This meta-analysis evaluated the relation between social support and depression in youth and compared the cumulative evidence for 2 theories that have been proposed to explain this association: the general benefits (GB; also known as main effects) and stress-buffering (SB) models. The study included 341 articles (19% unpublished) gathered through a search in PsycINFO, PsycARTICLES, ERIC, and ProQuest, and a hand search of 11 relevant journals. Using a random effects model, the overall effect size based on k = 341 studies and N = 273,149 participants was r = .26 (95% CI [.24, .28]), with robust support for the GB model and support for the SB model among medically ill youth. Stress-buffering analyses suggest that different stressful contexts may not allow youth to fully draw on the benefits of social support, and we propose value in seeking to better understand both stress-buffering (effects of social support are enhanced) and reverse stress-buffering (effects of social support are dampened) processes. Key findings regarding other moderators include a different pattern of effect sizes across various sources of support. In addition, gender differences were largely absent from this study, suggesting that social support may be a more critical resource for boys than is typically acknowledged. Results also demonstrated the importance of using instruments with adequate psychometric support, with careful consideration of methodological and conceptual issues. Building upon these collective findings, we provide recommendations for theory and practice, as well as recommendations for addressing limitations in the extant literature to guide future investigations. (PsycINFO Database Record

http://psycnet.apa.org/journals/bul/142/10/1017.pdf

A meta-analytic review of the association between perceived social support and depression in childhood and adolescence.

New Orleans school children participated in an assessment and field trial of two interventions 15 months after Hurricane Katrina. Children (N = 195) reported on hurricane exposure, lifetime trauma exposure, peer and parent support, posttraumatic stress disorder (PTSD), and depressive symptoms. Teachers reported on behavior. At baseline, 60.5% screened positive for PTSD symptoms and were offered a group intervention at school or individual treatment at a mental health clinic. Uptake of the mental health care was uneven across intervention groups, with 98% beginning the school intervention, compared to 37% beginning at the clinic. Both treatments led to significant symptom reduction of PTSD symptoms, but many still had elevated PTSD symptoms at posttreatment. Implications for future postdisaster mental health work are discussed.

Children's mental health care following Hurricane Katrina: a field trial of trauma-focused psychotherapies.

Recognition of the benefits to trauma-informed approaches is expanding, along with commensurate interest in extending delivery within school systems. Although information about trauma-informed approaches has quickly burgeoned, systematic attention to integration within multitiered service delivery frameworks has not occurred yet is essential to accurate, durable, and scalable implementation. In addition, there is a critical need to concurrently build a strong evidence base regarding trauma-informed service delivery in schools. In this paper, the literatures on trauma-informed approaches and multitiered frameworks for school-based service delivery are connected with the goal to provide suggestions toward building blueprints for trauma-informed service delivery in schools. Drawing from the literature on implementation blueprints for school-wide positive behavior supports, sections are organized around current knowledge about trauma-informed approaches with regard to blueprints for (a) implementation, (b) professional development, and (c) evaluation. Critical issues, strategy recommendations, and directions for research are discussed.

/pdf/toward-a-blueprint-for-trauma-informed-service-delivery-in-1gxnxcbg0p.pdf

Toward a Blueprint for Trauma-Informed Service Delivery in Schools.

Children in danger: Coping with the consequences of community violence

Preventing Bullying Through Science, Policy, and Practice

Project Fleur-de-lis™ (PFDL) was established to provide a tiered approach to triage and treat children experiencing trauma symptoms after Hurricane Katrina. PFDL provides school screening in schools in New Orleans and three tiers of evidence-based treatment (EBT) to disaster-exposed children utilizing a public health approach to meet the various needs of students referred to the program, some stemming from the disaster itself, some related to prior exposure to violence, and some relating to preexisting conditions and educational delays. The National Institute of Mental Health (NIMH) is funding a research project conducted in collaboration with PFDL, to examine two evidence-based practices for child PTSD in order to guide child treatment decisions after future disaster situations. This article describes the need for mental health services for children following disaster, the structure and purpose of PFDL, design of the NIMH project, two case descriptions of children treated within the project, and preliminary lessons learned.

/pdf/treating-traumatized-children-after-hurricane-katrina-1qmi2vdemz.pdf

Treating Traumatized Children After Hurricane Katrina: Project Fleur-de Lis

Children's Mental Health Care Following Hurricane Katrina

The purpose of this study was to examine prevalence, correlates and predictors of mental health in children in New Orleans 15 months post-Hurricane Katrina. Analyses were conducted on 195 children who completed self-reports of hurricane and lifetime trauma exposure, social support, post-traumatic stress disorder (PTSD) symptoms, and depression. Teachers completed the Strengths and Difficulties Questionnaire. Children reported high incidence of PTSD symptoms: 36.9% moderate to severe and 23.6% mild. In multiple regression analyses, gender, social support, and lifetime trauma exposure, but not hurricane exposure, significantly predicted PTSD. Age, social support, and lifetime trauma exposure, but not hurricane exposure, significantly predicted child depressive symptoms. Teachers reported lower levels of problems and no significant predictors of teacher reports other than age and school. PTSD and depression were significant problems for children 15 months post-Hurricane Katrina. Lifetime trauma exposure was the strongest predictor of both PTSD and depression. Effective and accessible treatment is needed for such children.

Douglas Walker

Papers

Children's mental health care following Hurricane Katrina: a field trial of trauma-focused psychotherapies.

Treating Traumatized Children After Hurricane Katrina: Project Fleur-de Lis

Children's Mental Health Care Following Hurricane Katrina

Trauma Exposure and Mental Health Problems among School Children 15 Months Post-Hurricane Katrina

Treating Traumatized Children After Hurricane Katrina