Youth Aggression and Peer Victimization as Predictors of Adolescent Alcohol and Marijuana Use: A Longitudinal Analysis of Youth with Aggressive Behavior Problems.

Youth who are behaviorally aggressive and victimized by their peers comprise a significant population with specific risks and vulnerabilities relative to substance use. The goals of the current study were to examine the roles that youth aggression and peer victimization play in determining the timing of alcohol and marijuana use initiation and the frequency of use 5-years later in a sample of at-risk, aggressive youth. 360 youth (Mage= 10.17 years; 65% boys, 35% girls; 78.1% African American, 20.3% Caucasian, 1.4% Hispanic, and 0.3% other) recruited for a prevention program for at-risk youth were followed for 5 years (4th - 9th grade). Cox PH regressions were conducted to predict timing of alcohol and marijuana use initiation. Zero-inflated negative binomial regressions were used to predict frequency of alcohol and marijuana use 5 years later. Results showed that peer victimization inferred decreased risk of alcohol use initiation. However, this effect was only observed for youth with relatively moderate, and low levels of aggression. Findings suggest that differences in youth aggression and victimization interact to predict distinct outcomes, suggesting the need for a more comprehensive approach when working with aggressive youth who have experienced peer victimization.

A Prospective Study of Co-Rumination in Parent-Adolescent Conversations Several Years After a Devastating Tornado.

OBJECTIVE: This study examined the association between youth post-disaster stress responses and co-rumination in conversations with a parent several years after a devastating tornado. METHOD: Adolescents (N = 200) drawn from an ongoing study for aggressive youth (ages 13 to 17; 80% African American) and their parents experienced an EF-4 tornado in 2011 and then provided joint recollections about their tornado experiences approximately 5 years later. Recollections were coded for the four components of co-rumination: rehashing problems, dwelling on negative affect, mutual encouragement of problem talk, and speculating about problems. Parent-rated post-traumatic stress symptoms (PTSS) and youth resting respiratory sinus arrhythmia (RSA) were measured approximately 6-months and 1-year post-tornado, respectively. RESULTS: Results indicated that co-rumination could be identified, and reliably measured, in the tornado conversations. Resting RSA moderated the association between post-disaster PTSS and the co-rumination component dwelling on negative affect, such that youth PTSS was associated with higher levels of dwelling on negative affect but only at lower levels of resting RSA (an index of physiological dysregulation). There was no association between youth PTSS and dwelling on negative affect at high resting RSA (an index of better physiological regulation). Youth PTSS and resting RSA were unrelated to the other three co-rumination components. No gender differences were found. CONCLUSIONS: Results provide preliminary evidence establishing the co-rumination coding scheme in a sample of disaster-exposed parents and adolescents. Results also indicated that PTSS and resting RSA are important youth-level factors that relate to how parents and adolescents discuss their disaster experiences even years post-exposure.

Disaster Exposure and Temperament as Predictors of Adolescent Substance Use.

OBJECTIVE: Children who have been exposed to a natural disaster in their lifetime comprise a significant population with specific risks and vulnerabilities, particularly for at-risk youth. The goal of the current study was to examine the role that severity of disaster exposure plays in determining the timing of alcohol and marijuana use initiation and the frequency of use four years later in a sample of at-risk, aggressive youth exposed to a devastating tornado. Of further interest was the examination of the moderating effect of temperamental fear and inhibitory control. METHOD: Three hundred and forty-six youth (Mage = 11.33; 65% boys; 77.5% African-Americans, 18.3% Caucasian, 1.7% Hispanic) initially recruited for a prevention program for at-risk youth were followed for 4 years after a tornado. Cox PH regressions were conducted to predict timing of alcohol and marijuana use initiation. Zero-inflated negative binomial regressions were used to predict frequency of alcohol and marijuana use 4 years after the tornado. RESULTS: Disaster exposure severity was predictive of frequency of marijuana use four years after the tornado, but exposure alone was not predictive of initiation. Exposure severity predicted increases in risk for alcohol use initiation only for youth high in fear. Additionally, greater levels of inhibitory control protected youth from earlier alcohol use initiation. CONCLUSIONS: Findings highlight a need to research the initiation and frequency of use for substances individually, while also assessing the needs of youth exposed to natural disasters with both their degree of disaster exposure and specific temperamental characteristics in mind.

Functions of Aggression and Peer Likeability in Elementary School Children Across Time.

