Resilience in Children

Disaster
Effects

Overview

Dose gradients
Normal reactions
Common trauma symptoms
Post-traumatic stress disorder
Developmental differences
Individual differences

Dose matters

Physical proximity
Emotional proximity
Magnitude of personal loss
Severity of life-threatening experiences
Cumulative exposure
Combination of traumatic experiences
Previous trauma exposures
Disaster on top of other adversities
Media exposure

Common post-traumatic symptoms

Re-experiencing
Nightmares; upsetting memories
Flashbacks; intense reactions to reminders

Numbing and avoidance

Feeling detached, numb, unreal
Avoiding reminders

Arousal and anxiety

Jumpy; easily startled; hyper-vigilant
Difficulty sleeping, concentrating
Irritability or outbursts of anger

Meta-analysis of post-traumatic stress

Furr et al 2010

96 studies published before 2009

42 with comparison data (pre-post or groups)

Small to medium effect of disaster on PTS

Similar for natural and human-made disasters

Higher risk for PTS associated with

Higher death toll (index of severity)

Female gender
Child proximity
Personal loss
Perceived threat to self
Child versus parent report of PTS
Assessment < 1 year after disaster

Post-traumatic stress disorder

PTSD is a diagnostic category

Multiple symptoms of PTS that persist

more than a month
difficult to tell when a month has passed in
prolonged and complex disasters

Symptoms impair function

Sichuan Earthquake 2008

> 80,000 dead or missing ~ many schoolchildren
Millions left homeless

Courtesy of miniwiki.org

Luo et al 2012
cortisol in hair
related to
earthquake
exposure
and PTSD

2004 Tsunami

Megathrust earthquake Indian Ocean

No warning ~ waves 30 meters (100 feet) hig
Over 200,000 lives lost in 14 countries

Catani et al 2008 after the tsunami

BMC Psychiatry 2008

Developmental variations
Older children usually have more PTS
Children report more PTS than parents do for them
Young children
Regression (losing skills and self-control)
Crying and clinging to caregivers
Re-enacting trauma experiences in play

Adolescents
Risky or reckless behavior
Suicidal thoughts and feelings
Loss of hope in the future

Age of exposure matters

Including prenatal

Understanding of events and media

Biological responses
Resources and relationships for coping

Chernobyl effects on development

FinnTwin12 study (Huizink et al 2008)
Compared twins in gestation during Chernobyl
(1986) and a year later

Fear vector in Finland about radiation

Not attributable to actual radiation exposure

Effects on twins varied

By gestational age of exposure to maternal stress

Individual differences
Gender
Girls often (not always) express more PTS

Cognitive skills and comprehension

Meaning and interpretation; self-control

Personality and mental health

Some children are more sensitive

Resilience and recovery

U.S. Army Photo of Joplin High School by John Daves