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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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... 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.
... Past studies have examined the effect of remote/indirect/media exposure to terrorist attacks and have shown a significant negative impact on adolescents' mental health (Braun-Lewensohn et al., 2009;Busso et al., 2014;Felix et al., 2021;Fremont et al., 2005). The past literature reveals that the excessive amount of exposure to viewing violent events (such as terrorist attacks) can have a profound effect on adolescent's sense of security, leaving strong feelings of vulnerability and resulting in emotional and psychological trauma, even though these events are presented through media (Ahern et al., 2002;Fairbrother et al., 2003;Otto et al., 2007). Exposure to such media content has adverse effects on their mental and physical health due to the crude nature of the content displayed (Wang et al., 2006). ...
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The escalating indirect exposure to terrorism through media has contributed to rising mental health issues among adolescents. The terrorist attack on Army Public School Peshawar (APSP) in Pakistan has received immense media coverage and the violence shown has touched the lives of natives. The current study adopts an Interpretative phenomenological analysis to explore the impact of indirect exposure to terrorism through media—television and Facebook—on adolescents' mental health in relation to terrorist attack on APSP. Moreover, the effect of changes occurred in parents’ behaviour and school settings after the stated terrorist attack were also considered. To gather data, six Focus Group Discussions (FGDs) were conducted with adolescents (N = 45) who were enrolled in educational institutes far from the epicentre of the attack and came to know about the attack through media. Acquired qualitative data was subjected to thematic analysis revealing that indirect exposure to terrorism through media negatively impact the mental health of adolescents. Likewise, the abrupt changes in school settings and parental behaviour cause disruption in their immediate environment that further impacts their well-being.
... As noted in the discussion, no instrument was provided to address the existential/cumulative stress caused by the pandemic. Consistent with previous literature related to disaster and crisis response surrounding the 9/11 terrorist attacks (Otto et al., 2007) and Hurricane Katrina (Davis et al., 2010;LaJoie et al., 2010), these global and existential threats posed by the COVID-19 pandemic -displacement from the learning environment, and consistent media exposure -may be actively contributing to the levels of stress that the students were experiencing. Counselors could benefit from integrating aspects of humanistic and existential counseling modalities into their practice to help clients gain increased awareness. ...
... CBT is favored due to its lack of adverse side effects, withdrawal problems, and association with a lower rate of subsequent relapse. Additionally, CBT can enhance self-esteem and foster an increased sense of agency [7,8]. ...
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... Nearby communities -such as Chinatown and lower Manhattan -are also presented with physiological and psychological symptoms demonstrating wider community impacts as the collective trauma has scarred the US and, indeed, global, psyches (Antao et al. 2019;Kung et al. 2019;North Atlantic Treaty Organization 2008). The extensive global media coverage triggered extreme stress and PTSD reactions within geographically distant communities; notably, amongst children and their parents (Otto et al. 2007). An enduring legacy of 9/11 is a visceral reminder of the critical need for governments, emergency services and the wider community to proactively address the psychological toll that high operational tempo and exposure to trauma imparts upon the brave men and women that protect the nation. ...
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War, disaster, and domestic terrorism have shaped Sri Lanka's military and emergency services which have evolved, over time, as a reaction to these threats. As a result, the men and women of the country's eight fire brigades and the Air Force Fire and Rescue Unit stand ready, 24-hours-a-day, to respond whenever disaster occurs. Lessons learned from 9/11, the London, Paris and Manchester Arena bombings indicates that a nation's preparedness, readiness, and operational capacity are dependent on the wellbeing of these personnel which are vital to the nation's security and resilience. The community expects its military and civilian firefighters to be brave, strong, and ready for anything. However, a high operational tempo exacts a heavy toll on the nation. Research indicates that an increasing operational tempo and regular exposure to trauma can result in chronic physical and psychological health problems. This results in higher work-related injury and absence rates, the breakdown of professional and personal relationships, self-medication with alcohol and/or drugs, depression, withdrawal, post-traumatic stress disorder, suicidal ideation, suicide and more. Beyond these often-devastating individual consequences, this hidden disaster within a disaster-which consists of stressors, negative emotions, and coping capacity-can significantly reduce operational capacity and undermine the nation's resilience building efforts. Similar to their military counterparts, civilian emergency services require appropriate consideration of their psychological health. INSS DEFENCE Review 78 Organizational and managerial environments can either help or hinder coping capacity. Environmental stressors such as task overload, personnel shortages, ineffective communication, and perceived lack of managerial support dramatically increase levels of stress. The ongoing pandemic with the constant fear of exposure, dynamic shifts in operating picture, and protests and riots add further COVID-19-related stressors which are exacerbated by unbalanced demands for increased service capacity. This inhibits, already strained, emotional resources meaning well-developed coping behaviors are required. Existing research points to several approaches. Exercise and social relationships are considered effective, whereas drug and alcohol use and avoidance are not. Ineffective coping behaviors can lead to harmful physical and psychological outcomes that significantly reduce organizational performance. However, little is understood about how firefighters cope with these stressors. Recent multi-agency incidents such as the Easter Bombings, COVID-19, and the Xpress Pearl, have drawn global media scrutiny toward Sri Lanka. Thus, the psychological wellbeing of firefighters is a very real and significant national security concern. Accordingly, this paper outlines a theoretical model for evaluating stressors, negative emotions, and coping capacity within Sri Lankan Fire Brigades.
