Skip to main content Accessibility help
×
Home

Framework for Research on Children's Reactions to Disasters and Terrorist Events

  • Betty Pfefferbaum (a1), Mary A. Noffsinger (a2), Kathleen Sherrieb (a3) and Fran H. Norris (a3)

Abstract

Clinical work and research relative to child mental health during and following disaster are especially challenging due to the complex child maturational processes and family and social contexts of children's lives. The effects of disasters and terrorist events on children and adolescents necessitate diligent and responsible preparation and implementation of research endeavors. Disasters present numerous practical and methodological barriers that may influence the selection of participants, timing of assessments, and constructs being investigated. This article describes an efficient approach to guide both novice and experienced researchers as they prepare to conduct disaster research involving children. The approach is based on five fundamental research questions: “Why?, Who?, When?, What?, and How?” Addressing each of the “four Ws” will assist researchers in determining “How” to construct and implement a study from start to finish. A simple diagram of the five questions guides the reader through the components involved in studying children's reactions to disasters. The use of this approach is illustrated with examples from disaster mental health studies in children, thus simultaneously providing a review of the literature.

PfefferbaumB, NoffsingerMA, SherriebK, FranH., NorrisFH.. Framework for Research on Children's Reactions to Disasters and Terrorist Events. Prehosp Disaster Med. 2012;27(6):1-10.

Copyright

Corresponding author

Correspondence: Betty Pfefferbaum, MD, JD Department of Psychiatry and Behavioral Sciences College of Medicine University of Oklahoma Health Sciences Center PO Box 26901, WP 3470 Oklahoma City, Oklahoma 73126-0901 USA E-mail betty-pfefferbaum@ouhsc.edu

