Although exposure to natural disasters can lead to diverse mental health (MH) outcomes in youth, most child disaster MH research has focused on posttraumatic stress symptoms (PTSS). To highlight the likelihood of other MH outcomes, we meta-analyzed studies that have examined other (non-PTSS) internalizing and externalizing behavior problems in youth exposed to natural disasters. We used PRISMA guidelines to systematically gather studies that have examined the association between natural disaster exposure and non-PTSS internalizing and/or externalizing problems in samples of children and adolescents. Analyses of random effects models of 62 studies examining non-PTSS internalizing problems and 26 studies examining externalizing problems showed exposure to natural disasters was significantly associated with non-PTSS internalizing, r_mean = .18, k = 70, and externalizing problems, r_mean = .08; k = 31, in youth. Moderator analyses revealed a stronger association between disaster exposure and non-PTSS internalizing problems in countries with a "medium" Human Development Index (HDI) ranking, r = .56, than in countries with "high," r = .15, and "very high," r = .16, HDI rankings. We also found a stronger association between disaster exposure and externalizing problems in countries with a medium HDI ranking, r = .54, versus high, r = .05, and very high, r = .04, HDI rankings, and based on parent, r = .16, compared to child, r = -.01, report. Results support the need for assessment of multiple postdisaster MH outcomes to inform comprehensive interventions. We also include a discussion of the state of the disaster MH research.

Although exposure to natural disasters can lead to diverse mental health (MH) outcomes in youth, most child disaster MH research has focused on posttraumatic stress symptoms (PTSS). To highlight the likelihood of other MH outcomes, we meta-analyzed studies that have examined other (non-PTSS) internalizing and externalizing behavior problems in youth exposed to natural disasters. We used PRISMA guidelines to systematically gather studies that have examined the association between natural disaster exposure and non-PTSS internalizing and/or externalizing problems in samples of children and adolescents. Analyses of random effects models of 62 studies examining non-PTSS internalizing problems and 26 studies examining externalizing problems showed exposure to natural disasters was significantly associated with non-PTSS internalizing, r_mean = .18, k = 70, and externalizing problems, r_mean = .08; k = 31, in youth. Moderator analyses revealed a stronger association between disaster exposure and non-PTSS internalizing problems in countries with a "medium" Human Development Index (HDI) ranking, r = .56, than in countries with "high," r = .15, and "very high," r = .16, HDI rankings. We also found a stronger association between disaster exposure and externalizing problems in countries with a medium HDI ranking, r = .54, versus high, r = .05, and very high, r = .04, HDI rankings, and based on parent, r = .16, compared to child, r = -.01, report. Results support the need for assessment of multiple postdisaster MH outcomes to inform comprehensive interventions. We also include a discussion of the state of the disaster MH research.

Although a relation between disaster exposure and ataques de nervios (ataques) has been established in adult samples, little is known about this among youth, including factors that may moderate this relation. This study examined the role of the peer context in the relation between exposure to Hurricane Georges and experiencing a past year and lifetime ataques among a representative community sample of 905 youth (N = 476 boys and 429 girls; ages 11-18) residing in Puerto Rico. Data were gathered from 1999-2000 in Puerto Rico, 12-27 months following Hurricane Georges. Logistic regression analyses found that peer violence significantly predicted experiencing an ataque in the past year. Hurricane exposure and peer violence were both significant predictors of a lifetime experience of an ataque. An interaction was found between hurricane exposure and peer violence, indicating that hurricane exposure was significantly related to a lifetime experience of an ataque among adolescents who do not report associating with violent peers. For participants reporting high levels of peer violence, hurricane exposure did not add additional risk for a lifetime experience of an ataque. Understanding the influence of peers in the relation between hurricane exposure and experiencing an ataque may assist in planning developmentally and culturally sensitive response plans.