[mentalhealth-l] PERIODIC UPDATE (10/20/05) –– Disaster Aftermath

[mentalhealth-l at lists.ucla.edu]

SPECIAL ENEWS

From: Center for Mental Health in Schools at UCLA

Re: PERIODIC UPDATE (10/20/05) –– Disaster Aftermath

We encourage you to keep sending us information to share with others.

*A FEW PRESS REPORTS

 >>Federal Aid May Bail out School Systems in Louisiana (by W. Sentell 
Capitol News Bureau)
"The state has a good chance of landing a major federal aid package to help 
public school districts housing 40,000 displaced students, state 
Superintendent of Education Cecil Picard said Wednesday.  Picard told a 
legislative committee that, under one plan pushed by the Bush 
administration, the state would receive up to $7,500 for each student who 
was forced to switch schools because of Hurricane Katrina.  That figure is 
close to the average amount that state and local school districts spend on 
each student now. It is about twice as much as other plans discussed in 
Congress. ...

Finding ways to bail out school districts that are educating 40,000 
displaced students in Louisiana, and about 62,000 in other states, is one 
of the key issues top state educators are wrestling with in the wake of 
Hurricane Katrina and Hurricane Rita. ... East Baton Rouge Parish has the 
most displaced students of any Louisiana district -- about 6,000. Total 
enrollment in the district is about 52,500. EBR and other school leaders 
say they need financial help for the costs of educating an unexpected surge 
of students, including new teachers, textbooks, building space, school 
materials and other expenses.

Even before Hurricane Katrina struck Aug. 29, Picard told lawmakers, 28 of 
Louisiana's 68 public school districts faced the prospect of bankruptcy by 
June because of years of financial problems.  He said extra spending to 
house displaced students has worsened the problem and made the need for 
federal aid even more urgent. "These 28 systems, they can't hang on much 
longer," Picard said. ... The list of school districts that face zero fund 
balances by June includes East Baton Rouge, Iberville, Livingston, Pointe 
Coupee, St. Helena and the city of Baker. 
..."  http://2theadvocate.com/stories/101305/new_bailout001.shtml

 >>Thousands of displaced students not attending school in Louisiana  (by 
W. Sentell, Capitol News Bureau )
"At least 20,000 public school students uprooted by Hurricane Katrina are 
not attending any school, state Superintendent of Education Cecil Picard 
said Thursday. Picard made the comment during a roundtable discussion with 
U.S. Secretary of Education Margaret Spellings, East Baton Rouge Parish 
School Superintendent Charlotte Placide and a handful of teachers. 
Spellings visited students at Cedarcrest-Southmoor Elementary School in 
Baton Rouge, which on Thursday had 51 students who were forced out of their 
home schools because of the hurricane. ... Picard later said his estimate 
may be conservative. "It could be 30,000 to 35,000," he said.

Picard said he will have a better idea next week on the breakdown of the 
186,000 displaced public school students in a state with about 700,000 
statewide. There are also concerns that thousands of Louisiana students 
listed as attending schools in Texas and other states have not shown up for 
classes.

Placide said that, while 6,000 displaced students have been assigned to 
classes in her district, daily attendance ranges from 4,700 to about 5,000. 
"There are over 1,000 not coming," Placide said. "Have they left? Are they 
in the community? We don't know." ...

Other issues include how displaced students are faring, and how East Baton 
Rouge Parish and others will pay for additional teachers, buildings, 
textbooks, materials and other costs to educate them. ..."

 >>Charter School Proposal Halted (NEW ORLEANS TIMES-PICAYUNE)
"An Orleans Parish Civil Court judge has ordered the School Board to stop 
its plans to charter public schools on the West Bank or anywhere else in 
the city, granting a motion by a community group that alleges the decision 
was made without adequate public input. The order does not prevent the 
state Board of Elementary and Secondary Education from approving the 
charters. It does freeze any further action, however. In her ruling, Judge 
Nadine Ramsey said the board's decision shows ‘a flagrant disregard of the 
constitutional right of public participation in government.' The judge 
added: ‘It is in this time of crisis, when the citizens of Orleans Parish 
are concerned about the very future of their communities, that the role of 
public input is crucial. The people of New Orleans are entitled to 
participate in the process that will potentially change the landscape of 
their public educational system.'"

 >>Tucked in Katrina Relief, a Boon for Online Colleges          (NEW YORK 
TIMES  Commentary)
"United States Senate Bill 1715 would provide more time for students 
displaced by the hurricanes to repay federal loans, flexibility for 
teachers to be hired outside the home states where they are licensed, and 
financial assistance for schools that enroll homeless and disabled 
children. Inconspicuously tucked on page 26, however, lies a potential 
bonanza for the profit-making online colleges. The provision bars federal 
student loans and grants from colleges that enroll more than half their 
students in online divisions or offer more than half their courses through 
distance education. Without the 50% rule, the proprietary colleges could 
receive $20,000 or more a year for each student who gets such common 
federal aid as Pell grants and Perkins, Stafford and PLUS loans."

