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Children’s Disaster Reactions: the Influence of Exposure and Personal Characteristics

Authors:

Abstract

This paper reviews children's reactions to disasters and the personal and situational factors that influence their reactions. Posttraumatic stress disorder (PTSD) and posttraumatic stress reactions are the most commonly studied outcomes, though other conditions also occur including anxiety, depression, behavior problems, and substance use. More recently, traumatic grief and posttraumatic growth have been explored. New research has delineated trajectories of children's posttraumatic stress reactions and offered insight into the long-term consequences of their disaster experiences. Risk factors for adverse outcomes include pre-disaster vulnerabilities, perception of threat, and loss and life disruptions post-disaster. Areas in need of additional research include studies on the timing and course of depression and anxiety post-event and their interactions with other disorders, disaster-related functional and cognitive impairment, positive outcomes, and coping.
CHILD AND FAMILY DISASTER PSYCHIATRY (B PFEFFERBAUM, SECTION EDITOR)
Childrens Disaster Reactions: the Influence of Exposure
and Personal Characteristics
Betty Pfefferbaum
1,2
&Anne K. Jacobs
2
&Natalie Griffin
2
&J. Brian Houston
3
#Springer Science+Business Media New York 2015
Abstract This paper reviews childrens reactions to disasters
and the personal and situational factors that influence their
reactions. Posttraumatic stress disorder (PTSD) and posttrau-
matic stress reactions are the most commonly studied out-
comes, though other conditions also occur including anxiety,
depression, behavior problems, and substance use. More re-
cently, traumatic grief and posttraumatic growth have been
explored. New research has delineated trajectories of chil-
drens posttraumatic stress reactions and offered insight into
the long-term consequences of their disaster experiences. Risk
factors for adverse outcomes include pre-disaster vulnerabil-
ities, perception of threat, and loss and life disruptions post-
disaster. Areas in need of additional research include studies
on the timing and course of depression and anxiety post-event
and their interactions with other disorders, disaster-related
functional and cognitive impairment, positive outcomes, and
coping.
Keywords Adolescents .Anxiety .Children .Coping .
Depression .Disaster .Exposure .Mental health .
Posttraumatic growth .Posttraumatic stress .Posttraumatic
stress disorder (PTSD) .Recovery .Resilience .Terr o r ism .
Trauma .Traumatic grief
Introduction
Children have been recognized as especially vulnerable to
disasters [1]. A nationally representative survey conducted in
the USA established a lifetime rate of disaster exposure at
13.9 % in children and adolescents [2]; almost one fourth of
those who experienced a lifetime disaster reported more than
one disaster. In another nationally representative US survey of
adolescents, exposure to natural or human-caused disasters
was 14.8 %, second only to unexpected death of a loved one
at 28.2 % as the most common potentially traumatic event [3].
Rates in other parts of the world, especially in less developed
regions, are likely to be higher due to less durable infrastruc-
tures, rapid expansion of populations and industrialization,
and political conflict.
This paper reviews childrens emotional and behavioral
reactions to disasters with a focus on recent studies that have
explored an expanded range of outcomes, trajectories of re-
sponse and long-term disaster effects, and nuances of expo-
sure and childrens personal characteristics that affect their
recovery. A companion paper reviews the environmental in-
fluences, such as family and community factors, on childrens
reactions [4••].
This article is part of the Topical Collection on Child and Family Disaster
Psychiatry
*Betty Pfefferbaum
Betty-Pfefferbaum@ouhsc.edu
Anne K. Jacobs
akzerg@yahoo.com
Natalie Griffin
Natalie-Griffin@ouhsc.edu
J. Brian Houston
houstonjb@missouri.edu
1
Department of Psychiatry and Behavioral Sciences, College of
Medicine, University of Oklahoma Health Sciences Center,
P.O. Box 26901, WP3217, Oklahoma City, OK 73126-0901, USA
2
Terrorism and Disaster Center, University of Oklahoma Health
Sciences Center, P.O. Box 26901, WP3217, Oklahoma
City, OK 73126-0901, USA
3
Department of Communication, University of Missouri, 115 Switzler
Hall, Columbia, MO 65211-2310, USA
Curr Psychiatry Rep (2015) 17:56
DOI 10.1007/s11920-015-0598-5
Childrens Reactions to Disasters
The literature describes a range of disaster outcomes in
children from transient emotional distress and behavior
changes to enduring psychopathology and impaired func-
tioning [5,6]. Many children, while experiencing distress
in association with their disaster experiences, do not de-
velop psychopathology, but instead adapt to their experi-
ences and environment. Commonly studied post-disaster
outcomes are internalizing reactions and conditions such
as posttraumatic stress disorder (PTSD) and posttraumatic
stress reactions, anxiety, and depression. Externalizing be-
havior problems including substance use, cognitive ef-
fects, and traumatic grief have also been investigated.
Some children are resilient, and some experience posttrau-
matic growth. Recent studies have illustrated the trajecto-
ry of childrens reactions over time, but few long-term
follow-up studies have been conducted.
Rates of PTSD and posttraumatic stress in children post-
disaster vary depending on the samples assessed, the specific
outcomes measured, and the research methodology used. For
example, rates of significantly elevated symptom severity
have been estimated to be below 30 % [7], and the rate of
moderate posttraumatic stress symptoms in the acute post-
disaster period has been estimated at 50 % [6]. A recent
meta-analysis of studies of children and adolescents from
countries around the world revealed that overall, 15.9 % of
youth exposed to a traumatic event developed PTSD,
which reflects 9.7 % of children exposed to non-
interpersonal trauma, such as accidents and natural disas-
ters, and 25.2 % of youth exposed to interpersonal trauma
[8]. Posttraumatic stress symptoms appear to be common
in the first months post-event with a decline over the first
year or longer [7].