References

Hide All
1.Litz, BT, Gibson, LE. Conducting research on mental health interventions. In: Ritchie EC, Watson PJ, Friedman MJ, eds. Interventions Following Mass Violence and Disasters: Strategies for Mental Health Practice. New York, NY: Guilford Press; 2006:387-403.
2.Pfefferbaum, B, North, CS. Research with children exposed to disasters. Int J Meth Psychiatr Res. 2008;17(2):S49-S56.
3.North, CS, Norris, FH. Choosing research methods to match research goals in studies of disaster or terrorism. In: Norris FH, Galea S, Friedman MJ, Watson PJ, eds. Methods for Disaster Mental Health. New York, NY: Guilford Press; 2006:45-61.
4.Pynoos, RS, Schreiber, MD, Steinberg, AM, Pfefferbaum, BJ. Impact of terrorism on children. In: Sadock BL, Sadock VA, eds. Kaplan & Sadock's Comprehensive Textbook of Psychiatry. vol II, 8th ed. Philadelphia, PA: Lippincott Williams & Wilkins; 2005:3551-3563.
5.Bolton, D, Hill, J, O'Ryan, D, et al. Long-term effects of psychological trauma on psychosocial functioning. J Child Psychol Psychiatry. 2004;45(5):1007-1014.
6.Goenjian, AK, Walling, D, Steinberg, AM, et al. A prospective study of posttraumatic stress and depressive reactions among treated and untreated adolescents 5 years after a catastrophic disaster. Am J Psychiatry. 2005;162(12):2302-2308.
7.Hoven, CW, Duarte, CS, Lucas, CP, et al. Psychopathology among New York City public school children 6 months after September 11. Arch Gen Psychiatry. 2005;62(5):545-552.
8.Brown, EJ, Goodman, RF. Childhood traumatic grief: an exploration of the construct in children bereaved on September 11. J Clin Child Adolesc Psychiatry. 2005;34(2):248-359.
9.Gil-Rivas, V, Holman, EA, Silver, RC. Adolescent vulnerability following the September 11th terrorist attacks: A study of parents and their children. Applied Developmental Science. 2004;8(3):130-142.
10.Koplewicz, HS, Vogel, JM, Solanto, MV, et al. Child and parent response to the 1993 World Trade Center bombing. J Trauma Stress. 2002;15(1):77-85.
11.McFarlane, AC. The relationship between patterns of family interaction and psychiatric disorder in children. Aust N Z J Psychiatry. 1987;21(3):383-390.
12.Proctor, LJ, Fauchier, A, Oliver, PH, et al. Family context and young children's responses to earthquake. J Child Psychol Psychiatry. 2007;48(9):941-949.
13.Cardeña, E, Dennis, JM, Winkel, M, Skitka, LJ. A snapshot of terror: acute posttraumatic responses to the September 11 attack. J Trauma Dissoc. 2005;6(2):69-84.
14.La Greca, AM, Silverman, WK, Vernberg, EM, Prinstein, MJ. Symptoms of posttraumatic stress in children after Hurricane Andrew: a prospective study. J Con Clin Psychology. 1996;64(4):712-723.
15.Lack, CW, Sullivan, MA. Attributions, coping, and exposure as predictors of long-term posttraumatic distress in tornado-exposed children. J Loss Trauma. 2008;13:72-84.
16.Russoniello, CV, Skalko, TK, O'Brien, KO, et al. Childhood posttraumatic stress disorder and efforts to cope after Hurricane Floyd. Behav Med. 2002;28(2):61-71.
17.Vernberg, EM, La Greca, AM, Silverman, WK, Prinstein, MJ. Prediction of posttraumatic stress symptoms in children after hurricane Andrew. J Abnorm Psychol. 1996;105(2):237-248.
18.Wadsworth, ME, Gudmundsen, GR, Raviv, T, et al. Coping with terrorism: age and gender differences in effortful and involuntary responses to September 11th. Applied Developmental Science. 2004;8(3):143-157.
19.Calhoun, LG, Tedeschi, RG. Beyond recovery from trauma: implications for clinical practice and research. J Social Issue. 1998;54(2):357-371.
20.Cryder, CH, Kilmer, RP, Tedeschi, RG, Calhoun, LG. An exploratory study of posttraumatic growth in children following a natural disaster. Am J Orthopsychiatry. 2006;76(1):65-69.
21.Bannon, W, DeVoe, ER, Klein, TP, Miranda, C. Gender as a moderator of the relationship between child exposure to the World Trade Centre disaster and behavioural outcomes. Child Adolesc Ment Health. 2009;14(3):121-126.
22.Chemtob, CM, Nomura, Y, Abramovitz, RA. Impact of conjoined exposure to the World Trade Center Attacks and to other traumatic events on the behavioral problems of preschool children. Arch Pediatr Adolesc Med. 2008;162(2):126-133.