We examined associations between proactive and reactive aggression and peer likability across two academic years. Analyses were based on a sample of 442 elementary school children. Proactive and reactive aggression were assessed through self-report and peer likability was assessed via a peer nomination inventory. Data were collected in the fall and spring of two academic years. Findings from cross-lagged multiple group longitudinal panel models where pathways were freely estimated for boys and girls provided evidence that the relation between reactive aggression and reciprocated liking and received only liking nominations was negative and transactional for girls. Proactive aggression had mixed associations with likability between boys and girls. Our findings suggest that preventative interventions that focus on reducing reactive aggression or increasing peer likability have the potential to shift children away from trajectories of long-term maladjustment.

The Use of Psychological First Aid in Children Exposed to Mass Trauma.

PURPOSE OF REVIEW: Psychological first aid (PFA) has been widely disseminated and promoted as an intervention to support short-term coping and long-term functioning after disasters. Despite its popularity, earlier reviews cite a startling lack of empirical outcome studies. The current review explores recent studies of PFA, especially pertaining to its use with children. RECENT FINDINGS: Initial studies of PFA show that it is well received by youth, families, and providers as well as being linked to decreases in depressive and posttraumatic stress symptoms, improved self-efficacy, increased knowledge about disaster preparedness and recovery, and enhanced feelings of safety and connection. The flexibility of the modular style of PFA and cultural adaptations emerged as significant themes. Although the studies reviewed cast a favorable light on PFA, more research is needed regarding its use and outcomes. This review describes the challenges to conducting these studies as well as suggestions for paths forward.

Co-reminiscing with a caregiver about a devastating tornado: Association with adolescent anxiety symptoms.

This study explores the association between caregivers' style of co-reminiscing with their adolescents about an EF4 tornado and youth anxiety symptoms several years following the disaster. Caregiver reward of their children's emotional expression, defined as attending to and validating emotionally salient content, is generally associated with adaptive youth psychosocial outcomes. However, caregiver reward of youth recollections that are centered around the youth's negative emotional expression could be an indicator that both caregivers and adolescents are engaged in co-rumination regarding negative emotional experiences. This process may contribute to relatively higher levels of anxiety over time. Adolescents (N = 169) drawn from an ongoing study for aggressive youth (ages 12 to 17; 82% African American) provided individual recollections about their experiences during a devastating tornado 4 to 5 years following the disaster. Caregivers and youth then co-reminisced about their tornado-related experiences. Individual youth recollections were coded for negative personal impact and use of negative emotion words; caregiver-adolescent conversations were coded for caregiver reward of negative emotional expression. Youth who noted more negative personal impacts and used more negative emotion words were higher in parent-rated youth anxiety, and these associations were moderated by caregiver reward of negative emotional expression. The associations between youth recollection qualities and anxiety emerged only when caregivers exhibited high levels of reward of negative emotional expression. These patterns were generally stronger for girls compared to boys. Findings suggest that excessively discussing and rehashing negative experiences, especially several years after the disaster, may be a risk factor for anxiety among disaster-exposed adolescents. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Caregiver-adolescent co-reminiscing and adolescents' individual recollections of a devastating tornado: Associations with enduring posttraumatic stress symptoms.

Although disaster-related posttraumatic stress symptoms (PTSS) typically decrease in intensity over time, some youth continue to report elevated levels of PTSS many years after the disaster. The current study examines two processes that may help to explain the link between disaster exposure and enduring PTSS: caregiver emotion socialization and youth recollection qualities. One hundred and twenty-two youth (ages 12 to 17) and their female caregivers who experienced an EF-4 tornado co-reminisced about the event, and adolescents provided independent recollections between 3 and 4 years after the tornado. Adolescent individual transcripts were coded for coherence and negative personal impact, qualities that have been found to contribute to meaning making. Parent-adolescent conversations were coded for caregiver egocentrism, a construct derived from the emotion socialization literature to reflect the extent to which the caregiver centered the conversation on her own emotions and experiences. Egocentrism predicted higher youth PTSS, and this association was mediated by the coherence of adolescents' narratives. The association between coherence and PTSS was stronger for youth who focused more on the negative personal impacts of the tornado event during their recollections. Results suggest that enduring tornado-related PTSS may be influenced in part by the interplay of caregiver emotion socialization practices and youth recollection qualities.

Trajectories of tornado-related posttraumatic stress symptoms and pre-exposure predictors in a sample of at-risk youth.

