Stacy Overstreet

Evaluation of individual and group grief and trauma interventions for children post disaster.

This study evaluated a community-based grief and trauma intervention for children conducted postdisaster. Fifty six children (7 to 12 years old) who reported moderate to severe levels of symptoms of posttraumatic stress were randomly assigned to group or individual treatment. Treatment consisted of a manualized 10-session grief- and trauma-focused intervention and a parent meeting. Measures of disaster-related exposure, posttraumatic stress symptoms, depression, traumatic grief, and distress were administered at preintervention, postintervention, and 3 weeks postintervention. There was a significant decrease in all outcome measures over time, and there were no differences in outcomes between children who participated in group intervention and those who participated in individual intervention. Results suggest that this intervention using either treatment modality may be effective for addressing childhood grief and trauma postdisaster.

Child and Adolescent Mental Health Research in the Context of Hurricane Katrina: An Ecological Needs-Based Perspective and Introduction to the Special Section.

This article introduces the special section on child and adolescent mental health research in the context of Hurricane Katrina. We outline the purpose and intent of the special section and present an integrative perspective based on broad contextual theories of human development with which to think about the impact of disasters like Katrina. The perspective emphasizes multiple levels of influence on mental health and normal development through the impairment of multiple human needs. The perspective helps show the interconnections among the diverse theoretical and methodological paradigms that are utilized to understand the impact of disasters on youth and may help to guide future research.

Relations between recurrent trauma exposure and recent life stress and salivary cortisol among children

The present study evaluated the independent and cumulative effects of recent life stress, previous trauma, and recent trauma exposure on salivary cortisol levels among school-aged children. Sixty-eight children (mean age=10.7 years) reported their exposure to life stressors and traumatic events in the 12 months preceding the study. Children and their caregivers reported frequency of exposure to trauma earlier in life. Exposure to life stress within the past 12 months was related to higher afternoon cortisol levels. Exposure to high levels of recent trauma in combination with frequent exposure to trauma earlier in life was related to both lower morning cortisol levels and higher afternoon cortisol levels. Results suggest that frequency, duration, and severity of exposure to stress and trauma played key roles in the prediction of basal cortisol levels in a community sample of urban youth.

Sociodemographic Risk Factors to Disease Control in Children with Diabetes

This study examined the effects of sociodemographic variables such as ethnicity, socioeconomic status (SES), and family structure on disease control in 58 children with diabetes stratified by ethnicity and SES. Three dependent variables were chosen to evaluate the disease control of the study participants, including HbA1 values averaged over the year prior to study participation, number of hospitalizations, and number of hypoglycaemic blackouts. SES and family structure, but not ethnicity, were the primary risk factors to disease control. Children from low SES families were in poorer glycaemic control (mean HbA1 = 12.6 %) and experienced more episodes of hypoglycaemia‐related loss of consciousness (mean = 0.5 per patient) than did children from middle income families (mean HbA1 = 10.4 %; mean blackouts = 0.1 per patient). In addition, children from middle‐class, two‐parent families were in better metabolic control than all other groups. These results indicate that it may not be ethnicity per se, but other factors that often covary with ethnic status, that may pose a risk to the disease status of children and adolescents with diabetes.

Grief and trauma intervention for children after disaster: Exploring coping skills versus trauma narration

This study evaluated the differential effects of the Grief and Trauma Intervention (GTI) with coping skills and trauma narrative processing (CN) and coping skills only (C). Seventy African American children (6-12 years old) were randomly assigned to GTI-CN or GTI-C. Both treatments consisted of a manualized 11-session intervention and a parent meeting. Measures of trauma exposure, posttraumatic stress symptoms, depression, traumatic grief, global distress, social support, and parent reported behavioral problems were administered at pre, post, 3 and 12 months post intervention. In general, children in both treatment groups demonstrated significant improvements in distress related symptoms and social support, which, with the exception of externalizing symptoms for GTI-C, were maintained up to 12 months post intervention. Results suggest that building coping skills without the structured trauma narrative may be a viable intervention to achieve symptom relief in children experiencing trauma-related distress. However, it may be that highly distressed children experience more symptom relief with coping skills plus narrative processing than with coping skills alone. More research on the differential effects of coping skills and trauma narration on child distress and adaptive functioning outcomes is needed.

