RESEARCH BULLETIN | JULY 2012
Abuse and Mental Health Services Administration (SAMHSA) Disaster
Technical Assistance Center (DTAC) is pleased to send you this
supplement to our ongoing monthly e-communication, the DTAC Bulletin.
This supplement will be sent twice annually in an effort to inform the
field of new and salient research. Please email your feedback or
suggestions for topics to: DTAC@samhsa.hhs.gov To subscribe,
please enter your email address into the “SAMHSA DTAC Bulletin” section
of the SAMHSA DTAC Resources page of our website at http://www.samhsa.gov/dtac/resources.asp.
administered by the Emergency Mental Health and Traumatic Stress
Services Branch of the SAMHSA Center for Mental Health Services
Division of Prevention, Traumatic Stress, and Special Programs, located
at 1 Choke Cherry Road, Rockville, MD 20857.
INTRODUCTION TO THE SAMHSA DTAC SUPPLEMENTAL RESEARCH
Over the last several decades, there has been a
considerable amount of research conducted to study the behavioral health
impact of disasters. SAMHSA DTAC introduces the first issue of the
Supplemental DTAC Research Bulletin, which will be published bi-annually.
The purpose of the Research Bulletin is to provide practitioners,
planners, and other responders a summary of the most recently published
research and literature reviews. Each of the Supplemental Research
Bulletins will highlight a number of chosen articles related to a
specific topic of interest. In this first Research Bulletin, we examine
the topic of the emotional impact that natural and man-made disasters
have on children and youth.
As the field of disaster behavioral health has evolved, we’ve seen a
continued and growing concern about how disasters impact one of our most
vulnerable populations, children. Although many children and youth learn
to adapt to disasters and other adverse situations, the stress and losses
they experience as a result can have long-lasting impacts on their
development. Too often, children and their specific needs for recovery
are overlooked as adults underestimate the extent to which children are
affected by disasters emotionally. The research in these articles alerts
us to the importance of addressing this high risk population.
The articles included in this edition were identified by searching
Academic Search Complete, Child Development & Adolescent Studies,
PsycInfo and PsycARTICLES online databases for relevant research in the
United States within in the last five years. Several of these articles
emanate from Child Development, which published an issue that included a
special section on disasters and their impact on child development.
Together these articles cover the types of symptoms that children and
youth experience as a result of exposure to traumatic events and typical
recovery patterns, as well as general implications for practice, policy,
and the disaster response planning process. Specifically, we focus on
issues concerning children with disabilities and associated barriers in
disaster situations, the impact of previous victimization or traumatic
experiences on children’s symptoms following a disaster, gender
differences in susceptibility to posttraumatic stress disorder (PTSD) and
other mental health issues, and how communities and child welfare
agencies can better prepare for the displacement of foster children as a
result of disasters.
The organization of the bulletin begins with an examination of risk
factors linked to children’s responses to disaster, then discusses
protective factors and resilience, followed by a discussion of social and
environmental factors related to children’s disaster response, and
concludes with suggestions for policy and practice. Abstracts for each of
the five articles are included at the end of the discussion to provide
additional information about the original research articles.
Becker-Blease, K. A., Turner, H. A., & Finkelhor, D. (2010,
July/August). Disasters, victimization, and children’s mental health.
Child Development, 81(4), 1040–1052. doi:
2. Daughtery, L. G., & Blome, W. W. (2009). Planning to plan: A
process to involve child welfare agencies in disaster preparedness
planning. Journal of Community Practice, 17, 483–501. doi:
3. Kronenberg, M. E., Hansel, T. C., Brennan, A. M., Osofsky, H. J.,
Osofsky, J. D. & Lawrason, B. (2010, July/August). Children of
Katrina: Lessons learned about postdisaster symptoms and recovery
patterns. Child Development, 81(4), 1241–1259. doi:
4. Murphy, S. A. (2010). Women’s and children’s exposure to mass
disaster and terrorist attacks. Issues in Mental Health Nursing, 31,
45–53. doi: 10.3109/01612840903200035
5. Peek, L., & Stough, L. M. (2010, July/August). Children with
disabilities in the context of disaster: A social vulnerability
perspective. Child Development, 81(4), 1260–1270. doi:
Factors Influencing Children’s Response to a Disaster
Children observe and learn much about the world around them from every
situation they encounter on a daily basis. Their growth and development
are highly influenced by exposure to their physical and social
environment especially traumatic events such as disasters. The research
noted here identifies those variables that have the potential to lead to
negative emotional outcomes for some children.
