Longitudinal Analysis of Children's Internal States Language and Posttraumatic Stress Symptoms Following a Natural Disaster

Abstract

Disclosure of internal states terms (e.g., emotions, cognitions, and perceptions) in traumatic event descriptions is thought to be associated with physical and mental health in adults, but studies with children have been mixed, and the interpretation of many findings is complicated by the lack of longitudinal data. Using data collected from 568 students (ages 7-12 years) attending schools in Miami-Dade County, Florida, this study examined the internal states language in participant's written descriptions of the 'worst things that happened during the hurricane' collected 3 and 7 months after Hurricane Andrew. Associations between these internal states and their posttraumatic stress symptoms (PTSS) 3, 7, and 10 months post-hurricane were evaluated using structural equation modeling. Patterns of association suggest that PTSS were not affected by internal states disclosure; rather, internal states language seemed to be a manifestation of PTSS. Implications for risk assessment, theory building, and treatment of PTSS in children are discussed.

Children’s Cognitive Functioning in Disasters and Terrorism

“…In their seminal 1996 study of child victims of Hurricane Andrew, Vernberg and colleagues [6] identified trauma exposure as the most important variable for predicting PTSD but it was unclear which components of the exposure construct, subjective (perceived life threat) or objective (life-threatening and lossdisruption experiences), had more predictive utility. Using data from this same sample reported in the paper by Vernberg and colleagues [6], Legerski and colleagues [7] found a relationship between children's appraisals and/or memories of the disaster and their post-event adjustment, thus supporting the importance of subjective aspects of exposure. The child's perception of threat and other subjective reactions were aspects of exposure that influenced post-traumatic stress outcomes in a metaanalysis of 96 child disaster studies [8] as well.…”

“…Appraisal is critical to the content encoded into memory during a traumatic event and is associated with certain emotions which are likely to resurface as intrusive images are recalled. Research findings on the relationship between appraisals and later symptoms and adjustment [7,8] indicate that measuring children's threat appraisal could have great utility in post-disaster screenings. The finding that beliefs and attributions about disasters were a stronger factor than exposure or coping strategies in predicting long-term post-traumatic distress [11] also suggests an important focus for both post-disaster screening and cognitive interventions.…”

Children's emotional experience two years after an earthquake: An exploration of knowledge of earthquakes and associated emotions

“…For example, narratives of preschoolers who had experienced more severe damage during the Hurricane Andrew (Florida, US, 1992) had fewer positive emotions a few months after, and a relatively higher number of negative emotions after six years [ 38 ]. Some authors have nevertheless suggested that the presence of negative emotional terms could be a manifestation of traumatic symptoms [ 39 ]. As age increases, children have also been shown to demonstrate higher introspective abilities expressed in terms of richer emotional language, for example for five to nine-year-olds narrating personally experienced suffering and wellbeing events [ 40 ].…”

Recalling a Devastating Tornado: Qualities of Child Recollections and Associations with Mental Health Symptoms

“…Evidence of cognitive and emotional processing (henceforth "processing") is evident in children's trauma recollections (Fivush and Baker-Ward 2005), and includes use of language that reflects their thoughts and feelings (Legerski et al 2015). Research suggests that such language mirrors a child's "thinking about and reflecting on [their own] experience" (Fivush and Baker-Ward 2005, p. 456).…”

“…However, little research has been conducted on how indicators of processing, when present in children's trauma recollections, are associated with post trauma adjustment. The goal of this project was to examine whether and how potential indicators of children's processing, such as coherence, emotion expression, and resolutions (Fivush and Baker-Ward 2005;Fivush et al 2003;Legerski et al 2015), when found in children's tornado recollections, were associated with post-trauma functioning. Extant literature on children's processing and how it relates to posttrauma adjustment is reviewed below.…”