Magazine article National Association of School Psychologists. Communique

Intrusive Memories among Child Earthquake Survivors

Magazine article National Association of School Psychologists. Communique

Intrusive Memories among Child Earthquake Survivors

Article excerpt

Contributing Editor's Note: In this column, members of the NASP Crisis Management in the School Interest Group bring you summaries of three studies relevant to school crisis response. The first study investigated the presence of intrusive memories among children who survived an earthquake . The second article explored anticipatory stress responses among children with PTSD. Finally, the third study summarized attempted to examine the degree to which model state-level school crisis plans were culturally competent.

A study by Eksi, Peykerli, Saydam, Toparla, and Braun (2008) examined the effects of a 7.4-magnitude earthquake on August 19, 1999, in the northwest region of Turkey. The official death toll after the quake and subsequent aftershocks was more than 20,000, with 30,000 more injured and left homeless. Most of the children affected were exposed to a range of extreme stressors, such as being trapped, getting injured, seeing their homes destroyed, and witnessing the injury, suffering, or death of others. E ski and colleagues conducted five case studies on Turkish children (one girl and four boys ages 10-15) experiencing repeated episodes of vivid intrusive memories and reliving the earthquake.

The authors utilized the Beck Depression Inventory, the Children's Depression Inventory, the State-Trait Anxiety Inventory for Children, and the Clinician-Administered Post-Traumatic Stress Disorder Scale (CAPS) to measure the improvement of each participant. Eksi and colleagues (2008) also conducted separate clinical interviews with children and their parents. Their results indicated the participants had visceral reactions that accompanied their memories of the earthquake. Participant reactions included persistent visions, smells, and a fear of closing their eyes that accompanied the emotional intensity of the original traumatic event. The participants also experienced reactions of anxiety, hyperarousal, dissociation, and depression, as well as occasional behaviors such as anger outbursts, dependency, or withdrawal.

Eksi and colleagues (2008) suggested several methods of treatment that have research-based evidence of effectiveness with children who have PTSD symptoms. While still controversial, eye movement desensitization and reprocessing (EMDR) therapy, which combined cognitive-behavior therapy with directed eye movements, has been shown to be effective in treating both children and adults with PTSD. At this time, there is inadequate empirical support for the use of any particular medication to treat PTSD symptoms. The authors suggest play therapy, group psychoeducation, cognitive-behavior therapy, brief supportive psychotherapy, and family therapy when possible. Family therapy can be beneficial because it utilizes protective factors to build an environment of support around the child who is suffering and often has beneficial outcomes for other family members affected by the trauma. School psychologists can utilize these various treatment practices at school to support individual or groups of children who exhibit PTSD symptoms.

School psychologists should also consider different risk and protective factors rs that influence an individual student's experience with PTSD. This study replicated other findings showing that displaced id children show greater symptoms. Specific questions related to reexperiencing, avoidant, and hyperarousal symptoms should be asked using developmentally appropriate language when interviewing children with PTSD, and treatment plans should be based on the clinical presentation of symptoms. …

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