Depression and anxiety are common reactions to disas-
ters often comorbid with PTSD or posttraumatic stress [7,
9]. Depression may occur secondary to loss and grief, un-
resolved trauma and posttraumatic stress, and/or secondary
adversities [9]. Depression also may precede posttraumatic
stress symptoms [10]. Lai and colleagues [10]foundco-
morbid posttraumatic stress and depression in their hurri-
cane study in which loss of life was relatively low with 10
and 7 % of children evidencing comorbid posttraumatic
stress and depression symptoms 8 and 15 months post-di-
saster, respectively; recovery was slower in those with co-
morbid posttraumatic stress and depression. A recent re-
view study reported elevated prevalence rates for post-
disaster depression ranging from 2 to 69 % in children
relative to cited general populationratesfrom1to9%
[11••]. Another review of depression in children after nat-
ural disasters revealed prevalence rates in children ranging
from 7.5 to 44.8 % across studies [12]. Given these high
rates, more empirical work is warranted to explore the
varied etiologies and time course of depression as well as
its relationship to other disorders.
Disaster exposure may initiate a path to the develop-
ment of anxiety disorders such as specific phobias, panic
disorder, and separation anxiety [6]. Studies have docu-
mented increases in childrens generalized anxiety in re-
lation to disaster exposure [7], but post-disaster anxiety
may represent the continuation of pre-event anxiety or
trait anxiety [13]. Not all longitudinal studies have con-
firmed an increase in anxiety symptoms post-event,
though this may simply reflect an absence of the normal
decline in rates over the course of development [14].
Thus, additional work is needed to clarify findings relat-
ed to post-disaster anxiety in children, to identify predis-
posing influences, and to explore the progression of anx-
iety symptomatology and its relationship to other disaster
reactions.
Behavior problems also have been studied in children in
the context of disasters with conflicting results. For example,
research has documented both an increase in externalizing
conditions [e.g., 15,16] and improvement in childrensbehav-
ior post-event with a return to pre-event levels over time [e.g.,
17,18]. Recent work in the Middle East suggests that expo-
sure to chronic terrorism and political violence is linked to
behavior problems [e.g., 19]. For example, Pat-Horenczyk
and colleagues [19] found that preschool children exposed to
ongoing political violence had higher rates of behavior prob-
lems as well as PTSD and depression symptoms than children
without chronic exposure. Moreover, maternal distress was
associated with child distress in the form of externalizing,
internalizing, and posttraumatic stress symptoms, and the ac-
cumulated and continuous exposure to political violence and
danger increased maternal distress which further affected the
child [19].
Recent literature has examined substance use in association
with disaster exposure in youth [e.g., 2024]. In a sample of
New York City high school students assessed 6 months after
the September 11 attacks, increased smoking was associated
with prior trauma and PTSD while increased drinking was
associated with direct exposure to the attacks [24]. A longitu-
dinal study of adolescents assessed 5 months following a
deadly café fire in the Netherlands revealed that students in
the affected school had significantly greater increases in ex-
cessive drinking than students in unaffected schools [22].
Twelve months later, increases in excessive use of alcohol
from baseline to follow-up also were significantly greater in
students from the affected school than in the comparison
group but the effects had decreased compared to those at
5 months, and there were no differences between the two
groups in behavioral and emotional problems or in the use
of other substances [23]. Long-term follow-up studies also
suggest that problem alcohol [25] and problem substance
[26] use may not persist in disaster samples.
56 Page 2 of 6 Curr Psychiatry Rep (2015) 17:56
Functioning and Cognitive Impairment
While the importance of addressing childrens post-disaster
functioning in general has been recognized for some time,
little research has focused on cognitive effects or on the rela-
tionship between functioning and other post-disaster prob-
lems. Impairment in childrens functioning post-disaster may
be most evident in school where they are required to perform
both academically and socially, sometimes in altered environ-
ments with damaged school facilities and disruptions in sched-
ules and routines. Scrimin and colleagues found difficulties in
attention, memory [27,28], and visual-spatial performance as
well as lower grades [28] in children exposed to the Beslan
school hostage crisis. In a study examining six domains of
school and interpersonal functioning in relationship to alcohol
and drug use in middle and high school students attending
schools near the World Trade Center at the time of the Sep-
tember 11 attacks, students with increased substance use ex-
perienced more impairment in school work and school behav-
ior compared to those without increased substance use
18 months post-incident [20].
Grief, Complicated Grief, and Traumatic Grief
Children who lose loved ones in a disaster suffer grief which
may be exacerbated in the context of the familyssocialand
economic adversities such as financial problems and lack of
housing [29]. Some children suffer complicated griefthe per-
sistence of acute grief or the development of complications in
the context of the grief process [30]and/or traumatic grief
the intrusion of trauma symptoms into the bereavement pro-
cess [31]in relationship to their loss. Little empirical re-
search has addressed these grief reactions. Dyregrov and col-
leagues [32] found a high prevalence of complicated grief,
posttraumatic stress reactions, and general psychological dis-
tress in parents and siblings 1.5 years after a 2011 terrorist
attack on a youth camp in Norway that killed 69 youth and
adults. Intense contemporaneous exposure through telephone
or text messaging with the victims as the event unfolded, ex-
tensive media coverage, and the previously peaceful context of
the environment were thought to influence reactions [32].
