Posttraumatic stress after disaster doesn’t always lead to chronic symptoms


Natural disasters can cause extreme stress. An investigation examines the trajectories of posttraumatic stress following such disasters.

Childhood is usually a period of learning and exploring, with little chance of extreme stress. However, some children will face a natural disaster such as a hurricane, earthquake, or tornado, and these events can lead to the development of posttraumatic stress symptoms. A report in JAMA Network Open examines the trajectories of these symptoms and how worried clinicians should be that the symptoms may become chronic.1

The researchers used integrative date analysis that looked at 4 studies that examined the response to 4 hurricanes: Andrew, Charley, Ike, and Katrina. The studies were conducted from 3 to 26 months after the hurricanes occurred. Each study recruited children and teenagers aged 6 to 16 years who attended schools that were near the path of destruction of the hurricane. The University of California, Los Angeles, Posttraumatic Stress Disorder Reaction Index (UCLA PTSD-RI) and the UCLA PTSD-RI-Revised was used to assess posttraumatic stress symptoms.

A total of 1707 children and adolescents with an average age of 9.61 years were included in the study. A total of 4 trajectories for posttraumatic symptoms were noted:

  • Chronic – 171 participants
  • Recovery – 393 participants
  • Moderate-stable – 563 participants
  • Low-decreasing – 580 participants

Older teenagers were less likely to be in the chronic group than their younger peers and each 1-year increase in age was linked to increased odds of being in one of the other groups (recovery: odds ratio [OR], 1.78 [95% CI, 1.29-2.48]; moderate-stable: OR, 1.94 [95% CI, 1.43-2.62]; and low-decreasing: OR, 2.71 [95% CI, 1.99-3.71]). When compared to their male peers, girls were found to have higher odds of being in the chronic group than in any other group (recovery group: OR, 0.48 [95% CI, 0.26-0.91]; moderate-stable group: OR, 0.37 [95% CI, 0.21-0.64]; and low-decreasing group: OR, 0.25 [95% CI, 0.14-0.44]).

The results of the study are good news for clinicians who provide care for children and teenagers who are impacted by a natural disaster. A high number of children in the study were either in recovery or low-decreasing for posttraumatic symptoms than had chronic symptoms. Additionally, older age and being male appeared to decrease the risk of a chronic trajectory. Younger children, girls, or the children illustrating moderate-stable or chronic trajectories could benefit from further intervention.


1. Lai B, La Greca A, Brincks A et al. Trajectories of posttraumatic stress in youths after natural disasters. JAMA Netw Open. 2021;4(2):e2036682. doi:10.1001/jamanetworkopen.2020.36682

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