U.S. Department of Defense


Date of this Version



Child and Adolescent Psychiatric Clinics of North America, Volume 23, Issue 2, April 2014, Pages 257-279


This article is a U.S. government work, and is not subject to copyright in the United States.


  • Mass-exposure events, such as disaster, terrorism, and war, have unique impacts on children.
  • Effective conceptual approaches must balance risk and resilience from a developmental perspective.
  • Models of mass trauma effects and exposures include exposure dose, cumulative risk, determinants, and moderators.
  • Children are a special needs population particularly vulnerable to the impact of mass trauma due to a lack of experience, skills, and resources to independently meet their mental and behavioral health needs.
  • The National Commission on Children and Disaster’s Report recommends a greater focus on the disaster mental and behavioral health needs of children throughout planning, training, exercises, and response and recovery effort.
  • Higher-intensity exposures lead to worse outcomes.
  • Parental and social support are critical protective factors as moderators of negative outcomes in children exposed to mass trauma.