After a Disaster, Kids Suffer Posttraumatic Stress Too

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Adrian Cross, 10, holds his 18-month-old sister Kailah Smith outside their parents' FEMA trailer just before the family moved to an apartment in Port Sulphur, La.

Popular wisdom has long held that young children survive traumatic events better than adults do, in part because they suffer less. Being too young to understand fully the nature of what's happening around them — during war or natural disaster, for instance — they should bounce back with much more resilience.

But new research on child survivors of Hurricane Katrina and witnesses of the 9/11 terrorist attacks suggests otherwise. "There is increasing evidence that kids know what is going on if they are directly exposed and see something like planes crashing into the [World Trade Center] towers," says child psychologist Claude Chemtob of New York University, lead author of one of several new papers on children and disaster, published in a special section of the July and August issue of Child Development.

Together, the new studies show that young children and teens not only exhibit symptoms of posttraumatic stress and depression that are similar to those of adults, but that they may react more strongly to trauma because adults do. They also show that younger children and girls are more likely to develop symptoms of posttraumatic stress disorder (PTSD) than boys and older kids.

In the first two studies, researchers analyzed the long-term effects on children and their parents of the 9/11 attacks. In one analysis, led by Chemtob, researchers followed 116 preschool children and their mothers in Lower Manhattan who had been directly exposed to the World Trade Center attacks. Interviews were conducted with the mothers and with the children's preschool teachers nearly three years after 9/11.

Chemtob found that compared with children whose mothers did not report symptoms of PTSD or depression, those whose mothers were affected were three times more likely to be emotionally reactive — being clingy and quick to become upset — and seven times more likely to exhibit aggressive behavior three years after the traumatic events. "Kids are very attuned to their moms because moms send cues to their kids about what's safe and what's not. If Mom is less available and more focused on the fearful aspects of life, then she is not helping," Chemtob says.

In contrast, a second study on 9/11 that looked at more than 400 children, aged 12 to 20, and their mothers, found that those who were directly exposed to the attacks — those who witnessed the planes hit the towers, for example — were only slightly more likely to suffer PTSD than children who did not directly experience the trauma, but were significantly more likely to be depressed. Only 4% of these children had PTSD 15 months after the attacks, but 12% were depressed.

Notably, this study, led by child-development researcher Elizabeth Gershoff of the University of Texas at Austin, mirrors the findings of a 2008 study that Chemtob conducted with the same group of children involved in his current paper. In the 2008 study, he also found that children who were directly exposed to the events of 9/11 — seeing dead or injured people, watching people jump out of a building or witnessing a tower collapse — were three times more likely to be depressed or anxious than those who were not directly exposed. "We have tended to say that young kids don't need help, but in fact they are very vulnerable," says Chemtob.

Chemtob's and Gershoff's conclusions are further supported by two other studies appearing in the current issue of Child Development on the child survivors of Hurricane Katrina. In the first study, a team of researchers from Louisiana State University (LSU) interviewed 387 public schoolchildren in St. Bernard Parish, one of the areas most devastated by Katrina, and found that young children were more profoundly affected than adolescents. Three years after the hurricane, children between the ages of 9 and 11 were four times more likely to show symptoms of PTSD than were teenagers between the ages of 15 and 18.

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