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CHILDREN'S REACTIONS TO DISASTERS


               

PRESENTER: Annette M. La Greca

In the wake of devastating natural disasters (Hurricanes Andrew and Hugo, the Northridge Earthquake, the Oakland fires, and the Loma Prieta Earthquake), human-made disasters (crash of TWA flight 800 and ValueJet disaster), as well as recent bombing and terrorist activities (Oklahoma City Federal Building; World Trade Center), tremendous interest and concern has developed regarding the impact of disasters on children and adolescents. Recent studies indicate that disasters represent traumatic events for children that can result in the emergence of post-traumatic stress reactions. Findings also indicate that children's reactions to disasters can be severe and are not merely fleeting, transitory events that quickly dissipate. In many cases, children's reactions linger and persist and, thus, are likely to cause much distress to children and their families. In this context, the purpose of the presentation will be to: a) review the available research on children's reactions following disasters, b) describe which children are most likely to be at risk for severe and persistent posttraumatic stress reactions, c) understand factors (at home, in school) that promote children's coping after a major disaster, and d) describe various interventions that have been developed for promoting children's adjustment following traumatic disasters. In reviewing existing research, the presentation will draw upon a conceptual framework for understanding children's reaction to disasters, with implications for postdisaster interventions. Furthermor e, the presentation will also consider developmental aspects of children's reactions to disasters, and the need for matching intervention strategies with the phase of postdisaster recovery (acute, short-term, long-term). *************************** Annette M. La Greca Department of Psychology PO Box 249229 University of Miami Coral Gables, FL 33124 (305) 284-5222 (ext. 1) (305) 284-4795 (fax) alagreca@miami.edu http://www.psy.miami.edu/faculty/alagreca/ ************************** Children's Reactions to Disasters: Lessons Learned from Andrew and Other Disasters Annette M. La Greca I. Background/Introduction In the wake of devastating natural disasters (Hurricanes Andrew and Hugo, the Northridge Earthquake, the Oakland fires, and the Loma Prieta Earthquake), human-made disasters (crash of TWA flight 800 and ValueJet disaster), as well as recent bombing and terrorist activities (Oklahoma City Federal Building; World Trade Center), tremendous interest and concern has developed regarding the impact of disasters on children and adolescents. Recent work from a number of investigators who have studied children's reactions to disasters (e.g., Green et al., 1991; La Greca, Silverman, Vernberg, & Prinstein, 1996; Lonigan, Shannon, Finch, Daugherty, & Taylor, 1991; Shannon, Lonigan, Finch, & Taylor, 1994; Shaw et al., 1995; Vernberg, La Greca, Silverman, & Prinstein, 1996) indicates that disasters represent traumatic events for children that can result in the emergence of post-traumatic stress reactions (DSM-IV, American Psychiatric Association, 1994). Findings indicate that children's reactions to natural disasters can be severe and are not merely fleeting, transitory events that quickly dissipate. On the contrary, children's reactions appear to linger and persist and, thus, are likely to cause much distress to children and their families. Moreover, because of the severe and persistent reactions children may have to disasters, efforts to provide effective services and interventions for children and adolescents following a disaster represent an important, and frequently overlooked, mental health need. Following from the above concerns, the main objectives of this presentation are to: a) review the available research on children's reactions following disasters, b) describe which children are most likely to be at risk for severe and persistent posttraumatic stress reactions, c) understand factors (at home, in school) that promote children's coping after a major disaster, and d) describe various interventions that have been developed for promoting children's adjustment following traumatic disasters. The review of available research on children and disasters will draw on a conceptual framework for understanding children's reaction to traumatic events, such as disasters (see Vernberg et al., 1996; La Greca et al., 1996). This conceptual framework places considerable emphasis on the importance of characteristics of the individual (e.g., ethnicity, prediaster functioning), of the disaster (e.g., degree of exposure, life threat), and of the recovery environment (e.g., availability of social support, intervening life events), in understanding children's short-term and long-term reactions. To the extent possible (given existing literature), the presentation will also consider developmental aspects of children's reactions. Furthermore, differentiation between immediate, short-term, and long-term disaster reactions will be emphasized, especially in terms of the types of intervention strategies that may be needed at different points in time. Although interventions with children following disasters have not, by and large, been evaluated in well-controlled outcome studies, there is a reasonable empirical literature on the course of recovery and factors that seem to play a critical role in recovery. The interventions that will be described in this presentation will meet the criteria of being consistent with research on factors affecting recovery. II. Summary of Key Objectives The presentation will address several specific goals or objectives: 1) How do children react to disasters -- both natural disasters and those that are human-made? 2) Which children are most at risk for severe posttraumatic stress (or other reactions), and how can they be identified early on?, 3) What factors affect children's readjustment during the recovery period?, 4) What kinds of postdisaster interventions (community-based, school- based and family-based) help children cope more effectively? 5) How does the above information vary as a function of the child's developmental level? 6) How does the above information vary as a function of the stage of disaster recovery? 7) What are some common obstacles that need to be considered in planning community-based disaster relief and recovery efforts? III. References American Psychiatric Association (1994). Diagnostic and statistical manual of mental disorders (IV ed.). Washington, DC: Author. Green, B. L., Korol, M. S., Grace, M. C., Vary, M. G., Leonard, A. C., Gleser, G. C., & Smitson-Cohen, S. (1991). Children and disaster: Gender and parental effects on PTSD symptoms. Journal of the American Academy of Child and Adolescent Psychiatry, 30, 945-951. La Greca, A. M., Silverman, W. S., Vernberg, E. M., & Prinstein, M. J. (1996). Posttraumatic stress symptoms in children after Hurricane Andrew: A prospective study. Journal of Consulting and Clinical Psychology, 64, 712-723. Lonigan, C. J., Shannon, M. P., Finch, A. J., Daugherty, T. K., & Taylor, C. M. (1991). Children's reactions to a natural disaster: Symptom severity and degree of exposure. Advances in Behaviour Research and Therapy, 13, 135-154. Shannon, M.P., Lonigan, C.J., Finch, A.J., & Taylor, C.M. (1994). Children exposed to disaster: I. Epidemiology of post-traumatic symptoms and symptom profiles. Journal of the American Academy of Child Psychiatry, 33, 80-93. Shaw, J.A., Applegate, B., Tanner, S., Perez, D., Rothe, E., Campo-Bowen, A.E., & Lahey, B.L. (1995). Psychological effects of Hurricane Andrew on an elementary school population. Journal of the American Academy of Child and Adolescent Psychiatry, 34, 1185-1192. Vernberg, E. M., La Greca, A. M., Silverman, W. S., & Prinstein, M. J. (1996). Prediction of posttraumatic stress symptoms in children after Hurricane Andrew. Journal of Abnormal Psychology, 105, 237-248. *************************** Annette M. La Greca Department of Psychology PO Box 249229 University of Miami Coral Gables, FL 33124 (305) 284-5222 (ext. 1) (305) 284-4795 (fax) alagreca@miami.edu http://www.psy.miami.edu/faculty/alagreca/

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