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Children face innumerable challenges following exposure to disasters. To address trauma sequelae, researchers and clinicians have developed a variety of mental health interventions. While the overall effectiveness of multiple interventions has been examined, few studies have focused on the individual components of these interventions. As a preliminary step to advancing intervention development and research, this literature review identifies and describes nine common components that comprise child disaster mental health interventions. This review concluded that future research should clearly define the constituent components included in available interventions. This will require that future studies dismantle interventions to examine the effectiveness of specific components and identify common therapeutic elements. Issues related to populations studied (eg, disaster exposure, demographic and cultural influences) and to intervention delivery (eg, timing and optimal sequencing of components) also warrant attention.
This chapter explores both major depressive disorder (MDD) and prolonged grief disorder (PGD) as responses to disasters and terrorist events. MDD should be diagnosed in individuals for whom intense dysphoria and feelings of sadness persist and who experience related depressive symptoms. PGD is more severe and unremitting than normal grief. PGD is associated with considerable functional impairment, physical and mental health morbidity, lost productivity, suicide, and fewer quality adjusted life years. Studies have shown that PGD symptoms form a coherent cluster distinct from bereavement-related depressive and anxiety symptom clusters. Postdisaster prevalence of depression varies considerably across disasters and estimates can be misleading without additional information. Risk and resilience factors can be temporally categorized into three categories: preevent predictors, perievent predictors, and postevent predictors. Grief and depression-focused treatments are rarely implemented systematically in the wake of disasters.