OBJECTIVE: The current study examined how severity of disaster exposure and predisaster individual and family characteristics predicted trajectories of disaster-related posttraumatic stress symptoms (PTSS) in children over 4 years following a devastating EF-4 tornado. METHOD: Participants (n = 346; 65% male; 77.5% African American) were 4th-6th-graders and their caregivers, from predominantly low-income households, who were already participating in a longitudinal study of indicated prevention effects for externalizing outcomes when the tornado occurred in 2011. Latent class trajectory analyses were used to identify disaster-related PTSS trajectory groups across the 4-year postdisaster period. RESULTS: Three groups were identified: (1) a group that declined (recovery) in PTSS over time (15.90%); (2) a group that was stable and low in PTSS over time (76.87%); and (3) a group that was stable and high (chronic) in PTSS over time (7.23%). Multinomial logistic regression analyses revealed that greater tornado exposure predicted membership in the declining trajectory group relative to the low-stable group. Positive parenting and pretornado caregiver trauma exposure also moderated how disaster exposure, particularly perceived life threat, predicted PTSS trajectories. CONCLUSIONS: Some youth reported elevated disaster-related PTSS repeatedly for 4 years following a devastating tornado. Consistent with the concept of equifinality, results suggest that there are several pre-exposure risk factors that may increase risk for a chronic PTSS trajectory following disaster exposure. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Recalling a Devastating Tornado: Qualities of Child Recollections and Associations with Mental Health Symptoms.

Trauma recollections often contain trauma-related cognitive and emotional processing. Research examining indicators of such processing in children's trauma recollections and their association with mental health symptoms is limited. Fifty 8 to 12-year-old children provided two open-ended recollections about (1) challenging/"bad" things and (2) positive/ "good" things that happened to them 1-year post experiencing an EF-5 tornado. Children completed exposure and mental health symptom measures (PTSD, anxiety, depression). Transcripts were coded for indicators of processing: coherence, positive and negative emotion terms, and resolutions. Age, gender, SES, family tornado-related discussion frequency, verbal ability, tornado-specific psychotherapy receipt, and exposure were controlled. Coherence and positive emotion were positively associated and resolutions were negatively associated with mental health symptoms when children discussed the "bad" things. Children's processing and mental health symptoms were unrelated when children discussed the "good" things. The measured indicators of children's processing may reflect children's meaning-making efforts and have implications for adjustment.

Functions of Aggression and Peer Victimization in Elementary School Children: the Mediating Role of Social Preference.

This study examined whether social preference was a mechanism that explained the relation between proactive and reactive aggression and peer victimization. Participants were 494 children in grades 2-5. Proactive and reactive aggression was assessed via a self-report measure and indices of social preference and peer victimization were assessed via a peer nomination inventory. Data was collected during the fall and spring of two academic years. The relations among aggression, social preference, and peer victimization varied as a function of aggression and gender. For girls, reactive aggression was a significant negative predictor of social preference. Findings also revealed social preference mediated the relation between reactive aggression and peer victimization for girls. This pathway did not hold for boys. There was some evidence that proactive aggression was negatively associated with peer victimization, but only for girls. Findings from the current study suggest social preference may be a key mechanism through which reactive aggression is associated with future victimization for girls. Boys' aggression was not related to subsequent peer victimization. Future research and intervention efforts should consider gender differences and the function of aggression when investigating children's peer victimization experiences.

Positive Psychology and Disaster Mental Health: Strategies for Working with Children and Adolescents.

Positive psychology concepts and principles can be incorporated into preparedness, crisis response, and recovery phases of disaster mental health efforts to address the needs of children, adolescents, and families. This article articulates general developmental considerations for applying positive psychology in disaster mental health contexts and discusses how 5 essential elements of immediate and midterm mass trauma intervention identified by Hobfoll et al. (2007) may be infused in applications of positive psychology for children and adolescents. Specific strategies for working with children, adolescents, and their families in home, community, and school contexts are drawn in part from disaster mental health resources developed jointly by the National Child Traumatic Stress Network and National Center for Posttraumatic Stress Disorder, including the Psychological First Aid Field Operations Guide (Brymer et al., 2006), the Skills for Psychological Recovery Field Operations Guide (Berkowitz et al., 2010), and the Psychological First Aid for Schools Field Operations Manual (Brymer et al., 2012). Two case examples illustrate the use of positive psychology principles.

Associations Between Physical and Relational Forms of Peer Aggression and Victimization and Risk for Substance Use Among Elementary School-Age Youth.

This study examined associations between physical and relational forms of aggression and victimization and risk for willingness to engage in substance use and actual use in a sample of 231 (50% Male) 2nd thru 4th grade students (Mean age = 8.3 years). Physical aggression was more strongly associated with risk for substance use outcomes than physical victimization. Neither relational aggression nor victimization were linked to risk for substance use. Specifically targeting physical aggression for the prevention of early substance use among elementary school-age youth appears to be warranted.