*IN THE U.S. CONGRESS – In a September speech to Congress entitled "Back to 
School and the No Child Left Behind Act," Senator Feingold (D-WI) said, 
"Hurricane Katrina and its aftermath also remind us of the importance of 
the availability of school counselors, psychologists, and social workers. 
These personnel work with teachers, administrators, and parents to ensure 
that students have the resources and tools they need to meet the challenges 
of the classroom and of everyday life 

 This natural disaster underscores 
the need to provide adequate resources to ensure that schools have the 
ability to recruit and retain school counselors, psychologists, and social 
workers in numbers that are appropriate to meet the needs of their students 

"

*NEW RESOURCES

*** "Creating & Maintaining Healthy Psychosocial Environments in the 
Aftermath of Disasters"
developed by the Louisiana Dept. of Education (Fall, 2005) –
  http://www.louisianaschools.net/lde/uploads/8043.pdf –  This specially 
developed resource can also be accessed at www.louisianaschools.net (look 
for the Hurricane Info and under it, click on Healing Environment).

***The Guidance Channel Zine has posted an issue dedicated to school 
response to the disasters.
Includes "Top Ten Websites For Restoring Hope In Katrina`s Wake," "Tips for 
School Counselors in the Aftermath," About Funding for Elementary and 
Secondary Students in Impacted Areas, and more. – 
http://www.guidancechannel.com/

***Request for Resources:
"I would like to request any research on what challenges are in store for 
our teachers/counselors/schools as we deal with the aftermath of this 
catastrophic event."

At the end of this email, we have included some resources and provided some 
excerpts and abstracts in response to this request. Anyone who has others 
to add, please let us know.


*UPDATES FROM VARIOUS LOCALES

 >>>U.S. Department of Education estimates that 350,000 students have been 
unable to attend school (public and private) because of the disasters.

 >>Louisiana's Department of Education estimates it has 186,565 displaced 
public school students. The Parish with the most displaced students is East 
Baton Rouge (6,040). As to where these student evacuees are, so far they 
have determined the following:
 >Not attending school: 25,000-30,000
 >In State: 40,222
 >Out of State: 62,017 (with 46,503 in Texas)
Obviously, there are many unaccounted for.


*SOME COMMENTS FROM THOSE ON THE GROUND

 >>>From Louisiana:
 >>"The pivotal question for kids right now seems to be whether they 
evacuated prior to Katrina hitting versus having to wait to be evacuated 
after the storm hit and the horrors we all saw from that failure to move 
quickly. We are experiencing elementary students who were evacuated after 
the storm presenting with very pronounced trauma and in need of intense 
help. The middle and high school students who made it out before the storm 
seem to be OK for now – but we know that will change over time. Students 
who lived for several weeks in a shelter and bonded with other adolescents 
are having more trouble with that ‘loss' than losing everything.  High 
school students are forming the 225 (Baton Rouge area code) and the 504 
(New Orleans area code) "gangs". The clash between these very disparate 
groups seems quite severe at the high school level. ...

The coordinating team is using a screening instrument that places students 
in one of three categories. We have over 6,000 children in EBR System –  I 
believe we are the biggest concentration of evacuees anywhere. We believe 
that number will continue to climb as we hear rumors that many students and 
their parents are reluctant to be parted at this time. The trailer cities 
are going into place and we hope to provide services both in school and in 
these ‘villages'. ... I am still most concerned about the ‘front-line' 
staff and providing them ways to discuss and process what they are hearing 
and experiencing. That includes all of my ninety staff members, the 
teachers, and school building level staff. ..."

 >>The Louisiana Dept. of Education reports receiving assistance from a 
variety of sources as they have prepared their "Rebuilding Louisiana 
Through Education Packet" that will soon be distributed to every school in 
Louisiana. "Four members of the United States Public Health Service (John 
Perez reports directly to the Surgeon General) were here with us for the 
past two weeks and we have been working with the Governor's Office, the 
Department of Health and Hospitals, the Office of Mental Health, the Office 
of Addictive Disorders, Office of Public Health and Department of Social 
Services to roll out a short term plan to get into the classrooms with 
training. We are contracting 30 teams of 3 members licensed clinical social 
worker, school counselor or school psychologist and a teacher to deliver 
trainings to school personnel. We are currently constructing the training 
for trainers and the units will include a piece on normal reactions to 
trauma and ‘red flags' to know when to refer to mental health professional, 
and units on ‘Creating Safe Environments,' ‘Creating Classroom 
Communities,' ‘ Healthy Responses to Life Changing Events' and ‘Training 
and Teaching Techniques for Trainers.' The training for the trainers is 
scheduled on October 25,26 and 27 and then we will be getting into the 
schools as soon after that as we can get the space and release of some 
teachers/school personnel and they will take it back to the rest of the 
school personnel. I am in charge of getting the training of trainers 
developed and we are working fast and furiously with our USPHS people and 
other agencies to put out a quality training. ... All of this is part of 
our short range plans to respond to the needs of our schools 
(students/staff/families) but we will also be working on long range plans 
which is when we may need some continued technical assistance/support from 
y'all (did you get the southern accent there?) ..."

