Psychological Associations of Multiple Disasters: A Longitudinal Study of Adolescents in Puerto Rico.

Objectives: Psychological reactions in response to disasters have been associated with increased mental health (MH) symptomatology, decreased quality of life (QOL), and post-traumatic stress (PTSD). This study provides a rare opportunity to examine post disaster MH longitudinally in a sample of adolescents.

Methods: From 2018-20, adolescents (12-18 years, N=228) were interviewed about disaster exposure, QOL using the Adolescent Quality of Life-Mental Health Scale (AQOL-MHS), psychological symptoms, and diagnoses.

Results: Having an MH diagnosis and PTSD are clear indicators of worse Emotional Regulation (ER) (P ≤ 0.03, P ≤ 0.0001) and Self-Concept (SC) (P ≤ 0.006, P ≤ 0.002) QOL. Girls were disproportionately affected in all models for SC and Social Context domains (P ≤ 0.0001, P ≤ 0.01). Interaction models results for ER (P ≤ 0.05) and SC (P ≤ 0.01) indicate that those with PTSD are improving over time at a greater rate than those without PTSD.

Conclusions: Recovery takes time and a clear sex disparity for girls was observed. Results for the different AQOL-MHS domains highlight how the challenges experienced by disasters are multifaceted. Knowing who is at greater risk can allow for better resource allocation and targeted population-based prevention strategies to promote and maintain MH and resolve risk factors for mental illnesses.