28/11/2014

TheImpactofTerrorismandDisastersonChildren

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TheImpactofTerrorismandDisastersonChildren
Children,thosebothdirectlyandindirectlyinvolved,areparticularlyvulnerabletothefarreachingimpactofterrorismanddisasters.Childrenatriskforexperiencingmental
healthdifficultiesafteradisasteroractofterrorismincludethosewhoareneartooractuallywitnesstheevent,thosewholoselovedonesasaresult,andeventhosechildren
whomerelyliveintheaffectedcommunityorwatchcoverageoftheeventontelevision.Thisbriefingpaperprovidesanempiricallybasedoverviewoftheriskandprotective
factorsforchildrenexposedtoterrorismandtheirtypicalresponses.Thispaperalsosetsforthwhatweknowaboutmentalhealthinterventionsandproposesrecommendations
foraddressingtheimpactofterrorismonournation'schildren.

RiskFactorsThatMayIncreaseAdjustmentProblemsforChildren
Intenseorprolongedexposuretotheevent,includinggeographicproximity
Witnessingorsustaininganinjury
Perceivingathreattothemselvesorlovedones
Othermajorlifestressors,suchasparentaldivorceorthedeathorhospitalizationofafamilymember
Deathofparents,siblings,orclosefriends
Havingparentswhoaretraumatizedthemselvesbytheevent
Disruptionindailyroutines,residence,orschool
Televisionexposurefollowingtheevent,evenifthechildwasnotdirectlyaffected

ProtectiveFactorsThatMayHelpPromoteCopingandPositiveAdjustment
Strongsocialsupportfromfamilies,teachers,andthecommunity
Parentalcopingandsupportforthechild
Economicresourcestofacilitatethefamily'sadaptation
Priorlowlevelsofanxietyanddepression
Positive,adaptivecopingandproblemsolvingskills
Priorsuccessfulacademicachievement
Abilitytounderstandtheeventsbasedonageanddevelopmentallevel

Children'sReactionstoTraumaticEvents
Posttraumaticstressdisorder(PTSD)isaconditionthatdevelopsinresponsetowitnessingorexperiencingathreateningor
harmfuleventthatelicitsfear,helplessness,orhorror.SymptomsofPTSDincludepersistentreexperiencingoftheevent,
avoidanceofthingsorplacesrelatedtotheevent,andpersistentsymptomsofincreasedarousal.PTSDisthemostcommon
responsetodisastrouseventsinchildren,occurringinupto40%ofchildrenexposedtodisastersandtypicallywithinthree
monthsaftertheevent.Itcanstillbepresentmorethan15yearsafteraterroristevent.
AlmostoneyearaftertheOklahomaCitybombing,50%oflocalelementaryschoolchildrenreportedclinicallevelsofPTSD,
andonehalfreportedbeingconcernedaboutthesafetyoftheirfamily.
ArecentstudyfoundthatsixmonthsafterSeptember11th,approximately75,000NewYorkCitypublicschoolchildrenin
grades4through12weresufferingfromPTSD,includingchildrenwhowerenotdirectlyaffectedbytheevent.
Disruptedconsciousness,uncontrollable,intensegrief,changesinsleepingoreatingpatterns,andextremecognitive
impairmentmayappearinseverelyaffectedchildren.
Othersymptomsincludedepression,anxiety,increasedstartleresponseandarousallevel,irritability,sleepdisturbance,safety
andsecurityconcerns,restlessness,socialisolation,aggression,peerrejection,bullying,schoolabsences,adeclinein
academicperformance,andadecreasedinterestinpreviouslyenjoyedactivitiesorhobbies.Childrenwithamilderformof
PTSDgenerallyrecoversooner.
Symptomstypicallydecreaseinfrequencyandintensityiftherehasbeennoreoccurrenceofthetraumaticeventorexposure
toothertraumaticevents.
Thepresumptionofparentsandteachersthatchildrenareresilientandcopingwellcanimpedetheirdetectingsymptomsof
stress.

ResearchFindingsSuggestThatMentalHealthInterventionsShouldBe...
Broad,comprehensiveandinitiatedwithacommunitywidescreeningtoidentifythoseatrisk.Communityneedsassessments
shoulddriveongoinginterventions,attempttoaddressanypersistentorrecurringsymptomsandchangesinneedsofchildren
overtime,andidentifythosechildrenwhowerenotidentifiedimmediatelyaftertheevent.
Wellcoordinatedwithmentalhealthprofessionalsenlistingtheschoolstaffintotheprocessofinitiatingandimplementing
interventionsforstudentstoensuresuccessfulutilization.
Implementedbyindividualswhoaretrainedandhaveexperienceworkingwithcrisis,disasterresponse,PTSD,andchildren's
griefresponses.
Theoreticallyandempiricallyinformedusingthemosteffectivemodels,includinguseofmanualizedcurriculadeveloped
throughresearch.
Culturallysensitive,developmentallyappropriate,shapedbysurvivors'needs,allowchildrentoresumefamiliarrolesand
responsibilities(suchasgoingtoschoolandhavingchildrenengageindevelopmentallyappropriatetasks),includeparents
andothercaregivers,andprovideeconomicreliefforfamilies,aswellasassistanceinobtaininghealthcare.
Concentratedoninsuringthebasicsafetyofthechildandlovedonesimmediatelyafteraterroristevent,addressingphysical
needs,andreunitinglovedones.
Focusedonencouragingchildrentoexpresstheirfeelingsabouttheevent,discussingnormalreactions,andteaching
problemsolvingskills.

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TheImpactofTerrorismandDisastersonChildren
Centeredaroundcurrentsymptomsoronthespecifictraumaticeventinordertobeeffectivebeyondtheinitialphaseof
response.
Inclusiveofpsychoeducationalprogramsforanxietymanagementandcopingskills,andmodifyingthechild'serroneousand
maladaptiveattributions.

GeneralRecommendationsforPolicymakers
Enhancingtrainingopportunitiesforhealthandmentalhealthprofessionalsthroughgraduateandcontinuingeducation
programsonhowtoscreen,identifyandreferchildreninneedofmentalhealthservicesafteradisasterorterroristevent.
Supportingresearchtoexplorechildren'simmediateresponses,changesinresponsesovertime,andfactorsthatinfluence,
eitherpositivelyornegatively,children'sreactions.
Translatinganddisseminatingresearchfindings(e.g.,aninformationexchangenetworkorthedevelopmentandmaintenance
ofanationaldatabase)byfederalagenciestopromoteevidencebasedinterventionsforchildren.
Providingfinancialassistanceforchildrenandfamilies(e.g.,MedicaidandtheSocialServicesBlockGrant)tofacilitate
recoveryfromtheeventandaccessthementalhealthsystem.

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