Psychotherapy for PTSD Among Traumatized Adolescents After Natural Disaster

Young survivors of the recent Indian Ocean tsunami, Kashmir earthquake, Gulf Coast hurricanes and other natural disasters face high risk of chronic post-traumatic stress disorder (PTSD) and depression if left untreated, according to a new study by a UCLA based research team.

Detailed in the December edition of the peer-reviewed American Journal of Psychiatry, the study examined the impact of the catastrophic 1988 Spitak earthquake in Armenia on adolescents near the temblor's epicenter. Researchers found untreated adolescents had significantly higher levels of PTSD and depressive symptoms than peers who received treatment.

"Chronic PTSD and depression can impair the psychosocial development and behavior of children and adolescents, which in turn can have a detrimental effect on their families and communities," said lead author Dr. Armen K. Goenjian, a researcher and psychiatrist at the Semel Institute for Neuroscience and Human Behavior at UCLA and the National Center for Child Traumatic Stress.

"The findings unequivocally show the sustained benefits of specific types of therapy, even when provided 1.5 years after the earthquake" according to Goenjian, who is also the director of the Armenian Relief Society's Mental Health Clinics in Gumri and Spitak.

Signs of the psychological effects of trauma in children include fear of abandonment and recurrence of the horrors of the trauma, anger, withdrawal, trouble with concentration, recurrent fearful memories of the trauma, and nightmares. Children feel vulnerable, view the world as unsafe and adults unable to protect them. These signs are not always apparent to caregivers and teachers.

Over time, the condition can lead to depression, substance abuse, promiscuity, reckless and aggressive behavior, academic impairment, and future marital and employment difficulties.

The study examined the impact of the Spitak earthquake that struck northern Armenia on Dec. 7, 1988, killing more than 25,000 people and causing massive destruction in four cities and numerous villages. In Spitak and Gumri, two of the hardest hit cities, nearly everyone experienced direct threats to their lives and witnessed mutilating injuries and grotesque deaths. Five years later, just 15 percent of the cities had been rebuilt and piles of debris and destroyed buildings served as constant reminders, making psychological recovery even harder.

By comparison, the recent Indian Ocean tsunami killed more than 170,000 people and left more than 1 million homeless. The earthquake in Kashmir killed an estimated 87,000 people and left hundreds of thousands without shelter as winter begins in this mountainous region of Kashmir. Hurricanes Katrina and Rita killed more than 1,000 people along the Gulf Coast of the United States and left well over half a million people homeless.

The research team evaluated the natural course of post-traumatic stress and depressive symptoms among untreated adolescents from Spitak and Gumri. In addition the research team examined the effectiveness of brief trauma and grief-focused psychotherapy among adolescents from Gumri.