Posttraumatic Growth
Posttraumatic growth includes psychological (e.g., greater ap-
preciation for life, modified values, increased sense of person-
al strength), interpersonal (e.g., improved relationships), and/
or functional (e.g., ways of coping) gains that were not appar-
ent pre-disaster but arose from the disaster experience [33,
34]. Posttraumatic growth and distress are not two ends on a
spectrum, and they may co-occur [35]. The traumatic circum-
stances that cause distress can also mobilize the coping at-
tempts and adaptation that result in growth. For example,
posttraumatic stress predicted posttraumatic growth in a study
of children from the Gulf Coast 1 year after Hurricane Katrina,
demonstrating that distress may spark growth [36].
Trajectories of Response and Long-Term Recovery
Recent research examining trajectories of childrensdisaster
reactions has identified adaptive and maladaptive outcomes
[13,37,38••]. For example, La Greca and colleagues [13]
identified three trajectories of posttraumatic stress symptoms
in children during the first year (3, 7, and 10 months) after
Hurricane Andrew. Approximately 20 % of the sample had a
chronic course, 43 % of the sample was characterized as re-
covering, and 37 % of the sample was described as resilient.
Mean posttraumatic stress symptom scores decreased signifi-
cantly over time in all three trajectories. Removing children
with minimal exposure in recalculating their findings, Weems
and Graham [38••] found the proportion of resilient children
in their sample dropped from 43 % to only 16 %, highlighting
the importance of considering exposure in determining resil-
ience. La Greca and colleagues [13] found that childrens
disaster exposureboth perceived and actual threatdid
not distinguish the recovering and chronic trajectories from
the resilient trajectory, but that children who reported per-
ceived life threat and/or more loss and disruption were more
likely to fit in the recovering or chronic trajectories rather than
the resilient trajectory.
Long-term follow-up studies suggest recovery for most
children following disasters. In a 20-year follow-up study,
McFarlane and Van Hooff [25] reported no significant differ-
ence in PTSD rates in Australian children exposed to a mas-
sive bushfire relative to a non-exposed comparison group, and
the risk of developing an anxiety disorder was small relative to
the controls except in those exposed to multiple traumas. Mor-
gan and colleagues [26] reported that 29 % of the child survi-
vors of a deadly 1966 coal pile collapse had current PTSD
33 years after the disaster though the comparison group from a
village nearby in the same economically depressed area of the
country also had high rates of psychopathology. Survivors
were at no greater risk for developing anxiety, depression, or
substance use than controls [26].
The Influence of Exposure on Childrens Disaster
Reactions
The extant research supports a dose-response relationship be-
tween disaster exposure and outcomes, with the severity of
outcomes associated with the intensity or severity of expo-
sures [39,40••]. In their meta-analysis of 96 child disaster
studies, Furr and colleagues [39] concluded that it is not mere
proximity to an event but specific aspects of exposure that
Curr Psychiatry Rep (2015) 17:56 Page 3 of 6 56
determine risk for adverse outcomes. For example, the childs
perception of threat and other subjective reactions; the extent
of disruption, destruction, injury, and death; and the childs
specific disaster experiences such as being injured, witnessing
the event, and loss of loved ones are aspects of disaster expo-
sure that influence posttraumatic stress [39] and depression
[11••,12]. The dose-response relationship applies to interper-
sonal disaster exposure through, for example, the closeness of
family and associates [41].
The Influence of Personal Factors on Childrens
Disaster Reactions
A number of child characteristics affect childrens disaster
reactions and recovery including demographics, preexisting
vulnerabilities, and post-disaster experiences. Girls are com-
monly identified as being at greater risk than boys for adverse
outcomes such as posttraumatic stress reactions [39] and de-
pression [11••], but it may be that boys and girls display dis-
tress differently with girls suffering more internalizing symp-
toms and boys evidencing more externalizing difficulties.
Moreover, boys and girls may interpret and report events dif-
ferently [40••]. Childrens age or stage of development influ-
ences their understanding of an event, the specific presentation
of their reactions [42], and adaptation [40••], but findings on
the effects of age or development on outcomes are inconclu-
sive [40••]. Children of ethnic minority heritage may be at
greater risk for adjustment problems post-disaster than chil-
dren from the majority culture, but these differences may rep-
resent, or be influenced by, differences in disaster experiences,
socioeconomic status, exposure to prior trauma, and/or family
or other social influences [6]. Childrens pre-event emotional
status, prior trauma, and major life events post-incident influ-
ence their disaster reactions and recovery [6,11••,12,40••].
Coping
Coping entails both involuntary and deliberate cognitive, be-
havioral, and emotional efforts to reconcile a perceived dis-
crepancy between the demands of environmental stressors and
the childs own personal resources [43]. Coping strategies can
be adaptive or maladaptive depending on their relationship to
adverse outcomes [44••]. Childrens ability to cope, their ap-
proach to coping, and their repertoire for coping vary with age
and development [44••,45], gender [45], and culture [e.g.,
46]. Other factors that may influence coping include aspects of
the childs event exposure [e.g., 47,48] or the interaction of
personal and exposure characteristics [e.g., 49], time since the
disaster [e.g., 50], the degree of perceived control the child has
over the situation [e.g., 51], and the childs disposition [45]
and self-esteem [e.g., 52]. The literature in general approaches
mass trauma as single incidents, though coping has been ex-
plored in the context of ongoing political violence [44••]. Lit-
tle disaster research has explored coping in relationship to
positive outcomes such as well-being [44••].