... Research has focused more on looking at the impact of TV on certain cognitive components as a function of age (Nathanson et al., 2014) and not so much on a direct link between these two variables in question (age/ TV television). On the other hand, studies have shown contradictory results when examining the enjoyment of TV programs in relation to developmental levels: For example, when considering the influence that watching news programs about the events of September 11 has on younger children (Otto et al., 2007), according to some studies it is greater for younger children, while according to other studies it is greater for older children (Smith & Moyer-Gusé, 2006). We also examined the relationships between personal characteristics and levels of fear, anxiety, and risk perception: age is negatively correlated with separation anxiety, consistent with reports in the literature: Research shows that as age increases, manifestations associated with separation anxiety decrease (Allen et al., 2010). ...
Article
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Mass media plays an important role in delivering and spreading information, increasing the probability of exposure of growing individuals to content of various kinds, even content that is inappropriate for their developmental stage. The aim of this study was to investigate the relationship between the type of television use, exposure to different types of programs potentially characterized by violent content, and psychological well-being in a sample of Italian children. 177 elementary school students, from grade 3 to grade 5 (94 females, 83 males, M age =9.6, SD=0.8, age range: 8-11 years) completed an ad hoc questionnaire, related to socio-demographic data and mode of television viewing, the Italian Fear Survey Schedule for Children-Revised, the Multidimensional Anxiety Scale for Children, and the Societal and Personal Risk Assessment for Youth. The results show that age has no significant correlation with television viewing time or parental co-viewing. However, there was a positive correlation with perceived social risk and general risk perception, while there was a negative correlation with separation anxiety. A cluster analysis revealed four unique behavioral patterns that illustrate the complex relationship between television content and psychological responses. In addition, ANOVA revealed significant differences in risk perceptions between groups. These findings underscore the need to employ nuanced media engagement techniques and design targeted media literacy programs that take into account the complex effects of media on children's development.
... Amerika'da meydana gelen 11 Eylül olaylarını medyadan özellikle de televizyondan izleyen çocuklarda kaygı ve travma sonrası stres belirtilerinin yordayıcılarının belirlenmesini amaçlayan başka bir araştırmada medyadan trajik olayların izlemesinin, çocuklar gibi savunmasız gruplarda kaygı ve TSSB semptomlarının ortaya çıkışını hızlandırdığı belirtilmiştir. Kaygı ve TSSB semptomları ile bu yayınları izleme süresi arasında ilişki olduğu görülmüştür.9 Bu araştırmada depremle ilgili yayınları takip eden ergenlerin durumluk kaygı ve travma sonrası stres belirtileri puan ortalamaları arasında istatistiksel olarak anlamlı bir fark bulunmuştur. ...