*>>>From Mississippi:
 >>A Principal reports – "We are doing better daily, but it will be a long 
time before we see normal or should I say a ‘new normal.' I do agree that 
young children are more resilient due to the fact that they do not 
understand quite as much. I also know that they do better depending on how 
the adults around them respond to the many situations created by this 
disaster. We were prepared when the children returned, even though many of 
our teachers, assistants and clerical people suffered minimal to totally 
devastating conditions due to the damage to their homes. My employees are 
doing great, but are still fragile. I handle them as such, because their 
state of mind impacts everything they do. Little stressors that have always 
been present in this environment are now much larger. We are kind and 
compassionate as we still expect high quality work for our children. This 
seems to work much better as I am not in the business of pushing people 
over the edge. It is easy for me to do this, because my nature is one of 
compassion.

High school students are on their own more, therefore they have independent 
time not so much supported by adults. Our Kindergarten, first and second 
graders have adults around them all the time to make interventions quickly 
or just be a constant support.

Having ones own place is very important. Living with relatives is good if 
the home is not too crowded. The temporary shelter (travel trailers, etc. 
are very small). That in itself is a problem and will be due to 
insufficient space for a family with babies and small children. It can be 
fun for only so long.

Living in the devastated house which is what has happened in so many 
instances creates it own stressors. Families are living in homes that are 
severely damaged, but not leaking. That has to be hard. The bottom line is 
losing ones private space is a problem. I think initially being with other 
displaced individuals brought comfort, but there is no place like home.

Approximately 10% of the students in our environment need continuous 
support. The parents of these students also need support. My counselor has 
a Katrina support group for counseling. The children love getting together 
once per week to talk  and share with each other. I too try to check on 
these children regularly.

We live in a wonderful community and neighbors took care of neighbors. If 
someone went to get ice or water they shared with everyone. The most 
important thing that our community has learned is that we are responsible 
for ourselves our families and each other. If we ever go through this 
again, each family member will be more prepared.

As far as the school goes, I would do things in the same way if faced with 
another disaster. I brought my employees back two days early to help 
debrief them and let them tell their stories. We eliminated homework for a 
month. The children had opportunities to tell their stories also. We were 
able to feed children and adults free for four weeks. We did away with 9 
weeks test and just spent that time teaching the curriculum.

There are many things, but I think that the most important thing is to deal 
with each individual gently. It is working as no one has had a melt-down. I 
am going to do this all year in order to have a more successful year. We 
had extensive damage to our school facilities, but not so severe that we 
couldn't open. Getting started back 3 weeks after the disaster helped 
children, employees and families. Being able to pretend normal for 8 hours 
out of each day has helped us all.

It will take decades to get back to normal. Our country is not capable of 
taking care of everyone and everything. This reminds me of the situation 
our founding fathers were in when they came to America. They took care of 
each other. That should prevail."

 >>From a community mental health center -- "We are in somewhat of a unique 
position at our agency since every county we serve in our Catchment Area 
was affected by Hurricane Katrina (we serve 9 counties in the Region XII 
Catchment Area). Each of our counties experienced Hurricane Katrina first 
hand. Hattiesburg (which is our "hub" in Forrest County) was hit especially 
hard. (Yet, we are well aware - and very thankful-  that our level of 
devastation pales in comparison to that of the Gulf Coast and New Orleans). 
In addition, most our counties have experienced an increase in population 
due to an influx of individuals from New Orleans, the Mississippi Gulf 
Coast and Alabama who came to our Region for refuge. Therefore, not only 
are we ourselves attempting to recuperate, but we are also attempting to 
help displaced individuals and families rebuild their lives. With that 
said, we have been able to work with children and families in their 
homes/community setting since just a few days after Katrina hit. Since we 
have provided day treatment, school based clinician, and case management 
services in our school systems for many years, we are fairly integrated 
into the school systems and have also been available to support the schools 
as they have reopened.

