Journal of Traumatic Stress

, Volume 1, Issue 4, pp 445–473 | Cite as

Psychological first aid and treatment approach to children exposed to community violence: Research implications

  • Robert S. Pynoos
  • Kathi Nader


This paper discusses research findings and their implications regarding children's responses to community violence. It outlines (1) theory and findings, (2) early intervention and psychological first aid, and (3) treatment approaches following a violent event. In each section we discuss post-traumatic stress, grief, worry about a significant other, and experience with previous trauma. Detailed steps for psychological first aid are outlined according to age and grade level. Intervention strategies are proposed for each category of response with designed interventions for the classroom, the family, the individual, and the group.

Key words

child victims trauma victims of violence PTSD symptom criteria psychological first aid post-trauma violence response 


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. Ayalon, O. (1983). Coping with terrorism: The Israeli case. In Meichenbaum, D., and Jaremko, M. E. (eds.),Stress Reduction and Prevention, Plenum Press, New York, pp. 293–339.Google Scholar
  2. Black, D. (1982). Children and disaster.Brit. Med. J. 285: 989–990.Google Scholar
  3. Block, D., Silber, E., and Perry, S. (1956). Some factors in the emotional reactions of children to disaster.Am. J. Psychiat. 113: 416–422.Google Scholar
  4. Brett, E. A., and Ostroff, R. (1985). Imagery and posttraumatic stress disorder: an overview.Am. J. Psychiat. 142: 417–424.Google Scholar
  5. Burgess, A. (1975). Family reaction to homicide.Am. J. Orthopsychiat. 45: 391–398.Google Scholar
  6. Burke, J. D., Jr., Borus, J. F., Burnes, B., Millstein, K. H. and Beasley, M. D. (1982), Changes in children's behavior after a natural disaster.Am. J. Psychist. 139: 1010–1014.Google Scholar
  7. Davis, M. (1983). Neurobiological perspectives on anxiety.Psychopharm. Bull. 19: 457–465.Google Scholar
  8. Elizur, E., and Kaffman, M. (1982). Children's bereavement reactions following death of the father: II.J. Am. Acad. Child Psychiat. 21: 474–480.Google Scholar
  9. Eth, S., and Pynoos, R. (1985). Interaction of trauma and grief in childhood. In Eth, S., and Pynoos, R. (eds.),Post-Traumatic Stress Disorder in Children American Psychiatric Press, Washington, D.C., pp. 169–186.Google Scholar
  10. Faschingbauer, T. R., Devaul, R. A., and Zisvok, S. (1977). Development of the Texas Inventory of Grief.Am. J. Psychiat. 134: 696–698.Google Scholar
  11. Fisher, C., Byrne, J., Edwards, A., and Kahn, E. (1973). A psychophysiological study of night-mares and night terrors. 1. Physiological aspects of the stage 4 night terror.J. Nerv. Ment. Dis. 157: 75–98.Google Scholar
  12. Foy, D., Sipprelle, R., Rueger, D., and Carroll, E. (1984). Etiology of Posttraumatic Stress Disorder in Vietnam veterans: analysis of premilitary, military, and combat exposure influences.J. Consult. Clin. Psychol. 52: 79–87.Google Scholar
  13. Frederick, C. (1985). Children traumatized by catastrophic situations. In Laube, J., and Murphy, S. A. (eds.),Perspectives on Disaster Recovery Appleton-Century-Crofts, Norwalk, Conn., pp. 110–130.Google Scholar
  14. Galante, R., and Foa, D. (1986). An epidemiological study of psychic trauma and treatment effectiveness for children after a natural disaster.J. Am. Acad. Child Psychiat. 25: 357–363.Google Scholar
  15. Gardner, G. E., (1971). Aggression and violence—the enemies of precision learning in children.Amer. J. Psychiat. 128(4): 445–450.Google Scholar
  16. Gislason, I., and Call, J. (1982). Dog bite in infancy: trauma and personality development.J. Am. Acad. Child Psychiat. 21: 203–207.Google Scholar
