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Chapter 3 - Treatment Outcome among Early Adolescents Two Decades Post-Earthquake

Published online by Cambridge University Press:  20 May 2022

By
Armen Goenjian ,
Alan Steinberg  and
Robert Pynoos
Edited by
Armen Goenjian ,
Alan Steinberg  and
Robert Pynoos
Armen Goenjian
Affiliation:
David Geffen School of Medicine; UCLA/Duke University National Center for Child Traumatic Stress
Alan Steinberg
Affiliation:
UCLA/Duke University National Center for Child Traumatic Stress
Robert Pynoos
Affiliation:
UCLA/Duke University National Center for Child Traumatic Stress
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Summary

There is a paucity of long-term treatment outcome studies among children and adolescents after natural disasters. This chapter summarizes findings from three long-term studies among severely traumatized early adolescents after the 1988 Spitak earthquake in Armenia, including a twenty-five-year follow-up that represents the most extended prospective treatment outcome study to date after a disaster. School-based trauma-grief-focused psychotherapy was provided at 1.5 years post-earthquake. The intervention addressed trauma and loss experiences due to the earthquake; post-trauma distress reactions, including PTSD and grief; current problems and adversities; trauma and loss reminders, interpersonal conflicts, and developmental progression. The findings showed significant long-term benefits of treatment in reducing PTSD and depressive symptoms. We also present findings regarding differences in recovery trajectories among treated and not treated subjects and risk and protective factors associated with PTSD and depression. Despite the improvements, a sub-group of the students continued to experience earthquake-related chronic PTSD and depressive symptoms at twenty-five-year follow-up, indicating the need for ongoing surveillance of severely traumatized survivors. The findings underscore the benefit of post-disaster therapeutic intervention, social support by family members and friends, and the need for assistance by governmental and non-governmental agencies to mitigate post-disaster adversities that contributed significantly to the chronicity of symptoms.

Keywords

traumaadolescentstreatment outcomecourse of PTSDdepressionlongitudinal studiesSpitak earthquakerisk and protective factors
Type
Chapter
Information
Lessons Learned in Disaster Mental Health
The Earthquake in Armenia and Beyond
 , pp. 18 - 47
Publisher: Cambridge University Press
Print publication year: 2022