Conclusions and Future Directions
An impressive literature over several decades has documented
childrens reactions to disasters and the various event, exposure,
and personal factors that influence those reactions. Recent re-
search has extended the examination of outcomes beyond in-
ternalizing conditions (e.g., PTSD, anxiety, depression) to in-
clude externalizing conditions (e.g., behavior problems, sub-
stance use), functioning and cognitive impairment, traumatic
grief, and posttraumatic growth. With a primary focus on PTSD
and posttraumatic stress reactions, relatively little is known
about pre- and post-event comorbid conditions that may affect
outcome [13]. Longitudinal assessment of children has charted
childrens reactions over several years post-disaster and delin-
eated trajectories of response. Many children exposed to disas-
ters are resilient. Studies suggest that in addition to aspects of
disaster exposure such as perceived life threat, preexisting child
characteristics and pre- and post-event life experiences are im-
portant determinants of the childs disaster outcomes. The liter-
ature has begun to address childrens coping in the context of
disasters, but the studies are too few and too diverse to draw
definitive conclusions about the strategies and determinants that
influence outcomes. Additional research to benefit the field
would include exploring the timing and course of depression
and anxiety post-event and their interactions with other disor-
ders and the effects of disasters on childrens quality of life and
potential growth as well as on psychopathology.
Acknowledgments This work was conducted by the Terrorism and
Disaster Center (TDC), at the University of Missouri and the University
of Oklahoma Health Sciences Center, a partner in the National Child
Traumatic Stress Network (NCTSN). TDC is funded by the Substance
Abuse and Mental Health Services Administration (SAMHSA), U.S.
Department of Health and Human Services (HHS). Points of view in this
document are those of the authors and do not necessarily represent the
official position of HHS, NCTSN, SAMHSA, the University of Missouri,
or the University of Oklahoma Health Sciences Center.
Compliance with Ethics Guidelines
Conflict of Interest Natalie Griffin and J. Brian Houston declare that
they have no conflict of interest.
Betty Pfefferbaum has received a grant from the Substance Abuse and
Mental Services Administration.
Anne K. Jacobs has received consulting fees/honorarium from the
University of Oklahoma Health Sciences Center and the University of
Missouri, Columbia, MO.
Human and Animal Rights and Informed Consent This article does
not contain any studies with human or animal subjects performed by any
of the authors.
56 Page 4 of 6 Curr Psychiatry Rep (2015) 17:56
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... In addition to disaster exposure, young people can experience a host of secondary stressors including separation from family and friends, loss of pets, displacement from home and school, and lack of basic needs, such as food, water, and medical care [4]. Common disaster-related distress reactions in children and adolescents include internalized symptoms, such as acute stress disorder, PTSD, depression, or generalized anxiety; and externalizing symptoms, such as behavior problems, substance abuse, and aggressive behaviors [5][6][7][8]. ...
... The development of psychological distress in children and adolescents has been closely linked to a myriad of risk and protective factors. Factors that put a young person at risk for mental health distress can include high levels of disaster exposure, low parental support, social isolation, poverty, and pre-existing mental health symptoms such as anxiety and depression [6,8,9]. Conversely, protective factors, such as peer social support, school connectedness, supportive parenting, problem solving, self-regulation skills, perceived self-efficacy, and positive maternal-child relationships can buffer the psychological impact of large-scale sudden-onset disasters [6,10]. ...
... Factors that put a young person at risk for mental health distress can include high levels of disaster exposure, low parental support, social isolation, poverty, and pre-existing mental health symptoms such as anxiety and depression [6,8,9]. Conversely, protective factors, such as peer social support, school connectedness, supportive parenting, problem solving, self-regulation skills, perceived self-efficacy, and positive maternal-child relationships can buffer the psychological impact of large-scale sudden-onset disasters [6,10]. ...
Article
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Acute onset disasters impact children’s and adolescents’ psychological well-being, often leading to mental health challenges. The way a young person copes with the event plays a significant role in development of post-disaster psychopathology. Coping has been widely studied after acute onset disasters, however, difficulties conducting research in post-disaster contexts and the individualized nature of coping make accurate assessment of coping a significant challenge. A systematic literature search of multiple databases and previous reviews was conducted, exploring scholarly documentation of coping measurement and the relationship between coping and post-traumatic stress (PTSS) symptoms after acute onset disasters. A total of 384 peer-reviewed manuscripts were identified, and 18 articles met the inclusion criteria and were included in the current review. The studies examined coping and post-traumatic stress in the wake of acute onset disasters such as terrorist events and natural disasters, such as hurricanes, earthquakes, and wildfires. Greater PTSS symptoms were related to internalizing, externalizing, rumination, and avoidant coping strategies. Coping measurement was constrained due to measurement variance, lack of developmentally and contextually validated instruments, theoretical misalignment, and absence of comprehensive tools to assess coping. Robust and consistent measures of coping should be established to inform research and interventions to reduce the impact of disasters on children’s and adolescents’ well-being.
... Female gender, a higher trauma exposure (i.e., suffering injury, perceived life threat), a higher number of life events, less social support, and negative coping were associated with less-favorable posttraumatic stress symptom trajectories. However, these results are not unexpected as these factors represent well-established risk and resilience factors for posttraumatic stress disorders [36] and the cumulation of negative life events increases the risk of maladaptation [37][38][39]. Especially, the assessment of peritraumatic factors, such as trauma load, the suffering of injuries, witnessing traumatic scenes, to have a close person being killed or missing, etc. can be easy to assess variables that may help to identify at risk populations and to support those in dealing with their experiences. Newly occurring traumatic events or the experience of negative life events may be especially linked to delayed or relapsing trajectories, as research underlines the impact of newly occurring negative events on the psychosocial development of children [40]. ...