Interview and recollection-based research with child disaster survivors: Participation-related changes in emotion and perceptions of participation.

Research suggests that some types of trauma research can be conducted safely with children ages 10 and older. The aim of this project was to learn more about potential risks or benefits of conducting research with younger children and with child disaster survivors, specifically about research that includes children providing trauma recollections. Fifty 8- to 12-year-old children who experienced a devastating tornado participated in an in-person interview that included both individual and joint (mother-child) recollections of their tornado experiences 1 year after exposure. These 50 children also rated 3 emotions at 3 time points and rated their perceptions (e.g., benefit and regret) of research post-participation. Children (N = 28) also participated in phone surveys 3 months later to assess persistent participation-related emotions and perceptions. Child reported that emotions worsened from pre- to during participation; however, reports of emotions returned to preparticipation levels post-participation and remained so at the 3-month follow-up. Sixty-four percent of children reported at least some participation benefit and no participation regret immediately postparticipation, as did 89.3% at the 3-month follow-up. Four percent of children reported some participation regret (no benefit) postparticipation, and 0% 3 months later. No children requested to stop participating, and none required postresearch connection with crisis services. Posttraumatic stress symptom severity, tornado exposure, and age were largely unrelated to child-reported emotions and perceptions of research. Results indicate that carefully planned and executed disaster-related research that includes children providing recollections can be conducted with preadolescents with little risk and some benefit.

The Role of Peers in the Relation between Hurricane Exposure and Ataques de Nervios among Puerto Rican Adolescents.

Although a relation between disaster exposure and ataques de nervios (ataques) has been established in adult samples, little is known about this among youth, including factors that may moderate this relation. This study examined the role of the peer context in the relation between exposure to Hurricane Georges and experiencing a past year and lifetime ataques among a representative community sample of 905 youth (N = 476 boys and 429 girls; ages 11-18) residing in Puerto Rico. Data were gathered from 1999-2000 in Puerto Rico, 12-27 months following Hurricane Georges. Logistic regression analyses found that peer violence significantly predicted experiencing an ataque in the past year. Hurricane exposure and peer violence were both significant predictors of a lifetime experience of an ataque. An interaction was found between hurricane exposure and peer violence, indicating that hurricane exposure was significantly related to a lifetime experience of an ataque among adolescents who do not report associating with violent peers. For participants reporting high levels of peer violence, hurricane exposure did not add additional risk for a lifetime experience of an ataque. Understanding the influence of peers in the relation between hurricane exposure and experiencing an ataque may assist in planning developmentally and culturally sensitive response plans.

Towards successful Dissemination of Psychological First Aid: a study of provider training preferences.

Dissemination of Psychological First Aid (PFA) is challenging considering the complex nature of disaster response and the various disaster mental health (DMH) trainings available. To understand challenges to dissemination in community mental health centers (CMHCs), interviews were conducted with nine DMH providers associated with CMHCs. Consensual qualitative analysis was used to analyze data. Interviews were targeted toward understanding organizational infrastructure, DMH training requirements, and training needs. Results clarified challenges to DMH training in CMHCs and factors that may promote buy-in for trainings. For example, resources are limited and thus allocated for state and federal training requirements. Therefore, including PFA in these requirements could promote adoption. Additionally, a variety of training approaches that differ in content, style, and length would be useful. To conclude, a conceptual model for ways to promote buy-in for the PFA Guide is proposed.

Peer deviance, social support, and symptoms of internalizing disorders among youth exposed to Hurricane Georges.

This study examined the influence of peers in meeting DSM-IV symptom criteria for an internalizing disorder in adolescents exposed to Hurricane Georges. Participants included a representative community sample of 905 youth (n = 476 boys) ages 11-17, residing in Puerto Rico. Data were gathered on hurricane exposure, symptoms of internalizing disorders, peer social support, peer violence, and peer substance use through in-person structured interviews with adolescents and caretakers from 1999 to 2000 in Puerto Rico, 12-27 months after Hurricane Georges. Hurricane exposure, peer violence, and peer substance use predicted whether adolescents met DSM-IV symptom criteria for a measured internalizing disorder. An interaction was found between hurricane exposure and peer violence, which indicated that hurricane exposure was significantly related to meeting DSM-IV symptom criteria for an internalizing disorder among adolescents who do not report associating with violent peers. However, for participants who reported high levels of peer violence, hurricane exposure did not convey additional risk for meeting DSM-IV symptom criteria for an internalizing disorder. With the increasing role peers play in adolescents' lives, understanding the influence of peers on the development of internalizing symptoms following hurricane exposure may assist in planning developmentally sensitive response plans.

