Disaster and Trauma Resource Center

The World Health Organization describes disaster as, “a severe ecological and psychosocial disruption which greatly exceeds a community’s ability to cope.”

Natural Disasters include:

• weather-related disasters like hurricanes, tornadoes, and floods
• geophysical disasters like earthquakes, volcanoes, and tsunamis,
• droughts and wildfires, and
• widespread diseases that affect a large region (Centre for Research on the Epidemiology of Disasters, 2006).

Man-Made Disasters include
accidents involving

• transportation, (for example plane or train crashes)
• industry (for example, a power plant meltdown),
• and other miscellaneous accidents

ecological/environmental destruction (for example, an oil spill)

violence including

• war
• civil strife
• ethnic violence
• and terrorism.

A child who has been exposed to a disaster may have been an eye-witness to a disaster. He or she might have been hurt or had a family member who was hurt or killed. Children are also exposed to disasters through TV, newspapers, word-of-mouth, or a mixture of these.

The most common response to disaster is not PTSD but rather a spectrum of emotional, behavioral and somatic, or physical, stress responses. It’s hard to predict whether a child will develop PTSD after a disaster because there are so many different factors at play. Many different things determine a child’s risk of developing PTSD.

Some of the most important factors include the size and length of trauma exposure, the degree of life threat and physical injury, the injury and death of loved ones, family and parent supports, whether a child has been exposed to trauma in the past, whether the child has adaptive and coping skills, whether the child has preexisting psychological problems, being female and the child’s ability to use caretaker support.

After 9/11 in 2001, a man-made disaster, a survey of 8266 children 4-12th grade found that PTSD increased from 2 to 10.5%. A natural disaster such as the Buffalo Creek Disaster, a major flood in West Virginia in 1972, resulted in one-third of the children being diagnosed with PTSD. A World Health Organization bulletin noted that 40% of children exposed to the Indian Oceana Tsunami in 2004 had PTSD.

• Assure children that they are safe.
• Bring your family together.
• Listen to your child.
• Let your child express how she feels. Don’t minimize, or make light of, their feelings.
• Tell your child that you understand how they feel and that you’re doing everything you can to manage the situation.
• Younger children may not be able talk about what is bothering them and they may become clingy.
• Include your children, when possible, in your activities.
• Restore normal routines quickly—this builds confidence, and positive coping
• Have meals at the same time of day as you always do.
• Convey usual expectations—for example, beds still need to be made, rooms still need to be picked up, if possible. This provides a sense of normalcy.
• Let your child grieve over a lost toy, pet, or a missing blanket.
• Limit your child’s exposure to television news, newspapers that contain imagery of violence, injury and death.
• Avoid places and situations that will bring back emotions and memories related to the disaster.

“It’s OK to tell me how you feel.” Try to explain the disaster in simple terms that your child can understand. Listen and answer questions honestly, as best as you can. Explain to your child what happened, what is happening and what is going to happen in words that he or she can understand. Do not give more information than they need or are prepared to hear.

Everybody feels stress after a disaster. Many children are afraid that the disaster will happen again. Some short-term signs of stress may include sleep and appetite changes, headaches and upset stomachs, clinging, moodiness, irritability, fearfulness, sadness, and behavior changes like hyperactivity or being quick to anger or startle. Most signs of stress will disappear within a couple weeks. However, if a child still shows these signs after a few weeks, and they are having trouble coping, or having trouble with family, friends, or school, parents should seek help from a primary care physician or mental health professional like a child and adolescent psychiatrist

Preschool Children may have more temper tantrums than usual, have hyperactive behavior, wet or soil themselves or “go backwards” from potty training, be fearful, have nightmares, have sleep and appetite changes, and/or be clingy and extra dependent.
Younger School-Age Children may show how they’re affected through play and behavioral symptoms like hyperactivity, sleep and appetite changes, a sudden drop in grades at school, not being able to focus, physical complaints like stomachaches and headaches, irritability, and sibling rivalry.
Older Children and Adolescents can express how they feel in words and describe their fears and concerns.

• Older Children may experience anxiety, panic, depression, and problem behaviors such as violence or conflicts with friends or family members.
• Adolescents may show anxiety, have a depressed mood, and a fear of a shortened life, plunge into pleasurable activities, act more independent than usual, withdrawal socially, have suicidal thoughts or negative behaviors like substance use or abuse.

PTSD or Posttraumatic Stress Disorder is a clearly-defined medical condition with specific symptom criteria that have to be present at least for one month. Individuals who have PTSD must have experienced, witnessed, or have been confronted with a situation in which there is actual or threatened death or serious injury or a threat of physical injury of the self or others. The dominant emotional responses are fear, helplessness and horror in adults while children may respond with disorganized or agitated behavior.

PTSD symptoms occur across three clusters:

• Re-experience of the Traumatic Event
  The traumatic event is re-experienced over and over again by the individual in dreams, flashbacks or disturbing memories. Children may engage in repetitive play in which themes of the disaster are repeated, have frightening dreams without recognizable content.
• Avoidance of Reminders of the Traumatic Event
  An individual may avoid situations or feelings that remind them of the disaster, feel detached, psychologically numb and may have a loss of interest in activities and a restricted range of emotions.
• Hyperarousal
  Symptoms of hyperarousal include trouble sleeping, or inability to sleep, irritability, startling often, being hypervigilent and having trouble focusing.