UTMB research reveals teens suffer post-hurricane

Galveston teenagers who weathered Hurricane Ike without evacuating the island reported higher rates of substance abuse and physical and sexual dating violence after the storm than teenagers who evacuated, according to new research from the University of Texas Medical Branch at Galveston. These findings are in keeping with other research about disaster-related trauma, which consistently shows that the closer a person is to the epicenter of a disaster, the higher that person’s risk of developing psychological problems and associated behavioral problems.

“Disaster exposure is associated with negative health outcomes,” said UTMB’s Jeff Temple, assistant professor and clinical psychologist and lead author of the UTMB study. “The more someone’s life (or the life of a loved one) is in danger, the more severe the traumatic reaction is likely to be.

“Youth exposed to traumatic experiences are at a heightened risk of developing risky health behaviors,” said Temple. “Facing a life-threatening situation is very traumatic, and it’s something that can stick with you.”

The results of the UTMB study were gleaned from an anonymous survey administered to 1,134 students, approximately 76 percent of the student body, at a public high school in Galveston in March 2009, seven months after Hurricane Ike. The study was published in the July/August 2011 issue of the American Journal of Disaster Medicine. 

Hurricane Ike, one of the largest and costliest hurricanes in U.S. history, swept through Galveston on Sept. 13, 2008. The Gulf Coast island was flooded by 14 feet of storm surge, submerging 75 percent of the city. Despite mandatory evacuation orders, an estimated 40 percent of the city’s population did not evacuate before the storm made landfall. 

Galveston’s only public high school had a pre-storm enrollment of 1,921. Many students were permanently displaced because of the hurricane. On the day of the survey, seven months later, 1,478 students were enrolled. 

Students were asked whether during the past year, their boyfriend or girlfriend had ever hit, slapped or physically hurt them on purpose. They were also asked whether a boyfriend or girlfriend had physically forced them to have sexual intercourse when they did not want to. Students also reported their past month’s use of alcohol, cigarettes, marijuana, cocaine and inhalants. They were asked whether they had evacuated from Galveston before Hurricane Ike made landfall. 

In the surveyed sample of Galveston teenagers, a little more than 11 percent of the survey participants reported that they did not evacuate prior to the storm. 

Non-evacuating boys had three times the odds of reporting that they had perpetrated physical violence or had sexually assaulted dating partners compared to boys who evacuated. Both boys and girls who did not evacuate reported higher levels of episodic heavy binge drinking, marijuana and cocaine use than their counterparts who did evacuate. 

In addition, non-evacuating girls were more likely to be current smokers than girls who evacuated. Non-evacuating boys were more likely to have used any amount of alcohol and inhalants than their evacuating male counterparts.

These results are consistent with other disaster studies that have taken place in the past decade. Adolescents in New York drank and smoked more in the aftermath of the 9/11 terrorist attacks. Exposure to Hurricane Rita was associated with increasing substance use among high school students, particularly with respect to marijuana. A Dutch study evaluating the impact of a café fire that killed 14 and wounded 250 adolescents found that youth exposed to the traumatic event had significantly higher rates of depression, anxiety, aggression and alcohol use than those children who had not been exposed. 

In a series of studies following Hurricane Andrew, school-aged children exposed to the destruction of the storm exhibited acute and persistent symptoms of post-traumatic stress disorder, depression and anxiety. Similar findings were reported after Hurricane Katrina. For example, there were high rates of PTSD in young children who did (43.5 percent) and did not (62.5 percent) evacuate from that devastating storm. 

The bottom line message for people who live in Galveston and other areas where evacuating before a disaster strikes is possible, Temple said, is “do everything you can to get out of town if a dangerous event is approaching. There is no reason to expose yourself — or your kids — to a life threatening event. The ability to evacuate is the one advantage hurricanes provide over other disasters.”

For those who find themselves or their children exhibiting behavioral changes after a traumatic event, Temple says it is important to find therapeutic support. “Trauma-focused cognitive behavioral therapy can help a person get past the traumatic event instead of replaying it in their heads over and over again with no resolution,” Temple said.

“Sometimes people will go to one or two sessions of emergency counseling and then say they’ve been there, done that, and that it didn’t work,” said Temple. “But longer-term therapy specifically focused on trauma resolution may be the key.”

Other members of the UTMB research team include Patricia van den Berg, Fred Thomas, James Northcutt, Dr. Christopher Thomas and Daniel Freeman Jr.