Effects of exposure to community violence on school functioning: The mediating role of posttraumatic stress symptoms

This study investigated the association between exposure to community violence (ECV) and school functioning, as well as posttraumatic stress (PTS) symptoms as a potential mediator of the relationship. PTS symptoms are commonly associated with ECV, and are characterized by difficulty regulating emotions and behaviors. Thus, PTS symptomatology may be one mechanism through which community violence impacts school functioning. The community-based sample included 47 low-income African American children (aged 10-13). Results revealed that ECV was inversely related to academic performance and attendance. Symptoms of posttraumatic stress emerged as a mediator of the relation between ECV and academic performance. Results have implications for urban students who face violence in their communities, and emphasize the need for school-based mental health services.

Advances and Future Directions in the Study of Children’s Neurobiological Responses to Trauma and Violence Exposure

One of the most exciting developments to emerge from the field in the past 20 years is the increasing attention to neurobiological responses to violence and trauma exposure. Although researchers have yet to identify a consensual pattern of neurobiological response to violence and trauma exposure, it does appear that some type of alteration in the hypothalamic pituitary adrenal (HPA) axis is likely. This article briefly reviews the multiple moderating factors that help account for the divergent patterns in HPA function as well as methodological advances that will continue to improve the assessment of HPA function in youth exposed to violence and trauma.

A School-Based Assessment of Secondary Stressors and Adolescent Mental Health 18 Months Post-Katrina.

The goals of the current study were to examine the prevalence of secondary stressors related to Hurricane Katrina and to determine their impact on posttraumatic stress disorder (PTSD) symptoms among a sample of high school students. In addition, the moderating role of problem substance use was examined to determine whether it increased the risk of PTSD symptoms in the face of secondary stressors. A total of 271 ethnically and socioeconomically diverse adolescents completed an anonymous survey. Results indicated that problem substance use potentiated the positive relation between secondary stressors and PTSD symptoms, specifically symptoms of re-experiencing. The findings highlight the need for school-based assessment of and interventions for the long-term psychological effects of disasters.

School-based mental health services in post-disaster contexts: A public health framework

Large scale natural disasters pose serious risks to mental health and simultaneously wreak havoc on the very systems called upon to ameliorate those risks. School-based mental health services have been identified as a potential mechanism through which gaps in service delivery systems can be addressed in post-disaster environments. We believe that a public health framework provides a useful guide for school psychologists who may be called upon to develop school-based systems of care following a disaster. In this article we discuss considerations and challenges in the application of this model in the context of our experience developing school-based mental health services in New Orleans, Louisiana, USA, following Hurricane Katrina.

Effects of early rearing conditions on cognitive performance in prepubescent male and female rats

The interactions between a mother and her offspring during early postnatal life impact cognitive development in altricial species. The current study examined the influence of postnatal rearing conditions on subsequent cognitive functioning in male and female Long-Evans rats prior to puberty. Maternal conditions were manipulated by repeated separations of rat pups from their dams on postnatal days 2 though 14. In the early handling condition, pups were removed from mothers briefly for 15min daily, while in the maternal separation condition pups were separated from their mothers for 180min daily. Offspring from handled or separated litters were evaluated prior to puberty between days 25-36 of life on a battery of cognitive tasks that assessed several types of memory. Male rats separated from mothers for 180min were impaired in their non-spatial and spatial memory compared to early-handled males as indicated by their performance on an object recognition task, a Y-maze task, and reference and working memory versions of the water maze task. In contrast, maternally-separated females were not impaired, and in some cases performed better on memory tasks, compared to early-handled females. Results indicate that the biological sex of offspring moderated the effects of maternal conditions on diverse cognitive tasks. Because sex differences were evident prior to puberty, gonadal hormones likely had a limited influence on cognition. Although the bases for sex differences in the cognitive response to rearing conditions are unknown, disparities in maternal attentiveness directed toward male and female offspring may play a role.