Article
Giriş: Depremler ve oluşturduğu etkiler küresel sağlık sorunlarına neden olmaktadır. Kaygı ve travma sonrası stres bozukluğu depremlerin ardından görülen en yaygın olumsuz psikolojik tepki olarak kabul edilmektedir. Bu araştırmada deprem haberlerinin ergenlerde kaygı ve travma sonrası stres bozukluğu belirtileriyle ilişkisi ve bu ilişkiye aracılık eden risk faktörlerinin belirlenmesi amaçlanmıştır. Yöntem: Kesitsel-tanımlayıcı modeldeki bu çalışma, depremden altı ay sonra Türkiye'nin doğusunda yer alan bir bölgedeki lise öğrencileriyle yürütülmüştür. Küme örnekleme yöntemiyle yüz yüze görüşme tekniğinin kullanıldığı araştırmaya 487 ergen katılmıştır. Kaygının travma stres belirtileri üzerindeki rolünü değerlendirmek amacıyla yapısal eşitlik modeli analizi kullanılmıştır. Bulgular: Ergenlerin kaygı ve travma sonrası stres belirtileri puanlarının orta düzeyde olduğu belirlenmiştir. Kaygının travma sonrası stres belirtilerini etkilediği, kronik veya psikiyatrik hastalığı olanların, daha önce enkaz altında kalan veya yaralanan herhangi bir yakını olanların, sürekli olarak deprem olacağı endişesi taşıyanların, depremle ilgili haber veya yayınları izleyenlerin kaygı ve travma sonrası stres puanları yüksek bulunmuştur. Sonuç: Uygun olmayan haber içerikleri ve yayınların çocuk ve ergenleri etkileyebileceği unutulmamalıdır. Ebeveynlerin özellikle deprem sonrası haber kanalları ve sosyal medyada çocuklarının izlediği içerikleri kontrol etmesi önemlidir. Doğal afetlerden etkilenen ergenlere, özellikle kaygı ve travma sonrası stres belirtileri gibi ruhsal problemler açısından yüksek risk taşıyanlara, bireyselleştirilmiş ve uygun psikososyal müdahaleler verilmelidir.
... Page 59 03/05/23 6:08 PM perceived vulnerability (Comer et al., 2008;Smith & Wilson, 2002), and even increase risk of developing anxiety or depressive disorders (Hoven et al., 2005). This impact is even greater on younger children (Otto et al., 2007) and may also contribute to lifelong fears. A study that asked adults to recall an incident from childhood TV that caused them to be fearful found that 26.1% reported that they are still experiencing residual fear from this event (Harrison & Cantor, 1999). ...
Article
Animal fears are common, emerging in early childhood and often continuing into adulthood. This study explores the outcomes of positive and negative storybooks about animals on children's attitudes and behaviors. Ninety-six children (ages 4–8 years) were exposed to either negative or positive information about two animals (snakes and frogs) via age-appropriate storybooks, and fear beliefs and avoidance behaviors were then measured. Our results suggest that prior knowledge influences learning and behavior, with children exhibiting more fear towards snakes than frogs, regardless of condition. Accordingly, children who showed fewer fear beliefs were more likely to reach for the animals. In addition, storybook information impacts learning and fear, with children exhibiting more fear in the negative storybook conditions than positive storybook conditions. Storybook information also influenced behavioral avoidance, especially for snakes, with more children reaching for the snake when they received positive information rather than negative information. Additionally, across negative conditions, more children reached for the frog compared to the snake. Finally, parental and child characteristics were associated with more both self-reported fear and observed fear. Implications for parents and educators are discussed.
... 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. ...
Article
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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.
... 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.
... 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
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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.
... 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). ...
... El impacto de las imágenes transmitidas por los medios de comunicación en los menores tras un acto terrorista es evidente y explica la presencia de malestar emocional en niños, niñas y adolescentes alejados físicamente de la tragedia (e.g., Fairbrother et al., 2003;Gil-Rivas et al., 2004;Mijanovich y Weitzman, 2010;Pfefferbaum et al., 2000b;Pfefferbaum et al., 2003d;Schuster et al., 2001). Se han encontrado síntomas de estrés postraumático, ansiedad, tristeza, aislamiento y malestar psicológico general (e.g., Barnes et al., 2005;Fairbrother et al., 2003;Gil-Rivas et al., 2004;Hock et al, 2004;Lengua et al., 2005;Mijanovich y Otto et al., 2007;Pfefferbaum, 2003d;Schuster et al., 2001;Stein et al., 2004;Whalen et al., 2004), una visión del mundo como un lugar más peligroso y menos seguro (Halpern-Felsher y Millstein, 2002;Phillips et al., 2004), alteración en la visión del futuro (Fairbrother et al., 2003) y mayor percepción de riesgo de muerte (Halpern-Felsher y Millstein, 2002), preocupación por la propia seguridad y cambios en las actividades cotidianas (Becker-Blease et al., 2008;Pfefferbaum et al., 2003c), así como problemas externalizantes (Lengua et al., 2005) en menores víctimas indirectas del terrorismo. ...
