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Posttraumatic stress disorder symptoms following media exposure to tragic events: Impact of 9/11 on children at risk for anxiety disorders

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Abstract

With the extensive media coverage on September 11, 2001, adults and children indirectly witnessed the terrorist attacks leading to the deaths of almost 3,000 people. An ongoing longitudinal study provided the opportunity to examine pre-event characteristics and the impact of this media exposure. We assessed symptoms of PTSD in 166 children and 84 mothers who had no direct exposure to the 9/11 attacks. The sample included children who had parents with or without anxiety and mood disorders, and who had been assessed for the presence or absence of temperamental behavioral inhibition (BI). We found a 5.4 percent rate of symptomatic PTSD in response to 9/11 in children and 1.2 percent in their mothers. Children's identification with victims of the attack, and for younger children, the amount of television viewing predicted increased risk of PTSD symptoms. Parental depression was associated with higher symptoms, and pre-event levels of family support was associated with a lower risk for PTSD symptoms. BI in children was also linked to lower rates of PTSD symptoms, suggesting that a cautious and fearful approach to novelty may offer protection against exposure to media-based traumatic images. Media viewing of tragic events is sufficient to produce PTSD symptoms in vulnerable populations such as children. Given the links between PTSD symptoms and viewing habits, parental monitoring of media exposure may be important for younger children.

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... a) The magnitude of the disaster, nature and severity of traumatic events (Bulut, 2010;Wang et al., 2009;Wolfe, Sas & Wekerle, 1994;Zhang et al. 2011), the type and characteristics of the disaster (Bulut, 2003;Leiva-Bianchi & Gallardo, 2013;Rubonis & Bickman, 1991), and the number of traumatic events (Priebe et al., 2009) are the factors most often cited in the literature. b) For the exposure; degree of exposure (March, Amaya-Jackson, Terry & Costanzo, 1997;Tuicomepee & Romano, 2008), dose of exposure (Bulut et al. 2005;Başoğlu et al. 2004;Cheng et al. 2014), high and low exposure (Bulut, 2006;Wang et al., 2009), direct exposure (Bulut 2010;Seino, Takano, Mashal, Helmat & Nakamura, 2008), indirect exposure (Vila, Porche & Mouren-Simeoni, 1999), indirect media exposure (Otto et al., 2007), print media exposure, broadcast media exposure (Pfeferbaum et al., 2003), emotional and television exposure (Pfeferbaum et al., 2001), physical exposure and indirect interpersonal exposure (Pfeferbaum et al., 2000), and objective exposure (Braun-Lewensohn, Celestin-Westreich, Celestin, Verté & Ponjaert-Kristoffersen, 2009) are all mentioned in defining the severity of the events an individual may experience in his exposure to a disaster or traumatic event. c) Subjective reactions (Pfeferbaum, 2005) are an individual's perception and evaluation of the event called "subjective exposure"; especially during the disasters, for the most part fear (Heetkamp & de Terte, 2015;Laufer & Salomon, 2006) is investigated in the research studies. ...
... Tuicomepee and Romano (2008) reported that family functioning and family support were protective factors in overcoming the psychological effects of a tsunami disaster. Similarly, Otto et al., (2007) mentioned the pre-event family support as the protective factor and children's perceptions of low social support and high conflict in family settings as the predictor of PTSD. There was a significant negative correlation between family member relationships, social support, and PTSD. ...
... Bulut (2010) conducted a longitudinal disaster study with directly effected children and reported a "fluctuation pattern" of PTSD with 3 years independent measurement follow ups. Otto et al. (2007) exclusively researched the effect of indirect exposure after 9/11 incidents via TV exposure. They concluded that even only indirectly witnessing the terrorist attacks via TV predicted the risk of PTSD. ...
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The purpose of this study was to test the direct, indirect, objective, and subjective exposure effect on the development of Post Traumatic Stress Disorder (PTSD). The impact of social and organizational support, as well as age and gender factors, were examined in development of PTSD. Participants were 270 disaster survivor elementary and secondary school students. One year after the disaster, each participant filled out a Children’s Post-Traumatic Stress Disorder Reaction Index (CPTSD), trauma exposure, trauma experiencing, social support, and organizational support scales. Male and female students were compared on these instruments with univariate Anova. Elementary school children outscored both on the organizational support and trauma scale and this reached significance level. Additionally, contributing factors were predicted with a stepwise regression analysis. A combination of direct, indirect, objective exposure scores, subjective exposure scores, gender, age, organizational and social support variables accounted for 17 % of the PTSD scores. Direct exposure accounted for 6 %, subjective exposure 5.4 %, age 3 %, having a friend moving away 2.6 % and food shortage contributed 1 %, and of the total variance. Direct exposure appeared to be the most significant predictors, followed by subjective exposure. Media exposure, gender, and physical exposure seemed to be especially poor contributors. Neither school nor home damage, the death of relatives or friends, or gas, water, and electric shortages contributed significantly to the results.
... In another study, however, older adults were found to consume more disaster media coverage than younger adults (Dougall et al., 2005). With regard to child and youth samples, the pattern was clearer; older children and youth consumed more disaster media coverage than did younger children (e.g., Duarte et al., 2011;Haravuori et al., 2011;Otto et al., 2007;Schuster et al., 2001). Beyond age, one study also found that less education was related to more disaster media use (Pfefferbaum, North, et al., 2014). ...
... In terms of developmental moderators, only one result was identified, in that younger children reported more PTSS related to disaster media use than did older children (Otto et al., 2007). With regard to social moderators, results for parental monitoring or restrictions of child disaster media use were mixed. ...
... Moreover, if individuals who stop disaster media use due to fear report low levels of disaster media use when provided with continuous response options, but are reporting high levels of reactions, then such reports might dampen the overall effects trend in the results, when in actuality disaster media use is exhibiting a strong effect among these individuals (so strong that the usage is stopped by individuals). More generally, it may be that the changing of ones' media behavior related to disaster media coverage (either in terms of consuming more or consuming less) is itself an important behavioral action that drives effects (Otto et al., 2007). Another interrupter of disaster media use may occur in the family setting, when parents chose to limit the disaster media use of children, an action that might be motivated based on parent perceptions that their children are upset by the media coverage (e.g., Phillips et al., 2004). ...
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Natural and human-caused disasters receive extensive media coverage that often includes images, video, and descriptions of death, injury, and destruction. Individual exposure to disaster media has been found to be associated with a variety of effects (e.g., mental health reactions) among children and adults in numerous studies. Despite evidence of disaster media effects, the literature is not well organized. To improve integration, we conducted a systematic review and used the Differential Susceptibility to Media Effects Model (DSMM) to organize results. We analyzed 66 studies, representing 78,643 participants, and found that the disaster media effects literature is built upon the theory of psychological trauma, that the role of uncertainty and social aspects of disaster media effects are understudied, and that transactional disaster media effect studies are nonexistent. Our analysis also indicates that adding a contextual category to the DSMM model is beneficial in synthesizing media effects. Opportunities for future research are discussed.
... Family dysfunction is arguably the most important universal risk factor for myriad negative health outcomes among crisis migrant children and adolescents (Otto et al., 2007). Pre-migration violence or threats within, or directed toward, the family are associated with poor mental health among adolescents (Bronstein & Montgomery, 2011). ...
... Among crisis migrant children, lower socioeconomic status is often coupled with traumatic stress and elevated risk for experiencing traumatic events. Severity of exposure is predictive of the risk for developing PTSD, anxiety, and depression in children and adolescents (Otto et al., 2007). At the school and peer level, poor grades and achievement, as well as peer rejection, can contribute to poor mental health among children (Muris, 2006). ...
Article
Crisis migration refers to displacement of large numbers of individuals and families from their home countries due to wars, dictatorial governments, and other critical hazards (e.g., hurricanes). Although crisis migration can adversely influence direct and indirect effects on the mental health of adults and their children collectively as families, there is a deficiency in theory that addresses family level processes in this crisis migration context. We propose the Family Crisis Migration Stress Framework, which consolidates what is known about the multiple factors affecting mental health outcomes of crisis migrants into one cohesive model. In our article, we synthesize relevant theories and models of disaster, migration, and family resilience in order to create a framework in which to organize the complex processes that occur within families as a result of migration and that affect the mental health of children. We include examples from various national settings to illustrate the tenets of our framework. Future policy and intervention for crisis migrant should focus on the family as a unit, instead of parents and children as individual entities.
... In a study of relatives of adults with PTSD, high EE was observed in 44.7% of relatives (Barrowclough et al., 2008). However, in a sample of young people who had indirect exposure to the 9/11 terrorist attacks in the USA, objectively measured parental EE, measured prior to the trauma, did not predict subsequent development of PTSD symptoms in young people (Otto et al., 2007). It is possible that high EE is a reaction to the development of the young people's symptoms post-event (Hale et al., 2011). ...
... In contrast, no association between parent or clinician-reported criticism and PTSS in young people was found. Significant small to medium effects between criticism rated on the FMSS and child anxiety disorders have been reported (Gar and Hudson, 2008;McCarty and Weisz, 2002) although a prospective study of PTSD found no effect of EE measured prior to a traumatic event (Otto et al., 2007). It is possible that criticism in response to a young people's symptoms after the event predicts the maintenance of PTSD (McFarlane and Cook, 2007), a longitudinal relationship that could not be tested in the present study. ...
Article
Background: Family factors may alter the risk of developing posttraumatic stress disorder (PTSD) or depression in young people after a traumatic event, but it is not clear which modifiable family variables can be addressed in psychological therapies. This study examined the relationships between family factors (Expressed Emotion [EE] and family accommodation) and psychopathology (posttraumatic stress symptoms; PTSS) in young people following a single incident trauma. Potential mediators of these relationships were also investigated. Method: Sixty-six parent-child dyads (aged 8–17 years) were assessed within one month of attending an Emergency Department. Self-reported PTSS and perceived EE were assessed in young people. Parents’ own PTSS, mood symptoms, EE, and accommodating behaviours were also assessed. Results: Cross-sectional analyses revealed that young person-perceived EE, parent-reported emotional over involvement (EOI) and accommodation behaviours significantly predicted higher PTSS in young people. The stress experienced as a consequence of EE mediated the relationship between young person-perceived EOI and PTSS in young people. Parental PTSS and anxiety were positively correlated with EOI and accommodation. Parental PTSS was not significantly associated with symptoms in young people. Conclusions: The results support the hypothesis that EE and accommodation are positively associated with PTSS in young people in the month following a potentially traumatic event. Understanding the child in the context of their family environment and relationships offers an important framework for making sense of and facilitating adaptive adjustment following a traumatic event.
... Another unanticipated finding regarding negative experiences was the number of children who described witnessing violence through social media or television. Media violence is known to play a role in forming and maintaining psychological distress, particularly in youths [26], but given the ongoing conflict around, it was not expected to feature in our results. However, in Syria, the crisis dominates news bulletins and the aftermath of terrorist atrocities, fighting, and dead or injured people are regularly shown. ...
... Sex differences in mental health are well established [32]. In agreement with other studies, it was found that females were more likely to display PTSD and depression symptoms than males although there was little difference regarding anxiety (Table 2) [16,26,29]. Anxiety and, in particular, depression, are known to co-occur with PTSD and nearly a third of our sample were comorbid. ...
