Perceptions of Trauma and Loss among Children and Adolescents Exposed to Disasters a Mixed-Methods Study

The purpose of the current study was to extend knowledge of youth exposed to multiple disasters and the experience of cumulative childhood adversity by analyzing perceptions of trauma and loss in children and adolescents. A concurrent mixed-methods design was utilized to explore an ethnically diverse, predominantly low-income sample of youth (N = 4,154) aged 8-18 years from three parishes (counties) in Louisiana impacted by Hurricane Katrina and the Gulf Oil Spill. Youth completed assessments of posttraumatic stress symptoms (PTSS), hurricane exposure and oil spill stress, and responded to an open-ended question regarding lifetime trauma and loss. Independent coders assigned responses to 30 categories using a qualitative codebook based on both predetermined and emerging information. Codes were compared and contrasted for meaning and grouped into broader, organizing themes. Themes of trauma and loss included: death and loss of others, threats to life, family disruption, interpersonal trauma, and life transitions. Trauma and loss predicted PTSS when controlling for hurricane exposure and oil spill stress. Most trauma and loss conferred generalized risk regardless of event typology, although interpersonal trauma had unique effects. Findings improve understanding of the nature and extent of trauma and loss among youth exposed to multiple disasters. The use of a mixed-methods design clarifies prior findings in the broader trauma literature and child disaster studies. Through identification of vulnerable subgroups and patterns in perceptions of trauma and loss, findings have important implications for prevention and intervention strategies that promote long-term recovery.