Up until this past week or so, we have seen that families have mostly been 
concerned with finding shelter, food, jobs, etc. and repairing damage that 
has happened to their homes. Since some of that has been taken care of, 
more parents/families are getting back on track with making appointments, 
etc. Many families have moved here from other states/regions, so they are 
focusing on getting resources here (i.e., getting Medicaid switched from 
one state to another).  As you would expect, the children's ability to cope 
is a reflection of the parent's ability to cope. As you would also expect, 
some parents are coping better than others.  It also appears that the 
younger children are presenting fewer issues than the adolescents 
are.  Many of them (young and adolescent) have had to leave pets behind and 
are attempting to deal with that.  Children and adolescents who have moved 
here from other areas seem to also differ in their ability to cope 
depending upon the amount of devastation they witnessed and whether or not 
they were separated from their parents or had loved ones to die.  In 
general, the younger children do seem to be coping more favorably.

Some displaced adolescents have told us that they do not feel as though 
they are a part of the school system they have moved to.  They do not feel 
as though the teachers understand their needs.  They are expressing 
frustration with the fact that they fully expected to return to their 
homes, but are unable to do so.  Some of them have also begun to focus on 
blaming political officials for their inability to move home. However, they 
are also stating that they are beginning to move on with their lives, 
including settling into a new home here.  They are reporting that they are 
being welcomed into the community and feel supported by the 
community.  They are going to church, clubs, etc. within the community setting.

Thus far, it appears that less than 10% or so of our pre-Katrina 
child/adolescent client base is in need of further counseling services 
directly related to Katrina (individual, group, family therapy, psychiatric 
meds...).  If you include the displaced students that have come here from 
New Orleans, the Mississippi Gulf Coast and Alabama, that number increases 
to about 55%.  Again, this is just an estimate. Since we are a Community 
Mental Health Center, we have worked hard to link our clients and other 
individuals/families with other community resources so that most of their 
needs can be addressed.  We have been working with the Red Cross and DRC's 
to provide counselors at the shelters and relief centers, and will continue 
to do so as long as it  is needed. Thankfully, the need seems to be 
minimizing somewhat."

 >>>From Texas:
 >>"We have found that all the children evacuated have adjustment and loss 
issues to some degree. Children generally do fairly well when their parents 
or guardians are doing well.  However, the children who are doing the best 
came from areas with similar backgrounds as those children in their new 
schools. They came with parents or guardians who are able to adjust quickly 
and provide stability, continuity, and a predictable routine. They are able 
to recognize and fit into a similar culture in their new setting with 
similar values, beliefs, routines and socioeconomic status.

The children most adversely affected are those from the families most 
adversely affected.  Those who were exposed to more trauma; those for whom 
the response in itself was traumatic; those finding it most difficult to 
adjust to new surroundings due to the lack of familiarity with the culture, 
values and norms of the new community. When parents and children, look 
around at other families and children in their new community and cannot 
relate to their socioeconomic status, their belief systems and values, they 
really struggle.  The more insular their life was back home, the more 
difficult they find it to feel "at home" in a different setting, seemingly 
regardless of the services offered.  In general, how well the child does 
depends upon how well the responsible adult in their life does.

Throwing money at these families is not as helpful as having a community 
that embraces them, builds relationships with them, and works with them to 
retain the positives of their culture, while helping them to adjust to the 
differences within their new community. In this case it truly does take a 
village."

 >>"Dallas ISD is working hard to keep services on going for our Katrina 
families. Currently, we developed a small group packet for the schools that 
are highly impacted with Katrina students. The triage of services  is 
provided by Counseling Services, Psychological and Social Service, and 
Youth and Family Centers. This has helped the three departments plan 
together and collaborate with the school where the small group sessions are 
co-facilitated for six sessions. In November, we will pull all the 
facilitators to discuss what worked and what didn't work."

 >>>From Kentucky:
"I would agree that the younger the student the better the adjustment. The 
high school students have had the most difficulty for the reasons you 
mentioned in the recent update.  They have lost their identity and their 
peers.  In addition, this is a small town and there is not as much to do as 
in a city.  They have mixed feelings about returning.  They mainly miss 
their friends and extended family. The younger students are very glad to be 
here and express that they don't want to return.  They want to live where 
there are no hurricane and levees.

All age ranges are talking about the incidents they witnessed in a most 
healthy therapeutic way at this point and they are the males. The female 
students do not seem to want to talk about it at school at  this point but 
seem to talk to their mothers. The students (very few) who had relatives to 
stay with here obviously did not have the trauma at the superdome and 
convention center to talk about so their concerns are much less in 
severity. The support our community and schools provided was well thought 
out and  well prepared.  We did have two days notice when they arrived to 
help prepare for their arrival.  For such a small town we had many good 
resources in place already to help."