Becker-Blease, Turner, and Finkelhor’s 2010 article provides the first
research to estimate the prevalence of disaster experiences among
children in the U.S. The article defines disaster experiences as events
of human or natural causes that include the threat of death, bereavement,
a disrupted support system, and difficulty maintaining basic human needs.
This study was conducted between 2002 and 2003 on 2,030 children and
adolescents aged 2–17 years old in the U.S. Of the study’s participants,
76 percent were Caucasian, 11 percent were African-American, 9 percent
were Hispanic, and 4 percent were of other races. 50 percent were female.
The researchers found that 14 percent of children in these age ranges had
experienced a disaster within their lifetime, and 4 percent within the
last year (p. 1046).
Although children and youth display many behavioral and psychological responses
to traumatic or disaster situations that are similar to adults, including
fearfulness, sadness, sleep disturbances, and posttraumatic stress
symptoms, they also may exhibit additional problems coping, such as
aggressive behavior, school phobia, and learning difficulties
(Becker-Blease et al., 2010; Kronenberg et al., 2010; Peek & Stough,
2010). The scope and severity of each disaster combined with key
demographics such as gender, age, race, socioeconomic status (SES), and
other social factors can significantly influence the mental health
responses of both adults and children (Murphy, 2010). The most
significant difference between child and adult responses is that children
are additionally influenced by how their caregivers respond. For example,
if a caregiver exposes the child to their own anxiety, the child may
become anxious and cry, even if they don’t know why.
Age. Many of the
articles point to different symptomatology dependent on the age of the
child when the disaster occurs. For example, several literature reviews
indicate that younger children’s reactions commonly include increased
fear, sleep disturbances, separation anxiety, reenactment of the trauma
during play, regression, or guilt; whereas older children may experience
disruption in forming identity, difficulty concentrating, social
withdrawal, and increased risky behaviors such as alcohol or other
substance use (Blos, 1967; Pynoos, 1993; Steinberg, Brymer, Decker, &
Pynoos, 2004; Vogel & Vernberg, 1993; as cited in Kronenberg et al.,
2010, p. 1243; Murphy, 2010, p. 50). Furthermore, some studies indicate
that younger children show a higher severity of symptoms; Kronenberg et
al. references studies that have shown increased likelihood of younger
children developing depression, PTSD, avoidance, and hyperarousal
symptoms than older children (McDermott & Palmer, 2002; Shannon,
Lonigan, Finch, & Taylor, 1994; as cited in Kronenberg et al., 2010,
p. 1243). At the same time, other studies have also suggested this is not
always the case, which warrants the need for more research to support
this conclusion (Vogel & Vernberg, 1993; Bal, 2008; as cited in
Kronenberg et al., 2010, p. 1243; Green et al., 1991, as cited in
Becker-Blease et al., 2010, p. 1041).
poorer mental health outcomes for girls and women post disaster
highlights gender as a known risk factor and is noted across several of
the articles cited in this review (Kronenberg et al., 2010; Murphy, 2010;
Peek & Stough, 2010). Murphy’s (2010) literature review found that 94
percent of disaster studies showed females more negatively affected than
males (p. 45). Similarly, Kronenberg et al. (2010) pointed to a recent
study that suggested females are twice as likely as males to report
posttraumatic stress symptoms, and note differences in how the genders
responded behaviorally; girls displayed more emotional reactions,
including guilt, whereas boys displayed more cognitive or behavioral
reactions, including academic difficulties and concentration problems
(Kronenberg et al., 2010, p. 1244). Kronenberg et al. note that some
studies have indicated that females are more likely to report expressions
of depression and PTSD, rather than significant differences in diagnoses
of these illnesses (Kar and Bastia, 2006; Shannon et al., 1994; as cited
in Kronenberg et al., 2010, p. 1244). This suggests that it is vital for
practitioners who are screening for posttraumatic symptoms to be
cognizant of the gender differences in psychological responses to trauma.
