Proposed is a cross-sectional survey to estimate the prevalence and correlates for symptoms of PTSD among children (less than 18) living in the New York City (NYC) six months following the events of 9/11, and how these estimates relate to psychological status of parents from whom data on children are ascertained. Specifically, we propose to add an interviewer- administered module about children to an already proposed (NIMH RAPID - PI: D.Vlahov) random-digit dial survey of adults. The adult study proposes to interview 2,670 adults 18 years or older 6 months after the disaster, who live in one of four zones (defined as concentric areas spreading out from lower Manhattan) in NYC and surrounding communities., and includes data on demographics, proximity to disaster, degree affected, scales on PTSD, major depressive disorder, substance use and other factors. A pilot of this effort has been completed. In this RAPID application, the adults surveyed (selected through random digit dialing with systematic over-sampling of areas closest to the WTC complex) who are also parents will be asked to respond to questions about an index child (less than 18) who lives in the household selected at random. Based on census estimates of the number of households with a child under age 18, this approach will yield parental responses for approximately 800 children; a sample size adequate to address the primary aims of this proposal. The instrument, also in English and Spanish, will ask about child's symptomotology (e.g., PTSD), child PTSD and the child's disaster event experiences and other enduring stressors including: proximity of school to WTC, location of home in relation to WTC, acute emotional and physical reaction, early media exposure, knowing relatives or friends directly affected, knowing others affected by the disaster, loss of parental employment, loss of resources/shelter, resettlement, changing and closing of schools. Also we will measure and assess parent's symptomology and experiences. Analysis will involve multivariable model building to distinguish symptomotology of children by status of the parents. These data extend the previous literature on effects of children in disasters, and have salience in that the impetus for children to access mental health care services is frequently an assessment made by a parent of their child. These data provide the basis for a separate R01 to establish a cohort of parents/children to be able to identify prognostic indicators for development of psychological effects of disaster and response to treatment.
| Fairbrother, Gerry; Stuber, Jennifer; Galea, Sandro et al. (2004) Unmet need for counseling services by children in New York City after the September 11th attacks on the World Trade Center: implications for pediatricians. Pediatrics 113:1367-74 |
| Fairbrother, Gerry; Stuber, Jennifer; Galea, Sandro et al. (2003) Posttraumatic stress reactions in new York City children after the September 11, 2001, terrorist attacks. Ambul Pediatr 3:304-11 |