 >>>From Wisconsin:
We heard from schools around the state accounting for about 13 displaced 
students. The reports indicate the schools have mobilized effectively to 
provide supports. Some comments:

"... two girls ... are my counselees. They have good family support 
and  economic resources, and that has helped  quite a  bit in their 
transition. Nevertheless, they have needed support in the form of 
counseling and psych services." "... 3 students ... living with extended 
family.  I see one ... on a regular basis, but all three seem to be 
adjusting quite well.  I think living with family has really helped and 
support from school staff has been really helpful." "...She is connected to 
two wonderful staff who are supporting her with social skills related to 
conflict resolution with peers and I know they are trying to sort out if 
this behavior is due to trauma related to the hurricane.  We had another 
family, that was here for a week and parents went back, needing to see 
their home and if they could recoup or reestablish their lives back home." 
"...He is receiving extra support from the grade level team, and has had at 
least three individual sessions.  He re-located to a family member's home 
and has spent summers here in the past, which has significantly improved 
his adjustment. His family is intact here in Madison. He does occasionally 
talk about violent images in class, which leave some teachers wondering if 
he is a "time bomb" or is not dealing with emotional aftereffects. We are 
watching this closely. I think it was very timely to have those materials 
for interviewing and support of hurricane victims right after the event." 
"We gave them extra support (i.e.,inclusion with psych/sw in new student 
group) and consulted with teachers (including checking in on them) for the 
first several weeks. They have adjusted well and have not needed further 
support...." "We had 2 brothers ..., but they stayed only a week. They had 
come ...because their grandparents were here. They adjusted extremely well 
for the time they were here and did not need any support outside the 
classroom. ...  They moved  to Mississippi because their mother ... got a 
position in Mississippi and it was so much closer to their home in LA." 
"...student is really doing well and not needing any more assistance." "... 
Adjusted well very quickly. No known outside services.  Best assistance was 
to help mom get kids registered and set up in school."

########################################

Response to request for research on what challenges are in store for 
teachers/counselors/schools as they deal with the disaster aftermath.
(1) Excerpt from "PSYCHOSOCIAL CONSEQUENCES OF DISASTERS" 
http://www.ncptsd.va.gov/publications/rq/rqpdf/V13N2.PDF) Fran H. Norris 
Ph.D.National Center for PTSD and Georgia State University

"The literature on the psychosocial consequences of disasters is extensive. 
It is interdisciplinary and scattered across a variety of journals and 
books. Disasters are difficult to study well, and much of the research is 
flawed. Even very good studies cannot be definitive. No matter how 
sophisticated, one study cannot tell us that disasters have (or do not 
have) implications for mental health, only that the particular disaster 
under study had (or did not have) an effect on that particular population 
in that particular place. This simple fact is often forgotten in practice, 
and the reader should beware of overgeneralized interpretations of specific 
results. Review articles and meta-analyses play an especially critical role 
in this field because they can ask: How large are the effects of disasters 
on mental health, generally? What types of events have the strongest 
effects, on average? For whom are they most stressful, usually? 
Unfortunately, even very good reviews (e.g., Rubonis & Bickman, 1991) have 
a limited life because the answers to these questions change as the 
research base evolves. Believing that the need to reexamine these questions 
was acute, my colleagues and I recently attempted to provide a new 
synthesis of the empirical research. Our empirical review (Norris et al., 
in press) incorporated findings from 160 samples and 102 disasters 
worldwide. The conclusions from that detailed review provided a framework 
for this brief one. With apologies to all of those whose work was omitted 
here, I have tried to select articles that reflect the diversity of events, 
people, and places that have been studied and that illustrate a method, 
trend, issue, or conclusion that is important in the field, overall.

Methodological heterogeneity complicates interpretation of this body of 
work but adds to its depth and breadth. Some studies provide detailed 
diagnostic data collected from profoundly traumatized disaster victims 
(e.g., North et al., 1999), whereas others provide survey data collected 
from large samples that are more geographically representative but include 
sizable proportions of persons who were less severely exposed (e.g., 
Garrison et al., 1995). School-based studies and needs assessments form 
another important category (e.g., March et al., 1997). Timeframes also vary 
considerably, with first assessments occurring as early as immediately 
postdisaster to as late as 7 years postdisaster. Only 1 in 3 studies are 
longitudinal in design, pointing to a need for further research that 
examines how effects and prevalence rates change over time. These 
methodological variations should be kept in mind when reading this research.

A fundamental issue for any review is establishing the boundaries for the 
phenomenon of interest. I adopted a working definition of a disaster as a 
sudden event that has the potential to terrify, horrify, or engender 
substantial losses for many people simultaneously. Even the most cursory 
reading of this literature will show that investigators quickly make 
distinctions between natural disasters, which result from weather or 
geophysical forces, and human-caused disasters, which result from human 
negligence and error (technological disasters) or actual intent to harm 
(mass violence). ...

