Theory predicts and empirical data confirm that adults suffer disaster stress and disturbing mental and physical symptoms subsequent to a disaster, and that self-efficacy, coping, and support enhance recovery. (1-5) Little is known about the disaster stress recovery trajectory of adolescents, although it is acknowledged that adolescence is an inherently stressful developmental stage because of undeveloped coping mechanisms and self-efficacy. (40-43) A reasonable proposition is that adolescent's, just as adults, are also vulnerable to disaster stress and that self-efficacy, coping, and support would enhance their recovery. Therefore, the two goals of this field/intervention trial are: 1) to measure the longterm mental and physical health effects of Hurricane Hugo in a sample of adolescents and 2) to test the efficacy of an intervention designed to decrease the negative consequences of disaster stress by increasing self-efficacy, coping, and support. Six groups of South Carolina high school students (n = 1372) will comprise the sample; four of the groups experienced serious effects of Hurricane Hugo and two did not. Physical and mental health will be assessed at baseline and on five subsequent occasions over a two-and-a- half year period. The intervention groups will receive the Adolescent Disaster Stress (ADS) intervention (a group protocol shown to be effective in decreasing stress and increasing coping skills in non-disaster adolescent populations) each year (three sessions per year) over the study period. Mental health will be assessed by repeated measures of symptoms of global mental distress, depression, anger, anxiety, somatization, post- traumatic stress, and other select variables. Physical health will be assessed through repeated paper-and-pencil measures, nursing assessments, vital signs, weight, and other select variables. The structural parameters for instituting the intervention parallel that previously used with a large sample of adult victims experiencing severe and chronic stress from catastrophic illness. The group intervention approach enhances the cost- effectiveness of the intervention. Primary Hypotheses are that: 1) adolescents who have experienced a disaster and receive the ADS intervention will have fewer symptoms of anxiety, depression, anger, global mental distress, somatization, post-traumatic stress, and increase physical health than adolescents who have experienced a disaster and receive no intervention; 2) adolescents who have experienced a disaster and receive the intervention will report higher self-efficacy, coping, and support than adolescents who have experienced a disaster and do not receive the intervention; and 3) adolescents who have experienced a disaster will have more symptoms of anxiety, depression, anger, global mental distress, somatization, post-traumatic stress, and decreased physical health than adolescents who have not experienced a disaster.
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| Hardin, Sally Brosz; Weinrich, Sally; Weinrich, Martin et al. (2002) Effects of a long-term psychosocial nursing intervention on adolescents exposed to catastrophic stress. Issues Ment Health Nurs 23:537-51 |
| Weinrich, S; Weinrich, M; Hardin, S et al. (2000) Effects of psychological distress on blood pressure in adolescents. Holist Nurs Pract 15:57-65 |
| Cheever, K H; Hardin, S B (1999) Effects of traumatic events, social support, and self-efficacy on adolescents' self-health assessments. West J Nurs Res 21:673-84 |
| Grant, S M; Hardin, S B; Pesut, D J et al. (1997) Psychological evaluations, referrals, and follow-up of adolescents after their exposure to Hurricane Hugo. J Child Adolesc Psychiatr Nurs 10:7-16 |
| Hardin, S B; Weinrich, M; Weinrich, S et al. (1994) Psychological distress of adolescents exposed to Hurricane Hugo. J Trauma Stress 7:427-40 |
| Garrison, C Z; Weinrich, M W; Hardin, S B et al. (1993) Post-traumatic stress disorder in adolescents after a hurricane. Am J Epidemiol 138:522-30 |
| Hardin, S B; Carbaugh, L; Weinrich, S et al. (1992) Stressors and coping in adolescents exposed to Hurricane Hugo. Issues Ment Health Nurs 13:191-205 |
| Grubbs, S; Hardin, S B; Weinrich, S et al. (1992) Self-efficacy in normal adolescents. Issues Ment Health Nurs 13:121-8 |
| Stewart, J B; Hardin, S B; Weinrich, S et al. (1992) Group protocol to mitigate disaster stress and enhance social support in adolescents exposed to Hurricane Hugo. Issues Ment Health Nurs 13:105-19 |
