A dissertation by Lev Zhuravsky submitted as partial fulfillment of the requirements for the degree of Master of Health Sciences Endorsed in Health Management, University of Otago, Dunedin, New Zealand.
Abstract. Natural (e.g., earthquake, flood, wildfires) and human-made (e.g., terrorism, civil strife) disasters are inevitable, can cause extensive disruption, and produce chronic and disabling psychological injuries leading to formal diagnoses (e.g., post-traumatic stress disorder [PTSD]). Following natural disasters of earthquake (Christchurch, Aotearoa/New Zealand, 2010–11) and flood (Calgary, Canada, 2013), controlled research showed statistically and clinically significant reductions in psychological distress for survivors who consumed minerals and vitamins (micronutrients) in the following months. Following a mass shooting in Christchurch (March 15, 2019), where a gunman entered mosques during Friday prayers and killed and injured many people, micronutrients were offered to survivors as a clinical service based on translational science principles and adapted to be culturally appropriate. In this first translational science study in the area of nutrition and disasters, clinical results were reported for 24 clients who completed the Impact of Event Scale – Revised (IES-R), the Depression Anxiety Stress Scales (DASS), and the Modified-Clinical Global Impression (M-CGI-I). The findings clearly replicated prior controlled research. The IES-R Cohen’s d ESs were 1.1 (earthquake), 1.2 (flood), and 1.13 (massacre). Effect sizes (ESs) for the DASS subscales were also consistently positive across all three events. The M-CGI-I identified 58% of the survivors as “responders” (i.e., self-reported as “much” to “very much” improved), in line with those reported in the earthquake (42%) and flood (57%) randomized controlled trials, and PTSD risk reduced from 75% to 17%. Given ease of use and large ESs, this evidence supports the routine use of micronutrients by disaster survivors as part of governmental response.
Previous research has found that the capacity to self-regulate is associated with a number of positive life outcomes and deficits in self-regulation have been linked with poorer life outcomes. Therefore, parent and child self-regulation is an important focus of the Positive Parenting Program for Teenagers (Teen Triple P). The aim of this study was to investigate if Group Teen Triple P was effective in promoting parental self-regulation and adolescent behaviour change in families affected by the earthquakes in Canterbury NZ between 2010 and 2012. METHOD: Five families with teenagers aged 12-16 years were recruited from among families participating in a Group Teen Triple P program specifically implemented by the education authorities for parents self-reporting long-term negative effects of the earthquakes on their family. A single-case multiple-baseline across participants design was used to examine change in target teenager behaviour. Measures of self-regulation skill acquisition were taken using a coding scheme devised for the study from transcripts of three telephone consultations and from three family discussions at pre-intervention, mid-intervention, and post-intervention. Parents and their child also completed questionnaires addressing adolescent functioning, the parent-adolescent relationship and parenting at pre- and post-intervention. RESULTS: The multiple-baseline data showed that parents were successful at changing targeted behaviour for their child. Analysis of the telephone consultations and family discussions showed that parents increased their self-regulation skills over the therapy period and there was positive change in adolescent behavior reported on the Strengths and Difficulties Questionnaire. Additionally, the results suggested that higher rates and levels of self-regulation in the parents were associated with greater improvements in adolescent behaviour. CONCLUSION: This study demonstrated that the Group Teen Triple P -Program was effective in promoting self-regulation in parents and behaviour change in adolescents, specifically in a post-disaster context.