A Longitudinal Study of Posttraumatic Stress Reactions in Norwegian Children and Adolescents Exposed to the 2004 Tsunami

Objective: To investigate the prevalence of symptoms of posttraumatic stress disorder (PTSD) and factors related to level of these in children who experienced a catastrophe as tourists and were therefore able to return to the safety of their homeland. Design: Face-to-face semistructured interviews and assessments. Setting: Children and adults were interviewed in their homes 10 months and 21/2 years after the tsunami. Participants: A volunteer sample of adults and children aged 6 to 17 years who were exposed to the 2004 tsunami (at 10 months, 133 children and 84 parents; at 21/2 years, 104 children and 68 parents). Main Exposure: The tsunami in Southeast Asia on December 26, 2004. Outcome Measures: University of California, Los Angeles (UCLA) PTSD Reaction Index. Results: Two children had scores indicative of PTSD at 10 months. There was a significant decrease in symptoms after 21/2 years, and no children had scores exceeding the clinical cutoff at this time. Only the death of a family member and subjective distress were independently and significantly associated with PTSD scores at 10 months, whereas sex, need for professional mental health services prior to the tsunami, and parental sick leave owing to the tsunami were independent predictors of PTSD symptoms at follow-up. Conclusions: The children reported fewer symptoms of PTSD compared with children in other disaster studies. Predictor variables changed from disaster-related subjective distress to factors related to general mental health at follow-up. The findings indicate the importance of secondary adversities and pretrauma functioning in the maintenance of posttraumatic stress reactions.