Pinsker: What did you find when you followed families affected by Hurricanes Katrina and Rita?
Self-Brown: I think the most innovative finding that we have is from a paper that we published along with Dr. Betty Lai, who is now at Boston College, looking at something that hadn’t been studied a lot, which is, what are the different long-term psychological trajectories for young people who have lived through a storm, and do those change over time? The paper included 426 youth, and we followed them across four time points after those two storms.
We essentially found three trajectories that youth tended to cluster in related to post-traumatic stress. About 71 percent of youth, the majority of them, were resilient, meaning that they didn’t have any stress symptoms, and they just stayed there for the two-year period. And then about a quarter of the youth were in what we called a “recovering trajectory,” so they initially met the criteria for PTSD—but over time, as you would expect, they just kind of got better.
However, the third group, which was about 4 percent of the sample, we classified as a chronic group. And those youth had PTSD immediately following the storm, and it stayed at that high level for about a two-year period. Our last follow-up time point was two years post-disaster, so we’re not certain about after that.
When I say PTSD criteria, I’m referring to the clinical symptoms you would need for a PTSD diagnosis. PTSD is a stress reaction to an event where you had extreme stress and either felt very threatened or vulnerable, or thought that you might die. And some of the hallmark symptoms are hyperarousal (a youth might have a really hard time paying attention or being calm) and reexperiencing (maybe the youth, when a slight rainstorm comes, for instance, after the hurricane, that might cause them much more stress than a typical rainstorm should).
Pinsker: Were there any things that made children more likely to fall into one group or another?
Self-Brown: One is that, as you’d expect, youth who had the most significant exposure to the hurricane were more likely to be in that chronic category than others. But also, youth who had been exposed to more violence in their communities had increased risk too—it’s often not only the experience of the disaster itself, but it could be other types of trauma that play into that poor long-term outcome. But on the positive side, we found that youth who really found a strong peer group and received good social support from them—that was a protective factor.
Pinsker: So if you were trying to help kids cope with natural disasters, how might you try to help them with their social-support systems?
Self-Brown: That’s a great question, and I think that’s something that people are still really working on. Because there’s so much displacement and disjointedness after hurricanes, there may be a loss of a peer group, because you may be starting in a new school and living in a new community. So how do you develop really strong peer relationships in a new area? I think that’s what we know the least about. What is a little more straightforward is that when communities are able to stay together, you can put programs in schools that help youth share their experiences, perhaps tell stories, and that open up a dialogue about what happened.