Rose L. Pfefferbaum

Media Exposure in Children One Hundred Miles From a Terrorist Bombing

This study assessed indirect interpersonal exposure to the 1995 Oklahoma City bombing, broadcast and print media exposure in the aftermath of the explosion, emotional reactions to media coverage, and posttraumatic stress reactions in children distant from the explosion. A survey was administered to 88 sixth-grade students in the public middle school in a community 100 miles from Oklahoma City 2 years after the bombing. Many children reported indirect interpersonal exposure and most reported bomb-related media exposure. Print media exposure was more strongly associated with enduring posttraumatic stress than broadcast exposure. Indirect interpersonal exposure and the interaction of media exposure with emotional reaction to media coverage in the aftermath of the explosion each predicted ongoing posttraumatic stress. The results suggest that children may have lingering reactions to highly publicized terrorist incidents. Concern about the influence of television viewing has long been proclaimed. This study implicates print media exposure as well. Media exposure to terrorist incidents, therefore, should be monitored and those working with children should assess exposure and stress even in children not directly impacted.

The Communities Advancing Resilience Toolkit (CART): an intervention to build community resilience to disasters.

Community resilience has emerged as a construct to support and foster healthy individual, family, and community adaptation to mass casualty incidents. The Communities Advancing Resilience Toolkit (CART) is a publicly available theory-based and evidence-informed community intervention designed to enhance community resilience by bringing stakeholders together to address community issues in a process that includes assessment, feedback, planning, and action. Tools include a field-tested community resilience survey and other assessment and analytical instruments. The CART process encourages public engagement in problem solving and the development and use of local assets to address community needs. CART recognizes 4 interrelated domains that contribute to community resilience: connection and caring, resources, transformative potential, and disaster management. The primary value of CART is its contribution to community participation, communication, self-awareness, cooperation, and critical reflection and its ability to stimulate analysis, collaboration, skill building, resource sharing, and purposeful action.

Exploring community resilience in workforce communities of first responders serving Katrina survivors.

Community resilience activities were assessed in workplace teams that became first responders for Hurricane Katrina survivors. Community resilience was assessed by a survey, focus groups, and key informant interviews. On the survey, 90 first responders ranked their teams disaster response performance as high on community resilience activities. The same participants, interviewed in 11 focus groups and 3 key informant interviews, discussed how their teams engaged in community resilience activities to strengthen their ability to deliver services. Specifically, their resilient behaviors were characterized by: shared organizational identity, purpose, and values; mutual support and trust; role flexibility; active problem solving; self-reflection; shared leadership; and skill building. The implications for research, policy, practice, and education of professionals are discussed.

Trauma, grief and depression in nairobi children after the 1998 bombing of the american embassy

Despite the increasingly dangerous world where trauma and loss are common, relatively few studies have explored traumatic grief in children. The 1998 American Embassy bombing in Nairobi, Kenya, provided an unfortunate opportunity to examine this topic. This report describes findings in 156 children who knew someone killed in the incident, assessed 8 to 14 months after the explosion. Bomb-related posttraumatic stress was associated with physical exposure, acute response, posttraumatic stress related to other negative life events, type of bomb-related loss, and subsequent loss. Grief was associated with bomb-related posttraumatic stress, posttraumatic stress related to other negative life events, and type of bomb-related loss. The study supports the developing literature on traumatic grief and the need for studies exploring the potentially unique aspects of this construct.

Assessing Community Resilience An Application of the Expanded CART Survey Instrument With Affiliated Volunteer Responders

This article describes an application of the Communities Advancing Resilience Toolkit Assessment Survey using a sample of affiliated volunteer responders. The Communities Advancing Resilience Toolkit Assessment Survey is a theory-based, evidence-informed instrument. Early applications of the survey identified four domains: Connection and Caring, Resources, Transformative Potential, and Disaster Management. The version of the instrument used in the current application added items related to Information and Communication, thus creating a fifth domain. The application confirmed the five-factor model and the instrument demonstrated good reliability. Affiliated volunteer responders served as key informants regarding community resilience because of their involvement in local disaster readiness and response. Home ownership and active membership in an affiliated volunteer responder group were associated with the total community resilience score and with multiple domain scores, suggesting the importance of community member investment and engagement for a community’s resilience. Although the study sample involved affiliated volunteer responders, it is likely that engagement in other community organizations and activities may yield similar benefits for resilience.

Community Resilience Interventions: Participatory, Assessment-Based, Action-Oriented Processes

This article compares six interventions to enhance community resilience. In this review, underlying principles for community resilience interventions are (a) use a multihazard approach relevant to the local context, (b) utilize community assessment, (c) focus on community engagement, (d) adhere to bioethical principles, (e) emphasize both assets and needs, and (f) encourage skill development. The interventions are compared with respect to parameters that address their foundation, methodology, and implementation.

Teachers in the aftermath of terrorism: a case study of one New York City school.

Teachers are frequently expected to support children psychologically in the aftermath of mass casualty events, yet they generally have not been trained to do so. This study of a small private school in New York City reports the reactions, needs, and interests in preparedness training among teachers in response to the September 11, 2001, terrorist attacks. By and large, teachers coped by talking to others and/or a health professional, but felt ill-equipped to intervene with students and expressed substantial need for assistance.

Change in smoking and drinking after september 11, 2001, in a national sample of ever smokers and ever drinkers.

Telephone survey methodology was used to examine smoking and drinking after the September 11 terrorist attacks in a representative national sample. Most ever smokers and ever drinkers reported no change in substance use after the attacks. Smokers and drinkers who increased substance use were significantly more likely than those who did not to endorse a number of emotional reactions and functional difficulties. The pattern of associations of decreased use with emotional reactions and functional difficulties differed between smokers and drinkers. In general, decreased smoking was associated with denial of emotional reactions and functional difficulties whereas decreased drinking was associated with endorsement of these reactions and difficulties. The results have implications for research, clinical practice, and public health.

Involving children in disaster risk reduction: the importance of participation

ABSTRACT Background: Millions of children are affected by disasters every year. Children need not be passive victims, however, but instead may contribute to disaster risk reduction activities. Objective: This paper provides a theoretical foundation for children’s involvement in disaster risk reduction activities. Method: The paper reviews and analyses the literature on children’s participation, on their developmental capacity to participate, and on disaster risk reduction activities involving children. Results: Participation yields numerous potential benefits for children, including enhanced personal development and skills, self-efficacy, and interpersonal relationships, and for communities through improved social connections and networks and disaster preparedness. Conclusions: Children are resources to be cultivated and mobilized for disaster preparedness, response, recovery, and resilience. Attention is needed to identify approaches to appropriately enlist, engage, and involve children in disaster risk reduction activities; to promote these efforts; and to evaluate these approaches.

Resilience and Coping Intervention with Children and Adolescents in At-Risk Neighborhoods

ABSTRACT This study evaluated the Resilience and Coping Intervention for Children (RCI), a group intervention to increase coping skills and resilience in children and adolescents. RCI was delivered to children and adolescents residing in five at-risk neighborhoods in a southern U.S. city. Children’s and adolescents’ self-report of coping strategies, strengths and difficulties with behaviors and emotions, and hope indicated decreased difficulties with behavior and emotions and increased feelings of hope postintervention. Parent report of difficulties with behavior and emotions revealed a significant decrease in children but not in adolescents. Mean scores for four coping dimensions increased, but the increase was not statistically significant.