Posttraumatic Stress and Depressive Reactions Among Nicaraguan Adolescents After Hurricane Mitch
Abstract
OBJECTIVE: This study determined the severity of posttraumatic stress and depressive reactions among Nicaraguan adolescents after Hurricane Mitch and the relationship of these reactions to objective and subjective features of hurricane exposure, death of a family member, forced relocation, and thoughts of revenge. METHOD: Six months after the hurricane, 158 adolescents from three differentially exposed cities were evaluated by using a hurricane exposure questionnaire, the Child Posttraumatic Stress Disorder Reaction Index, and the Depression Self-Rating SCALE: RESULTS: Severe levels of posttraumatic stress and depressive reactions were found among adolescents in the two most heavily affected cities. Severity of posttraumatic stress and depressive reactions and features of objective hurricane-related experiences followed a "dose-of-exposure" pattern that was congruent with the rates of death and destruction across cities. Level of impact (city), objective and subjective features, and thoughts of revenge accounted for 68% of the variance in severity of posttraumatic stress reaction. Severity of posttraumatic stress reaction, death of a family member, and sex accounted for 59% of the variance in severity of depression. CONCLUSIONS: After a category 5 hurricane, adolescents in heavily affected areas with extreme objective and subjective hurricane-related traumatic features of exposure experience severe and chronic posttraumatic stress and comorbid depressive reactions. The recovery of the severely affected Nicaraguan adolescents is vital to the social and economic recovery of a country ravaged by years of political violence and poverty. These findings strongly indicate the need to incorporate public mental health approaches, including systematic screening and trauma/grief-focused interventions, within a comprehensive disaster recovery program.
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Epidemiological studies have found high rates of psychological disorders, particularly PTSD, in children affected by war, natural disaster, or both.
“Epidemiological studies have found epidemic rates of psychological disorders, particularly posttraumatic stress disorder (PTSD), in children who have been affected by war [1], natural disaster [2], and natural disaster and war combined [3,4].”
From Treating children traumatized by war and tsunami: a comparison between exposure therapy and meditation-relaxation in north-east Sri Lanka (2009) · cites this paper as [2]
Goenjian and colleagues reported estimates of PTSD of 55% to 90% in two very affected cities of Nicaragua six months after Hurricane Mitch.
“Goenjian and colleagues [2] who investigated the severity of posttraumatic stress among Nicaraguan adolescents after Hurricane Mitch reported estimates of PTSD of 55% to 90% in two very affected cities of the countries six months after the natural disaster had occurred.”
From Treating children traumatized by war and tsunami: a comparison between exposure therapy and meditation-relaxation in north-east Sri Lanka (2009) · cites this paper as [2]
Cites
Posttraumatic stress disorder: the burden to the individual and to society.
Kessler, R. C. (2000) · PubMed · Cited by 1,443 · see citing works
Symptoms of posttraumatic stress in children after Hurricane Andrew: A prospective study.
La Greca, A. M., Silverman, W. K., Vernberg, E. M., & Prinstein, M. J. (1996) · Journal of Consulting and Clinical Psychology · doi:10.1037/0022-006x.64.4.712 · Cited by 728 · see citing works
Prediction of posttraumatic stress symptoms in children after Hurricane Andrew.
Vernberg, E. M., Greca, A. M. L., Silverman, W. K., & Prinstein, M. J. (1996) · Journal of Abnormal Psychology · doi:10.1037//0021-843x.105.2.237 · Cited by 560 · see citing works
Post-traumatic Stress Reactions in Children After the 1988 Armenian Earthquake
Pynoos, R. S., Goenjian, A. K., Tashjian, M., Karakashian, M., Manjikian, R., Manoukian, G., Steinberg, A. M., & Fairbanks, L. A. (1993) · The British Journal of Psychiatry · doi:10.1192/bjp.163.2.239 · Cited by 549 · see citing works
Self-citationPsychiatric Comorbidity in Children after the 1988: Earthquake in Armenia
Goenjian, A. K., Pynoos, R. S., Steinberg, A. M., Najarian, L. M., Asarnow, J. R., Karayan, I., GHURABI, M., & Fairbanks, L. A. (1995) · Journal of the American Academy of Child & Adolescent Psychiatry · doi:10.1097/00004583-199509000-00015 · Cited by 428 · see citing works
Self-citationChildren Exposed to Disaster: I. Epidemiology of Post-Traumatic Symptoms and Symptom Profiles
Shannon, M. P., Lonigan, C. J., Finch, A. J., Jr., & TAYLOR, C. M. (1994) · Journal of the American Academy of Child & Adolescent Psychiatry · doi:10.1097/00004583-199401000-00012 · Cited by 415 · see citing works
Children's PTSD reactions one year after a sniper attack at their school
Nader, K., Pynoos, R. S., Fairbanks, L. A., & Frederick, C. J. (1990) · American Journal of Psychiatry · doi:10.1176/ajp.147.11.1526 · Cited by 408 · see citing works
Self-citationOutcome of psychotherapy among early adolescents after trauma
(1997) · American Journal of Psychiatry · doi:10.1176/ajp.154.4.536 · Cited by 381 · cited 2× · see citing works
“(10) found an increase in levels of depression over time among adolescents with chronic PTSD.”