23.Scheeringa, MS, Zeanah, CH. Reconsideration of harm's way: onsets and comorbidity patterns of disorders in preschool children and their caregivers following Hurricane Katrina. J Clin Child Adolesc Psychol. 2008;37(3):508-518.
24.Norris, FH. Disaster research methods: past progress and future directions. J Trauma Stress. 2006;19(2):173-184.
25.Pynoos, RS, Frederick, C, Nader, K. Life threat and posttraumatic stress in school-age children. Arch Gen Psychiatry. 1987;44(12):1057-1063.
26.Desivilya, HS, Gal, R, Ayalon, O. Extent of victimization, traumatic stress symptoms, and adjustment of terrorist assault survivors: a long-term follow-up. J Trauma Stress. 1996;9(4):881-889.
27.Vila, G, Porche, LM, Mouren-Simeoni, MC. An 18-month longitudinal study of posttraumatic disorders in children who were taken hostage in their school. Psychosom Med. 1999;61(6):746-754.
28.Osofsky, HJ, Osofsky, JD, Kronenberg, M, et al. Posttraumatic stress symptoms in children after Hurricane Katrina: predicting the need for mental health services. Am J Orthopsychiatry. 2009;79(2):212-220.
29.Shaw, JA, Applegate, B, Tanner, S. Psychological effects of Hurricane Andrew on an elementary school population. J Am Acad Child Adolesc Psychiatry. 1995;34(9):1185-1192.
30.Shaw, JA, Applegate, B, Schorr, C. Twenty-one-month follow-up study of school-age children exposed to Hurricane Andrew. J Am Acad Child Adolesc Psychiatry. 1996;35(3):359-364.
31.Hoven, CW, Duarte, CS, Mandell, DJ. Children's mental health after disasters: the impact of the World Trade Center attack. Curr Psychiatry Rep. 2003;5(2):101-107.
32.Pfefferbaum, B, Call, JA, Sconzo, GM. Mental health services for children in the first two years after the 1995 Oklahoma City terrorist bombing. Psychiatric Services. 1999;50(7):956-958.
33.Lindy, JD, Grace, MC, Green, BL. Survivors: outreach to a reluctant population. Am J Orthopsychiatry. 1981;51(3):468-478.
34.Pfefferbaum, B, Tucker, P, North, CS. The Oklahoma City bombing. In: Neria Y, Galea S, Norris F, eds. Mental Health Consequences of Disasters. Cambridge, UK: Cambridge University Press; 2009:508-521.
35.Steinberg, AM, Brymer, MJ, Steinberg, JR, Pfefferbaum, B. Conducting research on children and adolescents after disaster. In: Norris FH, Galea S, Friedman MJ, Watson PJ, eds. Methods for Disaster Mental Health Research. New York, NY: Guilford Press; 2006:243-253.
36.Yule, W, Bolton, D, Udwin, O, et al. The long-term psychological effects of a disaster experienced in adolescence: I: The incidence and course of PTSD. J Child Psychol Psychiatry. 2000;41(4):503-511.
37.Pfefferbaum, B, Nixon, SJ, Krug, RS. Clinical needs assessment of middle and high school students following the 1995 Oklahoma City bombing. Am J Psychiatry. 1999;156(7):1069-1074.
38.Silverman, WK, La Greca, AM. Children experiencing disasters: definitions, reactions, and predictors of outcomes. In: La Greca AM, Silverman WK, Vernberg EM, Roberts MC, eds. Helping Children Cope with Disasters and Terrorism. Washington, DC: American Psychological Association; 2002:11-33.
39.Hoven, CW, Duarte, CS, Wu, P, et al. Exposure to trauma and separation anxiety in children after the WTC attack. Applied Developmental Science. 2004;8(4):172-183.
40.Milgram, NA, Toubiana, YH, Klingman, A, et al. Situational exposure and personal loss in children's acute and chronic stress reactions to a school bus disaster. J Trauma Stress. 1988;1(3):339-353.
41.Putnam, FW. Special methods for trauma research with children. In: Carlson EB, ed. Trauma Research Methodology. Lutherville, MD: Sidran Institute Press; 1996:153-173.
42.Balaban, V. Assessment of children. In: Foa EB, Keane TM, Friedman MJ, Cohen JA, eds. Effective Treatments for PTSD: Practice Guidelines from the International Society for Traumatic Stress Studies, 2nd ed. New York, NY: Guilford Press; 2009:63-80.
43.Breton, JJ, Valla, JP, Lambert, J. Industrial disaster and mental health of children and their parents. J Am Acad Child Adolesc Psychiatry. 1993;32(2):438-445.
44.Pfefferbaum, B, Stuber, J, Galea, S, Fairbrother, G. Panic reactions to terrorist attacks and probable posttraumatic stress disorder in adolescents. J Trauma Stress. 2006;19(2):217-228.