Children's Postdisaster Trajectories of PTS Symptoms: Predicting Chronic Distress.

BACKGROUND: There are no studies of the distinct trajectories of children's psychological distress over the first year after a destructive natural disaster and the determinants of these trajectories. OBJECTIVE: We examined these issues using an existing dataset of children exposed to Hurricane Andrew, one of the most devastating natural disasters in US history. METHODS: At 3-months postdisaster, 568 children (55 % girls; grades 3-5) residing in areas most directly affected by the hurricane completed measures of hurricane exposure and stressors, social support, coping, and general anxiety. Children also reported major life events occurring since the hurricane (at 7-months) and posttraumatic stress (PTS) symptoms at 3-, 7-, and 10-months postdisaster. RESULTS: Latent growth mixture modeling identified three trajectories of PTS reactions: resilient (37 %), recovering (43 %), and chronic distress (20 %). Predictors of the trajectories were examined. Odds ratios indicated that, compared to the resilient trajectory, girls were more likely to be in the recovering and chronically distressed trajectories, as were children reporting higher anxiety and greater use of coping strategies that reflected poor emotion regulation. Compared to the recovering trajectory, children in the chronically distressed trajectory had greater odds of reporting high anxiety, less social support, more intervening life events, and greater use of poor emotion regulation strategies. CONCLUSIONS: Hurricane exposure may be less effective in identifying children who develop chronic postdisaster distress than other child (anxiety, coping) and contextual variables (social support, life events). Effective screening after disasters is critical for identifying youth most in need of limited clinical resources.

A qualitative analysis of barriers, challenges, and successes in meeting the needs of Hurricane Katrina evacuee families.

Hurricane Katrina caused many individuals to evacuate to towns and cities throughout the United States. Psychological First Aid (PFA) is a treatment program designed to help clinicians and other disaster relief workers address the needs of adults, youth, and families immediately following disasters. We conducted focus groups with disaster relief and evacuee service providers in the Kansas City Metro Area as an exploratory study to identify their perceptions of the needs of evacuees. Participants identified a number of mental health needs, as well as displacement-related challenges, including loss of social support, material loss, unemployment, and other stressful life events that were secondary to the hurricane. Many of these needs are consistent with principles presented in the PFA manual. We also found that service providers faced unique challenges when attempting to assist evacuees. We discuss implications of these findings for treatment programs and provide suggestions for addressing barriers to care.

Victimization, aggression, and visits to the school nurse for somatic complaints, illnesses, and physical injuries.

OBJECTIVE: To examine how involvement in aggressor-victim interactions is linked to somatic complaints, illnesses, and physical injuries among elementary school-aged children. STUDY DESIGN: This study was composed of a school-based sample of 590 children in grades 3 through 5. Independent sources were used to assess victimization (self-report) and aggression (peer report) in the fall semester. School nursing logs for the entire school year were collected in May and coded for the number of times each child presented with a somatic complaint, illness, or injury. RESULTS: Both aggression and victimization were significantly related to all 3 reasons for nurse visits, controlling for demographic variables. Higher levels of aggression and victimization each were independently associated with more frequent visits to the school nurse for somatic complaints, illnesses, and injuries. A significant victimization-times-aggression interaction was found for illnesses, with nonaggressive victimized children presenting most frequently for illness visits. CONCLUSIONS: Involvement in aggressor-victim interactions, as either aggressor, victim, or both, is associated with more frequent health complaints, based on school nursing logs. Prevention, early identification, and treatment of problems with victimization and aggression may have important health implications for children.

Perceptions of psychological first aid among providers responding to Hurricanes Gustav and Ike.

Psychological First Aid (PFA), developed by the National Child Traumatic Stress Network and the Department of Veterans Affairs National Center for Posttraumatic Stress Disorder, has been widely disseminated both nationally and internationally, and adopted and used by a number of disaster response organizations and agencies after major catastrophic events across the United States. This study represents a first examination of the perceptions of providers who utilized PFA in response to a disaster. Study participants included 50 individuals who utilized PFA in their response to Hurricane Gustav or Ike. Findings indicated that participation in PFA training was perceived to increase confidence in working with adults and children. PFA was not seen as harmful to survivors, and was perceived as an appropriate intervention for responding in the aftermath of hurricanes.