The coronavirus pandemic will continue to change the lives of American children long after schools and daycares open back up. Whether or not there will be long term psychological effects constituting a sort of generational trauma is unclear at this juncture, but the experience of adversity writ large is not historically unique. Children have lived through analogous events: wars, natural disasters, terrorist attacks, economic collapse — even pandemics. Precedent provides a peek into a probable future.
The good news for parents is that psychologists, specifically psychologists who work on childhood trauma, are more or less unanimous on one specific point: Children are incredibly resilient. Most can recover even from profound traumas, including like what is being visited on children in the areas most affected by COVID-19. They can grow to live psychologically healthy lives according to Dr. Zachary Adams, Psychologist & Assistant Professor in the Indiana University School of Medicine Department of Psychiatry.
“When we look at other examples in history where there have been disasters, mass violence events, epidemic or pandemic situations, do we see increased rates of mental health concerns afterward? Sure,” Adams says. “But the vast majority of people are able to bounce back over time. For most people, we would actually expect that we wouldn’t see dramatic long term problems as a result.”
Previous traumas — think Pearl Harbor or, more all-encompassingly The Great Depression — have affected but not necessarily damaged generations of children. This is not to say those disasters had no effect on the behavior of the generations that experienced them. Children of the Great Depression exhibited a tendency to ration food and a skepticism towards banks for the rest of their lives. Those behaviors became cultural hallmarks of a generation, but do not seem to have represented worrying psychological pathologies. Children of the Great Depression had, in short, a fairly logical reaction to the Great Depression.
But that was a fundamentally economic event — albeit one with any number of material and immediate consequences. So let’s consider the long-term effects of more direct trauma. In 1972, West Virginia’s Buffalo Creek Dam collapsed, sending a 30-foot-high wall of coal slurry roaring through 16 mining towns. Of the 5,000 residents of those towns, 4,000 were left homeless, over 1,000 were injured. Nearly three percent of the population, some 125 people, were killed.
Two years after the incident, researchers evaluated 207 local children for signs of psychological distress and found that roughly a third were suffering from PTSD. When those same researchers returned 15 years later, only seven percent exhibited symptoms of PTSD, roughly the same percentage as adults who lived through the disaster. The tragedy had a more pronounced short-term effect on the kids, but they rebounded.
Unfortunately, the fact that children are broadly resilient doesn’t mean that they are specifically inoculated against the long-term effects of stress. On some level, the effects of the coronavirus pandemic on individual children will depend on family and community circumstances.
“There are going to be many children who are going to do just fine after this,” explains child psychologist Jessica Wozniak, Clinical Research & Development Manager at the Baystate Health Family Advocacy Center in Massachusetts. “There are going to be some children who have an acute response and so they may have symptoms initially, maybe trouble sleeping or increased worries or increased behavioral outbursts and there will be children who will have more long term effects. Even from twin studies, we know that two twins can have the exact same traumatic experiences and respond very differently.”
There are two primary twin studies compromising a total of 9,000 twins that have provided high quality data related to trauma and mental disorders: The Virginia Adult Twin Study of Psychiatric and Substance Use Disorders and the Vietnam Era Twin Registry. When studying these sets of twins over their lifetimes, researchers have found that shared genetics do not necessarily account for rates of PTSD. In fact, both PTSD and resilience to trauma seem to be inheritable but genetics can only account for half the likelihood a person might develop PTSD. The remaining factors are due to unique environmental factors that an individual is exposed to in their daily life.
Wozniak notes that there are some factors that can lead to decreased ability to withstand trauma from mass casualty events. She notes that a child’s proximity to the traumatic event is key. The more involved children are the more likely they are to develop psychological symptoms. In New York City or Seattle, both Covid-19 hotspots where cases of sickness and loss of life are already high, the likelihood of children experiencing some form of psychological distress is considerably higher.
That likelihood increases for children who are already destabilized. Rates of PTSD in populations where children already experience some form of insecurity — typically financial or familial — are considerably higher. If they already have symptoms it’s likely that those symptoms will become malignant. Kids heal when they have a chance to do so. Disadvantaged children often don’t get that chance.
Still, there are some ways to ameliorate the potential suffering of children. Wozniak notes that caregiver reactions are key. Children look to adults for cues on how to react. The more calm and collected caregivers are, the more calm and collected kids are likely to be. It also helps when schedules and routine offer some semblance of stability — regular bedtimes and mealtimes make a difference. Obviously, that’s a significant ask for parents struggling to work from home or to keep themselves safe while working outside of the home. But children’s resilience is at least in part a product of adult behavior.
Adams notes that purpose helps. Where enduring isolation might be traumatizing, thinking about participating in self-isolation in order to protect others can help children and families recognize their contributions to the greater good. Agency — even perceived agency — makes a remarkable difference. If children view their behavior and their parents’ behaviors as a product of sound thinking, then they’ll feel a sense of camaraderie likely to cushion the social blow.
“How do we make our decisions in ways that are in line with our values? How do we take care of others? We stay home,” Adams suggests. It’s this kind of shared purpose that can help both families and larger communities endure and blunt the trauma of adversity.
Still, the coronavirus epidemic is unusual. The scale and duration of the event are singular in modern history — and the economic ramifications could linger. Where 9/11 happened one day in New York, coronavirus continues to happen and is, in fact, gaining momentum in smaller cities across the country. Proximity is, in this case, almost a given. While the population of deeply traumatized children may not be statistically large, it will certainly be significant.
“Given how widespread this is, we would expect the overall number of the people affected will be higher than we would see even in extreme disasters like hurricanes and wildfires,” Adams explains, adding that many children are likely to experience the death of a loved one or of a community member.
“What doesn’t kill us makes us stronger” is a fairly common saying — and lip-synced Katy Perry lyric. Unfortunately, that is not true. What doesn’t kill us often leaves a mark, whether that’s physical or psychological. And coronavirus will doubtlessly leave some sign of its passing on a generation of children. Perhaps today’s children will grow up less likely to trust federal response measures or a bit more reluctant to shake hands. Perhaps they will be less likely to participate in anti-scientific, anti-vaccine conspiracy-mongering. Perhaps they’ll be more open to taking video calls. We don’t know.
What we do know is that the kids will likely be alright — except the ones who aren’t.