Natural disasters have been studied most frequently. Rates of 
psychopathology have been minimal after some natural disasters but 
substantial after others. Although composing only a small fraction of the 
total body of work, the abstracted studies were selected to provide a good 
cross-section of quality research. Illustrating an array of agents and 
locations, the studied disasters include the 1980 eruption of Mount St. 
Helens in Washington State (Shore et al., 1986), the 1981 floods in 
Kentucky (Norris et al., 1994), Hurricane Andrew in south Florida (LaGreca 
et al., 1996), Hurricane Mitch in central America (Caldera et al., 2001), 
the Sarno, Italy landslides (Catapano et al., 2001), the Newcastle 
earthquake (Carr et al., 1997), and the Armenian earthquake (Armenian et 
al., 2000; Goenjian et al., 1995)....

Even within samples that have experienced the same disaster, individuals 
vary greatly in their outcomes. Severity of exposure is nearly always 
predictive of postdisaster symptoms. Very often such effects are described 
as ‘dose-response' functions, meaning simply that as the severity of 
exposure increases, either mean symptom level or probability of disorder 
increases in a regular pattern. In the abstracted studies, individual-level 
stressors that affected mental health included bereavement, injury to self 
or family member, life threat, horror, property damage, and financial loss. 
That disasters are experienced collectively is perhaps their defining 
feature yet little research captures the implications of this for mental 
health. For a multi-county study of flood victims in Kentucky, Norris et 
al. (1994) used archival data to create a measure of ‘community 
destruction' that was independent of respondents' self-reported ‘personal 
loss.' Community destruction explained significant variance in postdisaster 
psychological, physical, and social functioning even after the effects of 
predisaster functioning and personal loss were controlled. Personal loss 
was associated most strongly with increases in negative affect, community 
destruction with decreases in positive affect. Such changes do not 
constitute psychopathology but do suggest that disasters harm the entire 
community's quality of life, which will be manifest in prevalent, though 
subclinical, expressions of stress.

New evidence emerging from lower Manhattan provides recent support for the 
value of public health perspectives regarding disaster effects (Galea et 
al., 2002). Survivors' characteristics, such as their gender and age, 
predisaster mental health and personality traits, and postdisaster 
psychosocial resources, also influence their outcomes. Steinglass and 
Gerrity's (1990) studies were particularly influential in calling attention 
to women as a highrisk group. In a cross-cultural study of Hurricanes 
Andrew and Paulina, Norris and colleagues (2001) showed that the magnitude 
of gender effects varied across cultures (Mexican being greater than 
Anglo-American, which was greater than African-American) in predictable 
ways according to the strength of male and female roles in those cultures. 
Findings for age are complex. On average, samples composed of school-aged 
children show greater psychological impairment after disasters than do 
samples of adults. Interest in children has increased tremendously in the 
past decade of disaster research, a welcome and important change. LaGreca 
et al.'s (1996) longitudinal study of young children and Warheit et al.'s 
(1996) prospective study of adolescents exposed to Hurricane Andrew are 
particularly good examples of research on youth....

Regardless of whether they are assessed retrospectively or prospectively, 
predisaster symptoms are almost always among the strongest predictors of 
postdisaster symptoms. McFarlane's (1989) study of firefighters after the 
Ash Wednesday bushfires is illustrative of research that has explored the 
role of predisposing factors in depth. Over the past 20 years, a large body 
of research has accumulated showing that psychosocial resources, such as 
hardiness, perceived control, and social support, afford critical 
protection for disaster victims (Norris et al., in press). Benight's work 
(e.g., Benight et al., 1999) on the importance of coping self-efficacy is a 
fine example, in part because it fostered theory in this field (which more 
often is atheoretical in tone) and in part because his findings appear to 
have significant implications for intervention.  An important trend in 
disaster research over the past decade has been the recognition that the 
protection afforded by psychosocial resources is limited because resources 
are themselves vulnerable to the impact of disasters. Like Benight's work, 
work in this area attempts to import theory into our understanding of 
disaster-related stress. Two studies were critical in bringing the idea of 
resource loss to center stage. Freedy and colleagues (1992) tested 
hypotheses derived from Hobfoll's theory of Conservation of Resources. In 
his original test, and several subsequent ones, Freedy showed that 
postdisaster resource loss (assessed globally across a range of resources) 
is a potent predictor of postdisaster distress. Kaniasty and Norris (1993) 
introduced a more specific theory, the ‘social support deterioration 
model.' In their initial test, as well as in subsequent ones that have 
spanned 6 disasters in 3 countries, declines in perceived social support 
and social embeddedness explained much of the mental health consequences of 
natural disasters. Palinkas et al. (1993) showed that the Exxon Valdez oil 
spill had significant impact on the social environments of the stricken 
communities.

