Posttraumatic Growth as a Response to Natural Disasters in Children and Adolescents

  • Melissa Bernstein
  • Betty Pfefferbaum
Child and Family Disaster Psychiatry (B Pfefferbaum, Section Editor)
Part of the following topical collections:
  1. Topical Collection on Child and Family Disaster Psychiatry


Purpose of Review

This review examines factors thought to be associated with posttraumatic growth (PTG) (demographic variables, exposure, and family and social processes) among youth exposed to natural disasters, describes the relationship between PTG and posttraumatic stress, and discusses psychological processes (rumination and coping) linked to PTG.

Recent Findings

Guided by PTG theory and the literature on PTG in adults, research has revealed relationships between PTG and child, environmental, and family and social factors among youth though the results are mixed. Youth’s subjective exposure to disasters, their level of posttraumatic stress following the disaster, and the type of psychological processes they employ to cope with the disaster appear to be associated with PTG.


Research has garnered preliminary support for PTG in children exposed to natural disasters but additional research is needed to fully explicate these relationships and to understand how these relationships change over time.


Posttraumatic growth Natural disasters Children Trauma Disaster reactions 



The editors would like to thank Dr. Matthew J. Friedman for taking the time to review this manuscript.

Compliance with Ethical Standards

Conflict of Interest

Melissa Bernstein and Betty Pfefferbaum declare no conflict of interest.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.


Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

  1. 1.
    Tedeschi R, Calhoun L. Trauma and Transformation: Growing in the Aftermath of Suffering. 1st ed. Sage Publications; 2012.Google Scholar
  2. 2.
    Meyerson D, Grant K, Carter J, Kilmer R. Posttraumatic growth among children and adolescents: a systematic review. Clin Psychol Rev. 2011;31:949–64.CrossRefPubMedGoogle Scholar
  3. 3.
    Ickovics J, Meade C, Kershaw T, Milan S, Lewis J, Ethier K. Urban teens: trauma, posttraumatic growth, and emotional distress among female adolescents. J Consult Clin Psychol. 2006;74:841–50.CrossRefPubMedGoogle Scholar
  4. 4.
    Milam J, Ritt-Olson A, Unger J. Posttraumatic growth among adolescents. J Adolesc Res. 2004;19:192–204.CrossRefGoogle Scholar
  5. 5.
    Santiago PN, Ursano RJ, Gray CL, Pynoos RS, Spiegel D, Lewis-Fernandez R, et al. A systematic review of PTSD prevalence and trajectories in DSM-5 defined trauma exposed populations: intentional and non-intentional traumatic events. PLoS One. 2013;8:e59236.CrossRefPubMedPubMedCentralGoogle Scholar
  6. 6.
    Alisic E, Zalta A, VanWesal F, Larsen S, Hafsted G, Hassanpour K, et al. Rates of post-traumatic stress disorder in trauma-exposed children and adolescents: a meta-analysis. Br J Psychiatry. 2014;204:335–40. Scholar
  7. 7.
    Tedeschi R, Calhoun L. Posttraumatic growth: conceptual foundations and empirical evidence. Psychol Inq. 2004;15:1–18.CrossRefGoogle Scholar
  8. 8.
    Tedeschi RG, Calhoun LG. The posttraumatic growth inventory: measuring the positive legacy of trauma. J Trauma Stress. 1996;9:455–71.CrossRefPubMedGoogle Scholar
  9. 9.
    Helgeson VS, Reynolds KA, Tomich PL. A meta-analytic review of benefit-finding and growth. J Consult Clin Psychol. 2006;74:797–816.CrossRefPubMedGoogle Scholar
  10. 10.
    Prati G, Pietrantoni L. Optimism, social support and coping strategies as factors contributing to posttraumatic growth: a meta-analysis. J Loss Trauma. 2009;14:364–88.CrossRefGoogle Scholar
  11. 11.
    Vishnevsky T, Cann A, Calhoun LG, Tedeschi RG, Demakis GJ. Gender differences in self-reported posttraumatic growth: a meta-analysis. Psychol Women Q. 2010;34:110–20.CrossRefGoogle Scholar
  12. 12.
    Cohen J, Mannarino AP, Deblinger E. Trauma-focused CBT for children and adolescents: treatment application. New York: Guilford Press; 2012. PrintGoogle Scholar
  13. 13.
    Cohen J, Mannarino AP, Deblinger E. Treating trauma and traumatic grief in children and adolescents. New York: The Guilford Press; 2006. Print.Google Scholar
  14. 14.
    Ungar M. The social ecology of resilience: addressing contextual and cultural ambiguity of a nascent construct. Am J Orthopsychiatry. 2011;81:1–17.CrossRefPubMedGoogle Scholar
  15. 15.
    Pfefferbaum B, Jacobs AK, Houston JB, Griffin N. Children’s disaster reactions: the influence of family and social factors. Curr Psychiatr Rep. 2015a;17:57.CrossRefGoogle Scholar
  16. 16.
    Bonanno GA, Brewin CR, Kaniasty K, La Greca AM. Weighing the costs of disasters: consequences, risks, and resilience in individuals, families, and communities. Psychol Sci Public Interest. 2010;11(1):1–49.CrossRefPubMedGoogle Scholar
  17. 17.
    Masten AS, Narayan AJ. Child development in the context of disaster, war, and terrorism: pathways of risk and resilience. Ann Rev Psychol. 2012;63:227–57.CrossRefGoogle Scholar
  18. 18.
    La Greca A, Lai B, Llabre M, Silverman W, Vernberg E, Prinstein M. Children’s post disaster trajectories of PTS symptoms: predicting chronic distress. Child Youth Care Forum. 2013;42:351–69.CrossRefPubMedPubMedCentralGoogle Scholar
  19. 19.
    Self-Brown S, Lai BS, Thompson JE, McGill T, Kelley ML. Posttraumatic stress disorder symptom trajectories in hurricane Katrina affected youth. J Affect Disord. 2013;147:198–204.CrossRefPubMedGoogle Scholar
  20. 20.
    Jieling C, Xinchun W. Post-traumatic stress symptoms and post-traumatic growth among children and adolescents following an earthquake: a latent profile analysis. Child Adolesc Mental Health. 2017;22(1):23–9.CrossRefGoogle Scholar
  21. 21.
    Cryder CH, Kilmer RP, Tedeschi RG, Calhoun LG. An exploratory study of posttraumatic growth in children following a natural disaster. Am J Orthop. 2006;76:65–9.CrossRefGoogle Scholar
  22. 22.
    •• Felix E, Afifi T, Kia-Keating M, Brown L, Afifi W, Reyes G. Family functioning and posttraumatic growth among parents and youth following wildfire disasters. Am J Orthopsychiatry. 2015;85:191–200. This study found that demographic variables, including age and gender, were related to greater posttraumatic growth among youth exposed to wild fires. Greater fire stress, life stressors and the use of positive reappraisal were also related to higher levels of posttraumatic growth among youth. CrossRefPubMedGoogle Scholar
  23. 23.
    •• Guo M, Gan Y, Tong J. The role of meaning-focused coping in significant loss. Anxiety, Stress, Coping. 2013;26:87–102. This study examined the relationship between three types of coping styles and posttraumatic growth, finding that meaning-focused coping was related to higher levels of posttraumatic growth, higher well-being, and positive affect compared to other coping styles. CrossRefPubMedGoogle Scholar
  24. 24.
    Hafstad GS, Gil-Rivas V, Kilmer RP, Raeder S. Parental adjustment, family functioning, and posttraumatic growth among Norwegian children and adolescents following a natural disaster. Am J Orthop. 2010;80:248–57.CrossRefGoogle Scholar
  25. 25.
    Hafstad G, Kilmer R, Gil-Rivas V. Posttraumatic growth among Norwegian children and adolescents exposed to the 2004 tsunami. Psychol Trauma: Theory, Res, Pract, Policy. 2011;3:130–8.CrossRefGoogle Scholar
  26. 26.
    •• Jia X, Ying L, Zhou X, Wu X, Lin C. The effects of extraversion, social support on the posttraumatic stress disorder and posttraumatic growth of adolescent survivors of the Wenchuan earthquake. PLoS One. 2015;10:e0121480. Social support partially mediated the relationship between extraversion and posttraumatic growth, and fully mediated the relationship between extraversion and posttraumatic stress disorder symptoms among youth survivors of the Wenchuan earthquake. CrossRefPubMedPubMedCentralGoogle Scholar