45.McClellan, JM, Werry, JS. Introduction. Research psychiatric diagnostic interviews for children and adolescents. J Am Acad Child Adolesc Psychiatry. 2000;39(1):19-26.
46.Friedman, MJ. Disaster mental health research: Challenges for the future. In: Norris FH, Galea S, Friedman MJ, Watson PJ, eds. Methods for Disaster Mental Health Research. New York: Guilford Press; 2006:288-300.
47.Norris, FH, Elrod, CL. Psychosocial consequences of disaster: A review of past research. In: Norris FH, Galea S, Friedman MJ, Watson PJ, eds. Methods for Disaster Mental Health. New York, NY: Guilford Press; 2006:20-42.
48.McLaughlin, KA, Fairbank, JA, Gruber, MJ, et al. Serious emotional disturbance among youths exposed to Hurricane Katrina 2 years postdisaster. J Am Acad Child Adolesc Psychiatry. 2009;48(11):1069-1078.
49.Asarnow, J, Glynn, S, Pynoos, RS. When the earth stops shaking: earthquake sequelae among children diagnosed for pre-earthquake psychopathology. J Am Acad Child Adolesc Psychiatry. 1999;38(8):1016-1023.
50.La Greca, AM, Silverman, WK, Wasserstein, SB. Children's predisaster functioning as a predictor of posttraumatic stress following Hurricane Andrew. J Con Clin Psychology. 1998;66(6):883-892.
51.Stuber, J, Galea, S, Pfefferbaum, B, et al. Behavior problems in New York City's children after the September 11, 2001, terrorist attacks. Am J Orthopsychiatry. 2005;75(2):190-200.
52.McFarlane, AC. Posttraumatic phenomena in a longitudinal study of children following a natural disaster. J Am Acad Child Adolesc Psychiatry. 1987;26(5):764-769.
53.McLaughlin, KA, Fairbank, JA, Gruber, MJ. Trends in serious emotional disturbance among youths exposed to Hurricane Katrina. J Am Acad Child Adolesc Psychiatry. 2010;49(10):990-1000.
54.Bolton, D, O'Ryan, D, Udwin, O, et al. The long-term psychological effects of a disaster experienced in adolescence: II: General psychopathology. J Child Psychol Psychiatry. 2000;41(4):513-523.
55.Green, BL, Grace, MC, Vary, MG, et al. Children of disaster in the second decade: a 17-year follow-up of Buffalo Creek survivors. J Am Acad Child Adolesc Psychiatry. 1994;33(1):71-79.
56.Terr, L. Chowchilla revisited: the effects of psychic trauma four years after a school-bus kidnapping. Am J Psychiatry. 1983;140(12):1543-1550.
57.Udwin, O, Boyle, S, Yule, W, et al. Risk factors for long-term psychological effects of a disaster experienced in adolescence: predictors of post traumatic stress disorder. J Child Psychol Psychiatry. 2000;41(8):969-979.
58.Norris, FH, Friedman, MJ, Watson, PJ, et al. 60,000 disaster victims speak: Part I. An empirical review of the empirical literature, 1981-2001. Psychiatry. 2002;65(3):207-239.
59.Pfefferbaum, B, Houston, JB, North, CS, Regens, JL. Youth's reactions to disasters and the factors that influence their response. The Prevention Researcher. 2008;15(3):3-6.
60.Balaban, V. Psychological assessment of children in disasters and emergencies. Disasters. 2006;30(2):178-198.
61.Malchiodi, CA, Steele, W, Kuban, C. Resilience and posttraumatic growth in traumatized children. In: Malchiodi CA, ed. Creative Interventions with Traumatized Children. New York, NY: Guilford Press; 2008:285-301.
62.Bonanno, GA. Loss, trauma, and human resilience: Have we underestimated the human capacity to thrive after extremely aversive events? Am Psychol. 2004;59(1):20-28.
63.Fairbrother, G, Stuber, J, Galea, S, et al. Posttraumatic stress reactions in New York City children after the September 11, 2001, terrorist attacks. Ambul Pediatr. 2003;3(6):304-311.
64.Kennedy, C, Charlesworth, A, Chen, JL. Disaster at a distance: impact of 9.11.01 televised news coverage on mothers’ and children's health. J Pediatr Nursing. 2004;19(5):329-339.
65.Pfefferbaum, B, Nixon, SJ, Tivis, RD, et al. Television exposure in children after a terrorist incident. Psychiatry. 2001;64(3):202-211.
66.Pfefferbaum, B, Seale, TW, Brandt, EN Jr, et al. Media exposure in children one hundred miles from a terrorist bombing. Ann Clin Psychiatry. 2003;15(1):1-8.
67.Phillips, D, Prince, S, Schiebelhut, L. Elementary school children's responses 3 months after the September 11 terrorist attacks: a study in Washington, DC. Am J Orthopsychiatry. 2004;74(4):509-528.