Article
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In the last decade, Europe has seen a rise in natural disasters. Due to climate change, an increase of such events is predicted for the future. While natural disasters have been a rare phenomenon in Europe so far, other regions of the world, such as Central and North America or Southeast Asia, have regularly been affected by Hurricanes and Tsunamis. The aim of the current study is to synthesize the literature on child development in immediate stress, prolonged reactions, trauma, and recovery after natural disasters with a special focus on trajectories of (mal-)adaptation. In a literature search using PubMed, Psychinfo and EBSCOhost, 15 studies reporting about 11 independent samples, including 11,519 participants aged 3–18 years, were identified. All studies identified resilience, recovery, and chronic trajectories. There was also evidence for delayed or relapsing trajectories. The proportions of participants within each trajectory varied across studies, but the more favorable trajectories such as resilient or recovering trajectory were the most prevalent. The results suggested a more dynamic development within the first 12 months post-disaster. Female gender, a higher trauma exposure, more life events, less social support, and negative coping emerged as risk factors. Based on the results, a stepped care approach seems useful for the treatment of victims of natural disasters. This may support victims in their recovery and strengthen their resilience. As mental health responses to disasters vary, a coordinated screening process is necessary, to plan interventions and to detect delayed or chronic trauma responses and initiate effective interventions.
... Dabei sind posttraumatische Belastungsstörungen und -reaktionen die häufigsten Folgen. Krisensituationen können bei Kindern auch zu Angstgefühlen, Depressionen und dem Konsum von Suchtmitteln führen (Pfefferbaum et al. 2015a(Pfefferbaum et al. , 2015b. Entgegen der Annahme, dass beispielsweise jüngere Kinder eine Krisensituation nicht wahrnehmen und von deren Ausmass nicht beeinflusst werden, zeigen Studien, dass bereits Kinder unter zwei Jahren mit Unruhe und Trauer auf Veränderungen in ihrem Umfeld reagieren, wie dem Wegfall ihrer Grosseltern als Betreuungspersonen in einer solchen Situation (Dalton, Rapa, und Stein 2020 Aufgrund der Omnipräsenz der Corona-Pandemie im öffentlichen und privaten Leben und den sich daraus ergebenden Veränderungen kommen auch Heranwachsende mit der Pandemie in Berührung (Loss et al. 2021;Malecki, Keating, und Safdar 2020). ...
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Der Ausbruch der Corona-Pandemie stellte Eltern und Kinder weltweit vor Herausforderungen und löste Unsicherheiten aus. Eltern mussten neben dem Alltag Homeoffice, Betreuungsaufgaben und die Begleitung des Homeschoolings ihrer Kinder bewältigen. Insbesondere die Schliessung der Kindestagesstätten und Schulen sowie Ausgangsbeschränkungen veränderten die familiären Tagesabläufe, was mit einer erhöhten Mediennutzung von Heranwachsenden und Erwachsenen einherging. Der Aufsatz untersucht auf Basis der Parental-Mediation-Theorie, welche Mediationsstrategien der kindlichen Mediennutzung Eltern während des ersten Lockdowns generell und bezogen auf Informationen über das Corona-Virus einsetzten, inwiefern sie diese Strategien pandemiebedingt anpassten und welche Faktoren bestimmten, für welche Form der Medienregulation sich Eltern entschieden. Er basiert auf Leitfadeninterviews (n = 55) sowie einer Onlinebefragung von Eltern mit Kindern im Alter von drei bis 18 Jahren (n = 146). Die Befunde zeigen, dass Eltern erstens verschiedene Mediationsstrategien miteinander kombinierten, diese zweitens in der Pandemie situativ den kindlichen Bedürfnisse anpassten und drittens Kind-, Eltern- und Kontextfaktoren die Wahl der Mediationsstrategie bestimmten.
... Research shows that schools are key community resources during "normal" times and even more so after a disaster (Pfefferbaum et al., 2015). A quick return to regular school operations post-disaster signals a degree of normalcy, a return to pre-disaster conditions with parents being able to work knowing their children are safe at school (Ronan & Johnston, 2005). ...