  27. 27.
    Kilmer RP, Gil-Rivas V. Exploring posttraumatic growth in children impacted by Hurricane Katrina: correlates of the phenomenon and developmental considerations. Child Dev. 2010;81:1211–27.CrossRefPubMedPubMedCentralGoogle Scholar
  28. 28.
    Kilmer RP, Gil-Rivas V, Tedeschi RG, Cann A, Calhoun LG, Buchanan T, et al. Use of the revised posttraumatic growth inventory for children. J Trauma Stress. 2009;22:248–53.CrossRefPubMedPubMedCentralGoogle Scholar
  29. 29.
    • Wu X, Zhou X, Wu Y, An Y. The role of rumination in posttraumatic stress disorder and posttraumatic growth among adolescents after the wenchuan earthquake. Front Psychol. 2015;6:1335. This study found that type and timing of rumination served as a mediator in the overall relationship between rumination and posttraumatic growth among school aged children following a natural disaster. PubMedPubMedCentralGoogle Scholar
  30. 30.
    •• Ying L, Lin C, Wu X, Chen C, Greenberger E, An Y. Trauma severity and control beliefs as predictors of posttraumatic growth among adolescent survivors of the Wenchuan earthquake. Psychol Trauma. 2014;6:192–8. In this longitudinal study of children exposed to the Wenchuan earthquake, primary control beliefs moderated the relationship between worry and posttraumatic growth. CrossRefGoogle Scholar
  31. 31.
    Ying L, Wang Y, Lin C, Chen C. Trait resilience moderates the longitudinal linkage between adolescent posttraumatic stress disorder symptoms and posttraumatic growth. Sch Psychol Int. 2016;37:207–22.CrossRefGoogle Scholar
  32. 32.
    Yoshida H, Kobayashi N, Honda N, Matsuoka H, Yamaguchi T, Homma H, et al. Post-traumatic growth of children affected by the great East Japan earthquake and their attitudes to memorial services and media coverage. Psychiatry Clin Neurosci. 2016;70:193–201.CrossRefPubMedGoogle Scholar
  33. 33.
    Yu X, JTF L, Zhang J, WWS M, Choi KC, WWS L, et al. Posttraumatic growth and reduced suicidal ideation among adolescents at month 1 after the Sichuan earthquake. J Affect Disord. 2010;123:327–31.CrossRefPubMedGoogle Scholar
  34. 34.
    Zhou X, Wu X, Chen J. Longitudinal linkages between posttraumatic stress disorder and posttraumatic growth in adolescent survivors following the Wenchuan earthquake in China: a three-wave, cross-lagged study. Psychiatry Res. 2015;228:107–11.CrossRefPubMedGoogle Scholar
  35. 35.
    Pfefferbaum B, Jacobs AK, Griffin N, Houston JB. Children’s disaster reactions: the influence of exposure and personal characteristics. Current Psychiatry Report. 2015b;17:56.CrossRefGoogle Scholar
  36. 36.
    Otto M, Henin A, Hirshfeld-Becker D, Pollack M, Biederman J, Rosenbaum J. Posttraumatic stress disorder symptoms following media exposure to tragic events: impact of 9/11 on children at risk for anxiety disorders. J Anxiety Disord. 2007;21:888–902.CrossRefPubMedGoogle Scholar
  37. 37.
    Pfefferbaum B, Nixon SJ, Krug RS, Tivis RD, Moore VL, Brown JM, et al. Clinical needs assessment of middle and high school students following the 1995 Oklahoma City bombing. Am J Psychiatr. 1999;156:1069–74.PubMedGoogle Scholar
  38. 38.
    Lau JTF, Yu X, Zhang J, Mak WWS, Choi KC, Lui WWS, et al. Psychological distress among adolescents in Chengdu, Sichuan at 1 month after the 2008 Sichuan earthquake. J Urban Health: Bull N Y Acad Med. 2010;87(3):504–23.CrossRefGoogle Scholar
  39. 39.
    Weems C, Scott B, Banks D, Graham R. Is TV traumatic for all youths? The role of preexisting posttraumatic-stress symptoms in the link between disaster coverage and stress. Psychol Sci. 2012;23:1293–7.CrossRefPubMedGoogle Scholar
  40. 40.
    American Psychiatric Association. Posttraumatic stress disorder. In: Diagnostic and Statistical Manual of Mental Disorders. 5th ed. Arlington, VA: American Psychiatric Publishing; 2013. Accessed 24 April 2017.
  41. 41.
    Norris FH, Friedman MJ, Watson PJ, Byrne CM, Diaz D, Kaniasty K. 60,000 disaster victims speak: part I. An empirical review of the empirical literature, 1981–2001. Psychiatry. 2002;65:207–39.CrossRefPubMedGoogle Scholar
  42. 42.
    Vázquez C, Pérez-Sales P, Ochoa C. Posttraumatic growth: challenges from a cross-cultural viewpoint. In: Ruini R, Giovani F, editors. Increasing psychological well-being across cultures. New York, NY: SPRINGER; 2014. p. 57–74.CrossRefGoogle Scholar
  43. 43.
    Spelvins K, Cohen K, Bowley J, Joseph D. Theories of posttraumatic growth: cross cultural persepectives. J Loss Trauma. 2010;15:259–77.CrossRefGoogle Scholar
  44. 44.
    Shakespeare-Finch L, Lurie-Beck J. A meta-analytic clarification of the relation- ship between posttraumatic growth and symptoms of posttraumatic distress disorder. J Anxiety Disord. 2014;28:223–9. Scholar
  45. 45.
    Linley A, Joseph S. Positive change following trauma and adversity: a review. J Trauma Stress. 2004;17:11–21.CrossRefPubMedGoogle Scholar
  46. 46.
    Compas BE, Epping JE. Stress and coping in children and families: implications for children coping with disaster. In: Saylor, Conway, Fleming, editors. Children and disasters. New York: Plenum Press; 1993. p. 11–28.Google Scholar
  47. 47.
    Park CL, Cohen LH, Murch RL. Assessment and prediction of stress-related growth. J Pers. 1996;64:71–105.CrossRefPubMedGoogle Scholar
  48. 48.
    Wild ND, Paivio SC. Psychological adjustment, coping, and emotion regulation as predictors of posttraumatic growth. J Aggress Maltreat Trauma. 2003;8:97–122.CrossRefGoogle Scholar
  49. 49.
    Wolchik S, Coxe S, Tein J, Sandler I, Ayers T. Six-year longitudinal predictors of posttraumatic growth in parentally bereaved adolescents and young adults. OMEGA - J Death Dying. 2009;58:107–28.CrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  1. 1.University of Oklahoma Health Sciences CenterOklahoma CityUSA

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