Severity and Proximity of
Disaster. Previous disaster research has shown that the
degree of impact and level of exposure are the highest risk factors for
poor mental health outcomes. Murphy’s (2010) review supports the
“hierarchy of exposure” model (Tucker et al., 1999; Wright, Ursano, &
Bartone, 1990), which has linked the most intense threats to self or
family to the highest levels of PTSD, depression, and generalized anxiety
in both adults and children. This model also describes lower levels of
disaster impact and identifies social and material supports, such as
access to schools and access to health care, as protective factors.
The Kronenberg et al. (2010) research outlines several studies that drew
correlations between a higher level of exposure or proximity to an event
and higher posttraumatic symptomatology, but suggests that the level of
exposure has not been consistently and specifically linked to depression
History of Trauma.
Kronenberg et al. (2010) also point to research suggesting that previous
trauma, including war, domestic violence, and abuse, were linked to
increased susceptibility to posttraumatic stress symptomatology (p.
1242). Becker-Blease et al.’s (2010) study described the complex web of
lower SES, urbanity, and status as an ethnic or racial minority as
“persistent predictors of vulnerability to disaster” (p. 1042). Those
children who fit these categories experienced a higher rate of previous
victimization, in part because of higher risk of exposure to traumatic
situations and also due to fewer resources to prepare for and respond to
adverse events. The authors also established that children experiencing
victimization and disaster events had a higher level of anxiety and
depression than those who experienced a disaster without history of
victimization (Becker-Blease et al., 2010).
Along with Becker-Blease et al. (2010), Daughtery and Blome’s (2009) work
supports the early research that found an increase in reports of child
abuse post disaster. These authors additionally identify the increased
vulnerability of those in the child welfare system, a large percentage of
whom have experienced multiple traumas, which may further intensify
posttraumatic stress symptoms in those with the disorder (Daughtery &
Blome, 2009, p. 486).
Each of these articles suggests that when screening for psychological
disorders following disasters, clinicians should ask children and their
caregivers about previous trauma and victimization to better identify
those most at risk for developing posttraumatic symptoms.
Children with Disabilities.
The final article reviewed for this bulletin focused on children with
disabilities (Peek & Stough, 2010). The authors first assert how the
myriad of social vulnerability factors (including gender, race, and SES),
when clustered, can amplify risk and negative outcomes following a
disaster, specifically for children with a disability. The research
suggests that children with disabilities are the most vulnerable to death
and injury, are less likely to receive or understand warning messages,
and have less access to economic and social resources that provide a safe
refuge in preparation for or in response to a disaster. Moreover, when
communities must be evacuated, children with disabilities experience
transportation difficulties and a lack of accessible shelters. The
article also notes that even when evacuations were successful, medical
care was significantly compromised and medical records were inaccessible.
Clearly, this research tells us that children with
disabilities are the subset within this category of high risk populations
that would most benefit from pre-disaster planning and post-disaster
Patterns of Resilience and Recovery
The duration of symptoms varies in children following disasters, but most
research finds that for ninety percent of children, their trauma response
symptoms decrease over time. The research conducted by Kronenberg et al.
