Time School

Normative Posttraumatic Distress of Non-disaster Caleb W. Lack & Maureen A. Sullivan

Oklahoma State University, Department of Psychology

Exposed Children in a Disaster Prone Area

Table 3

Introduction Method Table 1

BASC-SRP scores at Times 1 and 2

Procedure

The vast majority of children who survive a natural disaster will suffer some

Degree of PTSD Symptoms as measured by the Reaction Index

negative effects (Russoniello et al., 2002). For some children, these effects

To choose a sample that was unlikely to have exposure to a tornado,

Degree of Symptoms Time 1 Time 2

persist well beyond the immediate post-disaster period, causing significant

meteorological data were examined, and a town that had not had a tornado Scale Time 1 Time 2

distress and impairment in functioning. Posttraumatic stress symptoms such as

% %

within a 10 mile radius in five years was targeted for participation. The first data

reexperiencing the disaster in some manner, persistent avoidance of stimuli Mean (SD)

collection occurred in November, when risk of tornados is lower. A follow-up

No PTSD Symptoms 15.0 18.2

related to the disaster, and increased arousal levels can lead to impairments in

assessment took place in early May, at the height of tornado season. Data were Emotional Symptoms Index 51.03 (11.92) 48.68 (11.69)

social relationships and academic functioning that can have serious long-term

(n = 6) (n = 4)

(Range 0-11)

gathered from the elementary school in the non-exposed town. Children in

consequences. While there has been a great deal of research examining the Clinical Maladjustment 49.22 (11.20) 47.00 ( 9.93)

grades 3-6 and their parents were targeted as participants.

Mild PTSD Symptoms 50.0 68.2

reactions of children to various disasters, there has been little research that

School Maladjustment 48.73 (11.42) 50.55 (12.99)

examines how children living in a disaster-prone area react to disaster.

(n = 20) (n = 15)

(Range 12-24)

Depression 52.37 (10.67) 50.82 (11.29)

Measures

Moderate PTSD Symptoms 22.5 6.9

Anxiety 48.30 (10.91) 45.23 ( 9.91)

A few studies indicate that actually being exposed to a disaster may not be Parents completed a Demographic Questionnaire, a Tornado Exposure

(n = 9) (n = 3)

(Range 25-39)

necessary to develop PTSD symptoms. Several studies conducted in different Questionnaire (TEQ) used in previous Oklahoma disaster research (Lack &

Severe PTSD Symptoms 12.5 0.0

parts of Oklahoma have found higher than normal rates of posttraumatic stress Sullivan, 2004), and Behavior Assessment System for Children Parent Rating

symptoms (PTSS), even in children not directly exposed to a disaster. Oklahoma Scales (BASC-PRS; Reynolds & Kamphaus, 1992). The TEQ was administered to

(n = 5) (n = 0)

(Range 40-59)

is somewhat geographically unique in that it is situated directly in Tornado screen out those participants who had been exposed to a tornado in the past

Very Severe PTSD Symptoms 0.0 0.0 0.00

Alley and experiences an average of 54 tornadoes a year (National Weather five years, as well as gather information on vicarious exposure to tornadoes

Results (cont.)

Service, 2002). Indeed, one recent study found highly elevated levels of distress through television, school presentations, and other means. At the first

(n = 0) (n = 0)

(Range 60-80)

13 months after initial exposure to a disaster, with 52% of the sample reporting assessment, children completed the Frederick Reaction Index (RI; Frederick,

moderate to very severe posttraumatic distress (Lack & Sullivan, 2003). After an Pynoos, & Nader, 1992) and the BASC Self-report of Personality (BASC-SRP).

Changes in Distress and Psychological Symptoms

additional six months (19 months post-disaster), close to 40% of the children Both BASCs and the RI were again given at the second assessment.

Total RI Score

were still reporting moderate to severe distress. Romero (1997) found that 66% We hypothesized that there would be a change in RI scores between assessments.

Participants

Mean 22.53 16.18

of a sample of Oklahoma children with no record of direct, in vivo tornado While there was a slight change in scores, this was not significant (t = 1.692, p =

exposure in the past five years had moderate or higher levels of PTSS, as An original sample of 73 children and their parents participated in the first .106). Thus, scores remained stable across these two times. The hypothesis that

SD (12.14) (6.85)

measured by the Reaction Index (Frederick, Pynoos, & Nader, 1992). It should assessment. To illustrate the difficulty of finding a non-exposed sample in a general distress would not differ between assessment times was supported. There

be noted that this sample was collected during tornado season, which could disaster-prone area such as Oklahoma, parental screeners indicated that 30 of were no significant differences on either the parent or child versions of the BASC.

have caused a sensitization effect. While such an effect has not been found in these children had actually been exposed to a tornado in the past five years,

research using tornado-exposed samples (Lack & Sullivan, 2003), the same may leaving a truly non-exposed sample of 43 participants. The majority of the

not hold true for non-exposed samples. sample identified as Caucasian (76.9%), with self-identified American Indians Relationship between Vicarious Exposure and Distress

Results (cont.)