Where do we go from here? It is clearly time to move beyond the 
‘dose-response' paradigm that (rightly so far) has dominated the field. The 
evidence on this point is extensive and conclusive. Far more work is needed 
on family and community processes that foster resilience or  impede 
recovery. We know much more about survivors' problems than we do about how 
to solve them. It is essential that we develop evidence-based methods of 
treatment and intervention that are appropriate in the context of 
disasters. Notwithstanding the critical importance of clinical treatments 
for the minority of disaster victims who develop PTSD and other 
psychological disorders, we cannot focus solely on individual treatments 
because disasters affect whole families, whole communities. Moreover, 
disasters often occur in areas where few mental health professionals are 
available to provide such care. The most critical need may be to learn more 
about processes that halt, or even reverse, the erosion of disaster 
victims' intrapersonal and interpersonal resources that enable them to care 
for themselves and each other.


(2) SELECTED ABSTRACTS
La Greca, A. M., Silverman, W. K., Vernberg, E. M., & Prinstein, M. J. 
(1996). Symptoms of posttraumatic stress in children after Hurricane 
Andrew: A prospective study. Journal of Consulting and Clinical Psychology, 
64, 712-723. "The authors examined symptoms of posttraumatic stress in 
3rd-5th grade children during the school year after Hurricane Andrew. From 
a conceptual model of the effects of traumatic events, 442 children were 
evaluated 3, 7, and 10 months postdisaster with respect to (a) their 
exposure to traumatic events during and after the disaster, (b) their 
preexisting demographic characteristics, (c) the occurrence of major life 
stressors, (d) the availability of social support, and (e) the type of 
coping strategies used to cope with disaster-related distress. Although 
symptoms of PTSD declined over time, a substantial level of symptomatology 
was observed up to 10 months after the disaster. All 5 factors in the 
conceptual model were predictive of children''s PTSD symptoms 7 and 10 
months postdisaster. Findings are discussed in terms of the potential 
utility of the model for organizing thinking about factors that predict the 
emergence and persistence of PTSD symptoms in children...."

Norris, F. H., Friedman, M. J., Watson, P. J., Byrne, C. M., Diaz, E., & 
Kaniasty, K. (in press). 60,000 disaster victims speak, Part I: An 
empirical review of the empirical literature, 1981 –– 2001. Psychiatry. 
"Results for 160 samples of disaster victims were coded as to sample type, 
disaster type, disaster location, outcomes and risk factors observed, and 
overall severity of impairment. In order of frequency, outcomes included 
specific psychological problems, nonspecific distress, health problems, 
chronic problems in living, resource loss, and problems specific to youth. 
Samples were more likely to be impaired if they were composed of youth 
rather than adults, were from developing rather than developed countries, 
or experienced mass violence (e.g., terrorism, shooting sprees) rather than 
natural or technological disasters. Most samples of rescue and recovery 
workers showed remarkable resilience. Within adult samples, more severe 
exposure, female gender, middle age, ethnic minority status, secondary 
stressors, prior psychiatric problems, and weak or deteriorating 
psychosocial resources most consistently increased the likelihood of 
adverse outcomes. Among youth, family factors were primary. Implications of 
the research for clinical practice and community intervention are discussed 
in a companion article (Norris, Friedman, & Watson, in press)."

Yule, W., Bolton, D., Udwin, O., Boyle, S., O'Ryan, D., & Nurrish, J. 
(2000). The long-term psychological effects of a disaster experienced in 
adolescence: I: The incidence and course of PTSD. Journal of Child 
Psychology and Psychiatry and Allied Disciplines, 41, 503-511. "Previous 
studies have shown that children and adolescents exposed to traumatic 
experience in a disaster can suffer from high levels of post-traumatic 
stress. The present paper is the first a series reporting on the long-term 
follow-up of a group of young adults who as teenagers had survived a 
shipping disaster –  the sinking of the "Jupiter" in Greek waters — between 
5 and 8 years previously. The general methodology of the follow-up study as 
a whole is described, and the incidence and long-term course of PTSD. It is 
the first study of its kind on a relatively large, representative sample of 
survivors, using a standardized diagnostic interview, and comparing 
survivors with a community control group. Survivors of the Jupiter disaster 
(N = 217), and 87 young people as controls, were interviewed using the 
Clinician Administered PTSD Scale (CAPS). Of the 217 survivors, 111 (51.7%) 
had developed PTSD at some time during the follow-up period, compared with 
an incidence in the control group of 3.4% (N = 87). In the large majority 
of cases of PTSD in the survivors for whom time of onset was recorded, 90% 
(N = 110), onset was not delayed, being within 6 months of the disaster. 
About a third of those survivors who developed PTSD (30% , N = 111) 
recovered within a year of onset, through another third (34%, N = 111) were 
still suffering from the disorder at the time of follow-up, between 5 and 8 
years after the disaster. Issues relating to the generalisability of these 
findings are discussed."