(2010) generally concurs with this finding, but notes that some
children’s recovery can follow a different pattern, most especially in
cases where there is severe threat to life or long-term family or
Kronenberg et al.’s (2010) review found that children who lived in highly
impacted areas during Hurricane Katrina experienced a decrease in overall
symptoms from the second to third year after the disaster. Despite this
decline, three years after the disaster, over 25 percent of children
continued to experience significant symptoms of posttraumatic stress and
depression. The authors explain that when a neighborhood or family is
severely impacted and there is slow environmental recovery, symptoms can
persist or even increase over time. The Kronenberg et al. (2010) article
outlines other studies where this increase in symptoms occurred,
including the Buffalo Creek dam collapse (also described in Murphy’s
review), where over a period of 17 years, the disaster survivors
experienced a significant increase in alcohol and drug abuse as well as
suicidal ideation (2010, p. 46).
The Kronenberg et al. (2010) article expands its discussion beyond
symptomatology to explore other factors that affect children’s typical
recovery patterns, such as their natural resilience. Resilience is
defined here as the child’s ability to bounce back to their previous
level of functioning, despite the significant impact of a disaster. The
authors describe the complex pathways of both resilience and
maladaptation explaining their evolutionary nature as influenced by
previous experiences and coping abilities (Sroufe, 1997). The recovery
pattern structure that was chosen for Kronenberg et al.’s study was
adapted from Masten and Obradovic (2008). It outlines several possible
outcomes including: (1) stress resistance, (2) normal response and
recovery, (3) delayed breakdown, and (4) breakdown without recovery. The
authors used these different outcome trajectories to categorize their
study participants, and then conducted analyses to assess differences
between the categories (p. 1245).
The research undertaken by Kronenberg et al. (2010) further supports
previous studies’ findings that the vast majority of children (72
percent) display resilience following a disaster. In the study of
Hurricane Katrina survivors, 45 percent of all children who lived in St.
Bernard Parish were classified as “stress resistant,” displaying no
significant psychological symptoms. Further, 27 percent displayed
“normal” responses; that is, they displayed some struggles initially,
followed by recovery to normal functioning. The authors substantiate
these findings with several other studies of resilience and suggest that
these patterns are correlated with “self-efficacy, positive coping and
problem-solving skills, self-regulation, and supportive social systems”
(Kronenberg et al., 2010, p. 1254).
Still, evidence warns that large-scale disasters and human-caused
traumatic events such as terrorism can leave a long-lasting and
significant negative psychological impact on some children and youth.
Murphy’s (2010) literature review found that at least one-third of
children exposed to a mass disaster or terrorist attack experienced
mental health problems, described as “negative consequences of indefinite
duration and severity” (Galea et al., 2007; Hoven et al., 2005; Norris et
al., 2002; Pfefferbaum et al.,1999; Vernberg, LaGreca, Silverman, &
Prinstein, 1996; as cited in Murphy, 2010, p. 45). The study conducted by
Becker-Blease et al. (2010) adds to these conclusions by finding that
symptoms such as substance abuse and suicidal ideation can increase over
time post disaster. Over one-fourth of children in the 2010 Kronenberg et
al. study reported significant posttraumatic stress and depressive
symptoms, and the authors found that children who reported concern about
the wellbeing of their family were more likely to have longer-term
symptoms in the third year following Hurricane Katrina (p. 1255).
This variability of children’s responses to trauma and the potential for
recovery supports current recommendations to screen and assess
populations of children exposed to large scale disasters and mass
violence. Such variability also speaks to the need to incorporate
additional factors in the screening process, particularly social and
environmental effects. These influences are discussed in the following dedicated
section, as a means of stressing their importance.
and Environmental Effects
Family and Other Social Support
Networks. Multiple studies provide evidence that the
behavioral health of parents has a tremendous impact on children’s mental
health outcomes (Kronenberg et al., 2010; Peek & Stough, 2010). The
stress that parents feel as a result of a disaster can have detrimental
effects on their ability to care for their children. Peek and Stough
suggest that this impact may be felt quite acutely among children with
disabilities (2010, p. 1264). The authors also emphasize that children
with disabilities often rely on social networks for emotional support and
medical care that are more fragile and complex than the networks of
children without disabilities. When those social supports are threatened,
it can more thoroughly disrupt the child’s safety net (Peek & Stough,
2010, p. 1264). Many children with disabilities rely on their caregivers
for medical care or extra emotional or cognitive support to make sense of
their experiences. If their caregivers’ sense of wellbeing or ability is
impaired, these children may experience lasting negative impacts on their
health and development (Peek & Stough, 2010).