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Purpose: Studies show that conflict can negatively affect psychological health. The Syrian crisis is 8 years old and yet little is known about the impact of the conflict on the well-being of Syrians who remain. This gap was addressed by conducting an empirical study on the mental health burden of Syrian children in two areas of the country. Methods: 492 children between 8 and 15 years were randomly selected from schools in Damascus and Latakia. The incidence of psychological disorder symptoms was measured using self-report screening instruments, the Children's Revised Impact of Event Scale (CRIES-8) and the Revised Children's Anxiety and Depression Scale (RCADS-25). Simultaneously, sociodemographic and traumatic event information was collected. Binary logistic regression was used to identify factors that influence the development of post-traumatic stress disorder (PTSD) symptoms. Results: In our sample, 50.2% of students were internally displaced and 32.1% reported a negative experience. 60.5% of those tested had at least one probable psychological disorder with PTSD the most common (35.1%), followed by depression (32.0%), and anxiety (29.5%). Binary logistic regression indicated that PTSD symptoms were predicted by: living in Damascus [odds ratio (OR) 2.36, 95% confidence interval (CI) 1.51-3.69], being female (1.54, 1.02-2.34), having depression and anxiety (2.55, 1.48-4.40), and the negative experiences; displacement and daily warzone exposure (1.84, 1.02-3.30 and 2.67, 1.08-6.60). Conclusions: Syrian children are experiencing traumatic events and war-associated daily stresses that are hugely impacting psychological well-being. Our data offer guidance for mental health providers regarding risk factors and highlights the use of the school system to reach suffering children.
... In online study with 3,459 Chinese participants, perceived threat mediated the positive relationship between exposure level and mental health problems. Factors such as media coverage and perceptions of risk can be crucial for mental health (Blendon et al., 2004;Otto et al., 2007;Bhushan et al., 2022). Liu et al. (2020) found the concerns about the threat posed by COVID-19 to life and health was the only significant predictor of somatic symptoms in Chinese primary school children, which is consistent with our results that threat experience was the best predictor of children's mental health outcomes. ...
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The COVID-19 pandemic and the accompanying containment measures such as physical distancing and school closures led to major changes in children’s everyday lives. By means of a mixed-methods study, the “Tyrolean COVID-19 Children’s Study” investigated the effects of the pandemic and factors influencing mental health and health-related quality of life of North Tyrolean (Austria) and South Tyrolean (Italy) children aged 3–13 years. Parents filled out N = 2,691 online questionnaires (951 preschool children: 3–6 years; 1,740 schoolchildren: 7–13 years) at four measurement time points (March 2020, December 2020, June 2021, December 2021). For both age groups, children’s mental health outcomes (internalising problems, posttraumatic stress symptoms) were worse in December 2021 (t4) than children’s mental health outcomes in March 2020 (t1). With regard to aggressive behaviour, this difference was only found among schoolchildren. Thematic analysis of an open ended, written question revealed the following positive changes in children during the Corona crisis: (1) the importance of intra- and extra-familial relationships, (2) new competences and experiences, (3) values and virtues, (4) use of time, and (5) family strength. Using multilevel modelling, threat experience, economic disruption, and perceived posttraumatic growth were shown to be the strongest predictors of all outcomes. Additionally, male gender was shown to be a predictor of aggressive behaviour. In terms of age, schoolchildren showed more internalising problems, aggressive behaviour, and threat experience than preschool children. With regard to time, parents in December 2021 reported more threat experience in older children and less perceived posttraumatic growth in both older and younger children, than parents at the beginning of the pandemic. Targeted support for vulnerable children may prevent longer-term development of psychopathologies and contribute to society’s psychosocial resilience in the current COVID-19 pandemic. Moreover, sustainable promotion of children’s posttraumatic growth can also contribute to children’s mental health and could even offer a chance to turn the crisis into an opportunity.
... doi:10.1111/disa.12377 Studies following the terrorist attacks in the United States on 11 September 2001, conducted mainly from a mental health perspective, revealed an increase in trauma owing to more television viewing (Ahern et al., 2002;Otto et al., 2007). The same manifested in a comparison of the events on 11 September 2001 with the 8.8 magnitude earthquake in Chile on 27 February 2010 , and even after the detonation of two home-made pressure-cooker bombs during the Boston Marathon in the US on 15 April 2013 (Holman, Garfin, and Silver, 2014). ...
Article
This paper reviews the role of news with respect to the mental health of a population exposed to a disaster. It is based on the five essential elements of psychosocial care presented by Stevan E. Hobfoll et al. (2007) that can be introduced after a potentially traumatic event: promoting a sense of safety, calming, self and collective efficacy, connectedness, and hope. This study developed a method to relate these elements to television coverage and applied it to the stories (n=1,169) aired by the main networks in Chile in the 72 hours after an 8.8 magnitude earthquake struck on 27 February 2010. Of the five elements, promoting a sense of safety occurred most often (82.72 per cent), whereas the others were barely present (less than 10 per cent). The study argues that these elements can increase the possibility of framing the news, given that the audience watching can also be affected by a disaster.
... The school environment provides social support, playing a protective role in children and adolescents following disaster exposure. 35 Meanwhile, other reoprts 36 have studied 166 vulnerable children (mean age, 11 years; range, 7-15 years) in Boston who were exposed to the 9/11 disaster only through the media. These authors found that the prevalence of PTSD was 5.4% according to the Kiddie Schedule for Affective Disorders and Schizophrenia, Epidemiologic Version (K-SADS-E). ...
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Background Two hundred and fifty 11th grade students and teachers from Danwon High School drowned, during a school trip, in the Sewol Ferry Disaster. The goal of this study was to investigate the experiences of the psychiatrists who volunteered and provided psychiatric services to the students at Danwon High School. Methods From the second day to the 138th day after the disaster, pro bono psychiatrists provided post-disaster interventions to the 10th and 12th-grade Danwon High School students who did not attend the trip. Officially, 167 psychiatrists conducted outreach in approximately 550 encounters. The study questionnaires were distributed retrospectively to psychiatric volunteers who conducted outreach at Danwon High School. We surveyed the pro bono psychiatrists about their experiences, including the students' chief complaints, psychiatric problems, clinical diagnoses, and psychiatrists' treatment recommendations. Results We reached 72 (43.1%) of the 167 volunteers, and they reported on 212 (38.6%) of the 550 encounters. The common chief complaints were mental health problems, companion problems, and family problems. The most frequent psychiatric symptoms were anxiety (76.89%), depressive mood (51.42%), and concentration difficulty (50.94%). The most frequent clinical diagnoses of the students were normal reaction (41.04%), acute stress disorder (24.53%), adjustment disorder (17.92%), anxiety disorders (9.43%), and posttraumatic stress disorder (6.60%). More than half of the students needed “additional counseling/therapy” (41.04%) or “referral to psychiatric treatment” (14.15%). Conclusion During the acute aftermath of the Sewol Ferry Disaster, volunteer psychiatrists were able to provide services. These services included psychiatric assessments, crisis counseling, psychological first aid, and referrals for ongoing care. More than half of the students were perceived to have a psychiatric diagnosis, and a substantial proportion of students needed further treatment. Future research should focus on the short- and long-term effects of psychiatric interventions and the characterization of post-disaster mental health needs and service provision patterns.
... Although the revised DSM-5 PTSD criteria removed media exposure as a Criterion A event, the current study adds to previous studies (e.g. Hall et al., 2015;Horesh, 2016;North, Hong, & Downs, 2018;Otto et al., 2007) showing that media exposure was associated with PTSD. The more restrictive definition of trauma will reduce the prevalence of PTSD in populations, and may prevent 'bracket creep', but the influence of media exposure should also be considered (Lavenda, Grossman, Ben-Ezra, & Hoffman, 2017;Levin, Kleinman, & Adler, 2014;Marshall et al., 2007). ...
Article
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Background: Direct exposure to natural disasters and related losses are associated with posttraumatic stress disorder (PTSD). What is less clear is whether indirect media exposure is also associated with PTSD. Objective: This study investigated key exposure-related risk factors for PTSD and examined the effect of media exposure on the prevalence of disaster-related PTSD. Method: Typhoon Hato directly hit Macau on August 23 2017. It was one of the most serious natural disasters ever to strike Southern China. One month following the event a sample of 1,876 Chinese university students in Macao, China were recruited into a cross-sectional study (age M=20.01; SD=2.63; 66.2% female). Self-reported typhoon exposure, media use and exposure to disaster-related content, and PTSD symptoms were collected using an electronic survey. Univariable analyses assessed associations between risk factors and PTSD, which were then included in a series of multivariable logistic regressions. Results: The prevalence of PTSD was 5.1%. Adjusted models demonstrated that being male (compared to female) aOR=1.68, 95% CI (1.07–2.63), home damage aOR = 2.86, 95% CI (1.71–4.78), witnessing people injured aOR=2.33, 95% CI (1.36–4.00), and almost drowning during the storm aOR=8.99, 95% CI (1.92–41.99) was associated with PTSD. After adjusting for direct exposure, indirect exposure to disaster-related social media content, including information related to drowning victims aOR=1.29, 95% CI (1.00–1.67) and residents’ emotional reactions aOR=1.98, 95% CI (1.44–2.72), were associated with PTSD. Viewing more information about the storm itself aOR=0.37, 95% CI (0.28–0.49) and images of people being heroic aOR=0.72, 95% CI (0.55–0.94), were significantly associated with lower odds of PTSD. Conclusions: These findings add to the literature demonstrating that some types of media use and certain media content following a natural disaster are associated with PTSD.
... In another study, Rodgers, Franko, Brunet, Herbert, and Bui (2012) found that among of adults living in Canada, France, and the USA, more use of television or the Internet to find out about the 2011 Tōhoku, Japan earthquake and tsunami was associated with more distress related to the event. Additionally, in a study of young people age 7-15 in Boston, Massachusetts, Otto et al. (2007) found that youth who reported watching more television coverage of the September 11, 2001, terrorist attacks reported more posttraumatic stress reactions. These examples illustrate that exposure to disaster media coverage has been found to be associated with psychological distress for children and adults located both close to and farther from an event. ...
Article
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Addressing mental and behavioral health effects of disaster media coverage is an important part of a disaster public health response, and school staff may be particularly well suited to help children and youth cope with disaster media. We conducted qualitative interviews (N = 42) to explore US school staff (e.g., teachers, mental health staff, administrators) perspectives on disaster media coverage and students and used an inductive thematic method for analysis. We found that school staff reported that students often exhibited reactions to disaster media that included expressing emotions and asking questions. With regard to school staff coping efforts with students, participants described different ways they talked with students about disaster media, but also reported a need for help with these conversations.
... This increase has been accompanied by research focused on psychological sequelae of war-related trauma in children. Many researchers have shown that posttraumatic stress disorder (PTSD) appears to be the expected child's reaction to war atrocities (Khamis, 2005;Otto et al., 2007). According to the Diagnostic and Statistical Manual of Mental Disorders, fifth edition (DSM-5; American Psychological Association [APA], 2013), the symptoms of attention deficit hyperactivity disorder (ADHD) and PTSD in growing children have certain similarities. ...
Article
The study investigated whether religiosity mediates or moderates the relationship between war atrocities and inattention-hyperactivity in children from Gaza Strip and South Lebanon. Participants were 600 children aged 12–16 years, of whom 273 were males and 327 were females from public schools. Questionnaires were administered by two psychologists. To examine the mediating and moderating effects of religiosity, Baron and Kenney’s mediational criteria and hierarchal regression analysis were conducted. Results indicated that religiosity mediated and moderated the relationship between war atrocities and inattention–hyperactivity in children. The clinical and research implications of these conclusions are discussed.
... Stigmatized minorities may be further traumatized by familial, historical, or sociopolitical accounts of discrimination or ethnoviolence in their communities, often referred to as cultural trauma (Helms, Nicolas, & Green, 2012;SAM-HSA, 2014). Emerging literature has suggested that even watching news accounts of violence on TV can contribute to traumatization (Bernstein et al., 2007;Naeem, Taj, Khan, & Ayub, 2012), especially in the case of national events like September 11 (Ahern, Galea, Resnick, & Vlahov, 2004;Otto et al., 2007). This is particularly relevant to the African American experience, which currently includes mass media coverage of unarmed African Americans' being abused or killed by police. ...
