World Journal of Pediatrics

, Volume 4, Issue 3, pp 165–172 | Cite as

Psychological effects of earthquakes in children: prospects for brief behavioral treatment

Special Article

Abstract

Background

Treatment of child earthquake survivors is a relatively less investigated issue in disaster research. A review of the evidence on the mental health effects of earthquakes, risk factors, and findings from treatment studies may provide useful insights into effective treatment of traumatized children.

Data sources

Studies of child and adolescent earthquake survivors included the PILOTS database (electronic index for literature on psychological trauma) and relevant evidence from various studies of adult earthquake survivors.

Results

Evidence points to elevated rates of posttraumatic stress disorder (PTSD), depression, and earthquake-related fears in children and adolescents. Traumatic stress appears to be mediated by loss of control over fear induced by exposure to unpredictable and uncontrollable earthquakes. This implies that interventions enhancing sense of control over fear are likely to be most effective. Recent studies indeed show that a control focused behavioral treatment (CFBT) involving mainly encouragement for self-exposure to feared situations is highly effective in facilitating recovery from earthquake trauma. Evidence also suggests that CFBT can be delivered through booklets and similar media.

Conclusions

Pilot studies suggest that CFBT has promise in effective treatment of PTSD in children. Further research is needed to confirm these preliminary findings and to develop self-help tools for children.

Key words

behavioral treatment children disasters earthquakes posttraumatic stress disorder 