Schools and Peer Support.
Another environmental factor that influences children’s recovery post
disaster is the disruption to the school system. The loss of support from
experienced teachers places many children at risk. Peek and Stough
indicate this is especially true of children with disabilities, since
these children tend to rely on more specialized educational plans and may
have more difficulties in establishing social relationships (2010, p.
1266). Similarly, Kronenberg et al.’s study (2010) found that positive
peer and school support was linked to better recovery patterns for
children overall (p. 1255, 1257).
Peek and Stough (2010) also argue that when community infrastructure is
damaged during a disaster, the ability for children to adapt and recover
may be linked with recovery of the community as a whole. Thus, the
authors stress the importance of community recovery, including rebuilding
schools, restoring a sense of normalcy, and the restoration of essential
services to rebuild the social and environmental networks that are vital
in supporting children, more so, children with disabilities.
A child’s demographics (age, gender, race, functional abilities and
socioeconomic status), their history of trauma, their innate resilience
and learned coping mechanisms, along with the proximity to and size, type
and scope of a disaster create a complex set of variables that highly
influence the development of negative psychological outcomes. The link between these variables and a child’s social and
environmental supports strongly emphasizes the importance of
reestablishing community and school system infrastructure as quickly as
possible after a disaster. In addition, looking for ways to foster a
child’s natural resilience and enhance their coping skills can mitigate
the development of poor mental health outcomes and help move them towards
The articles reviewed reinforce current disaster behavioral health
principles recommending that practical clinical interventions following
potentially traumatic events should focus on “case finding, outreach, the
identification of those at highest risk for adverse outcomes, and having
well-trained providers to administer to those in need” (Murphy, 2010, p.
51). The findings support an additional understanding of disaster
survivors, that those in need of services may not accept mental health
referrals even in the aftermath of a disaster. In many of the studies
that were reviewed, reports of successful referrals for treatment were
low. In Becker-Blease et al.’s study (2010), only 2 out of 70
participants who had experienced a disaster within the past year had
received counseling (p. 1049). Murphy cited a 2008 study by Goodman and
Brown, whereby half of all parents either ignored recommendations to seek
help or refused treatment for their children (Murphy, 2010, p. 51).
Disaster behavioral health responders would benefit from training to identify
the needs of children and youth after disasters and to recognize common
symptoms, such as children’s development of separation anxiety. It is
crucial to build awareness of children’s experiences and emotions in
reaction to disasters across various developmental stages, and to
encourage response programs to provide public education for community
members (Murphy, 2010, p. 52).
Daughtery and Blome (2009) bring to light a serious, often overlooked
concern in provider agencies post-disaster: social workers and other
child welfare staff will likely experience an increase in their workload.
This may include attending to an influx of unaccompanied minors and an
increase in communications with caregivers in an effort to assure safety
(p. 493). Staff in these roles are already under considerable pressure
due to high turnover and large caseloads. It is essential for provider
agencies to consider that staff may need to be cross-trained should they
need to fill in for displaced colleagues, as occurred in the Louisiana
children’s service agencies after Hurricane Katrina.
The research suggests that health and mental health provider agencies
should follow a broad based, trauma-informed perspective that focuses on
strategies such as maximizing children’s sense of safety and
self-efficacy, helping to calm children’s emotional distress and to
facilitate an understanding of their experiences (Daughtery & Blome,
2009, p. 486). The authors also recommend strategies to address other
impacts of the disaster on the child’s behavior and relationships, such
as providing consultation to the family, and addressing the social
worker’s professional and personal stress (2009, p. 486).
for Policy and Planning
Translating research findings into effective disaster response plans and
policies is vital to ensuring that communities are prepared for future
disasters. Daughtery and Blome (2009, p. 487) describe the U.S.
