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Resilience in Children

Disaster

Effects

Resilience in Children Disaster Effects
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

Meta-analysis of post-traumatic stress Furr et al 2010 • 96 studies published before 2009 • 42

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

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

Catani et al 2008 after the tsunami BMC Psychiatry 2008

BMC Psychiatry 2008

Developmental variations

Older children usually have more PTS

  • Regression (losing skills and self-control)

Children report more PTS than parents do for them

Young children

  • 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