Study Investigates Children's Posttraumatic Stress After Experiencing a Residential Fire

Russell T. Jones, PhD, and Thomas H. Ollendick, PhD., Virginia Polytechnic Institute and State University

Over the past three years, we studied over 100 families who lived through a residential fire. The major aim of the investigation is to assess children's and adolescents' levels of psychological distress within a cross-sectional, longitudinal design.

More specifically, we are using a multi-method assessment strategy wherein children's and adolescents' functioning is being obtained at 1-, 6- and 12-month intervals following the fire.

With a $1.2 million research grant from the National Institute of Mental Health and through collaborative arrangements with other researchers, families residing in Virginia, West Virginia, North Carolina, South Carolina and Georgia have been examined. Our findings are interesting, although by no means fully analyzed or understood at this point in time.

Our initial findings provide important insights into this virtually unstudied area. Given the devastating consequences of fires and burns, ranking sixth among major causes of injury and death among persons newborn to 19 years, a compelling case for its systematic study certainly can be made. Identification of predictors of survivors' post-disaster functioning might provide important inroads into the understanding of this understudied event. One of the most valuable results of this investigation will hopefully be guidelines for the treatment of survivors of such traumatic events.

Initial Findings Vary Greatly
Approximately 55% of our families were of low socioeconomic status and about 52% were African-American or Hispanic American. Approximately 33% were single parents. They resided in both urban and rural areas, but most were poor. Moreover, 49% of our families lived in an apartment complex or trailers; furthermore, 76% experienced extensive or complete loss of their belongings and their dwelling. Of further concern, 63% had minimal or no home insurance. In about one-half of the cases, some member of the family was at home at the time of the fire; however, in the other half no one was at home.

Experiences of the families varied greatly as the families recounted their stories to us. Frequently in the midst of considerable distress, they invariably relayed details of helplessness and, in some instances, hopelessness as they felt little control over what had happened. Feelings of guilt were also present (e.g., "if only I had not gone to the store" or "if only I had checked the stove before going to bed"). Not unlike other victims or survivors of stressful events, they frequently questioned "Why me, why my family, why now?"

Three Predictors Stand Out
We have been impressed by the resilience of many of our families and struck by the fragility of others. There are, however, a couple of findings that cut across our survivors of residential fires. On several outcome measures (including measures of traumatic stress, anxiety and depression in the children and measures of parenting practices and psychopathology in the parents), it appears that the amount of subjective loss is the best predictor of negative outcomes. Loss is defined as subjective since the loss of a $15,000 trailer and personal belongings for one family might be as great as the loss of a $150,000 home and personal belongings to another family. In both instances, the loss is complete and potentially devastating.

The second best predictor has been the extent to which the parents now "need to know where the child is and what the child is doing." We view this measure as reflecting a degree of hyper-vigilance and overprotectiveness. In some instances, such hyper-vigilance is called for, in others it is not. In all cases, however, it is an understandable reaction on the part of parents who nearly lost or, in the least, could have lost their child in the fire. Yet, this normal reaction serves to potentiate the effects of the fire.

Although less clear, a third factor -on at least some of our measures - is the amount and quality of social support the child has and the types of coping strategies the child possesses. Perhaps to no surprise, social support and active, problem-focused coping appears to work best in averting negative outcomes.

We have not yet been able to determine the factors associated with negative outcomes in parents other than the amount of subjective loss as a result of the fire. At this point, socioeconomic status, minority status and other sociodemographic factors do not seem to serve as protective or risk factors. Being at home or not at home also does not seem to be associated with negative outcomes. We intend to explore our data more fully in the months ahead in order to ferret out potential significant influences beyond those we initially thought to be of predictive utility.

In short, although much remains to be determined, we also have learned a lot in our study. Mostly, we have learned that residential fires are potentially devastating to many families. But we have also learned that many of our suppositions are unfounded and that we need to go back to the drawing board to more fully understand our families and the effects that residential fires have upon them. We hope to have more definitive findings and more informed speculation on the import of those findings in the months ahead. In the interim, we thank the families for sharing their experiences with us and for making this journey with them so rewarding and fruitful.