Children's Resilience in the Face of Trauma (continued)

The experience of 9/11 has left us with the realization that terrorist attacks can occur in the United States. As a result, mental health professionals have highlighted the importance of strengthening resilience in children as a preventative strategy in protecting their psychological well-being in the face of decreased perceptions of safety and security. It is important to follow children who are doing well and identify the “magic” ingredients that contribute to their springing back. If we can isolate the critical characteristics of resilient children and families, perhaps we can develop programs to foster the same conditions among families and children who appear at risk for problems.

There is limited information about resilience following terrorism or political violence. A handful of studies have indicated that the capacity of preschool and middle school-aged children to function well after these events islargely  contingent upon the parents’ own reaction and their capacity to promote adaptive coping responses in their children, For example, in a study ofposttraumatic stress in Israeli preschool children 30 months after SCUD attacks, the psychological wellbeing of mothers and other family members was the best predictor of the child’s mental health. When families and mothers ‘did well,’ so did their children. Conversely, families and mothers who showed negative posttraumatic reactions to the attacks had children who showed similar negative outcomes.

Further understanding of factors influencing resilience can be obtained from reports of children who have experienced a range of other types of traumatic stressors. These include children who have had very ill parents or who have lived in highly impoverished environments For example, in a study done by Werner and Smith,12, 13 a cohort of 700 children born on the island of Kauai, Hawaii in 1955 was tracked over 30 years. One third of the group was designated as high risk because of impoverished living conditions such as chronic poverty, low maternal education, familial conflict or instability, and perinatal risk. Nevertheless, 10% of the high-risk cohort, having four or more of the above risk factors, was identified as resilient in adolescence. These adolescents were found to be more mature, achievement  motivated, and socially connected to their peers than their less competent high-risk equals who developed mental health problems, teen pregnancy, and delinquency. Resilient children displayed engaging social skills and had strong relationships with parents or parent substitutes, including siblings, and community support network.

While there are few long-term followup studies of children exposed to trauma, the information we do have suggest that resilience is shaped by individual differences in the child and variations in the recovery environment. As resilient
children bounce back from a stressor, they begin to trust familiar adults, play and laugh again, learn new skills, make and keep friends, do well in school, and create a positive attitude about the world.

What influences positive adaptation to trauma?

An array of protective characteristics or factors has been identified in resilient children. They are present at the individual, family, and community level and contribute, together, to adaptation following trauma during childhood:
These five sets of factors are: (1) trauma characteristics; (2) the child’s own resources; (3) the child’s family characteristics; (4) the community support (i.e. from teachers, peers, friends, mentors); and (5) developmental path.

(1) Trauma characteristics When the trauma is of low to moderate magnitude, children often are able to cope successfully. The child’s inner experience of the severity of the trauma may depend on the following characteristics: the proximity of the child to the event, closeness to the victims, and degree of emotional suffering at the time of the trauma. Children who are in close proximity, who feel emotionally close to the victim, and who experience intense emotional reactions (i.e., fear, panic) during the event tend to be at risk for subsequent problems. For example, East Coast children who lived in the same town in New Hampshire as the teacher who was killed in the Challenger space shuttle explosion experienced more distress after the event than the more removed West Coast children who resided in California.14 Children who lost friends in the Oklahoma City Bombing were found to be more distressed than those who lost acquaintances.15

(2) The child’s own resources Children may be genetically ‘wired’ to respond to stress in certain ways, some of which are more adaptive than others. The child’s own resources, however, consist of these initial dispositions as they are shaped by the environment. Characteristics such as persistence, goal-oriented, adaptability, optimism, willingness to approach novel events, high self-esteem, intelligence, good social skills contribute to positive adaptation (see box).16 Although there are wide individual differences among children, families can nurture these resilient characteristics during daily interactions in the home. Children who, before the traumatic event, were fearful, anxious, or sad may experience serious reactions, take longer to ‘spring back’, or require extra attention from their families.

(3) The child’s family characteristics
The availability and support from parents and other adults in the home when children are feeling fearful, down, or faced with trauma reminders (i.e., an anniversary, the same location) are critical. Children seek their families for comfort, advice, and/or fun. Studies have found that young children exposed to neighborhood violence who receive supportive parenting (e.g. positive and consistent discipline) show fewer stressful symptoms than those with less supportive parenting (e.g., negative or harsh discipline).17 Aside from supportive parenting, how members of the family communicate is also important. Resilient children have parents who tend to negotiate their conflicts in positive ways, communicate openly about their disagreements, agree on household rules and discipline, and do not place children ‘in the middle’ when family conflicts or crises arise.