BackgroundSelf-citationDEVELOPMENTS IN CHILD PSYCHIATRIC EPIDEMIOLOGY
Schowalter, J. E., & Costello, E. J. (1989) · Journal of the American Academy of Child & Adolescent Psychiatry · doi:10.1097/00004583-198911000-00004 · Cited by 360 · see citing works
Posttraumatic Stress Disorder in Adolescents after Hurricane Andrew
Garrison, C. Z., Bryant, E. S., Addy, C. L., Spurrier, P. G., Freedy, J. R., & Kilpatrick, D. G. (1995) · Journal of the American Academy of Child & Adolescent Psychiatry · doi:10.1097/00004583-199509000-00017 · Cited by 234 · see citing works
A longitudinal study of the psychological morbidity in children due to a natural disaster
McFARLANE, A. C., Policansky, S. K., & Irwin, C. (1987) · Psychological Medicine · doi:10.1017/s0033291700025964 · Cited by 217 · see citing works
Depression in recently bereaved prepubertal children
Weller, R. A., Weller, E. B., Fristad, M. A., & Bowes, J. M. (1991) · American Journal of Psychiatry · doi:10.1176/ajp.148.11.1536 · Cited by 177 · see citing works
Depression self-rating scale: Utility with child psychiatric inpatients.
Asarnow, J. R., & Carlson, G. A. (1985) · Journal of Consulting and Clinical Psychology · doi:10.1037//0022-006x.53.4.491 · Cited by 176 · see citing works
Twenty-One—Month Follow-up Study of School-Age Children Exposed to Hurricane Andrew
Shaw, J. A., Applegate, B. E., & SCHORR, C. (1996) · Journal of the American Academy of Child & Adolescent Psychiatry · doi:10.1097/00004583-199603000-00018 · Cited by 176 · see citing works
Yule, W., & Udwin, O. (1991) · British Journal of Clinical Psychology · doi:10.1111/j.2044-8260.1991.tb00928.x · Cited by 170 · see citing works
An investigation of the impact of posttraumatic stress disorder on physical health
Wagner, A. W., Wolfe, J., Rotnitsky, A., Proctor, S. P., & Erickson, D. J. (2000) · Journal of Traumatic Stress · doi:10.1023/a:1007716813407 · Cited by 168 · see citing works
Relocation after a Disaster: Posttraumatic Stress Disorder in Armenia after the Earthquake
Najarian, L. M., Goenjian, A. K., Pelcovttz, D., Mandel, F. S., & Najarian, B. (1996) · Journal of the American Academy of Child & Adolescent Psychiatry · doi:10.1097/00004583-199603000-00020 · Cited by 164 · see citing works
Self-citationPsychological Effects of Hurricane Andrew on an Elementary School Population
Shaw, J. A., Applegate, B. E., TANNER, S. L., Perez, D. L., Rothe, E. M., CAMPO-BOWEN, A. E., & LAHEY, B. L. (1995) · Journal of the American Academy of Child & Adolescent Psychiatry · doi:10.1097/00004583-199509000-00016 · Cited by 163 · see citing works
One-year follow-up of survivors of a mass shooting.
North, C., Smith, E. M., & Spitznagel, E. L. (1997) · American Journal of Psychiatry · doi:10.1176/ajp.154.12.1696 · Cited by 156 · see citing works
Eerdewegh, M. M. V., Bieri, M. D., Parilla, R. H., & Clayton, P. J. (1982) · The British Journal of Psychiatry · doi:10.1192/bjp.140.1.23 · Cited by 150 · see citing works
A Public Mental Health Approach to the Postdisaster Treatment of Children and Adolescents
Pynoos, R. S., Goenjian, A. K., & Steinberg, A. M. (1998) · Child and Adolescent Psychiatric Clinics of North America · doi:10.1016/s1056-4993(18)30268-2 · Cited by 126 · see citing works
Self-citationPost-traumatic Stress Disorder in Adolescents after a Hurricane
Garrison, C. Z., Weinrich, M. W., Hardin, S. B., Weinrich, S., & Wang, L. (1993) · American Journal of Epidemiology · doi:10.1093/oxfordjournals.aje.a116886 · Cited by 106 · see citing works
Goenjian, A. K., Stilwell, B. M., Steinberg, A. M., Fairbanks, L. A., Galvin, M. R., Karayan, I., & Pynoos, R. S. (1999) · Journal of the American Academy of Child & Adolescent Psychiatry · doi:10.1097/00004583-199904000-00009 · Cited by 84 · see citing works
Self-citationEngdahl, B. E., Speed, N., Eberly, R. E., & SCHWARTZ, J. (1991) · The Journal of Nervous and Mental Disease · doi:10.1097/00005053-199104000-00001 · Cited by 78 · see citing works
The psychological impact of hurricane Hugo on children: A needs assessment
Belter, R. W., Dunn, S. E., & Jeney, P. (1991) · Advances in Behaviour Research and Therapy · doi:10.1016/0146-6402(91)90003-s · Cited by 52 · see citing works
A model for psychodynamic psychotherapy with the rape victim.