Article
Journal: Practice Innovations. Many ethnic minority groups experience higher rates of posttraumatic stress disorder (PTSD) compared to their European American counterparts. One explanation for this is the differential experience of racism, which can itself be traumatic. This article aims to provide a theoretical basis for the traumatizing nature of various forms of racism within the 5th edition of the Diagnostic and Statistical Manual of Mental Disorders ’ framework for PTSD. PTSD caused by racism, or racial trauma, is likely to be underrecognized due to a lack of awareness among clinicians, discomfort surrounding conversations about race in therapeutic settings, and a lack of validated measures for its assessment. We review the literature and existing measures for the assessment of racial trauma and introduce the UConn Racial/Ethnic Stress & Trauma Survey (UnRESTS), a clinician-administered interview. The UnRESTS is useful to clinicians as an aid to uncovering racial trauma, developing a culturally informed case conceptualization, and including experiences of racism in the diagnosis of PTSD when warranted. Three case examples that describe the impact of racial stress and trauma and the role of the UnRESTS in understanding the experiences of those impacted by racism are included.
... The potential for exposure to such events to arouse fear and anxiety appears critical for understanding adults' political thought (see Robin, 2004Robin, , 2011; the same may be true among youth. For example, multiple studies have examined children's responses to televised news reports of the September 11, 2001, terrorist attacks in the United States (Otto et al., 2007;Saylor, Cowart, Lipovsky, Jackson, & Finch, 2003). Such news reports may affect children differently than adults, due to children's cognitive limitations (e.g., children may misinterpret footage of a single event being aired repeatedly as indicating that a new event is occurring each time; Franks, 2011). ...
Article
In this monograph, we argue for the establishment of a developmental science of politics that describes, explains, and predicts the formation and change of individuals' political knowledge, attitudes, and behavior beginning in childhood and continuing across the life course. Reflecting our goal of contributing both theoretical conceptualizations and empirical data, we have organized the monograph into two broad sections. In the first section, we outline theoretical contributions that the study of politics may make to developmental science and provide practical reasons that empirical research in the domain of politics is important (e.g., for identifying ways to improve civics education and for encouraging higher voting rates among young adults). We also review major historical approaches to the study of political development and provide an integrative theoretical framework to ground future work. Drawing on Bronfenbrenner's ecological systems model as an organizing scheme and emphasizing social justice issues, we describe how factors rooted in cultural contexts, families, and children themselves are likely to shape political development. In the second section of the monograph, we argue for the importance and utility of studying major political events, such as presidential elections, and introduce the major themes, rationales, and hypotheses for a study of U.S. children's views of the 2016 U.S. presidential election. In addition, we apply a social-justice lens to political thought and participation, addressing the role of gender/sex and race/ethnicity in children's political development broadly, and in their knowledge and views of the 2016 U.S. presidential election specifically. In interviews conducted within the month before and after the election, we examined two overarching categories of children's political attitudes: (a) knowledge, preferences, and expectations about the 2016 election, and (b) knowledge and attitudes concerning gender/sex and politics, particularly relevant for the 2016 election given Hillary Clinton's role as the first female major-party candidate for the presidency. Participants were 187 children (101 girls) between 5 and 11 years of age (M = 8.42 years, SD = 1.45 years). They were recruited from schools and youth organizations in five counties in four U.S. states (Kansas, Kentucky, Texas, and Washington) with varying voting patterns (e.g., Trump voters ranged from 27% to 71% of county voters). The sample was not a nationally representative one, but was racially diverse (35 African American, 50 Latinx, 81 White, and 21 multiracial, Asian American, Middle Eastern, or Native American children). In addition to several child characteristics (e.g., age, social dominance orientation [SDO]), we assessed several family and community characteristics (e.g., child-reported parental interest in the election and government-reported county-level voting patterns, respectively) hypothesized to predict outcome variables. Although our findings are shaped by the nature of our sample (e.g., our participants were less likely to support Trump than children in larger, nationwide samples were), they offer preliminary insights into children's political development. Overall, children in our sample were interested in and knowledgeable about the presidential election (e.g., a large majority identified the candidates correctly and reported some knowledge about their personal qualities or policy positions). They reported more information about Donald Trump's than Hillary Clinton's policies, largely accounted for by the substantial percentage of children (41%) who referred to Trump's immigration policies (e.g., building a wall between the United States and Mexico). Overall, children reported as many negative as positive personal qualities of the candidates, with negative qualities being reported more often for Trump than for Clinton (56% and 18% of children, respectively). Most children (88%) supported Clinton over Trump, a preference that did not vary by participants' gender/sex or race/ethnicity. In their responses to an open-ended inquiry about their reactions to Trump's win, 63% of children reported negative and 18% reported positive emotions. Latinx children reacted more negatively to the election outcome than did White children. Girls' and boys' emotional responses to the election outcome did not differ. Children's personal interest in serving as U.S. president did not vary across gender/sex or racial/ethnic groups (overall, 42% were interested). Clinton's loss of the election did not appear to depress (or pique) girls' interest in becoming U.S. president. With respect to the role of gender/sex in politics, many children (35%) were ignorant about women's absence from the U.S. presidency. Only a single child was able to name a historical individual who worked for women's civil rights or suffrage. Child characteristics predicted some outcome variables. For example, as expected, older children showed greater knowledge about the candidates than did younger children. Family and community characteristics also predicted some outcome variables. For example, as expected, participants were more likely to support Trump if they perceived that their parents supported him and if Trump received a greater percentage of votes in the children's county of residence. Our data suggest that civic education should be expanded and reformed. In addition to addressing societal problems requiring political solutions, civics lessons should include the histories of social groups' political participation, including information about gender discrimination and the women's suffrage movement in U.S. political history. Providing children with environments that are rich in information related to the purpose and value of politics, and with opportunities and encouragement for political thought and action, is potentially beneficial for youth and their nations.
... Sedney [6, p. 316] suggests that the media is an 'indirect [form of] death education' which can be just as powerful as directed forms of learning. There is evidence that exposure to media portrayals of real-life traumas (such as terrorist attacks) can produce symptoms of post-traumatic stress disorder in children [54,55]. However, as yet there is surprisingly little research addressing how exposure to death in the media relates to children's death concepts. ...
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In the last century, decreases in infant and child mortality, urbanization and increases in healthcare efficacy have reduced children's personal exposure to death and dying. So how do children acquire accurate conceptions of death in this context? In this paper, we discuss three sources of children's learning about death and dying, namely, direct experience of death, parental communication about death and portrayals of death in the media and the arts. We conclude with recommendations about how best to teach modern children about this aspect of life. This article is part of the theme issue ‘Evolutionary thanatology: impacts of the dead on the living in humans and other animals’.
... [12][13][14] Research exploring the role of age and developmental stage at the time of traumatic exposure also suggests that young children are more vulnerable than older children to develop maladaptive responses to stress caused by separation from caregivers, disruption in routines, or violent media reports. 13,15,16 Responsive care from a consistent, nurturing caregiver can protect and buffer children from the negative effects of conflict and crisis and support their health and development. 7,17 This is particularly critical during the very early years when the child is primarily dependent on primary caregivers, not just for protection and survival, but to help them downregulate arousal. ...
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Young children living in conditions of war, disaster, and displacement are at high risk for developmental difficulties that can follow them throughout their lives. While there is robust evidence supporting the need for early childhood development (ECD) in humanitarian settings, implementation of ECD programming remains sparse, largely due to the lack of evidence of how and why these programs can improve outcomes in humanitarian settings. In order to build the evidence base for ECD in humanitarian settings, we review the current state of implementation research for ECD programming (targeting children 0–8) in humanitarian settings, through a literature review and a series of key informant interviews. Drawing from existing frameworks of implementation research and the findings from our analysis, we present a framework for ECD implementation research in humanitarian settings and propose an agenda for future research.
... Children may also be affected by contact with disasterrelated media coverage which often plays a prevalent role after disasters. Studies have found, for example, a relationship between contact with media coverage in the acute phase after a terrorist incident and posttraumatic stress reactions in children [36,37]. While most child disaster media studies have examined terrorist incidents, several natural disaster studies have also been conducted [33,38,39]. ...
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Purpose of review: This review examines factors thought to be associated with posttraumatic growth (PTG) (demographic variables, exposure, and family and social processes) among youth exposed to natural disasters, describes the relationship between PTG and posttraumatic stress, and discusses psychological processes (rumination and coping) linked to PTG. Recent findings: Guided by PTG theory and the literature on PTG in adults, research has revealed relationships between PTG and child, environmental, and family and social factors among youth though the results are mixed. Youth's subjective exposure to disasters, their level of posttraumatic stress following the disaster, and the type of psychological processes they employ to cope with the disaster appear to be associated with PTG. Research has garnered preliminary support for PTG in children exposed to natural disasters but additional research is needed to fully explicate these relationships and to understand how these relationships change over time.
... For example, in a study conducted after 11-S terrorist attacks (four coordinated terrorist attacks by al-Qaeda on the United States on September 11, 2001), the Post-traumatic Stress Disorder (PTSD) rate in a sample of 109 workers was 6.4%, for those directly exposed to a disaster site (World Trade Center) and 4.6% for those indirectly exposed, as revealed through survivor narratives [2]. Likewise, other studies about 11-S attacks have found a relationship between indirect exposure to trauma and the development of PTSD [3,4], especially in vulnerable populations such as children [5]. In the same way, indirect exposure to terrorist attacks via the media (i.e. ...
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Background: The effect of indirect (versus direct) exposure to a traumatic event on the quality of life of terrorist attack victims has received considerable attention in the literature. However, more research is required to examine whether the symptoms and underlying processes caused by both types of exposure are equivalent. Our main hypothesis is that well-being plays a different role depending on indirect vs. direct trauma exposure. Methods: In this cross-sectional study, eighty direct victims of 11-M terrorist attacks (people who were traveling in trains where bombs were placed) and two-hundred indirect victims (individuals highly exposed to the 11-M terrorist attacks through communications media) voluntarily participated without compensation. To test our hypothesis regarding the mediating role of indirect exposure, we conducted a biased corrected bootstrapping procedure. To test our hypothesis regarding the moderating role of direct exposure, data were subjected to a hierarchical regression analysis. Results: As predicted, for indirect trauma exposure, well-being mediated the relationship between post-traumatic dysfunctional cognitions and trauma symptoms. However, for direct trauma exposure, well-being moderated the relationship between post-traumatic dysfunctional cognitions and trauma symptoms. Conclusions: The results of our study indicate that the different role of well-being found between indirect (causal factor) and direct exposure (protective factor) should be taken into consideration in interventions designed to improve victims' health.
... Charlesworth, & Chen, 2004;Otto et al., 2007;van Zelst, de Beurs, & Smit, 2003), the majority of research has been cross-sectional and correlational and, as such, has not allowed for inferences of causality. To help clarify the question of whether media exposure to disasters or large-scale threats can trigger negative outcomes, Hopwood and Schutte (2017) conducted a meta-analysis of experimental studies. ...
Article
Two studies, with a total of 707 participants, developed and examined the reliability and validity of a measure for anticipatory traumatic reaction (ATR), a novel construct describing a form of distress that may occur in response to threat-related media reports and discussions. Exploratory and confirmatory factor analysis resulted in a scale comprising three subscales: feelings related to future threat; preparatory thoughts and actions; and disruption to daily activities. Internal consistency was .93 for the overall ATR scale. The ATR scale demonstrated convergent validity through associations with negative affect, depression, anxiety, stress, neuroticism, and repetitive negative thinking. The scale showed discriminant validity in relationships to Big Five characteristics. The ATR scale had some overlap with a measure of posttraumatic stress disorder, but also showed substantial separate variance. This research provides preliminary evidence for the novel construct of ATR as well as a measure of the construct. The ATR scale will allow researchers to further investigate anticipatory traumatic reaction in the fields of trauma, clinical practice, and social psychology.
