Harvard Medical School, Boston, MA 02115, USA.
J Am Acad Child Adolesc Psychiatry. 2010 Oct;49(10):990-1000, 1000.e1-2. doi: 10.1016/j.jaac.2010.06.012. Epub 2010 Sep 6.
To examine patterns and predictors of trends in DSM-IV serious emotional disturbance (SED) among youths exposed to Hurricane Katrina.
A probability sample of adult pre-hurricane residents of the areas affected by Katrina completed baseline and follow-up telephone surveys 18 to 27 months post-hurricane and 12 to 18 months later. Baseline adult respondents residing with children and adolescents (4-17 years of age) provided informant reports about the emotional functioning of these youths (n = 576) with the Strengths and Difficulties Questionnaire (SDQ). The surveys also assessed hurricane-related stressors and ongoing stressors experienced by respondent families.
SED prevalence decreased significantly across survey waves from 15.1% to 11.5%, although even the latter prevalence was considerably higher than the pre-hurricane prevalence of 4.2% estimated in the US National Health Interview Survey. Trends in hurricane-related SED were predicted by both stressors experienced in the hurricane and ongoing stressors, with SED prevalence decreasing significantly only among youths with moderate stress exposure (16.8% versus 6.5%). SED prevalence did not change significantly between waves among youths with either high stress exposure (30.0% versus 41.9%) or low stress exposure (3.5% versus 3.4%). Pre-hurricane functioning did not predict SED persistence among youths with high stress exposure, but did predict SED persistence among youth with low-moderate stress exposure.
The prevalence of SED among youths exposed to Hurricane Katrina remains significantly elevated several years after the storm despite meaningful decrease since baseline. Youths with high stress exposure have the highest risk of long-term hurricane-related SED and consequently represent an important target for mental health intervention.
研究暴露于卡特里娜飓风的青少年中 DSM-IV 严重情绪障碍（SED）的趋势模式和预测因素。
一项针对卡特里娜飓风受灾地区成年居民的概率抽样研究，在飓风后 18 至 27 个月和 12 至 18 个月后进行了基线和随访电话调查。基线时居住在受飓风影响地区的成年受访者与儿童和青少年（4-17 岁）一起完成了关于这些青少年情绪功能的问卷调查（n=576），使用的是《长处和困难问卷》（SDQ）。这些调查还评估了受访者家庭经历的与飓风相关的应激源和持续应激源。
SED 患病率在各次调查中均呈显著下降趋势，从 15.1%降至 11.5%，尽管后者的患病率仍远高于美国国家健康访谈调查估计的飓风前患病率 4.2%。飓风相关 SED 的趋势受飓风期间经历的应激源和持续应激源的预测，只有中度应激暴露的青少年的 SED 患病率显著下降（16.8%对 6.5%）。在高应激暴露（30.0%对 41.9%）或低应激暴露（3.5%对 3.4%）的青少年中，SED 患病率在各次调查之间均无显著变化。高应激暴露的青少年的 SED 患病率与基线时相比无明显变化，但低中度应激暴露的青少年的 SED 患病率有显著变化。
尽管自基线以来 SED 的患病率已有明显下降，但暴露于卡特里娜飓风的青少年的 SED 患病率在风暴发生几年后仍显著升高。高应激暴露的青少年患长期与飓风相关的 SED 的风险最高，因此是心理健康干预的重要目标。
