The effects of a natural disaster on child behavior: evidence for posttraumatic stress

Objectives. A prospective study of children examined both before and after a flood disaster in Bangladesh is used to test the hypothesis that stressful events play a causal role in the development of behavioral disorders in children. Methods. Six months before the disaster, structured measures of selected behavioral problems were made during an epidemiological study of disability among 2- to 9-year-old children. Five months after the disaster, a representative sample of 162 surviving children was reevaluated. Results. Between the pre- and postflood assessments, the prevalence of aggressive behavior increased from zero to nearly 10%, and 45 of the 134 children who had bladder control before the flood (34%) developed enuresis. Conclusions. These results help define what may be considered symptoms of posttraumatic distress in childhood; they also contribute to mounting evidence of the need to develop and evaluate interventions aimed at ameliorating the behavioral and psychological consequences of children's exposure to extreme and traumatic situations.
Specific interventions may be needed to lessen the psychological impact of stressful events on children. Children in flood-prone Bangladesh were studied before and after such an event to determine the role of stress in childhood behavioral problems. Using structured criteria for measuring such problems, children two to nine years old were studied for indications of disability six months before the floods. Five months after the floods, 162 survivors were evaluated once more. Researchers found that the survivors' aggressive behavior had increased from none to almost 10% and that bladder control had been lost in 34% of children who had it before the flood. These findings were interpreted as being manifestations of posttraumatic stress syndrome.