  17. Haggerty, R. J. (1980). Life stress, illness and social support.Dev. Med. Child Neurol. 22: 391–400.Google Scholar
  18. Horowitz, M. (1976).Stress Response Syndromes, Jason Aronson, New York.Google Scholar
  19. Horowitz, M. J., Wilner, M., Kultreider, N., and Alvarez, W. (1980). Signs and symptoms of post-traumatic stress disorder.Arch. Gen. Psychiat. 37: 85–92.Google Scholar
  20. Kardiner, A. (1941).The Traumatic Neuroses of War. Psychosomatic Medicine Monograph II–III National Research Council, Washington, D.C.Google Scholar
  21. Kramer, M., Schoen, L. S., and Kinney, L. (1984). The dream experience in dream-disturbed Vietnam veterans. In Van der Kolk, B. (ed.),Post-Traumatic Stress Disorder: Psychological and Biological Sequelae American Psychiatric Press, Washington, D.C., pp. 82–95.Google Scholar
  22. Kristal, L. (1982). Bruxism: An Anxiety response to environmental stress. In Spielberger, C., Sarason, I., and Milgram, F. (eds.),Stress and Anxiety, Vol. 8 Hemisphere, Washington, D.C.Google Scholar
  23. Krystal, J. (1978). Trauma and effects.Psychoanal. Study Child 33: 81–116.Google Scholar
  24. Lundin, T. (1984). Morbidity following sudden and unexpected bereavement.Brit. J. Psychiat. 144: 84–88.Google Scholar
  25. Moynihan, D. P. (1986).Family and Nation Harcourt, Brace and Jovanovich, San Diego.Google Scholar
  26. Parkes, C. M. (1970). The first year of bereavement.Psychiat. 33: 444–467.Google Scholar
  27. Pynoos, R., and Eth, S. (1986a). Witnessing violence: Special interventions with children. In Lystad, M. (ed.),Violence and the Family Brunner/Mazel, New York, pp. 193–216.Google Scholar
  28. Pynoos, R., and Eth, S. (1986b). Witness to violence: The child interview.J. Acad. Child Psychiat. 25: 306–319.Google Scholar
  29. Pynoos, R., Frederick, C., Nader, K., Arroyo, E., Steinberg, A., eth, S., Nunez, F., and Fairbanks, L. (1987). Life threat and postraumantic stress in school age children.Arch. Gen. Psychiat. 44:1057–1063.Google Scholar
  30. Pynoos, R., Nader, K., Frederick, C., Gonda, L., and Stuber, M. (1987). Grief reactions in school age children following a smiper attack at school.Israeli J. Psychiat. Related Sci. 24(1–2): 53–63.Google Scholar
  31. Raphael, B. (1977). The Granville train disaster: Psychological needs and their management.Med. J. Austr. 1: 303–305.Google Scholar
  32. Terr, L. (1979). Children of Chowchilla: Study of psychic trauma.Psychoanal. Stud. Child 34: 547–623.Google Scholar
  33. Terr, L. (1981). Forbidden games: Post-traumatic child's play.J. Am. Acad. Child Psychiat. 20: 741–760.Google Scholar
  34. Terr, L. (1985). Children traumatized in small groups. In Eth, S., and Pynoos, R. (eds.),Post-Traumatic Stress Disorder in Children American Psychiatric Press, Washington, D.C., pp. 47–70.Google Scholar
  35. Van der Kolk, B., and Ducey, C. (1984). Clinical implications of the Rorschach in posttraumatic stress disorder. In Van der Kolk, B. (ed.),Traumatic Stress Disorder: Psychological and Biological Sequelae American Psychiatric Press, Washington, D.C., pp. 30–42.Google Scholar
  36. West, L. J. (1984). The epidemic of violence. Presented at the annual meeting of the American Psychiatric Association, Los Angeles, May 1984.Google Scholar
  37. Yamamoto, K. (1979). Children's ratings of the stressfulness of experiences.Dev. Psychol. 15: 581–582.Google Scholar
  38. Ziv, A., Kruglanski, A. W., and Shulman, S. (1974). Children's psychological reactions to wartime stress.J. Personal. Soc. Psychol. 30: 24–30.Google Scholar

Copyright information

© Plenum Publishing Corporation 1988

Authors and Affiliations

  • Robert S. Pynoos
  • Kathi Nader
    • 1
  1. 1.Prevention Intervention Program in Trauma, Violence and Sudden Bereavement in ChildhoodUCLA Department of Psychiatry and Biobehavioral SciencesLos Angeles

Personalised recommendations