![Sample our Medicine, Dentistry, Nursing & Allied Health journals, sign in here to start your FREE access for 14 days]({"type":"image" , "src" : "/sda/5944/TOC-Subject-Sample-2021-Medicine-Dentistry-Nursing-Allied-Health.jpg"})
Abstract
Objective: The purpose of this study was twofold: (1) to estimate the prevalence of comorbid posttraumatic stress disorder (PTSD), major depressive episode (MDE), and substance use disorder (SUD); and (2) to identify risk factors for patterns of comorbidity among adolescents affected by disasters. Method: A population-based sample of 2,000 adolescents (51% female; 71% Caucasian, 26% African American) aged 12 to 17 years (M = 14.5, SD = 1.7) and their parents was recruited from communities affected by the spring 2011 tornadoes in Alabama and Joplin, Missouri. Participants completed structured telephone interviews assessing demographic characteristics, impact of disaster, prior trauma history, Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV), symptoms of posttraumatic stress disorder (PTSD) and major depressive episode (MDE), and substance use disorder (SUD) symptoms. Prevalence estimates were calculated for PTSD + MDE, PTSD + SUD, MDE + SUD, and PTSD + MDE + SUD. Hierarchical logistic regression was used to identify risk factors for each comorbidity profile. Results: Overall prevalence since the tornado was 3.7% for PTSD + MDE, 1.1% for PTSD + SUD, 1.0% for MDE + SUD, and 0.7% for PTSD + MDE + SUD. Girls were significantly more likely than boys to meet criteria for PTSD + MDE and MDE + SUD (ps < .05). Female gender, exposure to prior traumatic events, and persistent loss of services were significant risk factors for patterns of comorbidity. Parental injury was associated with elevated risk for PTSD + MDE. Adolescents should be evaluated for comorbid problems, including SUD, following disasters so that appropriate referrals to evidence-based treatments can be made. Conclusions: Results suggest that screening procedures to identify adolescents at risk for comorbid disorders should assess demographic characteristics (gender), impact of the disaster on the family, and adolescents’ prior history of stressful events.
Additional information
Funding
Notes on contributors
Zachary W. Adams
Zachary W. Adams, PhD, Carla Kmett Danielson, PhD, and Joseph R. Cohen, PhD, are affiliated with the National Crime Victims Research and Treatment Center, Department of Psychiatry and Behavioral Sciences, at Medical University of South Carolina in Charleston. Jennifer A. Sumner, PhD, is affiliated with the Department of Epidemiology at Columbia University Mailman School of Public Health in New York City. Jenna L. McCauley, PhD, is affiliated with the Clinical Neurosciences Division, Department of Psychiatry and Behavioral Sciences, at Medical University of South Carolina in Charleston. Kenneth J. Ruggiero, PhD, is affiliated with the College of Nursing at Medical University of South Carolina and the Ralph H. Johnson Veterans Affairs Medical Center, both in Charleston.
Carla Kmett Danielson
Zachary W. Adams, PhD, Carla Kmett Danielson, PhD, and Joseph R. Cohen, PhD, are affiliated with the National Crime Victims Research and Treatment Center, Department of Psychiatry and Behavioral Sciences, at Medical University of South Carolina in Charleston. Jennifer A. Sumner, PhD, is affiliated with the Department of Epidemiology at Columbia University Mailman School of Public Health in New York City. Jenna L. McCauley, PhD, is affiliated with the Clinical Neurosciences Division, Department of Psychiatry and Behavioral Sciences, at Medical University of South Carolina in Charleston. Kenneth J. Ruggiero, PhD, is affiliated with the College of Nursing at Medical University of South Carolina and the Ralph H. Johnson Veterans Affairs Medical Center, both in Charleston.
Jennifer A. Sumner
Zachary W. Adams, PhD, Carla Kmett Danielson, PhD, and Joseph R. Cohen, PhD, are affiliated with the National Crime Victims Research and Treatment Center, Department of Psychiatry and Behavioral Sciences, at Medical University of South Carolina in Charleston. Jennifer A. Sumner, PhD, is affiliated with the Department of Epidemiology at Columbia University Mailman School of Public Health in New York City. Jenna L. McCauley, PhD, is affiliated with the Clinical Neurosciences Division, Department of Psychiatry and Behavioral Sciences, at Medical University of South Carolina in Charleston. Kenneth J. Ruggiero, PhD, is affiliated with the College of Nursing at Medical University of South Carolina and the Ralph H. Johnson Veterans Affairs Medical Center, both in Charleston.
Jenna L. McCauley
Zachary W. Adams, PhD, Carla Kmett Danielson, PhD, and Joseph R. Cohen, PhD, are affiliated with the National Crime Victims Research and Treatment Center, Department of Psychiatry and Behavioral Sciences, at Medical University of South Carolina in Charleston. Jennifer A. Sumner, PhD, is affiliated with the Department of Epidemiology at Columbia University Mailman School of Public Health in New York City. Jenna L. McCauley, PhD, is affiliated with the Clinical Neurosciences Division, Department of Psychiatry and Behavioral Sciences, at Medical University of South Carolina in Charleston. Kenneth J. Ruggiero, PhD, is affiliated with the College of Nursing at Medical University of South Carolina and the Ralph H. Johnson Veterans Affairs Medical Center, both in Charleston.
Joseph R. Cohen
Zachary W. Adams, PhD, Carla Kmett Danielson, PhD, and Joseph R. Cohen, PhD, are affiliated with the National Crime Victims Research and Treatment Center, Department of Psychiatry and Behavioral Sciences, at Medical University of South Carolina in Charleston. Jennifer A. Sumner, PhD, is affiliated with the Department of Epidemiology at Columbia University Mailman School of Public Health in New York City. Jenna L. McCauley, PhD, is affiliated with the Clinical Neurosciences Division, Department of Psychiatry and Behavioral Sciences, at Medical University of South Carolina in Charleston. Kenneth J. Ruggiero, PhD, is affiliated with the College of Nursing at Medical University of South Carolina and the Ralph H. Johnson Veterans Affairs Medical Center, both in Charleston.
Kenneth J. Ruggiero
Zachary W. Adams, PhD, Carla Kmett Danielson, PhD, and Joseph R. Cohen, PhD, are affiliated with the National Crime Victims Research and Treatment Center, Department of Psychiatry and Behavioral Sciences, at Medical University of South Carolina in Charleston. Jennifer A. Sumner, PhD, is affiliated with the Department of Epidemiology at Columbia University Mailman School of Public Health in New York City. Jenna L. McCauley, PhD, is affiliated with the Clinical Neurosciences Division, Department of Psychiatry and Behavioral Sciences, at Medical University of South Carolina in Charleston. Kenneth J. Ruggiero, PhD, is affiliated with the College of Nursing at Medical University of South Carolina and the Ralph H. Johnson Veterans Affairs Medical Center, both in Charleston.