... Longitudinal studies that measured psychological dimensions pre-and postdisasters (Cohen et al., 2006;Kennedy, Charlesworth, & Chen, 2004;Otto et al., 2007;van Zelst, de Beurs, & Smit, 2003) have helped support the theory of media exposure to disasters and large-scale violence effecting negative psychological outcomes. These studies, although again high in ecological validity, cannot control for a range of potentially confounding exposure variables, and so are unable to isolate the effects of media. ...
Article
A number of studies have investigated the impact of mindfulness-based interventions on symptoms of post-traumatic stress (PTSD) compared to control conditions. The current meta-analysis consolidated findings from 18 studies reporting results for 21 samples of participants. Across studies, mindfulness-based treatments compared to control conditions were effective in ameliorating symptoms of PTSD, with Hedges' g = − 0.44. Hedges' g was − 0.59 for comparison of mindfulness-based interventions to waitlist control conditions. Changes in mindfulness may underpin the effect of mindfulness-based interventions on PTSD symptoms and thus the meta-analysis examined findings regarding increases in mindfulness. The 12 studies that assessed mindfulness found that the interventions significantly increased mindfulness, Hedges' g = 0.52. Moderator analyses indicated that interventions with longer mindfulness training were more efficacious in reducing symptoms of PTSD. Across studies, gender, age, veteran status, or length of time between the intervention and assessment of PTSD symptoms did not moderate the impact of mindfulness-based interventions. The results provide a foundation for future research directions and have implications for work with those impacted by trauma.
... Their importance may be in their ability to mitigate the negative consequences of environmental instability. In humans, the presence of strong social support networks allay vulnerabilities to post-disaster stress disorders in a variety of circumstances, such as, to natural (Weems et al., 2007;Galea et al., 2008) and man-made (Cherry et al., 2015) disasters; to war (King et al., 1999) and terrorism (North et al., 2002;Otto et al., 2007;Neria et al., 2011). Social bonds in nonhuman primates also play a critical role in weathering destabilizing events. ...
Article
Across primates, socially integrated individuals exhibit improved genetic fitness compared to their peripheral conspecifics. However, the mechanisms through which this disparity operates is unclear. One hypothesis is that social bonds mitigate the stressors imparted by environmental instability. To date, this relationship has gone critically unexamined, owing to the inability to anticipate and account for instability in prospective research design. In this dissertation, I evaluate this hypothesis within a population of free-ranging rhesus macaques (M. mulatta). I employ a long-term behavioral data set comprised of 691 unique individuals across 6 groups, followed from 1 to 8 years. I employ the tool-kit of social network analysis to integrate social phenotypes at the individual, dyadic, and group-level. I examine two destabilizing events. First, I examine how affiliation patterns precede a matrilineal overthrow, an outburst of aggression which resulted in group dissolution. As a prelude to this analysis, I investigate the manifestation of rank instability more generally, and, in concert with other dimensions of social life, examine its relationship to psychosocial stress. Second, I examine affiliation in the wake of environmental disaster: here, that of Hurricane Maria, which in 2017 had caused near-complete deforestation. I find that instability leaves an enduring signature in expressions of psychosocial stress. In the context of instability, monkeys show critical transformations in their affiliative patterns — in frequency, variability, and direction — but in ways highly dependent on the type of instability experienced. Such transformations are not experienced uniformly across social units, but instead are concentrated upon those most likely to suffer (or endure) the costs of that instability. This analysis indicates that rhesus monkeys exhibit considerable social flexibility in response to environmental instability and that social bonds, rather than static, are continually renegotiated. Destabilizing events are rare but can impart instantaneously brutal fitness consequences. It is critical, then, that we accumulate case studies of their effects —messy though they may be — to avoid blind spots in our understanding of the evolution of social bonds.
... Those who have experienced more violence in their lives often see themselves at greater risk of exposure to future negative events (16) and are more likely to develop mental health problems following subsequent violent and nonviolent traumas (17). Individuals with previously diagnosed mental health ailments are also more likely to report high distress and greater incidence of physical health ailments over time following community-based traumas (18,19). Research also finds that individuals with past exposure to collective traumas encounter more media coverage of subsequent collective traumas (1) and suggests that mental health may be implicated in media exposure (1,20). ...
Article
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The established link between trauma-related media exposure and distress may be cyclical: Distress can increase subsequent trauma-related media consumption that promotes increased distress to later events. We tested this hypothesis in a 3-year longitudinal study following the 2013 Boston Marathon bombings and the 2016 Orlando Pulse nightclub massacre using a national U.S. sample ( N = 4165). Data were collected shortly after the bombings, 6 and 24 months post-bombings, and beginning 5 days after the Pulse nightclub massacre (approximately 1 year later; 36 months post-bombings). Bombing-related media exposure predicted posttraumatic stress symptoms (PTS) 6 months later; PTS predicted worry about future negative events 2 years after the bombings, which predicted increased media consumption and acute stress following the Pulse nightclub massacre 1 year later. Trauma-related media exposure perpetuates a cycle of high distress and media use.
... Recent evidence shows that media coverage of traumatic events may serve as a risk factor for psychopathological responses (Goodwin, Palgi, Hamama-Raz, & Ben-Ezra, 2013;Otto et al., 2007). One explanation is that media exposure may interact with sympathetic reactivity to predict posttraumatic stress disorder (PTSD) symptom onset (Bodas, Siman-Tov, Peleg, & Solomon, 2015). ...
Article
This study examined the relationship between negative and positive perceptions of media sources during wartime and posttraumatic stress disorder (PTSD) symptoms among older adults with varying levels of physical functioning. We examined perception of media sources as stressful or helpful, PTSD symptoms and physical functioning among 170 older adults (mean age = 66.87) four months after the 2014 Israel-Gaza conflict. After controlling for previous PTSD symptoms, the number of media sources perceived as stressful was positively related to PTSD symptoms, particularly among respondents with low physical functioning. The number of helpful media sources was unrelated to PTSD symptoms. The findings suggest that stressful media is especially maladaptive for older adults with low physical functioning, who are at a higher risk of being homebound. Moreover, favorable perception of media was not beneficial for older adults in the specific context of PTSD symptoms. Helping older adults regulate their perceptions regarding the media may restrict their negative outcomes.
... The reactions of children and adolescents to a terrorist attack do, however, vary and fluctuate according to time and place. They may span a wide range of emotions, such as fear, sadness, and anger (Otto et al., 2007). Tatar and Amram (2007), who investigated the reactions of adolescents following a terrorist attack in Israel, described their reactions as including-in descending order-fear, stress, anger, a wish to take revenge, attempts to receive more information, sadness, and indifference. ...
Article
This article investigates how 12 upper-elementary school teachers dealt with the occurrence of a terrorist attack in their city during school hours and in the immediate aftermath. All teachers were interviewed shortly after the terrorist attack about their goals, dilemmas, and pedagogical strategies employed in the classroom. We found that during the day of the attack the teachers tried to focus on providing both emotional support and adequate information to the pupils. While doing so, the teachers encountered four types of dilemmas: their perceived lack of knowledge concerning the attack and terrorism in general, their worry about increasing fear among pupils by discussing terrorism, the conundrum of balancing the different (and contrasting) perspectives of the pupils, and the lack of clear management support or guidelines issued. The findings are discussed through the lens of a pedagogy for political trauma, and a case is made for expanding this pedagogy with a historicizing approach. Such an approach may provide teachers with a (depoliticized) framework of reference that enables them to help pupils understand and reflect on the upsetting and contested topic of terrorism.
... More than half of the sample also reported limiting their exposure to traditional and social media as a way to cope. This may be an effective strategy based on historical findings of associations between adverse mental health consequences and repeated exposure to media after tragic events such as the 9/11 terrorist attacks (Otto et al., 2007) and the 2013 Boston Marathon bombing (Holman et al., 2014), as well as recent data linking increased social media use with increased depression during the COVID-19 pandemic (Holingue et al., 2020;Sun et al., 2021;Zhao & Zhou, 2020). In sum, the fact that the overwhelming majority of respondents reported engaging in adaptive and effective coping strategies is encouraging and suggests both awareness and practice of multiple empirically supported behavioral approaches for managing stress (e.g., Posluns & Gall, 2020). ...
Article
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There has been an emphasis on understanding the detrimental effects of coronavirus disease (COVID-19) on individuals’ wellbeing. Healthcare workers, including mental health providers, may experience increased emotional and behavioral health concerns to a greater degree than the general public. The objective of the present study was to examine the frequency and the perceived effectiveness of various coping strategies implemented by mental health practitioners during the COVID-19 pandemic, as well as differences across career stages (i.e., trainees versus licensed practitioners [LPs]). Survey data were collected from mental health practitioners (N = 888) assessing the strategies they used to manage COVID-19-associated anxiety/distress and the perceived effectiveness of these strategies. Bonferroni-adjusted chi-square tests and t-tests were conducted to assess differences by career stage. Overall, respondents used various coping strategies, most commonly behavioral strategies such as distraction/engaging in an enjoyable activity (88.63%), spending time with loved ones (77.82%), and exercise (72.64%). Over one-quarter reported using alcohol to cope (28.27%). Respondents generally perceived their coping strategies as somewhat to very effective; no strategies were generally perceived as ineffective. Compared to LPs, trainees were significantly more likely to manage COVID-19-related anxiety/distress using supervision (p < .001) and substances other than alcohol or tobacco (p < .001). There were no significant differences in how effective trainees and LPs perceived each strategy. U.S. mental health practitioners’ use of predominantly behavioral coping strategies, which were generally perceived as effective, during the first months of COVID-19 offers implications for interventions as the pandemic progresses.
... In contrast, CRIT was not related to broadband internalizing symptoms concurrently or longitudinally with a non-clinical sample of preschoolers [41] or in a sample of children and adolescents with intellectual disability [42]. CRIT was also not related to some specific internalizing problems, including suicidal ideation [43], posttraumatic stress disorder symptoms [44], or withdrawn behaviors [45] among young children. ...
Article
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The Five Minute Speech Sample’s (FMSS) measure of parental expressed emotion (EE), defined as criticism (CRIT) and emotional overinvolvement (EOI), has been increasingly used to measure family emotional climate in relation to youth psychopathological development. As CRIT and EOI were defined based on adults, a meta-analysis and systematic review was conducted to analyze the presence and strength of an effect among maternal CRIT and EOI with youth internalizing and externalizing problems. A random effects model was used to analyze the 42 studies on families of youth (aged 1.5 to 19). There was a small, significant relation among maternal CRIT with youth internalizing and externalizing problems and among EOI with youth internalizing problems. EOI was not significantly related to externalizing problems. The current study suggests that the FMSS measure of CRIT is a more robust correlate of youth internalizing and externalizing symptoms than EOI, but EOI does relate to internalizing behaviors. Few moderators emerged, highlighting a continued need to identify factors accounting for heterogeneity. The current results suggest that the FMSS measure of CRIT may be a valuable measure of the family emotional climate in families of youth, but care should be taken when including analyses on EOI.
... They include perceived life threat, emotional proximity to the perpetrator, and type of trauma (e.g., natural or interpersonal), and account in general to medium to large effect sizes (Trickey et al., 2012;Perrin et al., 2000). Post-event factors encompass aspects of the time after the traumatic event such as social support, family functioning, and thought suppression (Otto et al., 2007;Dalgleish et al., 2005). In general, this group shows medium to large effect sizes and is of substantial importance for adolescent patients (Trickey et al., 2012). ...