Article
en Research on the societal costs of disaster-related US school closures has focused, and due to COVID-19 will likely continue to focus, on pandemics, with very limited research on closures from natural hazards. This is surprising given that school closures occur frequently to protect children, teachers, and staff pre-event as well as post-disaster to convert facilities into emergency shelters, etc. This study investigates the secondary effects from post-flooding, temporary school closures after the catastrophic 2015 flash flood in Richland County, South Carolina. Lost productivity from school closures was quantified using the Human Capital Method. Out of the 208 completed surveys, 75% of households had children that missed school. Post-stratifying survey results on race produced an average of $437 in lost productivity due to school closures and an overall $2175 in lost productivity due to flood-related impacts in general. Expressed in FEMA benefit-cost analysis terms, our study shows that schools have a standard value of $215 per household and per day for the unweighted sample ($180 for the race-weighted sample). Furthermore, households' disutility for a late start is almost as great as their disutility for a school closure. These exploratory findings suggest that unplanned school closures should be minimized, and community characteristics carefully considered to avoid unintended socioeconomic consequences. 摘要 zh 与灾害相关的美国学校关闭,其产生的社会成本研究已聚焦于大流行,并在2019冠状病毒病(COVID-19)情境下很有可能继续聚焦于大流行,但鲜有研究聚焦于与自然灾害相关的学校关闭。这是出乎意料的,因为关闭学校一事频繁发生,用于在灾害前后保护儿童、教师和员工,并将学校设施转变为应急避难所等。本研究调查了2015年南卡罗莱纳州里奇兰县惨烈洪灾事件后临时关闭学校所产生的次级效应(secondary effect)。通过人力资本法对关闭学校所损失的生产力进行量化。在208份已完成的调查中,75%的家庭报告其子女想念上学。以种族为研究对象的事后分层调查结果显示,因关闭学校造成的生产力损失平均为437美元(以家庭为单位),并且因洪灾相关影响而总体造成的生产力损失为2,175美元(以家庭为单位)。以联邦紧急事务管理局的收益-成本分析术语为参考,我们的研究表明,对未加权样本而言,学校的标准值为每户每天215美金,而对种族加权样本的标准值为每户每天180美元。此外,家庭对晚点开学和对关闭学校所感受的负效用程度几乎相同。这些探索性发现暗示,应将未计划的关闭学校事件最小化,并谨慎考量社区特征,以期避免意料之外的社会经济结果。 Resumen es La investigación sobre los costos sociales de los cierres de escuelas en EE. UU. Relacionados con los desastres se ha centrado, y debido al COVID-19, es probable que continúe centrándose en las pandemias, con una investigación muy limitada sobre los cierres por peligros naturales. Esto es sorprendente dado que los cierres de escuelas ocurren con frecuencia para proteger a los niños, maestros y personal antes del evento y después del desastre para convertir las instalaciones en refugios de emergencia, etc. Este estudio investiga los efectos secundarios del cierre temporal de escuelas después de las inundaciones la catastrófica inundación repentina de 2015 en el condado de Richland, Carolina del Sur. La productividad perdida por el cierre de escuelas se cuantificó utilizando el Método de Capital Humano. De las 208 encuestas completadas, el 75% de los hogares tenían niños que faltaban a la escuela. Los resultados de la encuesta posterior a la estratificación sobre la raza produjeron un promedio de $ 437 en pérdida de productividad debido al cierre de escuelas y un total de $ 2.175 en pérdida de productividad debido a los impactos relacionados con las inundaciones en general. Expresado en términos de análisis de costo-beneficio de FEMA, nuestro estudio muestra que las escuelas tienen un valor estándar de $ 215 por hogar y por día para la muestra no ponderada ($ 180 para la muestra ponderada por raza). Además, la desutilidad de los hogares por un comienzo tardío es casi tan grande como su inutilidad por el cierre de una escuela. Estos hallazgos exploratorios sugieren que los cierres de escuelas no planificados deben minimizarse y las características de la comunidad deben considerarse cuidadosamente para evitar consecuencias socioeconómicas no deseadas.
... Mental health symptoms usually appear in childhood and then continue into adolescence (17)(18)(19). It may be expected to observe emotional and behavioral changes as a reaction of an adverse event like the pandemic, but these changes may also be affected by the caregivers' responses (20)(21)(22)(23). Studies have shown that toddlers' and preschoolers' behavioral problems and hyperactivity were associated with their parents' mental health (24). ...
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Background: There is limited evidence about emotional and behavioral responses in toddlers and preschoolers during the novel coronavirus (COVID-19) pandemic, particularly in Latin America. Objective: To assess associations between changes in movement behaviors (physical activity, screen time and sleeping) and emotional changes in toddlers and preschoolers during early stages of the pandemic in Chile. Methods: A cross-sectional study conducted from March 30th to April 27th, 2020. Main caregivers of 1- to 5-year-old children living in Chile answered an online survey that included questions about sociodemographic characteristics, changes in the child's emotions and behaviors, movement behaviors and caregivers' stress during the pandemic. Multiple linear regressions were used to assess the association between different factors and emotional changes in toddlers and preschoolers. Results: In total, 1727 caregivers provided complete data on emotional changes for children aged 2.9 ± 1.36 years old, 47.9% girls. A large proportion of toddlers and preschoolers in Chile experienced emotional and behavioral changes. Most caregivers reported that children “were more affectionate” (78.9%), “more restless” (65.1%), and ‘more frustrated' (54.1%) compared with pre-pandemic times. Apart from changes in movement behaviors, factors such as child age, caregivers' age and stress, and residential area (urban/rural) were consistently associated with changes in emotions and behaviors. Conclusion: The pandemic substantially affected the emotions and behaviors of toddlers and preschoolers in Chile. The findings suggest that supportive actions for caregivers may have a positive impact not only on adults but also on children. Mental health promotion programs should consider multilevel approaches in which the promotion of movement behaviors and support for caregivers should be essential pieces for future responses.
... Of these, most centered on post-traumatic stress. [17][18][19][20][21][22][23][24][25][26][27][28][29][30][31] Fewer consider internalizing problems such as depression, 32-37 behavioral concerns, [38][39][40] and changes to neural processes. 41,42 Further, few publications documented long-term mental health impacts, including sleep disturbances and anxiety, for children that can persist for years following a disaster. ...
