Dr. Betty Lai‘s guestpost on disaster recovery was planned a few weeks ago and couldn’t turn out more timely: Hurricane Sandy has affected many children while ravaging large areas in the Carribean and the US. Betty is a clinical psychologist and postdoctoral fellow at the University of Miami. 

Each year, millions of children are exposed to natural disasters. Many children who experience a natural disaster may report symptoms of posttraumatic stress or depressive symptoms. In a recent study, we examined these symptoms and their comorbidity among 277 children (7 -11 years old) exposed to Hurricane Ike, a destructive natural disaster that hit Galveston, Texas in September 2008.

We found that eight months after Hurricane Ike, most children (67%) were resilient and did not report distress. However, many children did report distress symptoms: 23% of children reported clinically significant posttraumatic stress symptoms, and 21% reported clinically significant depressive symptoms.

Among children who reported distress symptoms, the majority had comorbid symptoms of posttraumatic stress and depression. When we followed these children over time, we found that children who reported comorbid symptoms showed the most severe distress, and they also were the least likely to recover.

Based on our findings, consider the following tips for helping children after disasters:

1. Monitor children’s stressors. Disasters bring bundles of stressors with them. Sometimes children lose their pets, they may lose their favorite toys or clothes, or they may lose friends who have had to move out of the area. Children with high levels of stressors after disasters are at risk for developing posttraumatic stress or depressive symptoms. Help children cope with or reduce stressors.
2. Ask children how they’re feeling. Adults are poor judges of children’s internalizing symptoms. Provide children with opportunities to let you know how they are feeling.
3. Return to normal routines.Children feel comforted by routines. It lets them know that things are “returning to normal.” For example, disasters often destroy playgrounds and gyms. Thus, children may not be able to play outside or be active.  Think of ways to help children stay active or engage in physical activities they enjoyed before the disaster. As adults, we should consider rebuilding children’s play spaces quickly to help children return to these activities.
4. Screen for and address comorbid symptoms. Many of our best postdisaster treatments focus on posttraumatic stress symptoms. As clinicians, we also need to address comorbid symptoms. Our research shows that comorbid symptoms interfere with recovery and they may even worsen existing symptoms.

See also After the Storm: A guide to help children cope with the psychological effects of a hurricane. 

Lai BS, La Greca AM, Auslander BA, & Short MB (2012). Children’s symptoms of posttraumatic stress and depression after a natural disaster: Comorbidity and risk factors. Journal of affective disorders PMID: 22974469