Children's Resilience in the Face of Trauma

Introduction

Stressful events are common occurrences in the lives of our children. Traumatic stress, however, occurs following events which are unexpected and physically threatening to either children or their loved ones. Traumatic stress can occur as a result of exposure to a single event such as a natural disaster, a violent crime, the Challenger Space Shuttle Explosion, the Oklahoma City Bombing, the 9/11 terrorist attacks, exposure to a violent death (homicide or suicide). Traumatic stress can also occur as a result of exposure to ongoing events such as acts of war, community or domestic violence, and child abuse or neglect. In the presence of stressful events, the developmental challenge for children is to learn to cope, continue to adapt to changes and to grow into competent adults. Children who are able to succeed in the face of adversity have been described as resilient. This article will discuss what we have learned from resilient children about the capacity of human adaptation and will identify protective processes that help children deal successfully with traumatic stress and adversity. We will describe the personal haracteristics of resilient children, the types of families that foster resilience, and how communities can promote resilience and support every child’s recovery from trauma.

What are stressors and traumatic events?

A stressor is an event or experience that can be expected to cause stress in many children with the potential for disrupting normal functioning.¹  A traumatic event is expected to overwhelm a child’s coping resources. Children (or adults) are not expected to sustain high levels of psychological wellbeing in the immediate aftermath of a disaster or in situations of severe threat.² However, as the acute phase of distress passes, many children return to normal levels of functioning and proceed in their development in a healthy fashion.

Risk factors

Difficulty in a child’s ability to successfully deal with a trauma is likely to be influenced by the presence of the following risk factors:

• Directly witnessing the event or
• having a family member who was
• exposed to the event
• Surviving the death of a parent or another significant person
• Experiencing mental health or learning problems before the event
• Experiencing a previous traumatic event
• Lacking a strong support network
• Having a parent whose levels of stress and fear are on the rise³

The presence of at least one of these risk factors increases the chances that a child exposed to traumatic stress will face a more difficult road to recovery.⁴

Problems in coping after a traumatic event

The terrorist attacks that took place on September 11th left an indelible mark on all of our lives and elicited various reactions of sadness, anger, fear, confusion and grief. The largest study to date assessing children’s reactions following a traumatic event was completed six months after 9/11 among over 8,000 New York City public school children. The study, commissioned by the NYC Board of Education reported that a significant number of 4th -12th graders displayed a variety of symptoms and disorders including agoraphobia (fear of going out or taking public transportation), separation anxiety disorder (fear of separation from parents), posttraumatic stress disorder, conduct problems and depression.

After the Challenger space shuttle catastrophe in January of 1986, Lenore Terr et al reported that children reacted with a plethora of symptoms. The comments listed below describe some of the symptoms of posttraumatic stress such as jumpiness, flashbacks and nightmares. But perhaps most pervasive may be children’s changes in their beliefs about the future, about the world as safe and themselves and their parents as competent to respond effectively to the trauma, as well as to other dangers. Even every day risks such as having ambitions for
the future were affected.

• “Before the Challenger blew up, I thought everything was perfect. Now I realize things go wrong.” - Girl, age 15, Concord, 1986
• “I had a dream the other night of a fire in my barn. One horse of mine and eight other horses were killed.”
  – Girl, age 15, Concord, New Hampshire, 1986
• “I had wanted to be a space shuttle person but I gave it up.” – Girl, age 9, Porterville, CA, 1987

What is resilience?

There are no magical processes or superhero- like shields that guard children from symptomatic reactions to trauma and stress. While some children may require professional help to deal with the aftermath of traumatic events, most cope effectively and continue to master the developmental tasks appropriate for their age.

Resilience, understood as a set of beliefs, feelings, and behaviors that emerges at a time of adversity, refers to the ability of the child to ‘spring back’ from adversity. According to researchers it is “a process of, capacity for, or the outcome of successful adaptation despite challenging and threatening circumstances.”9 While there is currently great interest in resilience following single, large-scale traumatic events (such as 9/11), there are various other circumstances under which resilience has been observed and studied in children. The emergence of resilience has been noted among the following:

• Children who recover from traumaticevents: These children experience acute or chronic traumatic events such as 9/11 or the Oklahoma City Bombing, or are victims of physical and sexual abuse and child neglect.
• Children who show good outcomes despite stressful experiences: These children are exposed to common stressors like divorce or suffer from repetitive stressors over a short period of time such as the death of a sibling and parent illness.
• Children who show good outcomes despite their high-risk status: These are children born into adversity such as having a parent with schizophrenia, living in violent or very impoverished environments, or suffering from a developmental disability or chronic illness.

'Springing back' after a traumatic event

Unfortunately, we know very little about the timing or pace at which we should expect resilience to emerge in children. This phenomenon has been investigated in adults, and the emerging picture suggests that resilience is comprised of a host of factors. Researcher George Bonanno, Ph.D. has found, for example, that after a traumatic stressor, adults experience a dip in psychological and physical functioning which lasts for several months, but that on average, adults return to pre-trauma levels of functioning approximately one to two years later.10 However, the return to previous functioning can take longer depending on the nature of the event, the support the individual has, and the attitudes and beliefs the individual holds. Understanding and tracking resilience in children is likely to be even more complicated. All of the above factors must be taken into account as we consider the potential resilience in children, and we must be sensitive to its expression depending on the age of the child. Beliefs about the world are differently expressed depending on whether the child is 5 or 15 years of age.