1. Natural and man-made disasters

2. History of disasters studies Vicksburg tornado 1953 (Perry et al, 1965) Coal mining accident 1966 (Lacey, 1972) Buffalo Creek dam collapse 1972 (e.g. Gleser et al., 1981) Chowchilla school bus kidnapping 1976 (Terr, 1979, 1983)

3. Early descriptive studies Relatively mild response to more sever reactions parent reports to direct evaluations Most common disaster response –Specific fears –Separation difficulties –PTS

4. Current view PTSD symptoms –Comparison across studies difficult –Most extreme scores by children with most sever threat or loss –Differences in specific disaster experience –And/or age –Re-experiencing even after mild or indirect exposure –Avoidance/numbing more likely in high levels of exposure

5. Some specific PTSD/ stress- responses Reenactment in play –Course of play “stuck” Sleep problems –Sleep alone, getting to sleep, nightmares Increased irritability –Tantrums (↓), fearfulness, dependency on adults Regression –E.g. enuresis (↓) Somatic complaints –E.g. headaches and stomachaches (↑) Guilt –E.g. over pre-disaster behavior

6. Other symptoms and disorders Anxiety –Overlap with PTSD symptoms Depression –Less common than PTSD symptoms School performance –Most likely for children with persisting post-disaster symptoms High levels of parental symptoms

7. Factors influencing response Disaster characteristics Child characteristics Family and Community Effects

8. Factors influencing response Disaster characteristics –Life threat and exposure to the grotesque –Bereavement –Separation –(Injury) –Physical losses and disruption of the environment

9. Factors influencing response Child characteristics –Age Older Complex, maybe mediators, such as appraisal, coping strategies, control beliefs, community involvement –Gender Female, internalizing symptoms –Prior pathology and traumatic experiences unclear

10. Family and Community Effects Family factors –Corr. child-parent response –parental distress, communication patterns Effects of Evacuation/Relocation –Evacuation without subsequent return can be stressful Community support –E.g. rebuilding efforts