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On February 27th, 2010, the sixth strongest earthquake in recorded history (8.8 Mw) struck Chile. With over 500 deaths, the destruction of hundreds of buildings including schools, and a blackout that affected most of the country’s population (Earthquake Engineering Research Institute, 2010National Institute of Standards and Technology, 2016), approximately 75% of Chile’s population was affected. The earthquake hit in the early morning, two days before the new school year was scheduled to start, and children were unable to go to school for weeks. Prior studies have documented an association between the 2010 earthquake and child mental health problems (Garfin et al., 2014; Gomez & Yoshikawa, 2017); however, few studies with both pre- and post-disaster data exist and there is limited understanding of how children’s psychosocial functioning changes following exposure to a disaster. 

Moreover, no studies have simultaneously explored the effects of an exogenous natural disaster like the earthquake and more common, home-based adverse childhood experiences (ACEs). Adverse experiences in childhood do not occur in isolation from other events. A child exposed to illness or discord within the home may also be exposed to an environmental disaster, and being able to differentiate the impacts of a range of adverse experiences may help in developing targeted interventions for affected youth. Particularly, examining these effects on a population level is key to developing policy or interventions that best support youth.   

In our recently accepted manuscript in the Journal of Traumatic Stress (Dutta et al., 2022)we used multilevel modeling to assess a longitudinal sample of 19,627 Chilean elementary school students from first and third grades (in 2009 and 2011, respectively). Based on proximity to the epicenter, we categorized students’ geographical regions according to severity of earthquake exposure. We also coded each student’s exposure to micro-level, parent-reported ACEs within the home. Students’ overall psychosocial functioning and classroom behavior were assessed before and after the earthquake using the parent-report Pediatric Symptom Checklist-for Chile (PSC-CL) and the teacher-report Teacher Observation of Classroom Adaptation-Re Revised (TOCA-RR), respectively. These measures are administered every year as a part of the national school-based mental health program, Skills for Life.

After clustering for student’s schools and geographic district, and controlling for baseline demographic factors, the severity of earthquake exposure and exposure to ACEs (child illness, family psychopathology, and/or father absence) were consistently and significantly associated with higher (worse) third grade PSC-CL and TOCA-RR scores. Findings held when stressors were in individual models and after adjusting for the relative contribution of each. Compounded exposure to home-based stressors was associated with even worse psychosocial and behavioral functioning above and beyond the effects of earthquake exposure.

Our paper provides evidence that both micro- and macro-level stressors are relevant to children’s psychosocial and classroom adaptation. Although small effect sizes might suggest limited clinical utility on a case-by-case basis, they do provide valuable information regarding pediatric resilience in the face of adversity from a public health standpoint.School-based mental health officials may consider emphasizing resilience-based skills that address both internal and external stressors, particularly those that involve children’s family members, given how often traumatic events simultaneously occur in children’s lives. Routine behavioral health screening in schools can identify how individual children are affected by chronic versus acute stressors and serve as a guide for how to individualize treatment plans

Target Article

Dutta, A., Peña, F., Holcomb, J.M., Leiva, L,, Navarro, A.S., Canenguez, K.M., Bergmann, P., Riobueno-Naylor, A., Farley, A.M., Simonsohn, A., Garfin, D.R., Silver, R.C., Guzmán, J., Jellinek, M.S., & Murphy, J.M. (2022). Earthquake exposure, adverse childhood experiences, and psychosocial functioning in Chilean children: A longitudinal study. Journal of Traumatic Stress. https://doi.org/10.1002/jts.22826.

Discussion Questions

1. What is the utility of multi-informant routine screening?   
2. How can family members and school officials support youth following adverse experiences? 
3. How can we address the limitations of the current study in future research? 

About the Authors

Anamika Dutta, BA is the senior research coordinator in the Pediatric Psychosocial Group within the Division of Child & Adolescent Psychiatry at Massachusetts General Hospital. She will be starting a doctoral program in Clinical Psychology at Boston University in the Fall of 2022. She can be contacted at adutta@mgh.harvard.edu.
Talia S. Benheim, BA is a clinical research coordinator in the Pediatric Psychosocial Group within the Division of Child & Adolescent Psychiatry at Massachusetts General Hospital.
J. Michael Murphy, EdD. is a clinical and research psychologist and head of the Pediatric Psychosocial Group at Massachusetts General Hospital. He is the author of more than one hundred papers on child and adolescent risk and intervention. Dr. Murphy has collaborated with Chile’s Skills for Life program for more than fifteen years.

References Cited

Earthquake Engineering Research Institute. (2010). The Mw 8.8 Chile earthquake of February 27, 2010. EERI special earthquake report. https://www.eeri.org/site/images/eeri_newsletter/2010_pdf/Chile10_insert.pdf
Garfin, D. R., Silver, R. C., Gil-Rivas, V., Guzmán, J., Murphy, J. M., Cova, F., Rincón, P. P., Squicciarini, A. M., George, M., & Guzmán, M. P. (2014). Children’s reactions to the 2010 Chilean earthquake: The role of trauma exposure, family context, and school-based mental health programming. Psychological Trauma: Theory, Research, Practice, and Policy, 6(5), 563–573. https://doi.org/10.1037/a0036584
Gomez, C. J., & Yoshikawa, H. (2017). Earthquake effects: Estimating the relationship between exposure to the 2010 Chilean earthquake and preschool children’s early cognitive and executive function skills. Early Childhood Research Quarterly, 38, 127¬–136. https://doi.org/10.1016/j.ecresq.2016.08.004
National Institute of Standards and Technology. (2016). Chile quake at the epicenter of expanding disaster and failure data repository. National Institute of Standards and Technology. https://www.nist.gov/news-events/news/2016/04/chile-quake-epicenter-expanding-disaster-and-failure-data-repository