Benight, C. C., Swift, E., Sanger, J., Smith, A., & Zeppelin, D. (1999). 
Coping self-efficacy as a mediator of distress following a natural 
disaster. Journal of Applied Social Psychology, 29, 2443-2464. 
"Social-cognitive theory and conservation-of-resources theory were utilized 
to understand individual differences in psychological response to natural 
disaster. Coping self-efficacy, lost resources, social support, and 
optimism were assessed along with demographic variables in predicting 
distress following Hurricane Opal. Participants included 67 residents of 
Okaloosa County, Florida. Multiple regression analyses indicated that 
coping self-efficacy was the strongest predictor of general distress and 
trauma-related distress. Loss of resources and gender were also important 
predictors of general distress. Path analyses demonstrated that lost 
resources directly influenced general distress, social support, optimism, 
and coping self-efficacy. These analyses also indicated that coping 
self-efficacy perceptions mediated the relationships between loss of 
resources and trauma-related distress, social support and both trauma and 
general distress, and optimism and both types of distress. Theoretical 
implications are discussed...."

Freedy, J. R., Shaw, D.l., Jarrell, M. P., & Masters, C. R. (1992). Towards 
an understanding of the psychological impact of natural disasters: An 
application of the Conservation Resources stress model. Journal of 
Traumatic Stress, 5, 441-454. "The current study employed the Conservation 
of Resources (COR) stress model as a template for understanding short-term 
adjustment following a natural disaster. The following three hypotheses 
were supported: resource loss was positively related to psychological 
distress; resource loss was relatively more important in predicting 
psychological distress than personal characteristics and coping behavior; 
and, resource loss constitutes a risk factor for the development of 
clinically significant psychological distress. The theoretical importance 
of the current findings is discussed, particularly the tendency within 
disaster literature to confound crisis experiences (e.g., terror) with 
resource loss experiences (e.g., loss of possessions, loss of social 
support) when defining degree of disaster exposure. Also, the practical 
importance of considering resource loss in planning intervention services 
is highlighted...."

Kaniasty, K., & Norris, F.H. (1993). "A test of the social support 
deterioration model in the context of natural disaster. Journal of 
Personality and Social Psychology, 64, 395-408. "This prospective 
longitudinal study examined stress-mediating potentials of 3 types of 
social support: social embeddedness, perceived support from nonkin, and 
perceived support from kin. As participants in a statewide panel study, 222 
older adults were interviewed once before and twice after a severe flood. 
It was hypothesized that disaster exposure (stress) would influence 
depression directly and indirectly, through deterioriation of social 
support. LISREL analyses indicated that postdisaster declines in social 
embeddedness and nonkin support mediated the immediate and delayed impact 
of disaster stress. No evidence was found for the mediational role of kin 
support. Findings are in accord with conceptualizations of social support 
as an entity reflecting dynamic transactions among individuals, their 
social networks, and environmental pressures."

Norris, F.H., Perilla, J.l., Ibaññez, G.E., & Murphy, A.D. (2001). Sex 
differences in symptoms of posttraumatic stress disorder: Does culture play 
a role? Journal of Traumatic Stress, 14, 7-28. "If gender differences in 
PTSD follow from culturally-defined roles and rules, they should be greater 
in societies that foster traditional views of masculinity and femininity 
than in societies that adhere to these traditions less rigidly. Data were 
collected 6 months after Hurricanes Paulina (Acapulco; N = 200) and Andrew 
(Miami; White n = 135; Black n = 135). In regression analyses predicting 
scores on the Revised Civilian Mississippi Scale, Sex X Cultural group 
interactions emerged for the total scale and for subscales of Intrusion, 
Avoidance, and Remorse. Only a sex main effect (women higher) emerged for 
Arousal. Overall, the results indicated that Mexican culture amplified, 
whereas African American culture attenuated, differences in the 
posttraumatic stress of male and female disaster victims...."


(3) AN ANNOTATED BIBLIOGRAPHY ON THE LONG-TERM EFFECTS OF DISASTERS - 
http://www.cosw.sc.edu/katrinabib.pdf


School Mental Health Project/
Center for Mental Health in Schools
UCLA Dept. of Psychology
Los Angeles, CA  90095-1563
(310) 825-3634 / Toll Free: (866) 846-4843 / Fax: (310) 206-8716
Email: smhp at ucla.edu
Web: http://smhp.psych.ucla.edu 
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