(20.5%) the second largest group. The children ranged in age from 8-12 years,

To examine the potential relationship between level of reported tornado-related

with mean age of 10.34 years (SD = 1.15). Children were spread across grades

distress, as measured by the RI, and various means of vicarious exposure,

Behavior Assessment System for Children (BASC)

One possible contributor to tornado-related distress may be the high rate of 3-6 (9.8% in 3rd grade, 29.3% in 4th grade, 29.3% in 5th grade, 31.7% in 6th

correlation analyses were undertaken. No significant relationships were found

vicarious exposure that many Oklahomans get during tornado season. This grade). More females that males participated in the study (56.1% vs. 43.9%). The BASC is a measure of both specific and general psychological difficulties in between RI scores and the number of times that the family had taken shelter due

consists of tornado drills at school and home, television programs being children. T-scores of 60-70 indicate at-risk areas, while T-scores of 70 and above to threat of a tornado (Time 1 r = -.158; Time 2 r = .242), viewing of disaster

interrupted by breaking news about tornado warnings or watches, and indicate areas of clinically significant difficulties. Table 2 shows the BASC-PRS related movies (Time 1 r = -.004; Time 2 r = .245) or television programs (Time 1

television programs and specials related to tornadoes. The purpose of the scores, while Table 3 shows BASC-SRP scores for both assessment periods. r = -.300; Time 2 r = -.129), or how often parents turn the channel if

current study was to measure tornado-related posttraumatic distress outside of

Results programming were interrupted with tornado-coverage (Time 1 r = .059; Time 2 r

and during tornado season in children who had not been directly exposed to a

= -.113). A statistically significant relationship between RI score and the number of

tornado during the past five years but were highly at-risk for experiencing one, Tornado Exposure Questionnaire (TEQ)

times a child was exposed to disaster-related presentations outside of the home

as well as examine the role that vicarious exposure could play in maintaining

was found at Time 2 (r = .632, p = .004), but not at Time 1 (r = -.042, p = -.042).

As mentioned above, only 43 of the original sample of 73 children were truly non-

that distress.

Table 2

exposed. In addition to screening out those participants who were exposed to a

tornado, the primary purpose of the TEQ was to determine the level of vicarious

BASC-PRS scores at Times 1 and 2

exposure that children have received to tornadoes. The average number of times

the families reported having taken shelter due to threat of tornadoes in the past

year was 1.24 (SD = 1.59, range 0-5). The average estimate by parents for how

Scale Time 1 Time 2 Discussion

often their child was exposed to disaster related media outside the home was 2.26

(SD = 2.99, range 0-10). Parents estimated their children spent 2.53 (SD = .96) Mean (SD) While the small sample size of the current study limits the strength of any

hours watching TV on weekdays and 3.51 (SD = 1.60) hours on Saturday and

conclusions drawn from these data, further research in several areas is indicated.

Behavioral Symptoms Index 50.47 (11.48) 50.09 (11.81)

Sunday. The majority of the sample (66.7%) reported never turning the channel if

The lack of relationship between the majority of vicarious exposure variables and

a television program is interrupted by a weather alert that shows footage of Externalizing Problems 49.40 (10.97) 48.91 (12.75) distress at either assessment period was surprising. Previous research with

tornadoes currently happening. For specific disaster-related programming, most

disaster-exposed populations has found that the child s perceived exposure is more

Internalizing Problems 48.93 ( 9.50) 49.73 (10.02)

parents reported that their children see movies (92.6%), programs on TV

predictive of distress than parent-reported actual exposure (Lack & Sullivan,

(78.6%), and special reports (82.3%) at least several times a year that are related Depression 48.70 (11.00) 49.32 (10.48) 2004). This may also be the case with vicarious exposure, but this was

to natural or man-made disasters.

unfortunately not assessed in this study. Future research could more closely

Anxiety 54.14 (10.12) 51.09 ( 9.14)

Frederick s Reaction Index (RI) examine how much exposure the children feel that they have had over the past

year.

The RI has a range of scores from 0 to 80. The average RI total score at the first

assessment was 22.53 (SD = 12.14), which is in the mild range of PTSS, with

scores ranging from 2 to 56. The average RI total score for the second

The decrease in PTSS from outside to inside of tornado season went against

assessment was 16.18 (SD = 6.85). Table 1 shows the distribution of RI scores

expectations. It should be mentioned, however, that the tornado season in spring

across the degree of distress for both assessments.

2005 was unusually quiet, and that the month of May itself had no tornadoes. This

lack of cues may have contributed to the decrease in distress. More studies

Please address correspondence regarding this poster to: Caleb W. Lack,

examining non-disaster exposed children in disaster prone areas may find this to

Department of Psychology, 215 N. Murray Hall, Stillwater, OK 74078 or to

be a common pattern when the threat of a disaster is lowered for some reason.

*****@*********.***

Presented at the annual meeting of the Association for Behavioral and Cognitive

Therapies, Washington, DC, November 2005

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