Vulnerability factors for disaster-induced child post-traumatic stress disorder: The case for low family resilience and previous mental illness

Abstract

Objective: The aim of the present study was to investigate whether parent report of family resilience predicted children's disaster-induced post-traumatic stress disorder (PTSD) and general emotional symptoms, independent of a broad range of variables including event-related factors, previous child mental illness and social connectedness. Methods: A total of 568 children (mean age=10.2 years, SD=1.3) who attended public primary schools, were screened 3 months after Cyclone Larry devastated the Innisfail region of North Queensland. Measures included parent report on the Family Resilience Measure and Strengths and Difficulties Questionnaire (SDQ)-emotional subscale and child report on the PTSD Reaction Index, measures of event exposure and social connectedness. Results: Sixty-four students (11.3%) were in the severevery severe PTSD category and 53 families (28.6%) scored in the poor family resilience range. A lower family resilience score was associated with child emotional problems on the SDQ and longer duration of previous child mental health difficulties, but not disaster-induced child PTSD or child threat perception on either bivariate analysis, or as a main or moderator variable on multivariate analysis (main effect: adjusted odds ratio (ORadj)=0.57, 95% confidence interval (CI)=0.13-2.44). Similarly, previous mental illness was not a significant predictor of child PTSD in the multivariate model (ORadj=0.75, 95%CI=0.16-3.61). Conclusion: In this post-disaster sample children with existing mental health problems and those of low-resilience families were not at elevated risk of PTSD. The possibility that the aetiological model of disaster-induced child PTSD may differ from usual child and adolescent conceptualizations is discussed. © 2010 The Royal Australian and New Zealand College of Psychiatrists.