Government Accountability Office’s concerns regarding the impact of
Hurricane Katrina on the child welfare system in Louisiana, where 5,000
foster children were dispersed to 19 different States. The child welfare
system experienced many challenges, such as not having emergency contact
information for foster families, loss of telephone service and case
records, and the displacement of social workers (Daughtery & Blome,
2009, p. 487). Other communication issues were inhibited by the lack of
coordinated communication channels between jurisdictions within counties
Outlining a process case study based on Saleebey’s (2006) strengths-based
perspective, Daughtery and Blome (2009) describe a consultation process
which engaged seven public child welfare agencies in the Washington, DC
metropolitan area, where they used a disaster planning template for
incorporating emergency planning tasks. The challenges discovered
included failure in coordination among agencies and workforce issues
which served as a barrier for effective disaster response. The report
noted that State and local communities could better protect children if
they formed partnerships between child welfare and education agencies.
The Daughtery and Blome article states that the key to a strengths-based
disaster planning approach is to focus on building upon the existing
community capacity to deal with challenges and making connections between
the resources and assets already in place. The disaster planning template
was aimed at “translating tasks already mandated by law and policy into
tasks essential for disaster planning” (Daughtery & Blome, 2009, p. 489).
Throughout this process, the authors emphasized the importance of
establishing agreements with providers before disasters occur, as well as
focusing on the safety and accessibility of case records, which should be
backed up in a different location than where paper records are stored.
Furthermore, the authors suggest that child welfare agencies discuss
disaster planning with foster families, social workers, and other
involved parties to ensure key stakeholders are at the table during the
planning process. The authors additionally call for increased
interdisciplinary research among disaster planning, public safety, and
child welfare officials.
The five articles chosen for this Research Bulletin
provide information about the behavioral health effect of disasters on
children and their caregivers as well as recommendations for future
planning. Although most children demonstrate resilience following a
disaster, behavioral health responders need to be able to identify the
cohort of children who will experience long-lasting negative mental
health effects, maladaptive coping mechanisms, and social support system
disruptions. These articles support current knowledge indicating that
higher degree of exposure, female gender, younger age, minority
ethnicity, lower SES, and especially disability are known to increase the
risk of experiencing poor mental health outcomes in children following a
disaster. The articles also support emerging research that finds
children’s support networks, including parents, caregivers, school
systems, and providers, have a tremendous impact on behavioral health and
recovery patterns. Although the body of research on children’s disaster
reactions is ever growing, more studies are needed to identify risk and
protective factors that have the greatest influence on resilience
following a disaster. We recommend that the needs of children and youth
are addressed in the disaster response policy and planning processes to
maximize preparedness for future disasters.
Murphy, S. (2010). Women’s
and children’s exposure to mass disaster and terrorist attacks.
Mental Health Nursing, 31, 45–53. Published documents were
used to identify women’s and children’s exposure experience following two
mass disasters and two terrorist attacks that occurred in the United
States. Research reports, clinical needs assessments, and a case study
were analyzed to determine the type and severity of women’s and
children’s exposure. Research reports were given priority if
pre-event/post-event data were reported, if the study reported was
longitudinal in design, and if samples were representative of the
populations from which they were drawn. Clinical needs assessments were
included because these documents provide evidence of need for mental
health services by disaster victims. The case study selected was unique
in the literature reviewed. The results showed that both women’s and
children’s severity of exposure was related to posttraumatic stress
disorder (PTSD), depression, separation anxiety, and generalized anxiety.
In studies that made gender comparisons, data collected from women and
girls showed more negative mental health outcomes than data collected
from men and boys. Implications for clinical practice and traumatic event
policy are addressed. Longitudinal, prospective studies of potentially
traumatic events (PTE) are needed to better understand the longer-term
plight of children, especially girls.
Becker-Blease, K. A., Turner, H. A., & Finkelhor, D. (2010). Disasters,
Victimization, and Children’s Mental Health. Child
Development, 81(4), 1040–1052. In a representative sample of
2,030 U.S. children aged 2–17, 14 percent reported lifetime exposure to
disaster, and 4 percent reported 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.