... Notably, images generated were not of the "entire" event but of specific instances, including "hotspots" of highest peak (Grey & Holmes, 2008), such as "people jumping", and "warning signals" foreshadowing danger (Ehlers et al., 2004), such as "first tower collapsing" (see Table 1). Imagery was also associated with a sense of empathy, in line with cognitive models linking peri-traumatic sense of threat and victim identification to PTSD symptom development (Holmes et al., 2007;Otto et al., 2007). Thus a cognitive model of PTSD (Ehlers & Clark, 2000) holds relevance to imagery in the aftermath of media trauma. ...
Article
Background and Objectives: Media trauma in civilians is linked to intrusive imagery-based memory symptoms. We investigated whether mental imagery of the 9/11 terrorist attacks following media exposure is dampened by taxing working memory (WM). Methods: Forty-five young adult UK residents, who were exposed to the 9/11 terrorist attacks as children via the media, identified a personally-relevant mental image of the attacks. They were then randomly allocated to: (1) recall + Tetris, (2) recall + eye movements (EMs), or (3) recall-only. Ratings on imagery vividness and emotionality were provided at three time points: pre-, post-manipulations, and at 24-hr follow-up. Results: Repeated measures ANOVAs revealed that recall + Tetris and recall + EMs (relative to recall-only) significantly reduced imagery vividness and emotionality from pre- to post-manipulations, but not to follow-up. Limitations: A passive control group is needed to fully rule out the role of natural memory decay; the follow-up was exploratory and took place outside the laboratory with reduced experimental control. Conclusions: Aversive memory imagery from media trauma in civilians can be dampened by taxing WM, at least temporarily, which could be therapeutically useful. The use of such cognitive techniques may also hold relevance for public health approaches to address the impact of collective trauma.
... Disasters (i.e., terrorism) do not only have psychological impacts on people who experience them directly but also on those who learn about disasters through media [39]. Otto et al. [40] determined in their study that the amount of exposure to tragic events on media were sufficient to produce depressive symptoms in viewers, such as in children. Research reveal that during disasters, increased time spent on SNSs and high exposure to traditional media were modestly linked with levels of mental distress, including anxiety, hopelessness, and depression [41]. ...
... Disasters (i.e., terrorism) do not only have psychological impacts on people who experience them directly but also on those who learn about disasters through media [39]. Otto et al. [40] determined in their study that the amount of exposure to tragic events on media were sufficient to produce depressive symptoms in viewers, such as in children. Research reveal that during disasters, increased time spent on SNSs and high exposure to traditional media were modestly linked with levels of mental distress, including anxiety, hopelessness, and depression [41]. ...
Article
The current study focused on the effects of being exposed to terrorism-related information via social networking sites (SNSs) on the life dissatisfaction of individuals. This study examines depression as a mechanism between being exposed to terrorism-related information and life dissatisfaction and social support as a moderator in the relationships of being exposed to terrorism-related information, depression, and life dissatisfaction. A sample of 536 respondents completed a self-administered questionnaire about their exposure to terrorism-related information on SNSs, depression, life dissatisfaction, and social support. Findings showed that exposure to terrorism-related information on SNSs is associated with life dissatisfaction. Furthermore, we found that depression mediates the relationship between exposure to SNSs and life dissatisfaction. Moreover, social support buffers the association of exposure to terrorism-related information with depression and life dissatisfaction. In addition, social support moderates the association between depression and life dissatisfaction.
... They found symptoms of anxiety increased significantly amongst children initially high in inhibition who then experienced high levels of daily hassles across 6 weeks. Otto and colleagues [61] explored whether early childhood inhibition was a risk for school-age children (N = 105, M age 9-years) to develop posttraumatic stress symptoms after watching televised coverage of the 9/11 terrorist attacks. They found inhibited children were actually less likely to develop anxiety because they viewed less television after 9/11, thereby avoiding this potential stressor. ...
Article
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Background: This study explored whether temperamentally inhibited children who experience early trauma are vulnerable to developing internalizing problems in the face of later life-stressors. Methods: A validated screen for temperamental inhibition was distributed to parents of young children attending preschools in six government regions of Melbourne, Australia. Screening identified 11% of children as inhibited (703 of 6347 screened) and eligible for a prevention study. Participants were 545 parents of inhibited preschoolers (78% uptake), of whom 84% were followed into mid childhood (age 7-10 years: wave 1, n = 446; wave 2, n = 427; wave 3, n = 426). Parents and children then completed questionnaires for child internalizing (anxious and depressive) symptoms, and parents received a diagnostic interview for child anxiety disorder. In mid-childhood parents also completed questionnaires annually to describe recent life-stressors experienced by their child, and any potentially traumatic events in the first four years of life. Results: Only one in 14 temperamentally inhibited children had experienced a potentially traumatic event in early childhood. In mid childhood 56% experienced recent life-stressors. Inhibited children who had early life trauma experienced slightly more anxiety disorder and symptoms in mid childhood. Those children with more recent life-stressors in mid childhood also had slightly more symptoms of anxiety and depression. In contrast to stress sensitization, inhibited children with early trauma plus recent stressors did not show especially high mid-childhood internalizing difficulties. Conclusions: Early life trauma and recent life-stressors each convey a small risk for children with an inhibited temperament to develop internalizing problems. Nevertheless, early life stress may not always result in negative sensitization for children in the general population.
... Alpha changes occurred after reading either of the articles related to mass shootings but not after reading the filler article, which suggests that anxiety is affected by both emotional and unemotional media discussion of mass shootings. This is consistent with a multitude of research that has demonstrated the effect that media can have on anxiety (e.g., Nakayama et al., 2019;Otto et al., 2007). While these effects are not surprising, little research has examined the effects of different types of information presented through media on anxiety specifically as they pertain to mass shootings. ...
Article
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The present study investigated how an individual's state anxiety may change before and after exposure to different types of information about mass shootings. Changes were analyzed as either alpha or beta changes; beta changes indicate a “recalibration” of one's anxiety as opposed to experiencing a direct change. A total of 364 participants from a midwestern university were randomly assigned to one of three conditions, in which they read either emotional information (a news article about mass shootings), unemotional information (statistics about mass shootings), or a filler article. Before and after reading these articles, participants responded to questions from the state portion of the State-Trait Anxiety Inventory. Analyses revealed that participants experienced alpha changes in anxiety after reading either article related to mass shootings, but not after reading the filler article. Furthermore, participants did not experience beta changes after reading any of the articles. These results demonstrate that information about mass shootings is likely to elevate anxiety levels regardless of its emotionality, and that these are direct changes as opposed to cognitive recalibrations. The results may be relevant for news sources reporting on mass shootings or professionals attempting to educate about mass shootings.
... Social media has become one of the most used platforms for communication among black emerging adults, with 70% reporting using Facebook, 76% YouTube, and 26% Twitter, in comparison with their white counterparts (67%, 71%, and 24%, respectively) (Bostic, 2014;Noble, 2015;Smith & Anderson, 2018). Emerging adulthood is a period of identity exploration and transition for black men (Arnett,2016),and social media platforms provide online communities that enable these young adults to express themselves, socialize with their peers, and engage in identity exploration (R. Wolff, McDevitt, & Stark, 2011;Wright, 2017). ...
Article
The prevalence of community-based violence (CBV) exposure among black American male emerging adults ages 18 to 25 with a history of involvement with the criminal justice system is a major public health concern. Although exposure (whether as victim or witness) to CBV is linked with negative outcomes, empirical research examining black men's negative emotional responses to seeing videos of real-life incidents of CBV on social media is scant. To address these identified concerns and make recommendations for future research, the present study examines the relationship between seeing videos of CBV on social media and three types of negative emotional responses (that is, feeling sad, angry, and fearful) prior to incarceration among a sample of 101 black men detained in a midwestern jail. Social media use and seeing videos of CBV on social media were moderately high for study participants. Seeing a video involving police violence was significantly associated with an increase in the odds of feeling sad, angry, and fearful. Social media research is an emerging area that has the potential to advance our understanding of the impact of seeing social media videos of police violence on the well-being of black men and factors that mediate or moderate this relationship.
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We investigated the association between problematic internet use (PIU) and post-traumatic stress disorder (PTSD) symptoms in children and adolescents in South Korea. A cross-sectional survey was administered to community students who attended primary, secondary, and high schools in the Jindo area 1–2.5 months after the Sewol ferry disaster. Of the 1,744 respondents, 392 students who were exposed to the disaster, witnessing the rescue work directly, were evaluated. PTSD symptoms were measured using the University of California Los Angeles Post-traumatic Stress Disorder Reaction Index (UCLA PTSD-RI). The severity of impairment caused by excessive internet use was evaluated using Young's Internet Addiction Test. The Center for Epidemiological Studies Depression Scale (CES-D) and State Anxiety Inventory for Children (SAIC) were also used. Logistic regression analysis revealed that PIU was significantly and independently associated with a high level of PTSD symptoms. Our findings suggest that children and adolescents with PIU require intensive follow-up and special care to prevent the development of PTSD symptoms following a disaster.
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La phobie sociale est une pathologie fréquente, qui commence le plus souvent dans l'enfance ou l'adolescence. Cela cause de grandes souffrances et conduit à éviter certaines situations sociales importantes (de manière insidieuse). Les conséquences sont importantes et peuvent aller jusqu'à l'incapacité. La phobie sociale et l'inhibition comportementale (BI) sont décrites et étudiées ici: la BI, une caractéristique capillaire, apparaît comme un facteur de risque important pour la phobie sociale et les troubles anxieux comorbides, ainsi que l'attachement instable qui a également été trouvé, associé à une inhibition comportementale chez les enfants et L'anxiété ou la dépression de la mère. C'est l'hyperactivité innée de l'amygdale et du système nerveux végétatif sympathique qui sont impliqués. au niveau neurobiologique. En outre, l'évaluation de l'échelle de Liebowitz sur l'anxiété sociale montre que c'est un excellent outil de dépistage et d'évaluation de l'anxiété sociale. Enfin, le dépistage et le suivi attentif de ces enfants à risque est indiqué, surtout pour les familles monoparentales ou s'il y a des antécédents de dépression maternelle.
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Resilience is a broad concept that encompasses different kinds of phenomena, such as effective functioning under severe conditions, adaptation to stress and attaining normal functioning after exposure to potentially traumatic experiences. The study of resilient behavior of individuals, communities and societies provide researchers and practitioners with better knowledge and understanding of human coping and adaptation. Reports about unfortunate and stressful events in social media news sites trigger various appraisals among social media users. Some of these appraisals are translated into user generated symbolic, textual and visual content - and offer a unique opportunity to observe how the public “digests” and copes with the changing reality. With the rise of social media, the abundance of user-generated content, public application programming interfaces for social media services and the availability of efficient data extraction and analytical tools – researchers and practitioners can explore in detail citizen' attitudes towards various issues in their external environment, including in-depth understanding of their coping modes and resiliency. The objective of this review is to describe how existing and recently developed tools in the field of social computing can be utilized to assess different aspects of resilience, through mining of the social media. We propose several indicators for resilience factors, and present methods and techniques to search, processes and analyze textual and visual content, commonly published on social media. It is proposed that automatic and immediate detection of resilience factors in users’ discourse, will significantly improve the ability of decision makers generate public situational awareness based on social media data.
