Research Watch

Children’s well-being following natural disasters: PTSD and resilience

Year of Publication
Reviewed By
Marianna Healey & Kristen Lwin

Mohammadinia, L., Ardalan, A., Khorasani-Zavareh, D.,  Ebadi, A., Malekafzali, H., & Fazel, M. (2018). Domains and indicators of resilient children in natural disasters: A systematic literature review. International Journal of Preventive Medicine, 9(54), 1-11.

Terasaka, A., Tachibana, Y., Okuyama, M., & Igarashi, T. (2015). Post-traumatic stress disorder in children following natural disasters: A systematic review of the long-term follow-up studies. International Journal of Child, Youth, and Family Studies, 6(1), 111-133.


Children who live through mass natural disasters may experience a range of negative psychosocial outcomes, including long-lasting consequences to their personal well-being. These two systematic reviews summarized the peer-reviewed research that has been published on children’s resilience (Mohammadinia et al., 2018) and Post-traumatic Stress Disorder (PTSD; Terasaka et al., 2015) following natural disasters.

Both reviews followed the Preferred Reporting Items for Systematic Reviews and Metadata Analysis (PRISMA) guidelines to source and compile publications for their studies. Mohammadinia and colleagues (2018) reviewed 28 individual publications, while Terasaka and colleagues (2015) reviewed 10 studies.

Mohammadinia and colleagues (2018) found that resilience in children following disasters has been researched both as factors internal to the child (i.e. personal characteristics) and factors external to the child (i.e. socio-environmental conditions). The internal factors discussed in these studies related to childhood resilience following disasters included mental health factors (e.g. personality characteristics, feelings of being in-control), spiritual factors (e.g. engagement in religious or spiritual practices), and physical factors (e.g. physical recovery, health). External factors related to resilience included socio-behavioural circumstances (e.g. family, social relationships), and the built/natural environments. The majority of publications included in this review researched the concept of resilience from a multi-factorial perspective, without focusing on any particular category of resilience. Overall, this review compiled a list of 46 circumstances, characteristics, and indicators (spanning the five domains of internal/external factors) that have been discussed in the peer-reviewed literature as related to children’s resilience following disasters. No details about the relative strength or direction of these relationships was reported.

Terasaka and colleagues (2015) found that prevalence estimates of PTSD in children following natural disasters ranged from 2.7% to 22.4% across studies. These estimated prevalence rates differed between the specific natural disaster experienced by the children as well as when the occurrence of PTSD was assessed (i.e., between 15 months and 20 years post disaster). These prevalence estimates of PTSD in children tended to decrease over time. Some studies within this review (but not all) found that females had higher scores on PTSD than males. Most of the studies that assessed age-related differences found no differences in PTSD estimates between young and older children, though one study found younger children (i.e., ages 9 to 11) to have higher rates of PTSD than older children (ages 15 to 18). Other factors that were found to be related to higher rates of PTSD in children following natural disasters in at least one or more of the studies included: living closer to the epicenter of the disaster, having lost family members and/or important belongings (e.g., house) in the disaster, having symptoms of depression as a result of the disaster, being sensitive to anxiety, experiencing other previous traumatic incidents, and post disaster environmental factors such as family or school.

From these two reviews, it can be understood that children’s well-being following disasters is variable and may be influenced by a number of factors. While the body of literature on this topic is still in early stages of development, the information presented in these reviews can provide broad guidance to practitioners as to which domains and factors are potentially influential for children’s well-being following disasters. These identified domains and factors may be relevant considerations and/or intervention targets for professionals working with children who have lived through a public crisis such as a natural disaster.

Methodological Notes

The individual studies included in these reviews were of varying quality, as not one of them were identified as rigorous. Their limitations included, but were not limited to, small sample sizes and varying definitions and measurement of the outcome variables. While the Terasaka and colleagues’ (2015) article provided clear ratings of the respective quality and risks of bias for each of the studies it included, the review by Mohammadinia and colleagues (2018) did not include these types of ratings in their article. This lack of quality assurance limits the reliability and trustworthiness of the overall review. Further, some of the publications included in the Mohammadinia and colleagues (2018) study were not experimental studies and therefore have limited strength from a research quality perspective. Larger, more strictly controlled longitudinal studies are necessary to strengthen the body of literature for children’s well-being (both resilience and post-traumatic stress experiences) following mass natural disasters.