Welcome back everyone. In this segment we're going to talk about the effects of disaster on children and child development. We're going to talk about, dose gradients, and also commo, common trauma symptoms. And, individual differences in the way that children of different ages and personalities respond. We've known for a long time that dose of exposure matters. As you may remember, when we talked about Buffalo Creek, this disaster found that children who had more severe exposure had more symptoms, stronger reactions to the disaster. And the kind of dose that matters can vary quite a bit. Dose can mean that you have close proximity to terrible experiences, that you see more terrible things, or that you're closer in the sense that you're caught up in more of the destruction. You're closer to the center of the earthquake. Proximity can also take the form of psychological closeness. If, people you know and care about are more effected, they're killed. You lose your family. That is a more severe form of exposure, and again, children will show more symptoms with that kind of dose. Also, there's does in the sense of how much trauma is piling up in your life. So that, if you're a child who is already experiencing violence either in a war zone or in a violent family, and then a disaster happens on top of that, you are more likely to show reaction to the disaster as well. So how much trauma piles up in your life appears to matter. And another important aspect of exposure is media exposure. And there's been very interesting research showing that young children, for example, can be traumatized by watching disasters over and over on television. They may not understand that they're watching repeated footage. So, now adults are more careful about monitoring how much media exposure people, young children, and even themselves have to these trauma experiences. People respond in many different ways to traumatic experiences. But here's a list of very common trauma symptoms and your, you would be likely to observe these in the aftermath of a severe disaster. People of all ages including young and old. Often have nightmares and upsetting memories in response to traumatic experiences. They may have flashbacks, which is a sudden intense memory. You may feel like you're re-experiencing the event. People also have not sense of numbing, or shock, or they feel like things are unreal. They feel a sense of detachment, that's very common. And people often avoid reminders of the trauma, to try to forget about it. People also show arousal symptoms, and anxiety, that can take a form of intense fearfulness, or panic. They can be jumpy, easily startled. They can also have, for reasons related to that arousal, difficulty sleeping or concentrating in their life. And people also can show emotionality, outbursts of anger and stress. There's been a very interesting summary of the research on these kinds of symptoms, these post-traumatic symptoms, that was done by Furr and colleagues. This is a meta-analysis. A meta-analysis is a study of studies where, where researchers try to gather up, all of the studies of a particular topic and they analyzed the results together to try to combine all of the findings in these studies. And with this kind of analysis, you can figure out the big picture. What have we learned across many different studies. And in this study, they reviewed all of the published work that met certain criteria before 2009 and they analyzed on average what we have learned from this work on post traumatic symptoms in children. And the first thing they found is that there is an effect. That disaster does have a, appear to have a small to medium effect on the, the, these kinds of symptoms in children, and they learn that by look, averaging the results across studies that had either comparison groups or had before and after data. They also learned that, children are at greater risk for post-traumatic symptoms when they have greater exposure, more personal loss when they feel more threat to the self, and when they have you know, greater exposure to the center of destruction. And they could measure that by, disasters with a higher death toll showed, the children showed more symptoms. They also learned that, across multiple studies, if the child is reporting the symptoms they see great effects and if the parents or other adults are reporting the symptoms, which is an important finding because it suggests that children may have great reactions than adults realize. People have also studied post-traumatic stress disorder, that's a diagnostic category and to make this kind of diagnosis, people look at all of the symptoms that are occurring together and there are certain criteria that have to be met for a person to be given this kind of diagnostic label, and they often are having multiple of those post-traumatic symptoms all at the same time or in the same period of time. And the symptoms have persisted longer than a month. The tricky thing with this kind of diagnosis is when you have a disaster that continues to go over time that's prolonged over time because, if you keep having an acute reaction to multiple phases of a disaster, it's hard to tell when you're meeting criteria for this kind of disorder. But these, when you have this disorder, it means you are impaired in some way, you're feeling extreme distress or it's affecting the life of the individual. I want to show you a couple of examples of data on effects from specific disasters. Lets go back to the Sichuan Earthquake. This was a huge disaster with tremendous loss of life, and many people injured. Many school children were harmed in this particular earthquake in China, and millions of people were left homeless. And one of the studies that's come out of this particular disaster, that I think carries a great deal of importance is this study that was done measuring hair cortisol, using this as a strategy to measure stress responses in young school children. And in this study they compared children who lived very close to the epicenter of the earthquake and experienced tremendous loss and destruction with, with school children who were farther way. And they used a new technique to measure a stress response biological measure of the hormone cortisol which is an indicator of the stress in your body. And what they did was measure hair. It turns out that our hair collects cortisol as it grows and it gives you a rough, culmative idea of how much stress a person has been experiencing. Hair is almost like a diary of how much stress you've been exposed to in recent month, and hair grows at a fairly steady average rate. So, if you take a sample of hair months after a disaster, you can cut it into pieces. And as you get close