Article
Objective The 2015 earthquake in Nepal affected the country in terms of economy, and by causing damage and stress reactions. This study aimed to estimate the prevalence and determine individual child- and family-level predictors of post-traumatic stress disorder (PTSD) symptoms. Methods A community-based cross-sectional study was carried out in Kathmandu district 15 months after the earthquake. Multistage cluster sampling was adopted to collect 800 earthquake-affected children aged 7-16 years and a face-to-face interview was conducted. Trauma exposure questionnaire and Child PTSD Symptoms Scale were used for assessment of the level of exposure and PTSD symptoms. Multilevel generalized linear regression analysis was used to explore individual and family-level predictors. Results Among the children, 51% had moderate-to-severe PTSD symptoms. Children of school age (adjusted odds ratio=2.83 [1.45-5.49]), those attending lower-secondary school (2.26 [1.21-4.21]), those having a higher exposure to the severity of the earthquake, and those with low psychosocial acuity [1.70 (1.10-2.60)] were more likely to have more severe PTSD symptoms compared with those who were adolescents and in higher-secondary school, whereas children from a family living in an urban (0.33 [0.19-0.59]) setting and following Hindu religion (0.31 [0.16-0.60]) were less likely to have PTSD symptoms compared with children from suburban areas and those following Buddhist religion. Conclusion PTSD symptoms were prevalent among children of Nepal more than a year following the earthquake. Family-level indicators cannot be excluded when studying children’s trauma reactions. ( Disaster Med Public Health Preparedness . 2017;page 1 of 7)
Article
Between April 17 and 29, 2020, we conducted a nationwide online survey of parents of children between the ages of 3 and 17 years (N = 1560). A majority of children were reported to be negatively emotionally affected (frightened, disturbed, or upset) by news coverage of COVID-19. Every stress symptom asked about (including nervousness, crying, and sleep problems) was dramatically more prevalent among children frightened than not frightened by the coverage. Open-ended questions illustrated the emotional depths of some responses. Developmental differences occurred in elements of coverage seen to influence fright. Most parents of frightened children tried to help their child cope, but their choices of strategies were only partially consistent with developmental expectations. Children with digital devices in their bedroom showed greater fear; more hours of COVID news were transmitted in homes with frightened than unfrightened children; and the relationship between media access and children’s fear intensity and stress symptoms remained after controlling for parents’ own fear and parents’ closeness with people diagnosed with COVID. Parents are encouraged to monitor children’s exposure to media-conveyed catastrophes, to be mindful of potential age differences in child responses, and to be available to help children cope.
Article
Objective: Sweden is an international exception in its public health response to the COVID-19 pandemic, with a higher number of deaths, albeit not pediatric, compared with other Nordic countries. The objective of this study was to investigate what worries children and adolescents living in Sweden expressed in relation to the pandemic. Methods: Using an anonymous web-survey, 1,047 children (4-12 years; N = 717) and adolescents (13-18 years; N = 330) responded to five background and four open-ended questions, one of which was: Is there anything that you are worried about when it comes to 'Corona'? The responses were coded using manifest content analysis. Interrater reliability was .95, assessed on the code level. Results: Worry was common (77%); mostly (60%) related to disease or death of elderly relatives, parents, the child him/herself or general worry for the elderly/risk groups. Existential worry (15%) comprised worries about the future, including economy and worries about the world perishing or the contagion becoming uncontrollable. A developmental trajectory was evident in the nature of responses. Adolescents' worries about the future included missing out on their youth and employment. They also worried about society (6%), for example, the future of democracy and the world economy. There was no indication of socioeconomic status or geographic area (urban vs. rural) affecting the presence of worrisome thoughts. Conclusions: Worry about "Corona" was common. Universal preventative mental health intervention is warranted and could be conducted in the school setting. Intervention could be tailored by age, covering discussion on financial aspects with adolescents.
Article
Sociopolitical events have been associated with shifts in youth mental health and attitudes. This study assessed six cohorts of American 12th graders (2012–2017) to examine trends in youths’ attitudes about themselves, the future, and others surrounding the U.S. 2016 presidential race and election. Analyses assessed overall trends and variation by political affiliation. Results indicated a rise across cohorts in future pessimism and nihilism after 2015, driven by youth identified as Democrat rather than Republican. A rise in concern for others was similarly driven by Democrat youth, whereas a rise in value of diversity was shared across all political identities. In contrast, Republican youth cohorts reported increasing external locus of control relative to their Democratic peers. Implications are discussed.
Article
Objective: The current study examined how severity of disaster exposure and predisaster individual and family characteristics predicted trajectories of disaster-related posttraumatic stress symptoms (PTSS) in children over 4 years following a devastating EF-4 tornado. Method: Participants (n = 346; 65% male; 77.5% African American) were 4th-6th-graders and their caregivers, from predominantly low-income households, who were already participating in a longitudinal study of indicated prevention effects for externalizing outcomes when the tornado occurred in 2011. Latent class trajectory analyses were used to identify disaster-related PTSS trajectory groups across the 4-year postdisaster period. Results: Three groups were identified: (1) a group that declined (recovery) in PTSS over time (15.90%); (2) a group that was stable and low in PTSS over time (76.87%); and (3) a group that was stable and high (chronic) in PTSS over time (7.23%). Multinomial logistic regression analyses revealed that greater tornado exposure predicted membership in the declining trajectory group relative to the low-stable group. Positive parenting and pretornado caregiver trauma exposure also moderated how disaster exposure, particularly perceived life threat, predicted PTSS trajectories. Conclusions: Some youth reported elevated disaster-related PTSS repeatedly for 4 years following a devastating tornado. Consistent with the concept of equifinality, results suggest that there are several pre-exposure risk factors that may increase risk for a chronic PTSS trajectory following disaster exposure. (PsycINFO Database Record (c) 2019 APA, all rights reserved).
Article
We use data on all middle and high school aged children who survived a mass shooting incident on July 22, 2011 in Utøya, Norway, to understand how such events affect survivors, their families, and their peers. Using a difference-in-differences design to compare survivors to a matched control group, we find that in the short run children who survive have substantially lower GPA (nearly 0.5 SD) and increased utilization of health care services and more mental health diagnoses. In the medium run, survivors have fewer years of schooling completed and lower labor force participation. Parents and siblings of survivors are also impacted, experiencing substantial increases in doctor visits and mental health diagnoses. However, there appear to be limited impacts on school aged peers of survivors. While this event affected the entire country, we show that survivors and their families bear significant costs despite robust social safety nets and universal access to healthcare.
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Background. The topic of the psychological consequences of mass disasters for children and adolescents (victims of natural and man-made disasters, military conflicts, terrorism), and also the corresponding risks, threats to their mental development is insufficiently covered in modern psychology. Difficulties in carrying out research cause their quite a small number in relation to the children’s population. The Objective of the analytical theoretical research is 1. to study the general state of the issue and the most discussed modern models of experiencing mass disasters and its impact on the psychological well-being of children and adolescents who are victims and witnesses of mass natural cataclysms, socio-anthropogenic and technogenic catastrophes; 2. to conduct cultural and historical analysis of the issue; 3. to handle central discussion issues regarding the prevention of destructive psychological reactions in the younger generation. Progress Report. In the theoretical and analytical research, an array of ideas about the psychological consequences of mass disasters for the younger generation is consistently considered from the early historic periods up to modern days. A critical analysis of the main methodologies that lie in the basis of most modern research is presented, and finally, the paper considers the possibilities of systematic cultural and historical analysis in the framework of the issue stated in the title, including the prevention of destructive psychological reactions. Research Results. The analysis has revealed the partiality and diversity of research models, the often inconsistent conclusions drawn on the basis of their research development; discussion on issues of preventive intervention. Conclusion. The integrative possibilities of cultural and historical analysis are shown, including the methodology of the research carried out earlier, the possibilities of designing preventive measures that increase the psychological stability of children and adolescents to the traumatic consequences of extreme situations. The essence of the proposed approach is the cultural and historical understanding of internal and external causes and mechanisms of various posttraumatic stress disorder (PTSD), the nature of care and work with them, and also in the possibilities of diagnosing «weaknesses», premises for the development of such disorders in the conditions of a society.
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Objectives: In this study, we aimed to conduct a systematic review of studies investigating psychosocial factors affecting children exposed to disasters. Methods: In total, 140 studies were retrieved. The studies were published from 1988 to 2015. A systematic review was performed using the PRISMA guidelines. MEDLINE, EMBASE, Cochrane Central, Web of Science, PsycINFO, PubMed, and Google Scholar were searched. Each database was searched using the following terms: 'Child,' 'Adolescent,' 'Youth,' 'Disaster,' 'Posttraumatic,' 'Psychosocial,' 'Assessment,' 'Evaluation,' and 'Screening.' The identified studies were subjected to data extraction and appraisal. Results: The database search identified 713 articles. Based on the titles and abstracts, the full texts of 118 articles were obtained. The findings of this review can be used as a basis for the design of a psychosocial evaluation tool for disaster preparedness. Conclusion: Given the paramount importance of post-disaster evaluation and the weaknesses of current disaster evaluation tools, the need to develop valid and reliable tools and psychometric evaluations cannot be overstated. Our findings provide current evidence supporting various assessments in children, who are very vulnerable psychologically following disasters.
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This study analyzes what "emergency sources" (authorities, emergency managers, and experts) expect from journalists during a disaster, using a mixed-method approach with six focus groups and a survey of 166 official Chilean sources. Based on the first three levels of the hierarchy of influences model, we explore how they perceive journalists' roles and performance when covering disasters. The results suggest that emergency sources' evaluations, while affected by a combination of individual, routine, and organizational variables, are mostly shaped by sources' direct and mediated experience with journalists. Thus, a more fluid relationship between journalists and emergency sources, as well as more communication experience by sources, could lead to a better understanding between both groups, which, ultimately, may lead to delivering more accurate and timely information.
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Newly released 2019 Youth Risk Behavior Surveillance System data and the Center for Disease Control and Prevention’s (CDC)’2019 Youth Risk Behavior Survey Data Summary and Trends Report show that US adolescents continue to suffer from poor mental health and suicidality at alarming rates. These data alone would be cause for concern, but the COVID-19 pandemic has the potential to further erode adolescent mental health, particularly for those whose mental health was poor prior to the pandemic. Given the status of adolescent mental health prior to COVID-19 and the impact of COVID-19, health professionals and schools must partner together now to mitigate potentially deleterious health, mental health and education impacts for children and adolescents.
Article
This study presents the findings of meta-analyses examining the association between viewing mass trauma television coverage and posttraumatic stress (PTS) outcomes as well as acute stress reactions (ASR) among adults and youth. A literature search identified 43 (N = 31,162) studies assessing the association between viewing mass trauma television coverage and PTS and four (N = 9,083) assessing the association with ASR. The overall size of the association between viewing television coverage and PTS, estimated using a random-effect model, was small but statistically significant, r = .17, 95% CI [.13, .22]. The moderator analysis examined eight preselected variables: man-made versus natural trauma, specific incident versus chronic stressor, adult versus youth sample, proximal versus distal event exposure, television only versus combined media form, specific content in coverage versus no specific content, quantification of media contact using numeric measurement versus subjective measurement versus a binary item, and posttraumatic stress symptoms (PTSS) versus posttraumatic stress disorder (PTSD) outcome. The analysis revealed a statistically significant moderation effect for the quantification of media contact (numeric vs. subjective vs. binary) only, which accounted for 19% of the observed heterogeneity. With a summary estimate of r = .26, 95% CI [.06, .44], the analysis of the ASR studies corroborated the PTS findings. The results suggest that clinicians and public health practitioners should discuss mass trauma television viewing with their patients and with the public. Limitations of the extant research are discussed. © 2019 International Society for Traumatic Stress Studies.
Article
While it is still unclear how many young people have suffered mental health problems as a result of the pandemic, data from previous disasters suggests that many will have been affected in some way, with some also suffering post-traumatic stress disorder as a result.
