Page 167 - Creating Spiritual and Psychological Resilience

136 Creating Spiritual and Psychological Resilence

from peers and others; stigma due to scars or deformities; compromised
parental function, such as increased maternal depression; increase in fam-
ily violence or substance abuse during a posttrauma period; and so forth.

Cognitive and Physiological Effects

Traumas such as disasters have other effects that vary with age and stage
of development, including effects on memory, cognition, and physiologi-
cal functioning. Regarding memory, young children may recall events
with a distortion of the sequence to developmentally normal immaturity
in temporal memory (Pynoos et al., 1996). Disasters elicit many feelings
at once, and young children may later recall the experience inadequately
because of lack of familiarity of being aware of having two emotions at
the same time. Young children’s memory may focus on single images,
sounds, or smells (such as cries for help of a family member) but not on
internal sensations, feelings, thoughts. A child’s recall of the story may
be laced with intervention fantasies, and so the narrative may involve
altering events, interrupting the action of the trauma, reversing negative
consequences, or retaliations that in fact never occurred.
Experiencing a disaster can also interfere with a child’s verbal coher-
ence. First memories of the trauma are often fragmented and sensory.
Children’s narratives are also influenced by parental coconstructions.
These interferences with narrative coherence can lead on to trouble with
communicating, writing, and reading comprehension and with conse-
quent school trouble. Other common reactions include interference with
concentration and focused attention and greater irritability, leading to
trouble with peers and with learning.
Yet another effect of disaster is on children’s physiological function-
ing. While it is hard to distinguish preexisting factors from psychophysi-
ological outcomes of PTSD, it is clear that most children who experience
trauma have more intense reactions to sound afterward, with greater
trouble controlling the startle reflex. Extinction of autonomic responses
is impaired after trauma. Trauma also disturbs sleep, especially non-REM
sleep, leading to disturbances, such as sleep walking, calling out while
sleeping, motor restlessness, and night terror. Not getting a good night’s
sleep leads, in turn, to daytime difficulty in concentration and attention
and to greater irritability, which can affect family life, peer relations, and
learning ability (Yehuda, 1999).