Article
The co-occurring crises of climate change, a global pandemic, and the social justice movement has put demands on psychosocial resilience. The country and global community has witnessed that those who contribute the least to climate change are the most impacted, and that black, indigenous, and people of color bear the health and financial burdens brought on by a changing climate. Given that eco-anxiety is on the rise amongst young people, such increases in awareness building have not yielded action at the speed and scale necessary to protect the most climate-sensitive among us: children and youth. Raising healthy children and youth is not divorced from nurturing mental health and wellness. Through a literature review of peer reviewed and gray literature, as well as expert interviews, the paper demonstrates the imperative to acknowledge and address contemporary needs of mental health in children and youth due to the co-occurring crises. It is time for a national effort to prioritize building psychosocial resilience in children and youth. It is essential to center psychosocial resilience through these various levers on the lives of BIPOC children and youth who experience disproportionate negative effects of one or more crises exacerbated by historic, structural and current environmental injustices. Not only is it imperative to expedite just and equitable actions to protect a world borrowed from children and generations to come, it is a responsibility to ensure those generations have the social and emotional tools to thrive.
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Disasters have numerous effects on children as one of the vulnerable groups in society. To this end, in this study, using the qualitative method of phenomenology and painting tool, we analyzed the experiences of children who encountered a flood disaster in Lorestan province in western Iran. The study was conducted through deep interviews with 34 children who experienced floods. Analysis of interviews with and paintings obtained from the studied children revealed that ten key experiences and effects from children's flood experiences could be identified. The study's findings revealed that children's lived experiences of flood can provide a suitable opportunity for individual, social, economic, geographical, spatial, and environmental recognition, understanding, education, and preparedness of them as the future generation. Therefore, understanding children's experiences of flood disasters and their effects can be beneficial not only for planning and managing hazards, but also for reducing the vulnerability of both the future generation and their children.
Article
The present study uses data from a 2020 survey conducted in Shaanxi Province during the COVID-19 outbreak to examine the family resources and psychological well-being of four major groups of Chinese children (urban, migrant, rural nonmigrant, and rural left-behind children). The results highlight the complex ways in which family resources intersect with the pandemic to affect these different groups of children. Family economic resources have generally declined across all groups, but left-behind children have suffered the most severe economic shock. However, parent–child relationships for all children have improved across the board during the pandemic. Diminished economic resources act as a risk factor, while improved family relationships play a protective role in children’s psychological well-being. Parent–child relationships have had a more pronounced positive impact on psychological outcomes for migrant and left-behind children, who are the most deprived of parental input under normal circumstances, than for other groups of children. Because of these processes, migrant children and left-behind children fare similarly to urban children in terms of their resilience to the COVID-19 crisis. Among children enjoying especially favorable parent–child relationships, migrant children and left-behind children even appear to have higher psychological well-being than urban children during the pandemic. In comparison to this social impact, the impact of family economic resources is more moderate in magnitude and does not vary systematically across different groups of children. As a result, the positive impact of improved parent–child relationships largely outweighs the adverse effect of reduced family economic resources. Overall, the findings provide new insight into the relationship among disasters, family resources, and child well-being in the context of the COVID-19 crisis in China.
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Shelter in place mandates due to the COVID-19 pandemic left caregivers to determine how to best meet the therapeutic requirements of their children with autism spectrum disorder (ASD). Understanding the challenges faced by families, and their experiences using telehealth for the first time, may help make services sustainable in future public health emergencies. A sample of 70 caregivers of people with ASD from across the US completed an anonymous online survey. Results indicate that impaired emotion regulation was a primary contributor of parent-reported stress for persons with ASD during the pandemic, while loss of established structure and routine contributed to parental stress. Nearly half the sample reported using telehealth for the first time. Many caregivers were appreciative that telehealth permitted continuation of services, but expressed concerns about limited effectiveness due in part to their children’s social communication problems.
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This study examined whether pre-disaster indicators of sympathetic and parasympathetic activity moderated the relation between degree of disaster exposure from an EF-4 tornado and changes in the externalizing and internalizing behavior problems of children at-risk for aggression. Participants included 188 children in 4th-6th grades (65% male; 78% African American; ages 9–13) and their parents from predominantly low-income households who were participating in a prevention study when the tornado occurred in 2011. Fourth-grade children who exhibited elevated levels of aggressive behavior were recruited in three annual cohorts. Parent-rated externalizing and internalizing problems were assessed prior to the tornado (Wave 1; W1), and at 4–12 months (W2), 16–24 months (W3), 42–28 months (W4) and 56–60 months (W5) post-tornado. Children’s pre-tornado Skin Conductance Level (SCL) reactivity and Respiratory Sinus Arrhythmia (RSA) withdrawal were assessed at W1 using SCL and RSA measured during resting baseline and during the first 5 min of the Iowa Gambling Task (IGT). Children and parents reported their exposure to tornado-related trauma and disruptions at Wave 3. Children displayed less reduction in externalizing problems if there had been higher child- or parent-reported tornado exposure and less RSA withdrawal, or if they had lower parent-reported TORTE and less SCL reactivity or lower SCL baseline. Highlighting the importance of children’s pre-disaster arousal, higher levels of disaster exposure negatively affected children’s level of improvement in externalizing problems when children had less vagal withdrawal, and when tornado exposure disrupted the protective effects of higher SCL reactivity and higher SCL baseline.
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This review examines family (demographics, parent reactions and interactions, and parenting style) and social (remote effects, disaster media coverage, exposure to secondary adversities, and social support) factors that influence children's disaster reactions. Lower family socioeconomic status, high parental stress, poor parental coping, contact with media coverage, and exposure to secondary adversities have been associated with adverse outcomes. Social support may provide protection to children in the post-disaster environment though more research is needed to clarify the effects of certain forms of social support. The interaction of the factors described in this review with culture needs further exploration.