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This study assessed youth anxiety about political issues and associated characteristics. Caregivers (N = 374) were recruited through Amazon Mechanical Turk and reported on their child’s anxiety about 15 voting issues covered in the media since the 2016 presidential election as well as their child’s psychological functioning and their own trait anxiety. For the majority of voting issues, over 50% of caregivers indicated that their child experienced at least one related worry; worries about the environment and gun violence were most common. Youth empathy and intolerance of uncertainty were each positively associated with worry about political issues but did not predict such worry after accounting for the effect of youth trait anxiety. Youth with clinical levels of generalized anxiety experienced more severe worry about political issues than did youth with minimal/subthreshold anxiety. Future studies should identify strategies for mitigating the negative impact of political news on youth with anxiety disorders.
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Vietnam combat veterans with post-traumatic stress disorder (PTSD) were compared to non-combat Vietnam era veterans without PTSD on their perceptions of their children's social and emotional functioning. A total of 107 veterans completed a parent's behavior checklist on their 191 children. The results indicated that fathers with PTSD perceived their children as exhibiting a substantially greater degree of dysfunctional social and emotional behavior. The types of dysfunctional behaviors were a function of the child's age and sex; however, children of PTSD fathers were generally rated as significantly more likely to exhibit an inadequate level of self-control resulting in various externalizing problem behaviors such as aggression, hyperactivity and delinquency. Further, these children were perceived as having difficulty establishing and maintaining friendships. The findings support the notion that a father's anxiety disorder, such as PTSD, may be related to his children's social and emotional functioning.
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About 15% of Caucasian children in the second year of life are consistently shy and emotionally subdued in unfamiliar situations, whereas another 15% are consistently sociable and affectively spontaneous. A majority of the children in these two groups retain these profiles through their eighth year. In addition, the two groups differ in physiological qualities that imply differential thresholds in limbic sites, especially the amygdala and the hypothalamus, suggesting that the two temperamental groups are analogous to closely related strains of mammals. However, the behavioral profiles of the children are influenced in a major way by environmental conditions existing during the early years of life. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
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Background: The scope of the terrorist attacks of September 11, 2001, was unprecedented in the United States. We assessed the prevalence and correlates of acute post-traumatic stress disorder (PTSD) and depression among residents of Manhattan five to eight weeks after the attacks. Methods: We used random-digit dialing to contact a representative sample of adults living south of 110th Street in Manhattan. Participants were asked about demographic characteristics, exposure to the events of September 11, and psychological symptoms after the attacks. Results: Among 1008 adults interviewed, 7.5 percent reported symptoms consistent with a diagnosis of current PTSD related to the attacks, and 9.7 percent reported symptoms consistent with current depression (with "current" defined as occurring within the previous 30 days). Among respondents who lived south of Canal Street (i.e., near the World Trade Center), the prevalence of PTSD was 20.0 percent. Predictors of PTSD in a multivariate model were Hispanic ethnicity, two or more prior stressors, a panic attack during or shortly after the events, residence south of Canal Street, and loss of possessions due to the events. Predictors of depression were Hispanic ethnicity, two or more prior stressors, a panic attack, a low level of social support, the death of a friend or relative during the attacks, and loss of a job due to the attacks. Conclusions: There was a substantial burden of acute PTSD and depression in Manhattan after the September 11 attacks. Experiences involving exposure to the attacks were predictors of current PTSD, and losses as a result of the events were predictors of current depression. In the aftermath of terrorist attacks, there may be substantial psychological morbidity in the population.
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The nature of traumatic memories is currently the subject of intense scientific investigation. While some researchers have described traumatic memory as fixed and indelible, others have found it to be malleable and subject to substantial alteration. The current study is a prospective investigation of memory for serious combat-related traumatic events in veterans of Operation Desert Storm. Fifty-nine National Guard reservists from two separate units completed a 19-item trauma questionnaire about their combat experiences 1 month and 2 years after their return from the Gulf War. Responses were compared for consistency between the two time points and correlated with level of symptoms of posttraumatic stress disorder (PTSD). There were many instances of inconsistent recall for events that were objective and highly traumatic in nature. Eighty-eight percent of subjects changed their responses on at least one of the 19 items, while 61% changed two or more items. There was a significant positive correlation between score on the Mississippi Scale for Combat-Related Posttraumatic Stress Disorder at 2 years and the number of responses on the trauma questionnaire changed from no at 1 month to yes at 2 years. These findings do not support the position that traumatic memories are fixed or indelible. Further, the data suggest that as PTSD symptoms increase, so does amplification of memory for traumatic events. This study raises questions about the accuracy of recall for traumatic events, as well as about the well-established but retrospectively determined relationship between level of exposure to trauma and degree of PTSD symptoms.
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The objective of this study was to examine the relationship between combat-related posttraumatic stress disorder (PTSD) and comorbid DSM-III-R psychiatric diagnoses to determine commonalities in risk factors, relative onsets and the role of combat exposure. An epidemiological cohort study using standardised psychiatric, social and health interviews was undertaken with a national random sample of male Australian Army Vietnam veterans. Interviews and searches of military records yielded risk factors for PTSD, which were examined for association with each psychiatric diagnosis. Relative onsets of PTSD and each Diagnostic Interview Schedule diagnosis were compared. Comorbidity odds ratios were adjusted for combat exposure effects using logistic regression, and the relation between each diagnosis and combat was assessed after controlling for PTSD. Commonality of risk factor profile was evident for several diagnoses, and for many their onset preceded PTSD onset. Combat was independently related to only a few diagnoses after controlling for PTSD, and PTSD remained strongly associated with several conditions after controlling for combat exposure. The analysis suggests that the disorders that may constitute risk factors or vulnerabilities for PTSD comprise depression and dysthymia, antisocial personality disorder, agoraphobia and simple phobia, while those that may be consequent on PTSD are panic and generalised anxiety disorder, drug use disorders and somatoform pain disorder. Alcohol and drug use disorders and social phobia may have a mixed aetiology, while obsessive-compulsive disorder may be serendipitously related to PTSD through an association with risk of combat. Gambling disorder is unrelated.
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The authors assessed DSM-III-R disorders among American former prisoners of war. Comorbidity, time of onset, and the relationship of trauma severity to complicated versus uncomplicated posttraumatic stress disorder (PTSD) were examined. A community sample (N=262) of men exposed to combat and imprisonment was assessed by clinicians using the Structured Clinical Interview for DSM-III-R. The rates of comorbidity among the men with PTSD were lower than rates from community samples assessed by lay interviewers. Over one-third of the cases of lifetime PTSD were uncomplicated by another axis I disorder; over one-half of the cases of current PTSD were uncomplicated. PTSD almost always emerged soon after exposure to trauma. Lifetime PTSD was associated with increased risk of lifetime panic disorder, major depression, alcohol abuse/dependence, and social phobia. Current PTSD was associated with increased risk of current panic disorder, dysthymia, social phobia, major depression, and generalized anxiety disorder. Relative to PTSD, the onset of the comorbid disorders was as follows: major depression, predominantly secondary; alcohol abuse/dependence and agoraphobia, predominantly concurrent (same year); social phobia, equal proportions primary and concurrent; and panic disorder, equal proportions concurrent and secondary. Trauma exposure was comparable in the subjects with complicated and uncomplicated PTSD. The types of comorbid diagnoses and their patterns of onset were comparable to the diagnoses and patterns observed in other community samples. The findings support the validity of the PTSD construct; PTSD can be distinguished from comorbid disorders. Uncomplicated PTSD may be more common than previous studies suggest, particularly in clinician-assessed subjects exposed to severe trauma.
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This clinical assessment was designed to identify middle and high school students in need of formal evaluation for posttraumatic response symptoms following the 1995 bombing of the Alfred P. Murrah Federal Building in Oklahoma City. A clinical needs assessment instrument was developed and administered to grade 6 through 12 students 7 weeks after the bombing (N = 3,218). More than 40% of the students reported knowing someone injured, and more than one-third reported knowing someone killed in the blast. Posttraumatic stress symptoms at 7 weeks significantly correlated with gender, exposure through knowing someone injured or killed, and bomb-related television viewing. This study documents the intensity of community exposure to the bombing and the lingering symptoms of stress. The assessment was used in planning for clinical service delivery, training professional responders, and supporting funding requests.
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To investigate the responses of middle and high school students exposed to the 1995 Oklahoma City bombing across a spectrum of loss. A questionnaire measuring exposure, personal consequences, initial response, and current posttraumatic stress and other symptoms was administered to 3,218 students 7 weeks after the explosion. More than one third of the sample knew someone killed in the explosion. Bereaved youths were more likely than nonbereaved peers to report immediate symptoms of arousal and fear, changes in their home and school environment, and posttraumatic stress symptoms. Retrospective measures of initial arousal and fear predicted posttraumatic stress symptoms at 7 weeks. The results support the literature addressing the role of initial response in posttraumatic stress symptom development. The study raises concern about the impact of television, and traumatized youths' reactivity to it, in the aftermath of disaster.
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This study examined the experiential factors and interacting vulnerabilities that contribute to the development of posttraumatic stress disorder (PTSD) in children and adolescents. Of 100 consecutive referrals to an inner-city child and adolescent psychiatry clinic, 59 had experienced a trauma that qualified as a precipitant of PTSD. For those with trauma, ages ranged from 3 to 18 years (mean=9.9, SD=4.10); 39 (66%) were males. The authors used a series of multiple regression analyses to examine the contribution of demographic characteristics, the nature of the stressor(s), and the role of preexisting clinical signs in the development of PTSD. Twenty-two percent of the 59 children who had been traumatized met full criteria for PTSD, 32% had some symptoms of PTSD but did not meet full criteria, and 46% had no symptoms of PTSD. Witnessing domestic violence or being physically abused predicted severity of PTSD. Children with preexisting aggressive behavior were more likely to be victims of physical abuse. Traumatic experience interacts with factors in the child and family to contribute to the development of PTSD. Trauma that threatens family integrity appears to make a strong contribution to the development of PTSD. Increased understanding of the factors contributing to PTSD may provide additional opportunities for developing effective interventions.
Article
The past decade has greatly increased our understanding of the effects of trauma on children. Recent studies have elucidated which children are most at risk for developing PTSD, what types of stressors are most likely to result in chronic post-traumatic reactions, and the differential impact of trauma on the child at different stages of development. There is far less research regarding which psychotherapeutic interventions are most beneficial for child survivors of disaster or interpersonal victimization, and there are virtually no studies of the effectiveness of psychopharmacologic treatments. Studies of adults with PTSD, however, suggest that cognitive-behavioral treatments, possibly supplemented with medication, show much promise.
Article
• Behavioral inhibition is a laboratory-based temperamental category by the tendency to constrict behavior in unfamiliar situations and assumed to reflect low thresholds of limbic arousal. We previously found behavioral inhibition prevalent in the offspring of parents with panic disorder and agoraphobia. In this report, we examined the psychiatric correlates of behavioral inhibition by evaluating the sample of offspring of parents with panic disorder and agoraphobia, previously dichotomized as inhibited and not inhibited, and an existing epidemiologically derived sample of children, followed by Kagan and colleagues and originally identified at 21 months of age as inhibited or uninhibited. A third group of healthy children was added for comparison. Our findings indicate that inhibited children had increased risk for multiple anxiety, overanxious, and phobic disorders. It is suggested that behavioral inhibition may be associated with risk for anxiety disorders in children.
Article
The potential influence of maternal adjustment and parenting style on children's psychological adjustment following sexual abuse was examined. A battery of standardized parent and child self-report instruments were administered to 100 sexually abused children and their nonoffending mothers. The results of a series of multiple regression analyses indicated that the maternal self-reported depression significantly contributed to the expression of both post-traumatic stress disorder (PTSD) symptoms and parent-reported internalizing behavior problems in sexually abused children. In addition, children's perceptions of their mothers' parenting style as rejecting rather than accepting contributed to the children's self-reported levels of depression. Children's perceptions of maternal use of guilt and anxiety-provoking parenting methods contributed to increased levels of PTSD symptoms and parent-reported externalizing behavior problems. These findings are discussed in terms of their research and treatment implications.