Daughtery, L. G., & Blome, W. W. (2009). Planning to Plan: A Process to
Involve Child Welfare Agencies in Disaster Preparedness Planning.
Community Practice, 17, 483–501. In the aftermath of
Hurricane Katrina when child welfare officials in Louisiana reported they
did not know the whereabouts of the foster children under their care, disaster
planning in the public child welfare system became a new area of concern.
This article reports on a process of engaging seven public child welfare
agencies in disaster planning to address child safety and service
delivery. The Washington Metropolitan Area Disaster Planning Project used
a strengths-based approach to help agencies responsible for protecting
and serving children in foster care and families at risk of abuse and
neglect to develop plans to augment and continue service delivery and
responsiveness in the aftermath of a natural or man-made disaster. The
article details the process of gathering information on disaster
responsiveness, interviewing community and professional informants,
developing a template to guide disaster planning within the agencies, and
implementing a tabletop exercise. As a result of this consultation
effort, agencies became aware that disaster planning at the State and
county levels had proceeded without child welfare at the table, that the
increase in need for child welfare services during a disaster was not
recognized by disaster professionals, and that practicing disaster
responsiveness is necessary to address the welfare of children in foster
Peek, L., & Stough, L. M. (2010). Children with disabilities in
the context of disaster: A social vulnerability perspective.
Development, 81(4), 1260–1270. An estimated 200 million
children worldwide experience various forms of disability. This critical
review extrapolates from existing literature in two distinct areas of
scholarship: one on individuals with disabilities in disaster, and the
other on children in disaster. The extant literature suggests that
various factors may contribute to the physical, psychological, and
educational vulnerability of children with disabilities in disaster,
including higher poverty rates, elevated risk exposure, greater
vulnerability to traumatic loss or separation from caregivers, more
strain on parents, and poor postdisaster outcomes, unless medical,
familial, social, and educational protections are in place and vital
social networks are quickly reestablished. Future research needs are
outlined in the conclusion.
Kronenberg, M. E., Hansel, T. C., Brennan, A. M., Osofsky, H. J.,
Osofsky, J. D., & Lawrason, B. (2010). Children of Katrina: Lessons
Learned About Postdisaster Symptoms and Recovery Patterns.
Development, 81(4), 1241–1259. Trauma symptoms, recovery
patterns, and life stressors of children between the ages of 9 and 18 (n
= 387) following Hurricane Katrina were assessed using an adapted version
of the National Child Traumatic Stress Network Hurricane Assessment and
Referral Tool for Children and Adolescents (National Child Traumatic
Stress Network, 2005). Based on assessments 2 and 3 years after the
hurricane, most children showed a decrease in posttraumatic stress and
depressive symptoms. Students were also classified into outcome
trajectories of stress resistant, normal response and recovery, delayed
breakdown, and breakdown without recovery (Masten & Obradovic, 2008).
Age, gender, and life stressors were related to these recovery patterns.
Overall, the findings highlight the importance of building and
maintaining supportive relationships following disasters.
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survivors three years after the Marmara Earthquake.
Child and Adolescent
Mental Health, 13, 134–139.
K. A., Turner, H. A., & Finkelhor, D. (2010). Disasters,
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health. Child Development, 81(4), 1040–
P. (1967). The second individuation process of adolescence.
Psychoanalytic Study of the Child, 22, 162–186.
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R. F., & Brown, E. J. (2008). Service and science in times of crisis:
planning, and implementing a clinical research program for
children traumatically bereaved after 9/11. Death Studies, 32, 154–180.
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and parental effects on PTSD symptoms.
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SAMHSA DTAC Discussion Board
SAMHSA DTAC continues to offer this online forum for discussing
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helpful resources. To become a member, please visit http://dtac-discussion.samhsa.gov/register.aspx
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The Dialogue–DTAC's Quarterly E–Communication to the
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practical and down-to-earth information for DBH coordinators, local
service providers, Federal agencies, and nongovernmental organizations.
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