Rose, D. S. (1991) · Psychotherapy · doi:10.1037/0033-3204.28.1.85 · Cited by 18 · see citing works
Flagged first, then by citations
Cited by
Sorted by citations
Tolin, D. F., & Foa, E. B. (2006) · Psychological Bulletin · doi:10.1037/0033-2909.132.6.959 · Cited by 2,197 · see citing works
The Epidemiology of Post-Traumatic Stress Disorder after Disasters
Galea, S., Nandi, A., & Vlahov, D. (2005) · Epidemiologic Reviews · doi:10.1093/epirev/mxi003 · Cited by 1,287 · see citing works
The University of California at Los Angeles post-traumatic stress disorder reaction index
Steinberg, A. M., Brymer, M. J., Decker, K. B., & Pynoos, R. S. (2004) · Current Psychiatry Reports · doi:10.1007/s11920-004-0048-2 · Cited by 1,212 · see citing works
Self-citationGender differences in posttraumatic stress disorder.
Olff, M., Langeland, W., Draijer, N., & Gersons, B. P. R. (2007) · Psychological Bulletin · doi:10.1037/0033-2909.133.2.183 · Cited by 1,058 · see citing works
A meta-analysis of risk factors for post-traumatic stress disorder in children and adolescents
Trickey, D., Siddaway, A. P., Meiser-Stedman, R., Serpell, L., & Field, A. P. (2012) · Clinical Psychology Review · doi:10.1016/j.cpr.2011.12.001 · Cited by 828 · see citing works
Posttraumatic stress disorder and physical illness: results from clinical and epidemiologic studies
BOSCARINO, J. A. (2004) · Annals of the New York Academy of Sciences · doi:10.1196/annals.1314.011 · Cited by 691 · see citing works
Catani, C., Jacob, N., Schauer, E., Kohila, M., & Neuner, F. (2008) · BMC Psychiatry · doi:10.1186/1471-244x-8-33 · Cited by 423 · see citing works
Mental Illness and Suicidality after Hurricane Katrina
Kessler, R. (2006) · Bulletin of the World Health Organization · doi:10.2471/blt.06.033019 · Cited by 395 · see citing works
Tolin, D. F., & Foa, E. B. (2008) · Psychological Trauma: Theory, Research, Practice, and Policy · doi:10.1037/1942-9681.s.1.37 · Cited by 376 · see citing works
Catani, C., Kohiladevy, M., Ruf, M., Schauer, E., Elbert, T., & Neuner, F. (2009) · BMC Psychiatry · doi:10.1186/1471-244x-9-22 · Cited by 290 · see citing works
Psychological impact of disasters on children: review of assessment and interventions
Kar, N. (2009) · World Journal of Pediatrics · doi:10.1007/s12519-009-0001-x · Cited by 254 · see citing works
Pediatric and Adolescent Mental Health Emergencies in the Emergency Medical Services System
Dolan, M. A., Fein, J. A., & the Committee on Pediatric Emergency Medicine (2011) · Pediatrics · doi:10.1542/peds.2011-0522 · Cited by 235 · see citing works
La Greca, A. M., Silverman, W. K., Lai, B., & Jaccard, J. (2010) · Journal of Consulting and Clinical Psychology · doi:10.1037/a0020775 · Cited by 225 · see citing works
Neuner, F., Schauer, E., Catani, C., Ruf, M., & Elbert, T. (2006) · Journal of Traumatic Stress · doi:10.1002/jts.20121 · Cited by 196 · see citing works
Weathering the Storm: The Impact of Hurricanes on Physical and Mental Health
Bourque, L. B., Siegel, J. M., Kano, M., & Wood, M. M. (2006) · The ANNALS of the American Academy of Political and Social Science · doi:10.1177/0002716205284920 · Cited by 178 · see citing works
McFarlane, A. C., & Van Hooff, M. (2009) · British Journal of Psychiatry · doi:10.1192/bjp.bp.108.054270 · Cited by 169 · see citing works
An Epidemiologic Study of Posttraumatic Stress Disorder in Flood Victims in Hunan China
Liu, A., Tan, H., Zhou, J., Li, S., Yang, T., Wang, J., Liu, J., Tang, X., Sun, Z., & Wen, S. W. (2006) · The Canadian Journal of Psychiatry · doi:10.1177/070674370605100603 · Cited by 157 · see citing works