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. 1.
    Guha-Sapir D, Hargitt D, Hoyois P. Thirty years of natural disasters 1974–2003: the numbers. Centre for Research on the Epidemiology of Disasters. Louvain-La-Neuve: UCL Presses, Universitaires de Louvain, 2004.Google Scholar
  2. 2.
    Scheeringa MS, Zeanah CH, Drell MJ, Larrieu JA. Two approaches to the diagnosis of posttraumatic stress disorder in infancy and early childhood. J Am Acad Child Adolesc Psychiatry 1995;34:191–200.PubMedCrossRefGoogle Scholar
  3. 3.
    Cohen JA. Practice parameters for the assessment and treatment of children and adolescents with posttraumatic stress disorder. J Am Acad Child Adolesc Psychiatry 1998;37(10 Suppl):4S–26S.Google Scholar
  4. 4.
    Abalı O, Tüzün U, Göktürk U, Gürkan K, Alyanak B, Görker I. Acute psychological reactions of children and adolescents after the Marmara earthquake: a brief preliminary report. Clin Child Psychol Psychiatry 2002;7:283–287.CrossRefGoogle Scholar
  5. 5.
    Ekşi A, Braun KL, Ertem-Vehid H, Peykerli G, Saydam R, Toparlak D, et al. Risk factors for the development of PTSD and depression among child and adolescent victims following a 7.4 magnitude earthquake. Int J Psychiatry Clin Pract 2007;11:190–199.CrossRefGoogle Scholar
  6. 6.
    Hsu CC, Chong MY, Yang P, Yen CF. Posttraumatic stress disorder among adolescent earthquake victims in Taiwan. J Am Acad Child Adolesc Psychiatry 2002;41:875–881.PubMedCrossRefGoogle Scholar
  7. 7.
    Roussos A, Goenjian AK, Steinberg AM, Sotiropoulou C, Kakaki M, Kabakos C, et al. Posttraumatic stress and depressive reactions among children and adolescents after the 1999 earthquake in Ano Liosia, Greece. Am J Psychiatry 2005;162:530–537.PubMedCrossRefGoogle Scholar
  8. 8.
    Giannopoulou I, Strouthos M, Smith P, Dikaiakou A, Galanopoulou V, Yule W. Post-traumatic stress reactions of children and adolescents exposed to the Athens 1999 earthquake. Eur Psychiatry 2006;21:160–166.PubMedCrossRefGoogle Scholar
  9. 9.
    Bulut S, Bulut S, Tayli A. The dose of exposure and prevalence rates of post-traumatic stress disorder in a sample of Turkish children eleven months after the 1999 Marmara earthquakes. School Psychol Inter 2005;26:55–70.CrossRefGoogle Scholar
  10. 10.
    Şahin NH, Batıgün AD, Yılmaz B. Psychological symptoms of Turkish children and adolescents after the 1999 earthquake: exposure, gender, location, and time duration. J Trauma Stress 2007;20:335–345.PubMedCrossRefGoogle Scholar
  11. 11.
    Kolaitis G, Kotsopoulos J, Tsiantis J, Haritaki S, Rigizou F, Zacharaki L, et al. Posttraumatic stress reactions among children following the Athens earthquake of September 1999. Eur Child Adolesc Psychiatry 2003;12:273–280.PubMedCrossRefGoogle Scholar
  12. 12.
    Pynoos RS, Goenjian A, Tashjian M, Karakashian M, Manjikian R, Manoukian G, et al. Post-traumatic stress reactions in children after the 1988 Armenian earthquake. Br J Psychiatry 1993;163:239–247.PubMedCrossRefGoogle Scholar
  13. 13.
    Goenjian AK, Pynoos RS, Steinberg AM, Najarian LM, Asarnow JR, Karayan I. Psychiatric comorbidity in children after the 1988 earthquake in Armenia. J Am Acad Child Adolesc Psychiatry 1995;34:1174–1184.PubMedCrossRefGoogle Scholar
  14. 14.
    Bal A, Jensen B. Post-traumatic stress disorder symptom clusters in Turkish child and adolescent trauma survivors. Eur Child Adolesc Psychiatry 2007;16:449–457.PubMedCrossRefGoogle Scholar
  15. 15.
    Evans LSG. Theoretical constructs of post traumatic stress disorder as assessed in children in a natural disaster involving tornadoes in their communities. Dissertation Abstracts International: Section B: The Sciences & Engineering 2003;64:951.Google Scholar
  16. 16.
    Announcement. School Psychol Int 2006;27:258.Google Scholar
  17. 17.
    Azarian A, Skriptchenko-Gregorian V, Miller TW, Kraus RF. Childhood trauma in victims of the Armenian earthquake. J Contemp Psychother 1994;24:77–85.CrossRefGoogle Scholar
  18. 18.
    Başoğlu M, Şalcıoğlu E, Livanou M. Traumatic stress responses in earthquake survivors in Turkey. J Trauma Stress 2002;15:269–276.PubMedCrossRefGoogle Scholar
  19. 19.
    Şalcıoğlu E, Başoğlu M, Livanou M. Long-term psychological outcome for non-treatment-seeking earthquake survivors in Turkey. J Nerv Ment Dis 2003;191:154–160.PubMedCrossRefGoogle Scholar
  20. 20.
    Şalcıoğlu E, Başoğlu M, Livanou M. Post-traumatic stress disorder and comorbid depression among survivors of the 1999 earthquake in Turkey. Disasters 2007;31:115–129.PubMedCrossRefGoogle Scholar
  21. 21.