to the scalp, it's further away in time from the disaster. And in this case, they were able to show this stress hormone level, even before the disaster occurred. And if you look here, the red arrow marks when the earthquake happened. The study itself was done seven months later over this on this side of the disaster and they would measured segments of hair in different groups of children and they show three lines here. One line is the children that were farther away from the disaster, that's the blue line, and their average hair cortisol levels over time. This black line in the middle is children who were very close to the disaster but developed post traumatic stress symptoms and then you have the red line which is children who are close to the disaster but didn't develop the post traumatic symptoms. And what's really important about this study is how they were able to solve that dilemma, of not knowing how, not having evidence before the disaster or very early on, and in the, in the disaster. Since they used to measure that could take them backwards in time, we don't know if this will be replicated over time, but one of the most interesting findings here is that the children who developed post traumatic stress disorder, actually showed lower levels of cortisol as if their body is trying to you know, level off or down regulate the occurrence of this stress hormone in the body. There's a lot of interest in the post-traumatic stress literature. Another really large magnitude disaster that has generated a lot of research, is the 2004 Tsunami in the Indian Ocean. There was enormous loss of life with this Tsunami came out of the blue without any warming, warning it was caused by a megathrust huge under ocean earthquake that caused these huge waves to propagate around the perimeter of the Indian Ocean and in many countries were infected. One of the countries that was affected was Sri Lanka. And there was considerable loss of life there. This study by Catani is important because it's an effort to show, dose effects where these researchers combined the measures of exposure to the Tsunami itself. And severity of exposure. And also severity of other things going on in the children's lives. Part of Sri Lanka had been involved in a civil war, and they were able to measure exposure to the war was effects in some of the children. And they also measured family violence. Which is, of course, all, ongoing in families at any time, in development. And what you see in this diagram, is that the number of stressful life events, combined together, of all these three different kinds. From family violence, to Tsunami disaster and war, combined together to show this, dose gradients. So that the higher your exposure level, the more symptoms of post traumatic stress you show. There are all kinds of variations in people in terms of how they respond to disasters. Some of those differences are related to development depending on how old you are, what your understanding of the disaster. Older children tend to show more post-traumatic symptoms potentially because they understand more of what's going on. But young children simply show different kinds of symptoms. So very young children, in disasters, for example, often show regression where they lose skills they have, like, they lose their toilet training. Young children often show a lot of crying and clinging in the context of a disaster, and children are more likely to show reenactment, kind of traumatic re-experiencing, in the form of play. Because children are more likely to be playing than older people are. In contrast, in adolescence, we often see more concerns about the impact of the disaster on their future. Adolescents are more likely to lose hope about the future. They show more suicidal thoughts and feelings. And they also show a more risky and reckless behavior. Adolescents in general, show more of these behaviors but these appears to be exacerbated in the context of a disaster. We also know that you can be exposed to disaster even before you're born. Because prenatally, the disaster experiences of the mother who's carrying any of us can affect through biological systems, the experience of the fetus. Just as what a mother eats affects the fetus developing, a mother's traumatic experiences can also affect the fetus. And there's been some very interesting research on pre-natal effects and one of the most interesting studies was done in relation to the Chernobyl nuclear disaster. The study was done in Finland where they, there was ongoing research on twins growing up in Finland. And they realized that they had data available where they could compare, twins who were in gestation, who were developing, in the womb, during the Chernobyl incident, with those who were born a year later. There was tremendous fear, in Finland, at the time of Chernobyl because it was unknown how much radiation had exposure there was to two pregnant mothers, and everybody was very worried that that might affect the unborn child. Later on, they were able to realize that there were very small radiation effects. However, the fear and the stress of mothers who were pregnant during this disaster at Chernobyl did have some lingering effects on their unborn children. Interesting biological effects and the children are being followed to examine how long these last over time. They've been followed into their teenage years so far. But it is possible through biological effects on a developing child for disasters to affect a child even before that child is born. Individual differences of other kinds also matter. There's research suggesting that some children are more sensitive than other children to disasters. We've already heard that girls can have more post traumatic symptoms in the, in the face of disaster and there's also evidence that your personality may make a difference. Some people are just more sensitive to experience and that will influence how they respond,. Also, children vary in how cognitively aware they are to what's going on in the world and how you interpret disaster makes a difference as well. We're going to see that a lot of the same individual and developmental differences are related to how children fare in the context of war and terror as well. Next we're going to talk about resilience and recovery and we're going to take a look at a PopTech talk by the superintendent of the Joplin public schools who talks about recovery in this district, school district, and community that was devastated by a huge tornado that involve loss of life. We're going to talk about what we've learned from research about what makes the difference for resilience. And then we're going to take a look after that at some intervention programs. [SOUND]
