems limit the generalizability of previous findings. This study addressed prevalence estimates and risk factors for PTSD and MDE among adolescents exposed to the Spring 2011 tornado outbreak in Alabama and Joplin, Missouri. A large (N=2000), population-based sample of adolescents and caregivers, recruited randomly from tornado-affected communities, participated in structured telephone interviews. PTSD and MDE prevalence were estimated for the overall sample, by gender, and by age. Hierarchical logistic regression was used to identify risk factors for PTSD and MDE. Overall, 6.7% of adolescents met diagnostic criteria for PTSD and 7.5% of adolescents met diagnostic criteria for MDE since the tornado. Girls were significantly more likely than boys to meet diagnostic criteria for MDE, and older adolescents were more likely than younger adolescents to report MDE since the tornado. Female gender, prior trauma exposure, and an injured family member were associated with greater risk for PTSD and MDE. Specific incident characteristics (loss of services, concern about others' safety) were associated with greater PTSD risk; prior disaster exposure was associated with lower MDE risk. However, most adolescents were resilient following tornado exposure, roughly 1 in 15 developed PTSD, 1 in 13 developed MDE, and many more endorsed subclinical mental health problems. Information regarding specific risk factors can guide early screening, prevention, and intervention efforts in disaster-affected communities.