Epidemiology of Trauma and Trauma-related Disorders in Children and Youth

Abramson, D. , Redlener, I. , Stehling-Ariza, T. , & Fuller, E. (2007). The legacy of Katrina’s children: Estimating the numbers of at-risk children in the Gulf Coast states of Louisiana and Mississippi. (National Center for Disaster Preparedness, research brief 2007:12). New York: Columbia University Mailman School of Public Health. This research brief from the National Center for Disaster Preparedness examined the long-term consequences of the 2005 hurricanes (Katrina and Rita) on children of the Gulf Coast. Basing their answers on publicly available data and a variety of other sources of information, the authors sought to determine how many children were displaced, how many had returned to their home communities, how many were still living in transient housing, and how many were at risk for poor outcomes. The total number of displaced persons in Louisiana and Mississippi was estimated at 448,000, including 163,000 children. The rate of return as of September 2007 was 55%, involving approximately 82,000 to 95,000 children. Approximately 11,000 children still resided in trailer parks as of September 29, 2007. The children affected by the hurricanes were exposed to a number of factors associated with poor outcomes. The overall proportion of children with at least one major risk factor was 55% in Louisiana and 47% in Mississippi, causing the authors to estimate that 47,000 to 65,000 children were at risk for poor health, mental health, or educational outcomes. Breslau, N. , Davis, G.C. , Andreski, P., & Peterson, E.L. (1991). Traumatic events and posttraumatic stress disorder in an urban population of young adults. Archives of General Psychiatry, 48, 216-222. To ascertain the prevalence of PTSD and risk factors associated with it, we studied a random sample of 1007 young adults from a large health maintenance organization in the Detroit, Michigan area. The lifetime prevalence of exposure to traumatic events was 39.1%. The rate of PTSD in those who were exposed was 23.6%, yielding a lifetime prevalence in the sample of 9.2%. Persons with PTSD were at increased risk for other psychiatric disorders; PTSD had stronger associations with anxiety and affective disorders than with substance abuse or dependence. Risk factors for exposure to traumatic events included low education, male sex, early conduct problems, extraversion, and family history of psychiatric disorder or substance problems. Risk factors for PTSD following exposure included early separation from parents, neuroticism, preexisting anxiety or depression, and family history of anxiety. Life-style differences associated with differential exposure to situations that have a high risk for traumatic events and personal predispositions to the PTSD effects of traumatic events might be responsible for a substantial part of PTSD in this population. Breslau, N. , Wilcox, H.C. , Storr, C.L. , Lucia, V.C. , & Anthony, J.C. (2004). Trauma exposure and posttraumatic stress disorder: A study of youths in urban America. Journal of Urban Health: Bulletin of the New York Academy of Medicine, 81, 530-544. We estimate the cumulative occurrence of traumatic events and PTSD, using DSM-IV criteria, in a high-risk sample of young people in the urban United States. The epidemiological sample (n=2,311) was recruited in 1985–1986 at entry into first grade of a public school system of a large mid-Atlantic city. Participants were interviewed about history of trauma and PTSD in 2000–2002 when their mean age was 21 years (n=1,698). Lifetime occurrence of assaultive volumE 19/no.1 WInTER 2008 PAGE 3