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References

Asarnow, J. R., & Carlson, G. A. (1985). Depression self-rating scale: Utility with child psychiatric inpatients. Journal of Consulting and Clinical Psychology, 53(4), 491–499. https://doi.org/10.1037/0022-006X.53.4.491.CrossRefGoogle ScholarPubMed
Başoğlu, M., Salcioğlu, E., & Livanou, M. (2002).Traumatic stress responses in earthquake survivors in Turkey. Journal of Traumatic Stress, 15(4), 269–276. https://doi.org/10.1023/A:1016241826589.CrossRefGoogle ScholarPubMed
Başoğlu, M., Salcioglu, E., & Livanou, M. (2007). A randomized controlled study of single-session behavioural treatment of earthquake-related posttraumatic stress disorder using an earthquake simulator. Psychological Medicine, 37, 203–213.Google Scholar
Berkowitz, S. Bryant, R. Brymer, M. Hamblen, J. Jacobs, A. Layne, C., & Watson, P. (2010). The National Center for PTSD & the National Child Traumatic Stress Network. Skills for psychological recovery: Field operations guide. Retrieved from http://www.ptsd.va.gov/professional/manuals/manual-pdf/SPR_Manual.pdf [last accessed July 15, 2021].Google Scholar
Bourque, L. B, & Russell, L. A. (1993). Experiences during and response to the Loma Prieta earthquake. Report to the Governor’s Office of Emergency Services, State of California.Google Scholar
Bradley, R., Greene, J., Russ, E., Dutra., L. , & Western, D. (2005). A multidimensional meta-analysis of psychotherapy for PTSD. American Journal of Psychiatry, 162, 214–227. https://doi.org/10.1176/appi.ajp.162.2.214.Google Scholar
Brymer, M., Jacobs, A., Layne, C., Pynoos, R., Ruzek, J., Steinberg, A. … Watson, P. (2006). Psychological first aid: field operations guide. National Child Traumatic Stress Network, National Center for PTSD. Retrieved from: www.nctsn.org/resources/psychological-first-aid-pfa-field-operations-guide-2nd-editionGoogle Scholar
Chemtob, C. M., Nakashima, J. P., & Hamada, R. S. (2002). Psychosocial intervention for post-disaster trauma symptoms in elementary school children. Archives of Pediatrics & Adolescent Medicine, 156(3), 211. https://doi.org/10.1001/archpedi.156.3.211.CrossRefGoogle Scholar
De Haan, A. M., Boon, A. E., de Jong, J. T., Hoeve, M., & Vermeiren, R. R. (2013). A metaanalytic review on treatment dropout in child and adolescent outpatient mental health care. Clinical Psychology Review, 33(5), 698–711.CrossRefGoogle ScholarPubMed
Demirchyan, A., Petrosyan, V., Thompson, M. F. (2011). Psychometric value of the Center for Epidemiologic Studies Depression (CES-D) scale for screening of depressive symptoms in Armenian population. Journal of Affective Disorders, 133, 489–498.CrossRefGoogle Scholar
Dogan, A. (2011). Adolescents’ posttraumatic stress reactions and behavior problems following Marmara earthquake. European Journal of Psychotraumatology, 2, 10.3402/ejpt.v2i0.5825. https://doi.org/10.3402/ejpt.v2i0.5825.Google Scholar
Durkin, D. (1993). Teaching Them to Read (6th ed.). Boston: Allyn & Bacon.Google Scholar
Durkin, M. S., Khan, N., Davidson, L. L., Zaman, S. S., & Stein, Z. A. (1993). The effects of a natural disaster on child behavior: evidence for posttraumatic stress. American Journal of Public Health, 83(11), 1549–1553. https://doi.org/10.2105/ajph.83.11.1549.CrossRefGoogle ScholarPubMed
Foa, E. B., Keane, T., Friedman, M., & Cohen, J. (2010). Effective Treatments for PTSD. Practice Guidelines from the International Society for Traumatic Stress Studies. New York: Guilford Press.Google Scholar
Foa, E. B., Steketee, G., Olasov, B. (1989). Behavioral/cognitive conceptualizations of posttraumatic stress disorder. Behavior Therapy, 20, 155–176.CrossRefGoogle Scholar
Giannopoulou, I., Dikaiakou, A., & Yule, W. (2006). Cognitive-behavioural group intervention for PTSD symptoms in children following the Athens 1999 earthquake: a pilot study. Clinical Child Psychology and Psychiatry, 11, 543–553.Google Scholar
Goenjian, A. K., Najarian, L. M., Pynoos, R. S., Steinberg, A. M., Petrosian, P., Setrakyan, S., & Fairbanks, L. A. (1994). Posttraumatic stress reactions after single and double trauma. Acta Psychiatrica Scandinavica, 90, 214–221. https://doi:10.1111/j.1600-0447.1994.tb01580.x.Google Scholar
Goenjian, A. K., Pynoos, R. S., Steinberg, A. M., Najarian, L. M., Asarnow, J. R., Karayan, I., … Fairbanks, L. A. (1995). Psychiatric comorbidity in children after the 1988 earthquake in Armenia. Journal of the American Academy of Child and Adolescent Psychiatry, 34(9), 1174–1184. https://doi.org/10.1097/00004583-199509000-00015.CrossRefGoogle ScholarPubMed
