Family Influences on the Relationship Between Hurricane Exposure and Ataques de Nervios.

This study focused on characteristics of the family environment that may influence the relationship between hurricane exposure and ataques de nervios in Puerto Rican children and youth. Approximately 18 months after Hurricane Georges hit Puerto Rico in 1998, participants were randomly selected based on a probability household sample using 1990 US Census block groups. Caregivers and children were interviewed about past year and lifetime experience of ataques de nervios, hurricane exposure, and the family environment in Spanish. Areas of the family environment assessed include parent-child relationship quality, parent-child involvement, parental monitoring, discipline, and parents' relationship quality. Structural equation models were estimated for parents and children, and by age group. For children (4-10 years old, N = 582), hurricane exposure was directly related to lifetime experience of ataques, but not for past year experience of ataques. However, for children, none of the family variables had a significant mediating role in the relation between hurricane exposure and either past year or lifetime experience of ataques; rather, parent-child involvement decreased risk for lifetime and past year ataques. For youth (11-17 years old, N = 569), per youth report, positive discipline mediated the hurricane exposure to lifetime experience of ataques relationship, whereas parents' relationship quality mediated the relationship between exposure and past year experience of ataques. Hurricane exposure decreased positive discipline and parents' relationship quality, and positive discipline and parents' relationship quality decreased risk for ataques. Per parent report, parent-child involvement decreased risk for past year or lifetime experience of ataques. Implications for post-disaster mental health recovery efforts are discussed.