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) high

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