Goenjian, A. K., Karayan, I., Pynoos, R. S., Minassian, D., Najarian, L. M., Steinberg, A. M., & Fairbanks, L. A. (1997). Outcome of psychotherapy among early adolescents after trauma. The American Journal of Psychiatry, 154(4), 536–542. https://doi.org/10.1176/ajp.154.4.536.Google Scholar
Goenjian, A. K., Walling, D., Steinberg, A. M., Karayan, I., Najarian, L. M., & Pynoos, R. (2005). A prospective study of posttraumatic stress and depressive reactions among treated and untreated adolescents 5 years after a catastrophic disaster. American Journal of Psychiatry, 162(12), 2302–2308. https://doi.org/10.1176/appi.ajp.162.12.2302.CrossRefGoogle ScholarPubMed
Goenjian, A. K., Khachadourian, V., Armenian, H., Demirchyan, A., & Steinberg, A. M. (2018). Posttraumatic stress disorder 23 years after the 1988 Spitak earthquake in Armenia. Journal of Traumatic Stress, 31, 47–56. https://doi:10.1002/jts.22260.Google Scholar
Goenjian, A. K., Steinberg, A. M., Walling, D., Bishop, S., Karayan, I., & Pynoos, R. (2020). 25-year follow-up of treated and not-treated adolescents after the Spitak earthquake: course and predictors of PTSD and depression. Psychological Medicine, 1–13. Advance online publication. https://doi.org/10.1017/S0033291719003891.Google Scholar
Gutermann, J., Schreiber, F., Matulis, S., Schwartzkopff, L., Deppe, J., & Steil, R. (2016). Psychological treatments for symptoms of posttraumatic stress disorder in children, adolescents, and young adults: a meta-analysis. Clinical Child and Family Psychology Review, 19, 77–93.CrossRefGoogle Scholar
Herjanic, B., Reich, W. (1982). Development of a structured psychiatric interview for children: agreement between child and parent on individual symptoms. Journal of Abnormal Child Psychology, 10, 307–324.Google Scholar
Imel, Z. E., Laska, K., Jakupcak, M., & Simpson, T. L. 2013. A meta-analysis of dropouts during treatment for posttraumatic stress disorder. Journal of Consulting and Clinical Psychology, 81, 394–404. https://doi:10.1037/a0031474.Google Scholar
John, P. B., Russell, S., & Russell, P. S. (2007). The prevalence of posttraumatic stress disorder among children and adolescents affected by tsunami disaster in Tamil Nadu. Disaster Management & Response, 5(1), 3–7. https://doi.org/10.1016/j.dmr.2006.11.001.Google Scholar
Kar, N. (2009). Psychological impact of disasters on children: review of assessment and interventions. World Journal of Pediatrics, 5(1), 5–11. https://doi.org/10.1007/s12519-009-0001-x.Google Scholar
Lyons, J. A., & Keans, T. M. (1989). Implosive therapy in the treatment of combat-related PTSD. Journal of Traumatic Stress, 2, 137–152.Google Scholar
March, J. S., Amaya-Jackson, L., Murray, M. C., & Schulte, A. (1998). Cognitive-behavioral psychotherapy for children and adolescents with posttraumatic stress disorder after a single-incident stressor. Journal of American Academy of Child and Adolescent Psychiatry, 37(6), 585–593.CrossRefGoogle ScholarPubMed
McDermott, B., Berry, H., & Cobham, V. (2012). Social connectedness: a potential aetiological factor in the development of child post-traumatic stress disorder. Australian and New Zealand Journal of Psychiatry, 46, 109–117.Google Scholar
McDonald, S. D., & Calhoun, P. S. (2010). The diagnostic accuracy of the PTSD checklist: a critical review. Clinical Psychology Review, 30(8), 976–987. https://doi.org/10.1016/j.cpr.2010.06.012.Google Scholar
Norris, F. H., & Bellamy, N. D. (2009). Evaluation of a national effort to reach Hurricane Katrina survivors and evacuees: The Crisis Counseling Assistance and Training Program. Administration and Policy in Mental Health and Mental Health Services Research, 36(3), 165–175. https://doi.org/10.1007/s10488-009-0217zCrossRefGoogle ScholarPubMed
National Institute for Clinical Excellence (NICE) (2018). Post-traumatic stress disorder NICE guidelines (update): guideline consultation. London: NICE. Available at: www.nice.org.uk/guidance/NG116. Published December 5, 2018.Google Scholar
Ofonedu, M. E., Belcher, H. E., Budhathoki, C., & Gross, D. A. (2017). Understanding barriers to initial treatment engagement among underserved families seeking mental health services. Journal of Child and Family Studies, 26(3), 863–876.CrossRefGoogle ScholarPubMed