de Roos, C., Greenwald, R., den Hollander-Gijsman, M., Noorthoorn, E., van Buuren, S., & de Jongh, A. (2011) · European Journal of Psychotraumatology · doi:10.3402/ejpt.v2i0.5694 · Cited by 155 · see citing works
Vibhakar, V., Allen, L. R., Gee, B., & Meiser-Stedman, R. (2019) · Journal of Affective Disorders · doi:10.1016/j.jad.2019.05.005 · Cited by 148 · see citing works
Clemens, V., von Hirschhausen, E., & Fegert, J. M. (2022) · European Child & Adolescent Psychiatry · doi:10.1007/s00787-020-01615-3 · Cited by 147 · see citing works
Rataj, E., Kunzweiler, K., & Garthus-Niegel, S. (2016) · BMC Public Health · doi:10.1186/s12889-016-3692-7 · Cited by 119 · see citing works
Salloum, A., & Overstreet, S. (2012) · Behaviour Research and Therapy · doi:10.1016/j.brat.2012.01.001 · Cited by 114 · see citing works
Posttraumatic stress disorder in adolescents after Typhoon Morakot-associated mudslides
Yang, P., Yen, C.-F., Tang, T.-C., Chen, C.-S., Yang, R.-C., Huang, M.-S., Jong, Y.-J., & Yu, H.-S. (2011) · Journal of Anxiety Disorders · doi:10.1016/j.janxdis.2010.10.010 · Cited by 59 · see citing works
An, Y., Yuan, G., Zhang, N., Xu, W., Liu, Z., & Zhou, F. (2018) · Psychiatry Research · doi:10.1016/j.psychres.2018.03.034 · Cited by 40 · see citing works
Taylor, L. K., & Weems, C. F. (2011) · Behavior Therapy · doi:10.1016/j.beth.2010.09.001 · Cited by 34 · see citing works
Anxiety, Depression, and Post-traumatic Stress a month after 2019 Cyclone Fani in Odisha, India
Kar, N., Samantaray, N. N., Kar, S., & Kar, B. (2022) · Disaster Medicine and Public Health Preparedness · doi:10.1017/dmp.2020.368 · Cited by 26 · see citing works
Xu, W., Ding, X., Goh, P. H., & An, Y. (2018) · Personality and Individual Differences · doi:10.1016/j.paid.2018.01.032 · Cited by 22 · see citing works
Hurricane Katrina's impact on the mental health of adolescent female offenders
Robertson, A. A., Morse, D. T., & Baird-Thomas, C. (2009) · Anxiety, Stress & Coping · doi:10.1080/10615800802290634 · Cited by 15 · see citing works
- Authors
- Goenjian, A. K., Molina, L., Steinberg, A. M., Fairbanks, L. A., Alvarez, M. L., Goenjian, H. A., & Pynoos
- Affiliations
- University of California, Los Angeles (US)
- Venue
- American Journal of Psychiatry
- Published
- 2001-05-01
- Volume
- 158
- Issue
- 5
- Pages
- 788-794
- ISSN
- 0002-953X (ISSN-L)
- 1535-7228
- OpenAlex
- W2144163509
- Cited by
- 379
- References
- 26
- Citations by year
- 2026: 4 · 2025: 5 · 2024: 7 · 2023: 5 · 2022: 12 · 2021: 12 · 2020: 12 · 2019: 9 · 2018: 15 · 2017: 9 · 2016: 16 · 2015: 19 · 2014: 16 · 2013: 30 · 2012: 15
- FWCI
- 15.50
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- American Journal of Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Posttraumatic Stress Disorder Research
- Health Sciences › Health Professions › Emergency Medical Services › Disaster Response and Management
- Social Sciences › Psychology › Clinical Psychology › Migration, Health and Trauma
- Keywords
- post-traumatic stress disorder, depression, adolescents, Hurricane Mitch, natural disasters, hurricane exposure, family bereavement, forced relocation, revenge, dose-response relationship, disaster recovery, mental health screening, grief, Nicaragua
- MeSH terms
- Adjustment Disorders, Adolescent, Age Factors, Depressive Disorder, Disasters, Female, Humans, Life Change Events, Male, Nicaragua, Probability, Psychiatric Status Rating Scales, Regression Analysis, Severity of Illness Index, Sex Factors, Stress Disorders, Post-Traumatic, Comorbidity
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