Betty J Pfefferbaum

..To present a framework for assessing children's disaster reactions and mental health needs...

..The use of this approach is illustrated with examples from disaster mental health studies in children, thus simultaneously providing a review of the literature...

..This article examines the theoretical and practical issues in assessing coping in children exposed to mass trauma, and includes recommendations to guide assessment and research of children's coping within this specialized context...

..The objective of this exploratory pilot study was to examine autonomic reactivity and hypothalamic pituitary adrenal axis dysregulation in spouses of highly exposed survivors of the 1995 Oklahoma City bombing...

..Integration must be supported in underlying policies and administration with clear lines of responsibility for formulating and implementing policy and practice...

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..The study supports the developing literature on traumatic grief and the need for studies exploring the potentially unique aspects of this construct...

..Twenty percent reported difficulty handling demands; 5% sought counseling. Outreach efforts should assess and assist teachers...

..This study implicates print media exposure as well. Media exposure to terrorist incidents, therefore, should be monitored and those working with children should assess exposure and stress even in children not directly impacted...

..These perceptions persisted for approximately 10% of the children. Our Findings suggest the importance of primary care and public health interventions to determine and monitor children's reactions...

..Future studies should focus on specific aspects of exposure and outcomes, indirect forms of exposure, the clinical significance of findings, and the various factors that influence a child's reaction to trauma...

..The results have implications for research, clinical practice, and public health...

..As the field matures, greater attention to the sophistication of research methods and design will increase our understanding of children in the context of disasters...

..This article describes the creation and training of 10 specialized research teams, curriculum development, implementation of the program, and progress to date as well as lessons learned and challenges to sustainability...

..Relatively few studies of children exposed to trauma have used objective indicators such as heart rate and blood pressure measurements to assess physiological reactivity...

..These findings suggest that children geographically distant from disaster who have not directly experienced an interpersonal loss report PTSD symptoms and functional impairment associated with increased media exposure and indirect loss...

..There was no relationship between posttraumatic stress symptomatology and counseling contact for students with the highest levels of posttraumatic stress. Implications for school-based services are discussed...

..This article indicates significant challenges in the identification, evaluation, and treatment of children potentially in need of attention...

..These findings suggest the importance of peritraumatic response in children's reactions to terrorism. These early responses can be used to help determine which children may experience difficulty over time...

..Increased alcohol consumption may present a problem in disaster victims months after exposure to trauma. Therefore, the use of alcohol should be routinely assessed in those who remain symptomatic over time...

..Children with strong initial reactions should be followed over time, and disaster-related television viewing should be carefully monitored...

..Future research should examine further whether early symptoms predict increased television viewing and/or whether television viewing predicts subsequent symptoms...

..The results support the construct of traumatic grief and have important implications for the treatment of people exposed to large-scale traumatic events and for the training of mental health professionals...

..Parents and those working with children should be alert to the impact of loss even when it involves nonrelatives...

..To investigate the responses of middle and high school students exposed to the 1995 Oklahoma City bombing across a spectrum of loss...

..A clinical needs assessment of all children in the Oklahoma City public school system was carried out, and clinicians provided emergency and crisis services, counseling, and support groups...

..The authors describe lessons learned in the areas of planning and service delivery, as well as the types and extent of services provided in the project's first two years...

..This clinical assessment was designed to identify middle and high school students in need of formal evaluation for posttraumatic response symptoms following the 1995 bombing of the Alfred P. Murrah Federal Building in Oklahoma City...

..Terrorism represents a major public health threat throughout the world. Bombings of the United States Embassies in East Africa in 1998 resulted in extensive physical and emotional casualties...

..The results suggest the need for further study of the impact of interpersonal exposure in those who provide support for rescue-and-recovery workers in major terrorist incidents...

..Posttraumatic stress reactions to the bombing were related to posttraumatic stress reactions to other trauma and to peritraumatic reaction. Self-reported functional impairment was minimal...

..Coping techniques are described, as well as possible reasons for unexpected resilience in the majority...

..Although no causal relationship can be assumed, our findings indicate an association of grief and posttraumatic stress with increased substance use behaviors in disaster victims...

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..It is important to understand long-term biological and psychiatric correlates of intense exposure to terrorism...

..The authors assessed relocated Hurricane Katrina survivors' emotional and biological stress measures 20 months postdisaster to understand effects of both hurricane exposure and forced relocation on emotional and physical health...

..Policy-makers and systems of care hold great responsibility for resource allocation, and also are well-placed to understand the impact of trauma and disaster on children and children's unique needs in such situations...

..Six and a half to 7 years after the 1995 terrorist bombing in Oklahoma City, the authors assessed autonomic reactivity to trauma reminders and psychiatric symptoms in adults who had some degree of direct exposure to the blast...

..Future studies should use longitudinal designs to examine the course and pathogenic pathways for the development of panic, PTSD, and other anxiety disorders after exposure to disasters...

..Interviewees reported numerous barriers and strategies, which we cataloged according to a well-accepted eight-step plan for transforming organizations...

..Bomb-related PTSD symptoms increased with current age and were inversely related to age at the time of prior trauma. Results underscore the importance of providing long-term disaster assistance to immigrants with prior trauma...

..6) To design a modular, multidisciplinary research-training curriculum on child and family disaster mental health incorporating modern principles of public mental health and a scientifically informed developmental psychopathology model. ..