NDLI: Psychosocial Intervention for Postdisaster Trauma Symptoms in Elementary School Children: A Controlled Community Field Study

Content Provider	JAMA Network
Author	Chemtob, Claude M. Nakashima, Joanne P. Hamada, Roger S.
Copyright Year	2002
Abstract	Context: Natural disasters negatively affect children's emotional and behavioral adjustment. Although treatments to reduce psychological morbidity following disasters are needed, it has been difficult to conduct treatment research in postdisaster environments because of the sensitivity of victims to perceived intrusiveness and exploitation. Objective: To evaluate the efficacy of a public health–inspired intervention combining school-based screening and psychosocial treatment to identify and treat children with persistent disaster-related trauma symptoms. Design: To identify children with continued high levels of trauma-related symptoms 2 years after a major disaster, we conducted a community-wide school-based screening of disaster-exposed public elementary school children. Children with the highest levels of trauma-related symptoms were randomly assigned to 1 of 3 consecutively treated cohorts. Children in the cohorts awaiting treatment served as wait-list controls. Within each cohort, children were randomly assigned to either individual or group treatment to allow comparison of the efficacy of the 2 treatment modalities. Setting: All 10 public elementary schools on the island of Kauai (one of the Hawaiian Islands) 2 years after Hurricane Iniki. Participants: All 4258 children in second through sixth grade were screened. The 248 children with the highest levels of psychological trauma symptoms were selected for treatment. Intervention: Children were randomly assigned to either individual or group treatment provided by specially trained school-based counselors. Treatment comprised 4 sessions. Main Outcome Measures: The Kauai Reaction Inventory, a self-report measure of trauma symptoms, and the Child Reaction Inventory, a semistructured clinical interview for posttraumatic stress disorder symptoms. Results: After treatment, children reported significant reductions in self-reported trauma-related symptoms. This symptom reduction was maintained at the 1-year follow-up. Clinical interviews also indicated that treated children had fewer trauma symptoms compared with untreated children. Conclusions: School-based community-wide screening followed by psychosocial intervention seems to effectively identify and reduce children's disaster-related trauma symptoms and may facilitate psychological recovery. While group and individual treatments did not differ in efficacy, fewer children dropped out of the group treatment. This approach may be applicable to screening and treating children exposed to a variety of large-scale disasters.
Ending Page	216
Starting Page	211
Page Count	6
File Format	PDF HTM / HTML
ISSN	10724710
DOI	10.1001/archpedi.156.3.211
Issue Number	3
Journal	Archives of Pediatrics & Adolescent Medicine
Volume Number	156
Language	English
Publisher	American Medical Association
Publisher Date	2002-03-01
Access Restriction	Open
Subject Keyword	wounds and injuries screening follow-up elementary schools post-traumatic stress disorder disasters psychosocial intervention
Content Type	Text
Resource Type	Article
Subject	Pediatrics, Perinatology and Child Health

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1	Ministry of Education (GoI), Department of Higher Education	Sanctioning Authority	https://www.education.gov.in/ict-initiatives
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