Will the Thailand Cave Survivor Boys Develop PTSD?

Being stranded in the cave may not have been the scariest part.

Posted Jul 30, 2018

Wikimedia Commons
Source: Wikimedia Commons

Eleven-year-old Chanin “Titan” Vibulrungruang was the youngest of the 12 members of the Wild Boars soccer team who were rescued from a flooded cave in Thailand.  When interviewed by CBS news and asked what it was like in the cave, he answered, “It was dark and quite scary” (CBS News, July 19, 2018). Since the day the boys were rescued from the cave, many have asked, would that dark and scary experience give the boys posttraumatic stress disorder (PTSD)?

The image we have of the boys is all of them huddled together in that dark chamber, consistent with young Chanin’s brief narrative for the CBS reporter.  Thus, the narrative that is likely playing through the minds of most observers is a story of whether being stranded in a dark cave will cause PTSD.  If any of the boys develop PTSD, this version of a narrative of what might cause PTSD is wrong.

It Takes Discrete Moments of Sheer Panic to Cause PTSD

To know if they’ll develop PTSD, we need to know more about what they experienced.  We know from research and clinical experience that the events that cause PTSD are sudden and unexpected moments when individuals fear that their lives are threatened.  These are typically discrete moments of intense panic when individuals believe they or a loved one are about to die.  I’ve written about the difference between stress, which does not cause PTSD, and life-threatening trauma in a previous blog called “Stress Is Not Trauma.”

In the situation of the Thailand cave experience, the most likely events that could have instilled moments of sudden, intense panic might include things like the first recognition that water was flooding the cave and blocking their exit, retreating deeper into the cave and having to dive under water, wriggling through or getting stuck in a choke point, believing for a moment that one of their team might be missing during their trek, or being frightened by bats flying past their heads in the dark.  I don’t know if any of those events happened because we have not yet heard first-hand accounts of this trek from any of the boys.  For these boys, sitting on dry ground in the dark cavern, surrounded by all of their teammates, was possibly one of the safer parts of their entire experience.

It is conceivable that the most frightening time for the boys was after they were rescued and they were informed that a Thai Navy SEAL diver had died while trying to rescue them.  Up to that point, they may not have realized just how dangerous the rescue could be. 

I can think of a similar experience from a study I conducted with very young children who experienced Hurricane Katrina in New Orleans.  One of the groups of children we studied were children who had evacuated the city ahead of the storm.  They were never in harm’s way in any fashion.  But the homes of many of these children who had evacuated were destroyed by the flood.  Their homes were not only destroyed, their entire neighborhoods were destroyed, including the neighborhoods to the east, the west, the north, and the south.  Cars were in trees. House were moved off their foundations.  Much of the city was a scene of massive destruction of Biblical proportions. 

Upon returning to see their destroyed homes for the first time, the children who had evacuated now understood very clearly what they had not been able to understand before, which was if their parents had not evacuated them, they could have easily died.  Many of these children in the evacuated group developed PTSD on the day they stepped out of their cars and stood on the sidewalks in front of their destroyed homes and were walloped with the stomach-punch of this realization (Scheeringa and Zeanah, 2008).

If no life-threatening events such as those occurred, it is conceivable that the boys were never panicked during their retreat into the cave or during their wait to be rescued.  They may have been thinking that a hole would be drilled in the mountain and they would walk out.  They may have been thinking that time or water pumps would drain the water and they would walk out the same way they walked in.  We just don’t know yet exactly what they experienced.

They were undoubtedly scared, stressed, and confused.  Being scared, stressed, and confused may cause other problems such as depression, phobias, and anxiety, but those emotions do not typically cause PTSD. 

References

CBS News (July 19, 2018). Uncertainty remains for the stateless as boys rescued from Thai cave return home. https://www.cbsnews.com/news/uncertainty-remains-for-the-stateless-as-boys-rescued-from-thai-cave-return-home-2018-07-19/. 

Scheeringa MS, Zeanah CH (2008). Reconsideration of harm’s way: Onsets and comorbidity patterns of disorders in preschool children and their caregivers following Hurricane Katrina. Journal of Clinical Child and Adolescent Psychology 37(3), 508-518.

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