    Başoğlu M, Kılıç C, Şalcıoğlu E, Livanou M. Prevalence of posttraumatic stress disorder and comorbid depression in earthquake survivors in Turkey: an epidemiological study. J Trauma Stress 2004;17:133–141.PubMedCrossRefGoogle Scholar
  22. 22.
    Goenjian AK, Walling D, Steinberg AM, Karayan I, Najarian LM, Pynoos R. A prospective study of posttraumatic stress and depressive reactions among treated and untreated adolescents 5 years after a catastrophic disaster. Am J Psychiatry 2005;162:2302–2308.PubMedCrossRefGoogle Scholar
  23. 23.
    Groome D, Soureti A. Post-traumatic stress disorder and anxiety symptoms in children exposed to the 1999 Greek earthquake. Br J Psychol 2004;95(Pt 3):387–397.PubMedCrossRefGoogle Scholar
  24. 24.
    Chen SH, Wu YC. Changes of PTSD symptoms and school reconstruction: a two-year prospective study of children and adolescents after the Taiwan 921 earthquake. Natural Hazards 2006;37:225–244.CrossRefGoogle Scholar
  25. 25.
    Ozer EJ, Best SR, Lipsey TL, Weiss DS. Predictors of posttraumatic stress disorder and symptoms in adults: a metaanalysis. Psychol Bull 2003;129:52–73.PubMedCrossRefGoogle Scholar
  26. 26.
    Başoğlu M, Livanou M, Crnobaric C. Torture vs other cruel, inhuman, and degrading treatment: is the distinction real or apparent? Arch Gen Psychiatry 2007;64:277–285.PubMedCrossRefGoogle Scholar
  27. 27.
    Başoğlu M, Paker M. Severity of trauma as predictor of longterm psychological status in survivors of torture. J Anxiety Disord 1995;9:339–350.CrossRefGoogle Scholar
  28. 28.
    Şalcıoğlu E, Başoğlu M, Livanou M. Psychosocial determinants of relocation in survivors of the 1999 earthquake in Turkey. J Nerv Ment Dis 2008;196:55–61.Google Scholar
  29. 29.
    Bergiannaki JD, Psarros C, Varsou E, Paparrigopoulos T, Soldatos CR. Protracted acute stress reaction following an earthquake. Acta Psychiatr Scand 2003;107:18–24.PubMedCrossRefGoogle Scholar
  30. 30.
    Kılıç C, Ulusoy M. Psychological effects of the November 1999 earthquake in Turkey: an epidemiological study. Acta Psychiatr Scand 2003;108:232–238.PubMedCrossRefGoogle Scholar
  31. 31.
    Tural U, Coşkun B, Onder E, Çorapçıoğlu A, Yıldız M, Kesepara C, et al. Psychological consequences of the 1999 earthquake in Turkey. J Trauma Stress 2004;17:451–459.PubMedCrossRefGoogle Scholar
  32. 32.
    Livanou M, Başoğlu M, Şalcıoğlu, Kalender D. Traumatic stress responses in treatment-seeking earthquake survivors in Turkey. J Nerv Ment Dis 2002;190:816–823.PubMedCrossRefGoogle Scholar
  33. 33.
    National Institute of Clinical Excellence. Posttraumatic Stress Disorder (PTSD): The management of PTSD in adults and children in primary and secondary care. London: Gaskel and the British Psychological Society, 2005.Google Scholar
  34. 34.
    Stallard P. Psychological interventions for posttraumatic reactions in children and young people: a review of randomised controlled trials. Clin Psychol Rev 2006;26:895–911.PubMedCrossRefGoogle Scholar
  35. 35.
    Goenjian AK, Karayan I, Pynoos RS, Minassian D, Najarian LM, Steinberg AM, et al. Outcome of psychotherapy among early adolescents after trauma. Am J Psychiatry 1997;154:536–542.PubMedGoogle Scholar
  36. 36.
    Wolmer L, Laor N, Yazgan Y. School reactivation programs after disaster: could teachers serve as clinical mediators? Child Adolesc Psychiatr Clin N Am 2003;12:363–381.PubMedCrossRefGoogle Scholar
  37. 37.
    Wolmer L, Laor N, Dedeoglu C, Siev J, Yazgan Y. Teachermediated intervention after disaster: a controlled three-year follow-up of children’s functioning. J Child Psychol Psychiatry 2005;46:1161–1168.PubMedCrossRefGoogle Scholar
  38. 38.
    Giannopoulou I, Dikaiakou A, Yule W. Cognitive-behavioural group intervention for PTSD symptoms in children following the Athens 1999 earthquake: a pilot study. Clin Child Psychol Psychiatry 2006;11:543–553.PubMedCrossRefGoogle Scholar
  39. 39.
    Galante R, Foa D. An epidemiological study of psychic trauma and treatment effectiveness for children after a natural disaster. J Am Acad Child Adolesc Psychiatry 1986;25:357–363.CrossRefGoogle Scholar
  40. 40.
    Shen YJ. Short-term group play therapy with Chinese earthquake victims: effects on anxiety, depression, and adjustment. Int J Play Ther 2002;11:43–63.CrossRefGoogle Scholar
  41. 41.
    Gregorian VS, Azarian A, De Maria MB, McDonald LD. Colors of disaster: the psychology of the “Black sun”. Arts Psychother 1996;23:1–14.CrossRefGoogle Scholar
  42. 42.
    Roje J. LA’94 earthquake in the eyes of children: art therapy with elementary school children who were victims of disaster. Art Ther 1995;12:237–243.Google Scholar