Pfefferbaum, B., Shaw, J. A., & the American Academy of Child and Adolescent Psychiatry Committee on Quality issues. (2013). Practice parameters on disaster preparedness. Journal of the American Academy of Child and Adolescent Psychiatry, 52(11), 1224–1238.Google Scholar
Pfefferbaum, B., Nitie, P., Tucker, P., & Newman, E. (2017). Early child disaster mental health interventions: a review of the empirical evidence. Child & Youth Care Forum, 46, 621–642. https://doi.org/10.1007/s10566-017-9397-y.Google Scholar
Pityaratstian, N., Piyasil, V., Ketumarn, P., Sitdhiraksa, N., Ularntinon, S., & Pariwatcharakul, P. (2015). Randomized controlled trial of group cognitive behavioral therapy for posttraumatic stress disorder in children and adolescents exposed to tsunami in Thailand. Behavioral and Cognitive Psychotherapy, 43, 549–561.Google Scholar
Pynoos, R. S., & Nader, K. (1988). Psychological first aid and treatment approach to children exposed to community violence: research implications. Journal of Traumatic Stress, 1, 445–473.CrossRefGoogle Scholar
Pynoos, R. S., Goenjian, A., Tashjian, M., Karakashian, M., Manjikian, R., Manoukian, R., … Rairbanks, L. A. (1993). Posttraumatic stress reactions in children after the 1988 Armenian earthquake. British Journal of Psychiatry, 163, 239–247.Google Scholar
Raphael, B. (1986). When Disaster Strikes: How Individuals and Communities Cope with Catastrophe. New York: Basic Books.Google Scholar
Saigh, P. A. (1987). In vitro flooding of an adolescent’s posttraumatic stress disorder. Journal of Clinical Child Psychology, 16, 147–150.Google Scholar
Sharma, A., & Kar, N. (2019). Posttraumatic stress, depression, and coping following the 2015 Nepal Earthquake: a study on adolescents. Disaster Medicine and Public Health Preparedness, 13(2), 236–242. https://doi.org/10.1017/dmp.2018.37CrossRefGoogle Scholar
Steenkamp, M. M., Litz, B. T., Hoge, C. W., & Marmar, C. R. (2015). Psychotherapy for military-related PTSD: a review of randomized clinical trials. Journal of the American Medical Association 314(5), 489–500. https://doi.org/10.1001/jama.2015.8370.Google Scholar
Steinberg, A. M., Brymer, M. J., Decker, K. B., Pynoos, R. S. (2004). The University of California at Los Angeles Posttraumatic Stress Disorder Reaction Index. Current Psychiatry Reports, 6, 96–100.CrossRefGoogle Scholar
Van Dis, E. A. M, van Veen, S. C., Hagenaars, M. A., Batelaan, N. M., Bockting, C. L. H., van den Heuvel, R. M. … Engelhard, I. M. (2020). Long-term outcomes of cognitive behavioral therapy for anxiety-related disorders: a systematic review and meta-analysis. Journal of the American Medical Association of Psychiatry, 77(3), 265–273. https://doi.org/10.1001/jamapsychiatry.2019.3986.Google Scholar
Vilagut, G., Forero, C. G., Barbaglia, G., & Alonso, J. (2016). Screening for depression in the general population with the Center for Epidemiologic Studies Depression (CES-D): a systematic review with meta-analysis. PLoS One, 11(5), e0155431. https://doi.org/10.1371/journal.pone.0155431.Google Scholar
Watson, P. J., Brymer, M. J., & Bonanno, G. A. (2011). Postdisaster psychological intervention since 9/11. American Psychologist, 66(6), 482–494. https://doi.org/10.1037/a0024806.Google Scholar
Watts, B. V., Schnurr, P. P., Mayo, L., Young-Xu, Y., Weeks, W. B., & Friedman, M. J. (2013). Meta-analysis of the efficacy of treatments for posttraumatic stress disorder. Journal of Clinical Psychiatry, 74(6): e541-550. https://doi.org/10.4088/JCP.12r08225.Google Scholar
Yasinskia, C., Hayesa, A. M., Alperta, E., McCauley, T., Ready, C. B., Webb, C., & Deblinger, E. (2018). Treatment processes and demographic variables as predictors of dropout from trauma-focused cognitive behavioral therapy (TF-CBT) for youth. Journal of Behavioral Research and Therapy, 107, 10–18.Google Scholar
Zhou, X., Wu, X., Zhen, R. (2018). Patterns of posttraumatic stress disorder and posttraumatic growth among adolescents after the Wenchuan Earthquake in China: a latent profile analysis. Journal of Traumatic Stress, 31, 57–63.CrossRefGoogle Scholar
Zhou, X., Teng, T., Zhang, Y., Del Giovane, C. D., Furukawa, T. A., Weisz, J. R., … Peng Xie, M. D. (2020). Comparative efficacy and acceptability of antidepressants, psychotherapies, and their combination for acute treatment of children and adolescents with depressive disorder: a systematic review and network meta-analysis. Lancet Psychiatry, 7, 581–601.Google Scholar

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