Course The Emotional Impact of Disaster on Children and Families

Normal Emotional Response

When a child is exposed to a disaster, the emotional responses can range from minimal distress to inattention, fear, lack of enjoyment (anhedonia), anxiety, and depressed mood, to symptoms of re-experiencing, avoidance, hypervigilance, and disruptive behavior.

In many instances these symptomatic reactions are considered normal responses to a traumatic experience and are time-limited. Children, however, may also have significant impairment and chronic symptomatology. As emphasized in the mhGAP Humanitarian Intervention Guide, children in humanitarian emergencies are often exposed to major losses and/or potentially traumatic events. Such events trigger a wide range of emotional, cognitive, behavioral and somatic reactions. People with severe reactions are particularly likely to present to clinical services for help. Clinicians need to be able to distinguish between reactions that do not require clinical management, and those who need clinical management. Transient reactions for which people do not seek help and that do not impair day-to-day functioning (beyond what is culturally expected in case of bereavement) do not need clinical management. In these cases, health providers need to be supportive, help address the person’s need and concerns, and monitor whether expected natural recovery occurs. People with acute stress or grief may present with a wide range of non-specific psychological and medically unexplained physical complaints. Recognize that help seeking may be a poor indicator of need — various factors including shame, fear of consequences, actual physical barriers may lead people in need to not seek services or resist being identified as in need of help.