Article
This paper proposes an extension of generalized linear models to the analysis of longitudinal data. We introduce a class of estimating equations that give consistent estimates of the regression parameters and of their variance under mild assumptions about the time dependence. The estimating equations are derived without specifying the joint distribution of a subject's observations yet they reduce to the score equations for niultivariate Gaussian outcomes. Asymptotic theory is presented for the general class of estimators. Specific cases in which we assume independence, m-dependence and exchangeable correlation structures from each subject are discussed. Efficiency of the pioposecl estimators in two simple situations is considered. The approach is closely related to quasi-likelihood.
Article
Examines individual differences in response to childhood sexual abuse (CSA) and compares commonalities of this population with other groups of children who have experienced stress and trauma. Despite considerable heterogeneity among CSA victims, these children tend to display significantly higher levels of symptomatology than their nonabused, nonclinic-referred peers. Two problem areas appear to differentiate those with CSA: posttraumatic stress disorder (PTSD) symptomatology and sexuality problems. Variables mediating CSA sequelae include severity and course of CSA; child's age at time of CSA, at time of disclosure, and at time of psychological assessment; the child's attributional style; and family variables. Research suggests the need for thorough multidimensional, multi-informant assessments of global and abuse-specific adjustment and consideration of factors that exacerbate the sequelae of CSA. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
Article
This paper examines risk factors for the development of Post Traumatic Stress Disorder (PTSD), and its severity and chronicity, in a group of 217 young adults who survived a shipping disaster in adolescence. The survivors were followed up 5 to 8 years after the disaster. Risk factors examined fell into three main categories: pre-disaster child and family vulnerability factors, including childhood psychopathology; objective and subjective disaster-related experiences; and post-disaster factors, including results from screening questionnaires administered 5 months post-disaster, coping mechanisms adopted subsequently, life events, and availability of social supports. Developing PTSD following the disaster was significantly associated with being female, with pre-disaster factors of learning and psychological difficulties in the child and violence in the home, with severity of exposure to the disaster, survivors' subjective appraisal of the experience, adjustment in the early post-disaster period, and life events and social supports subsequently. When all these factors were considered together, measures of the degree of exposure to the disaster and of subjective appraisal of life threat, and ratings of anxiety obtained 5 months post-disaster, best predicted whether survivors developed PTSD. For those survivors who developed PTSD, its duration and severity were best predicted not by objective and subjective disaster-related factors, but by pre-disaster vulnerability factors of social, physical, and psychological difficulties in childhood together with ratings of depression obtained 5 months post-disaster, and whether survivors received post-disaster support at school. The implications of these findings are considered for targeting assessment and intervention efforts at survivors most at risk of developing difficulties in adjustment following similar traumatic experiences.
Article
Objective: The objective of this study was to examine the relationship between combat-related posttraumatic stress disorder (PTSD) and comorbid DSM-III-R psychiatric diagnoses to determine commonalities in risk factors, relative onsets and the role of combat exposure.Method: An epidemiological cohort study using standardised psychiatric, social and health interviews was undertaken with a national random sample of male Australian Army Vietnam veterans. Interviews and searches of military records yielded risk factors for PTSD, which were examined for association with each psychiatric diagnosis. Relative onsets of PTSD and each Diagnostic Interview Schedule diagnosis were compared. Comorbidity odds ratios were adjusted for combat exposure effects using logistic regression, and the relation between each diagnosis and combat was assessed after controlling for PTSD.Results: Commonality of risk factor profile was evident for several diagnoses, and for many their onset preceded PTSD onset. Combat was independently related to only a few diagnoses after controlling for PTSD, and PTSD remained strongly associated with several conditions after controlling for combat exposure.Conclusions: The analysis suggests that the disorders that may constitute risk factors or vulnerabilities for PTSD comprise depression and dysthymia, antisocial personality disorder, agoraphobia and simple phobia, while those that may be consequent on PTSD are panic and generalised anxiety disorder, drug use disorders and somatoform pain disorder. Alcohol and drug use disorders and social phobia may have a mixed aetiology, while obsessive–compulsive disorder may be serendipitously related to PTSD through an association with risk of combat. Gambling disorder is unrelated.
Article
Posttraumatic nightmares are a hallmark of PTSD and distinct from general nightmares as they are often repetitive and faithful representations of the traumatic event. This paper presents data from a pilot study that examined the use of Imagery Rehearsal in treating combat-related nightmares of 12 Vietnam veterans with PTSD. Three treatment groups, comprising 4 veterans in each, completed standardised treatment across 6 sessions. Treatment effects were investigated using nightmare diaries and established instruments, including the IES-R, BDI, BAI, and SCL-90-R. The data demonstrate significant reductions in nightmares targeted, and improvements in PTSD and comorbid symptomatology. The paper recommends that, on the basis of the promising preliminary data, a randomised control trial be established to assess imagery ability and attidude toward nightmares.
Article
Although decades of research have examined relationships between social anxiety and negative outcomes, this study examined relations with indices of positive psychological functioning. In college students (n = 204), a factor analysis on self-report measures of positive psychological functioning derived 3 conceptually meaningful broad domains: Positive Subjective Experiences, Curiosity, and Appetitive Motivations. Analyses were conducted to test whether social interaction anxiety demonstrated unique relationships with positive psychological domains after controlling for shared variance with social observation anxiety (e.g., eating in public, public speaking) and neuroticism. Social interaction anxiety explained unique variance in all 3 domains after separately controlling for social observation anxiety and neuroticism. In contrast, social observation anxiety demonstrated near-zero relationships with all 3 domains, and neuroticism predicted Positive Subjective Experiences, and to a lesser degree, Curiosity. These data provide evidence for the unique association between social interaction anxiety and positive psychological functioning, with implications for future basic and applied research.
Article
OBJECTIVE: To prospectively assess the presence of posttraumatic stress disorder (PTSD) in children hospitalized following acute physical injury. The focus was identification of the incidence of PTSD, PTSD symptoms, and exploration of factors associated with development of PTSD symptoms and disorder. METHOD: Forty children ages 8-17 were interviewed approximately 1 month following a serious injury and assessed for PTSD, pretrauma behavior problems, levels of peritraumatic fear, and posttraumatic thought suppression. RESULTS: Twenty-two and a half percent of participants met DSM-IV diagnostic criteria for PTSD; 47.5% met criteria for at least two of the three PTSD symptom clusters. Greater thought suppression was associated with increased symptoms of PTSD, as were the child's peritraumatic fear response and pretrauma internalizing behaviors. CONCLUSIONS: Results suggest that many children who have been hospitalized for physical trauma may be experiencing clinically significant PTSD symptomatology and may benefit from psychological as well as medical intervention.
Article
"Behavioral inhibition to the unfamiliar" is a temperamental construct reflecting the tendency to be shy, timid, and constrained in novel situations. Previous work has suggested that it may be associated with anxiety disorders in children. Psychopathology was assessed in children from a nonclinical sample originally identified as behaviorally inhibited or uninhibited at 21 months and followed through 7 1/2 years. Children who remained inhibited at 4, 5 1/2 and 7 1/2 years (Stable Inhibited) had higher rates of anxiety disorders than children who were not consistently inhibited. Their parents had higher rates of multiple childhood anxiety disorders and of continuing anxiety disorder. These results suggest that the association between behavioral inhibition and anxiety disorder is accounted for by children who have stable behavioral inhibition.
Article
Behavioral inhibition to the unfamiliar, identifiable in early childhood and reflecting the tendency to exhibit withdrawal and excessive autonomic arousal to challenge or novelty, has been found to be prevalent in young offspring of parents with panic disorder and agoraphobia and associated with risk for anxiety disorders in these children. Using family study methodology, we now examine psychopathology in first degree relatives of children from a non-clinical longitudinal cohort identified at 21 months of age as inhibited (N = 22) or uninhibited (N = 19) and followed through the age of seven years for a study of preservation of temperamental characteristics in normal children. These assessments were compared with evaluations of the first degree relatives of 20 normal comparison children. Psychiatric assessments of parents (N = 110) and siblings (N = 72) were based on structured interviews conducted blindly to the temperamental classification of the index child. Parents of inhibited children, compared with parents of uninhibited and normal controls, had significantly higher risks for multiple (greater than or equal to 2) anxiety disorders, continuing anxiety disorders (both a childhood and adulthood anxiety disorder in the same parent), social phobia, and childhood avoidant and overanxious disorders. These findings provide additional support for the hypothesis linking behavioral inhibition with risk for anxiety disorder.
Article
Twenty-four girls who survived the sinking of the 'Jupiter' in October 1988 were screened 10 days after the accident on the Impact of Events Scale, the Birleson Depression Scale and the Revised Children's Manifest Anxiety Scale. Scores at 10 days were associated strongly with help seeking over the following few months and were highly predictive of scores five months after the accident. Survivors were clearly differentiated from controls on all three measures. The battery seems useful in screening post-traumatic stress disorders in teenage children.
Article
Fourteen months after a sniper attack at an elementary school, level of exposure to that event remained the primary predictor of ongoing posttraumatic stress reactions in 100 schoolchildren who were followed up. Guilt feelings and knowing the child who was killed were associated with a greater number of symptoms. Grief reactions occurred independent of degree of exposure to the event. The authors discuss the public health implications of these longitudinal findings.
Article
Behavioral inhibition is a laboratory-based temperamental category by the tendency to constrict behavior in unfamiliar situations and assumed to reflect low thresholds of limbic arousal. We previously found behavioral inhibition prevalent in the offspring of parents with panic disorder and agoraphobia. In this report, we examined the psychiatric correlates of behavioral inhibition by evaluating the sample of offspring of parents with panic disorder and agoraphobia, previously dichotomized as inhibited and not inhibited, and an existing epidemiologically derived sample of children, followed by Kagan and colleagues and originally identified at 21 months of age as inhibited or uninhibited. A third group of healthy children was added for comparison. Our findings indicate that inhibited children had increased risk for multiple anxiety, overanxious, and phobic disorders. It is suggested that behavioral inhibition may be associated with risk for anxiety disorders in children.
Article
Accidental injury in a child is sudden, often violent, and emotionally stressful, particularly when it is accompanied by hospitalization and rehabilitation. The following case report examines the presence of post-traumatic stress disorder and other psychiatric illnesses in five children involved in a boating accident during the 1988 Pittsburgh Regatta and considered severity of injury as well as complicating psychosocial stressors in the development of the disorders. The presence of symptoms was not related to the nature or extent of the injury but was instead the by-product of additional factors, including level of family stress, coping styles of the patient and family, positive psychiatric history in the child and/or family, and experience in effectively dealing with stressful episodes in the past.
Article
This paper reports on a pilot study examining the reactions of children to a disaster of severe flooding in a circumscribed area of rural Missouri. Both parents and children were interviewed separately approximately 1 year after the flood using parallel versions of a structured diagnostic interview designed to identify children with DSM-III diagnoses. The results document the importance of interviewing children directly. Children reported more anxiety symptoms than parents reported for their children. Although symptoms of posttraumatic stress were reported, none of the children met full criteria for the disorder. Children most likely to be adversely affected were those with a preexisting disorder and those with parents who also reported a high number of symptoms in themselves.
Article
The initial behavioral reaction to unfamiliar events is a distinctive source of intraspecific variation in humans and other animals. Two longitudinal studies of 2-year-old children who were extreme in the display of either behavioral restraint or spontaneity in unfamiliar contexts revealed that by 7 years of age a majority of the restrained group were quiet and socially avoidant with unfamiliar children and adults whereas a majority of the more spontaneous children were talkative and interactive. The group differences in peripheral physiological reactions suggest that inherited variation in the threshold of arousal in selected limbic sites may contribute to shyness in childhood and even extreme degrees of social avoidance in adults.