  43. 43.
    Konkov FE. Primary psychological intervention with families of earthquake survivors in Armenia. Amer J Family Therapy 1991;19:54–59.CrossRefGoogle Scholar
  44. 44.
    Chemtob CM, Nakashima JP, Hamada RS. Psychosocial intervention for postdisaster trauma symptoms in elementary school children: a controlled community field study. Arch Pediatr Adolesc Med 2002;156:211–216.PubMedGoogle Scholar
  45. 45.
    Jaberghaderi N, Greenwald R, Rubin A, Zand SO, Dolatabadi S. A comparison of CBT and EMDR for sexually-abused Iranian girls. Clin Psychol Psychother 2004;11:358–368.CrossRefGoogle Scholar
  46. 46.
    Devilly GJ, Spence SH, Rapee RM. Statistical and reliable change with eye movement desensitization and reprocessing: Treating trauma within a veteran population. Behav Ther 1998;29:435–455.CrossRefGoogle Scholar
  47. 47.
    Pitman RK, Orr SP, Altman B, Longpre RE, Poire RE, Macklin ML. Emotional processing and outcome of imaginal fl ooding therapy in Vietnam veterans with chronic posttraumatic stress disorder. Compr Psychiatry 1996;37:409–418.PubMedCrossRefGoogle Scholar
  48. 48.
    Başoğlu M, Şalcıoğlu E. A Mental Health Care Model for Earthquake and Other Mass Trauma. Cambridge: Cambridge University Press, forthcoming in 2009.Google Scholar
  49. 49.
    Mineka S, Zinbarg R. A contemporary learning theory perspective on the etiology of anxiety disorders: it’s not what you thought it was. Am Psychol 2006;61:10–26.PubMedCrossRefGoogle Scholar
  50. 50.
    Başoğlu M, Mineka S. The role of uncontrollable and unpredictable stress in post-traumatic stress responses in torture survivors. In: Başoğlu M, eds. Torture and its Consequences: Current Treatment Approaches. Cambridge: Cambridge University Press, 1992: 182–225.Google Scholar
  51. 51.
    Başoğlu M, Şalcıoğlu E, Livanou M. Advances in our understanding of earthquake trauma and its treatment-A selfhelp model of mental health care for survivors. In: Neria Y, Galea S, Norris FH, eds. Mental Health Consequences of Disasters. Cambridge: Cambridge University Press, forthcoming.Google Scholar
  52. 52.
    Şalcıoğlu E. The effect of beliefs, attribution of responsibility, redress and compensation on posttraumatic stress disorder in earthquake survivors in Turkey. PhD dissertation. London: King’s College London, 2004.Google Scholar
  53. 53.
    Craske MG, Kircanski K, Zelikowsky M, Mystkowski J, Chowdhury N, Baker A. Optimizing inhibitory learning during exposure therapy. Behav Res Ther 2008;46:5–27.PubMedCrossRefGoogle Scholar
  54. 54.
    Başoğlu M, Livanou M, Crnobari’c C, Franciskovi’c T, Sulji’c E, Duri’c D, et al. Psychiatric and cognitive effects of war in former Yugoslavia-Association of lack of redress for trauma and posttraumatic stress reactions. JAMA 2005;294:580–590.PubMedCrossRefGoogle Scholar
  55. 55.
    Başoğlu M, Livanou M, Şalcıoğlu E, Kalender D. A brief behavioural treatment of chronic post-traumatic stress disorder in earthquake survivors: results from an open clinical trial. Psychol Med 2003;33:647–654.PubMedCrossRefGoogle Scholar
  56. 56.
    Başoğlu M, Şalcıoğlu E, Livanou M, Kalender D, Acar G. Single-session behavioral treatment of earthquake-related posttraumatic stress disorder: A randomized waiting list controlled trial. J Trauma Stress 2005;18:1–11.PubMedCrossRefGoogle Scholar
  57. 57.
    Şalcıoğlu E, Başoğlu M, Livanou M. Effects of live exposure on symptoms of posttraumatic stress disorder: The role of reduced behavioral avoidance in improvement. Behav Res Ther 2007;45:2268–2279.PubMedCrossRefGoogle Scholar
  58. 58.
    Başoğlu M, Livanou M, Şalcıoğlu E. A single session with an earthquake simulator for traumatic stress in earthquake survivors. Am J Psychiatry 2003;160:788–790.PubMedCrossRefGoogle Scholar
  59. 59.
    Başoğlu M, Şalcıoğlu E, Livanou M. A randomized controlled study of single-session behavioural treatment of earthquakerelated post-traumatic stress disorder using an earthquake simulator. Psychol Med 2007;37:203–213.PubMedCrossRefGoogle Scholar
  60. 60.
    Başoğlu M, Şalcıoğlu E, Livanou M. Single-case experimental studies of a self-help manual for traumatic stress in earthquake survivors. J Behav Ther Exp Psychiatry 2008 Apr 10. [Epub ahead of print].Google Scholar

Copyright information

© Springer 2008

Authors and Affiliations

  1. 1.LondonUK
  2. 2.IstanbulTurkey
  3. 3.Section of Trauma Studies, Institute of PsychiatryKing’s College London & Istanbul Center for Behavior Research and Therapy (ICBRT/DABATEM)LondonUK

Personalised recommendations