• Mental trauma may be greatest challenge for boys rescued from cave

    Rescue efforts will resume Tuesday after divers removed four more members of a youth soccer team from a cave in Thailand  Monday. A total of eight boys have now been freed, while four more boys and their 25-year-old coach remain trapped inside the flooded cave. The team has been stranded since June 23.

    The official heading the rescue operation said the four boys brought out of the cave Monday were “safe and conscious” and in a hospital. While the medical rescue teams on the ground are trying to ensure the boys are in good physical condition, experts say the mental trauma they’ve experienced may be their greatest challenge to overcome.

    “They’ve been put in a completely foreign and terrifying situation,” Dr. Jessie Warner Cohen, a health psychologist at the Long Island Jewish Medical Center, told CBS News. “They were in the dark for days without knowing what would happen.”

    This extreme environment can make the brain react in “very unusual” ways, says Dr. Robert Glatter, an emergency physician at New York’s Lenox Hill Hospital.

    “You start to hallucinate, you see things, you hear things. You can’t really have a sense of who you are,” Glatter told “CBS This Morning.”

    The boys’ ages, ranging from 11 to 16, may play a big role in how they are affected, experts say. “Kids of this age are very resilient,” Glatter noted. But as the pre-teen and teen years are when people begin to form their own independent identity, the trauma they’ve experienced may shape who they are in the long-term.

    “There are things that happen immediately and that can be sleeplessness, trouble with some of the triggers like being in dark spaces or being some place enclosed, but then as you progress through life and especially now that they’re at the age where they’re still developing it can really help form who they are as a person,” Warner Cohen said.

    As life goes on, she said certain stressors could retrigger them.

    “In the brain, the place that stores traumatic memories and sensations are right next to each other. So things like a smell, a certain sight, a sound can be triggering really lifelong, and it’s working through the issues now and having access to services throughout their life,” Warner Cohen said.

    However, many experts believe their natural resilience is a trait that help a great deal in how they recover.

    “They are 11 to 16 and they have a lot more resilience than someone who may be older, who may have developed more intense fears,” family therapist Dr. Kathryn Smerling said.

    Still, other experts note that there is the threat of post-traumatic stress disorder (PTSD), which can develop after protracted trauma. But Dr. Andrew Adesman, chief of developmental pediatrics at Cohen Children’s Medical Center in New Hyde Park, New York, said he is hopeful it won’t be an issue for a majority of the boys and their coach.

    “There’s a likelihood of resilience, assuming everyone comes out, there’s no fatalities, I think the worst is behind them,” Adesman told CBS News.

    The boys’ parents and mental health professionals will need to be on the lookout for symptoms of PTSD, including nightmares, flashbacks, concentration issues and impulsive or aggressive behavior in order to get them appropriate treatment.

    Currently, the rescued boys are being kept in quarantine due to fear of infection, officials said. Glatter said doctors there are probably concerned about leptospirosis, a disease spread by contaminated water, which also claimed a number of lives in Puerto Rico after Hurricane Maria.

    But Glatter believes mental health should be a greater concern.

    “In my mind, I think the psychological effects are really more severe at this point,” he said. “This is so critical. I think the children need to be hugged, loved. It’s so important, the support. They have to understand that their parents are here for them.”

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