Australian & New Zealand Journal of Psychiatry 2014, Vol 48(1) 80–86 DOI: 10.1177/0004867413500349 © The Royal Australian and New Zealand College of Psychiatrists 2013 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav anp.sagepub.com Australian & New Zealand Journal of Psychiatry, 48(1) Introduction Natural disasters, such as earthquakes, floods, cyclones or tsunami, have substantial impact on the mental health of children and adolescents. Children who have lived through a natural disaster may develop distressing symptoms, such as sleep or behavioural disturbance or severe emotional dis- turbance (McLaughlin et al., 2009), or specific disorders, such as depression (McDermott and Palmer, 2002) or anxi- ety (Hoven et al., 2005). Research following man-made disasters has reported increased substance use in adoles- cents in the post-disaster period (Reijneveld et al., 2005). Given that most post-disaster research is cross-sectional in design, it is difficult to comment on causation. Possible explanations for drug and alcohol excess include a coping mechanism for general distress or self-medication of Correlates of persisting posttraumatic symptoms in children and adolescents 18 months after a cyclone disaster Brett McDermott 1 , Vanessa Cobham 2 , Helen Berry 3 and Bungnyun Kim 4 Abstract Objective: To describe PTSD symptom persistence and resolution, including the potential phenomenon of late-onset PTSD, in children and adolescents 18 months after a cyclone disaster; and to investigate factors that predict longer-term symptom outcome. Method: 71 children and 191 adolescents who were screened three months after a Category 5 Cyclone were re- screened 18 months post-disaster. Child-report measures included the PTSD Reaction Index, measures of event exposure and social connectedness. Results: Approximately 1-in-5 children and 1-in-12 adolescents endorsed cyclone-related PTSD symptoms at the moderate to severe level 18 months post-disaster. Of these approximately one-half (44.8%) of children were in the ‘high-persister’ group at 18-month follow-up. Persistence of low symptoms was very common (97.6%) and late-onset PTSD was a rare phenomenon. This pattern was similar in adolescents: 25.0% were in the ‘high-persister’ group and few students experienced late-onset PTSD. In multivariate analysis, only initial severe to very severe PTSD category made a significant independent contribution to explaining persisting moderate to severe PTSD symptoms in primary school students (ORadj=8.33, 95% CI=1.45-47.84). There was a trend for a similar result in secondary students. Conclusion: A child or adolescent with few PTSD symptoms three months post-disaster is likely to remain so unless a further traumatic event occurs. However, if symptomatic at three months, there is approximately a 30-45% chance that the child or adolescent will still be symptomatic 18 months after the disaster. Given the high rate of students in the ‘resolver’ group, initial posttraumatic symptoms are a necessary but not sufficient condition for predicting chronic symptomatology. Other targets for predictive modelling include initial threat perception and high and low social connectedness. Keywords Posttraumatic stress disorder, longitudinal, children, adolescents 1 Mater Child and Youth Mental Health Service, Brisbane, Australia 2 School of Psychology, University of Queensland, Brisbane, Australia 3 Centre for Research and Action in Public Health, University of Canberra, Australia 4 Division of Child and Adolescent Psychiatry, Seoul, Republic of Korea Corresponding author: Brett McDermott, Mater Children’s Hospital, Raymond Terrace, South Brisbane, Brisbane, QLD 4101, Australia. Email: brett.mcdermott@mater.org.au 500349 Research at James Cook University on July 5, 2016 anp.sagepub.com Downloaded from