68.Schlenger, WE, Caddell, JM, Ebert, L, et al. Psychological reactions to terrorist attacks: findings from the national study of Americans’ reactions to September 11. JAMA. 2002;288(5):581-588.
69.Schuster, MA, Stein, BD, Jaycox, LH, et al. A national survey of stress reactions after the September 11, 2001, terrorist attacks. N Engl J Med. 2001;345(20):1507-1512.
70.La Greca, AM, Silverman, WK. Treating children and adolescents affected by disasters and terrorism. In: Kendall PC, ed. Child and Adolescent Therapy: Cognitive-Behavioral Procedures, 3rd ed. New York, NY: Guilford Press; 2006:356-382.
71.Lonigan, CJ, Shannon, MP, Taylor, CM, et al. Children exposed to disaster: II. Risk factors for the development of post-traumatic symptomatology. J Am Acad Child Adolesc Psychiatry. 1994;33(1):94-105.
72.Shannon, MP, Lonigan, CJ, Finch, AJ, Taylor, CM. Children exposed to disaster: I. epidemiology of post-traumatic symptoms and symptom profiles. J Am Acad Child Adolesc Psychiatry. 1994;33(1):80-93.
73.Weems, CF, Watts, SE, Marsee, MA, et al. The psychosocial impact of Hurricane Katrina: contextual differences in psychological symptoms, social support, and discrimination. Behav Res Ther. 2007;45(10):2295-2306.
74.Lengua, LJ, Long, AC, Meltzoff, AN. Pre-attack stress-load, appraisals and coping in children's responses to the 9/11 terrorist attacks. J Child Psychol Psychiatry. 2006;47(12):1219-1227.
75.Earls, F, Smith, E, Reich, W, Jung, KG. Investigating psychopathological consequences of a disaster in children: a pilot study incorporating a structured diagnostic interview. J Am Acad Child Adolesc Psychiatry. 1988;271(1):90-95.
76.Garrison, CZ, Weinrich, MW, Hardin, SB, et al. Post-traumatic stress disorder in adolescents after a hurricane. Am J Epidemiol. 1993;138(7):522-530.
77.Green, BL, Korol, M, Grace, MC, et al. Children and disaster: Age, gender, and parental effects on PTSD symptoms. J Am Acad Child Adolesc Psychiatry. 1991;30(6):945-951.
78.Pfefferbaum, B, North, CS. Children and families in the context of disasters: implications for preparedness and response. The Family Psychologist. 2008;24(2):6-10.
79.Wolmer, L, Laor, N, Gershon, A, et al. The mother-child dyad facing trauma: a developmental outlook. J Nerv Men Dis. 2000;188(7):409-415.
80.Laor, N, Wolmer, L, Mayes, LC, et al. Israeli preschoolers under Scud missile attacks. A developmental perspective on risk-modifying factors. Arch Gen Psychiatry. 1996;53(5):416-423.
81.Laor, N, Wolmer, L, Cohen, DJ. Mothers’ functioning and children's symptoms 5 years after a SCUD missile attack. Am J Psychiatry. 2001;158(7):1020-1026.
82.Wasserstein, SB, La Greca, AM. Hurricane Andrew: parent conflict as a moderator of children's adjustment. Hispanic J Behav Sci. 1998;20(2):212-224.
83.Garrison, CZ, Bryant, ES, Addy, CL, et al. Posttraumatic stress disorder in adolescents after Hurricane Andrew. J Am Acad Child Adolesc Psychiatry. 1995;34(9):1193-1201.
84.Norris, FH, Friedman, MJ, Watson, PJ. 60,000 disaster victims speak: Part II. Summary and implications of the disaster mental health research. Psychiatry. 2002;65(3):240-260.
85.Raphael, B. The challenges of purpose in the face of chaos: commentary paper by Professor Beverley Raphael. Int J Methods Psychiatr Res. 2008;17(S2):S42-S48.
86.Gil-Rivas, V, Silver, RC, Holman, EA, et al. Parental response and adolescent adjustment to the September 11, 2001 terrorist attacks. J Trauma Stress. 2007;20(6):1063-1068.
87.Weissbecker, I, Sephton, SE, Martin, MB, Simpson, DM. Psychological and physiological correlates of stress in children exposed to disaster: current research and recommendations for intervention. Children, Youth and Environments. 2008;18(1):30-70.

Keywords

Framework for Research on Children's Reactions to Disasters and Terrorist Events

  • Betty Pfefferbaum (a1), Mary A. Noffsinger (a2), Kathleen Sherrieb (a3) and Fran H. Norris (a3)

Metrics

Altmetric attention score

Full text views

Total number of HTML views: 0
Total number of PDF views: 0 *
Loading metrics...

Abstract views

Total abstract views: 0 *
Loading metrics...

* Views captured on Cambridge Core between <date>. This data will be updated every 24 hours.

Usage data cannot currently be displayed