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The goal of this paper was to critically evaluate the literature on children coping with mass trauma published between the years 2011 and 2014 and to emphasize interesting and important findings with the aim of proposing a new comprehensive model for better understanding the process of coping with these events in this unique developmental stage. Using a variety of databases, 26 research papers were selected. The papers were divided into two main categories, natural and manmade disasters. The findings suggest that several areas in this context still lack foundational knowledge and should be further investigated. Thus, it has been suggested that future research should emphasize the developmental stage of the children, the cultural context and atmosphere in which the investigated children grow up and live, and the type of event (acute vs. chronic; natural vs. manmade). A more comprehensive coping model which addresses these omissions and combines main theories is suggested for use in future research as well.
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Disasters typically strike quickly and cause great harm. Unfortunately, because of the spontaneous and chaotic nature of disasters, the psychological consequences have proved exceedingly difficult to assess. Published reports have often overestimated a disaster's psychological cost to survivors, suggesting, for example, that many if not most survivors will develop posttraumatic stress disorder (PTSD); at the same time, these reports have underestimated the scope of the disaster's broader impact in other domains. We argue that such ambiguities can be attributed to methodological limitations. When we focus on only the most scientifically sound research-studies that use prospective designs or include multivariate analyses of predictor and outcome measures-relatively clear conclusions about the psychological parameters of disasters emerge. We summarize the major aspects of these conclusions in five key points and close with a brief review of possible implications these points suggest for disaster intervention.
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In a representative sample of 2,030 U.S. children aged 2-17, 13.9% report lifetime exposure to disaster, and 4.1% report experiencing a disaster in the past year. Disaster exposure was associated with some forms of victimization and adversity. Victimization was associated with depression among 2- to 9-year-old disaster survivors, and with depression and aggression among 10- to 17-year-old disaster survivors. Children exposed to either victimization only or both disaster and victimization had worse mental health compared to those who experienced neither. More research into the prevalence and effects of disasters and other stressful events among children is needed to better understand the interactive risks for and effects of multiple forms of trauma.
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Children who have had someone close die as a result of a mass trauma event such as war, armed conflict, acts of terror, political violence, torture, mass accidents, and natural disasters are at risk for biopsychosocial problems. Research on how to classify when grief becomes complicated or traumatic in children is scarce, and while functioning level may provide a good indication, assessing functioning may be difficult in mass trauma environments where routines and structure are often lacking. There are promising trauma- and grief-focused interventions for children post-mass trauma, which are mostly provided in school settings. However, more advanced multi-method interventions are needed that address grief and trauma in the context of the child's overall mental health, parent/caregiver role in assisting the child, family system issues, ways to provide safe caring environments amidst chaos and change, and interventions that take into account local consumer perspectives, including the voices of children.
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Background: Disasters are destructive, potentially traumatic events that affect millions of youth each year. Objective: The purpose of this paper was to review the literature on depressive symptoms among youth after disasters. Specifically, we examined the prevalence of depression, risk factors associated with depressive symptoms, and theories utilized in this research area. Methods: We searched MEDLINE, PsycInfo, and PubMed electronic databases for English language articles published up to May 1, 2013. Reference lists from included studies were reviewed to capture additional studies. Only quantitative, peer reviewed studies, conducted with youth under the age of 18 years, that examined postdisaster depressive symptoms were included. Seventy-two studies met inclusion criteria. Prevalence of depressive symptoms, disaster type, correlates of depressive symptoms, and theories of depressive symptoms were reviewed. Results: Only 27 studies (38%) reported on prevalence rates among youth in their sample. Prevalence rates of depression among youth postdisaster ranged from 2% to 69%. Potential risk factors were identified (e.g., female gender, exposure stressors, posttraumatic stress symptoms). Theories were examined in less than one-third of studies (k = 21). Conclusions: Given the variability in prevalence rates, difficulty identifying a single profile of youth at risk for developing depressive symptoms, and lack of a unifying theory emerging from the studies, recommendations for future research are discussed. Use of established batteries of assessments could enable comparisons across studies. Merging existing theories from children's postdisaster and depression literatures could aid in the identification of risk factors and causal pathways.
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Children’s exposure to political violence has been found to be associated with posttraumatic symptoms and emotional and behavioral problems. However, little distinction has been made between the impact of exposure to continuous political violence and exposure to past political violence. This study in Israel compared a sample of preschool children and mothers (N = 85) with ongoing and recurring exposure to missile and rocket attacks (“Continuous sample”) to a sample (N = 177) from a recent time-limited war (“Past sample”). Mothers completed self-report questionnaires, including exposure to both political violence and other traumatic events, the Posttraumatic Diagnostic Scale (PDS), and a Depression Scale (CES-D). Mothers also reported on the child’s exposure to political violence and other traumatic events, posttraumatic symptoms, and the Child Behavior Checklist (CBCL). The results indicate the severe consequences of living in the face of ongoing traumatic stress. Children and mothers from the continuous exposure sample had more posttraumatic distress and their children had higher behavior problem scores compared with those in the past exposure sample, supporting the allostatic load hypothesis that cumulative stress exacts a heavier toll. Because the mother–child relationship is challenged in situations of exposure to violence, we compared relational trauma (measured by co-occurrence of posttraumatic distress in both mother and child) and found, as hypothesized, that relational trauma was more prevalent in the Continuous sample than in the Past sample. (PsycINFO Database Record (c) 2013 APA, all rights reserved)