Factors Associated With an Increased Risk of Adjustment Problems After a Disaster24

1. Preexisting factors
 • Previous psychopathology, significant losses, attachment disturbances, limited coping skills, or other traumatic events.
 • Socioeconomic differences that result in lower levels of postdisaster resources and support.
2. Nature of disaster experience
 • Injury of the child or death or injury of those close to the child.
 • Nature and extent of exposure, including number of deaths, physical proximity to disaster, and extent of personal loss. Human-made disasters, especially terrorist attacks that have a high degree of intentionality, generally create reactions that are more prevalent and long-lasting.
 • Extent of exposure to horrific scenes (including indirectly through the media).
 • Child’s perception (at the time of the event) that his or her life was in jeopardy.
3. Subsequent factors
 • Personal identification with the disaster or victims.
 • Separation of child from parents or other important caregivers as result of event.
 • Loss of property or belongings; need to relocate or other disruption in daily routine or environment.
 • Parental difficulty in coping, substance abuse, mental illness.
 • Lack of supportive family communication style.
 • Lack of community resources and support.