Article
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Los actos terroristas presentan un enorme potencial traumatogénico, especialmente para un colectivo vulnerable como son los niños, niñas y jóvenes. Sin embargo, son escasos los estudios que han analizado las posibles consecuencias adversas del terrorismo en menores. El presente trabajo tiene como finalidad realizar una revisión sistemática de las publicaciones sobre consecuencias psicológicas en menores expuestos a actos terroristas. Se revisaron 54 trabajos, principalmente, de los Estados Unidos de América (72,22%) y vinculados al atentado del 11 de septiembre de 2001 en Nueva York (50%). En la mayoría de casos se analizaron síntomas postraumáticos (64,81%) en menores que sufrieron la victimización de forma indirecta, a través de su exposición a información del atentado en los medios de comunicación (33,33%). Son necesarios profesionales formados para trabajar con menores víctimas del terrorismo, que sepan reconocer los síntomas asociados a estas experiencias y los dañinos efectos que pueden conllevar para los niños y niñas.
... 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.
... A wealth of studies ensued with a great many reaffirming the connection between television exposure and PTSD symptoms. Here is a small selection: 'intensive exposure to the news coverage of such an intense disaster situation is associated with psychopathology' (Ahern et al., 2002: 299); people who watched television the most were 66 percent more likely of having 'probable PTSD' than those who watched least (Ahern et al., 2004: 224); stress in parents who watched the disaster on television was associated with stress in children (Fairbrother et al., 2003); television-related PTSD symptoms were found significant even when controlling for directly experiencing the attack, the kind of coverage seen, and sociodemographic characteristics (Schlenger et al., 2002); each hour increase of television viewing resulted in 5-6 percent increase in dreams containing references to the disaster, which 'strengthen the hypothesis that there was a causal path from television viewing of these events to increased stress and trauma' (Propper et al., 2007: 340); in addition to television exposure, changes in viewing habits (like avoidance or seeking out more coverage) were also associated with PTSD symptoms (Otto et al., 2007). ...
Chapter
Shortly after the 1989 Hillsborough Stadium disaster in Sheffield, England, sixteen people brought actions claiming to suffer a “nervous shock” as a result of learning from the media about the fatal human crush that occurred during a soccer match. The plaintiffs, most of whom were relatives of the victims, demanded compensations as secondary victims, arguing that their injury was within the “immediate aftermath”—a category recognized by British law as having been involved in the consequences of a tragic event. The court rejected the claim, but not before speculating on the hypothetical possibility of a traumatic live broadcast. Numerous claims for psychiatric injury had been filed prior to this case, yet this is probably one of the first to consider whether media could cause trauma to viewers, and consequently be compensable by law. Were such a case to be heard today, however, it might find support from recent developments in psychiatric research. For there is now a growing acceptance among mental health experts that trauma could transfer, under certain conditions, through visual media. Referring to notions such as “distant trauma,” “traumatic media exposure,” and “vicarious traumatization,” clinicians and researchers are now willing to acknowledge that witnessing disastrous events through the media could cause a reaction that complies with existing PTSD clinical criteria. How did this development come about? How does such mediated trauma manifest itself? What are its social, legal, and moral consequences? And what are the implications for our understanding of both media and trauma? These are the questions this chapter sets out to explore. Psychiatry has long been in the business of understanding how external violence affects mental processes. While operating under various nomenclatures, modern conceptions of trauma have dovetailed with modern developments in technology and warfare. As already noted earlier in this book, trauma is a central theme in the grand narrative of the shock of modernity.
... 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. ...
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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.
... 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.
... In particular, a number of cross-sectional studies have suggested that the repeated exposure to violent/tragic news may have both short-and long-term emotional consequences for children and adolescents, particularly posttraumatic stress symptoms, depression, and anxiety (Busso, McLaughlin, & Sheridan, 2014;Comer, DeSerisy, & Greif Green, 2016;Comer & Kendall, 2007;Ferrara et al., 2016;Otto et al., 2007;Pfefferbaum, Newman, & Nelson, 2014). Especially among youth with high levels of anxiety, TV use has been positively associated with elevated perceptions of personal vulnerability to world threats such as crime, terrorism, earthquakes, hurricanes, and floods (Comer, Furr, Beidas, Weiner, & Kendall, 2008). ...
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Objective: Although youths’ exposure to violent/tragic events (e.g., natural disasters and terrorist attacks) in the media has been positively associated with anxiety and posttraumatic stress, few studies have examined ways in which caregivers might buffer the impact of violent/tragic news. The current study further evaluates the psychometric properties of a measure of caregiver behaviors in relation to youths’ exposure and response to violent news. Method: Using data from caregivers (N = 350) recruited through Amazon Mechanical Turk, a confirmatory factor analysis of the Caregiver Responses to Youth Media Exposure (CRYME) was performed, and factorial invariance across male and female caregivers was examined. Concurrent and discriminant validity as well as 2-week test–retest reliability were also assessed. Results: The results support a 3-factor structure that is stable across female and male caregivers, with subscales reflecting caregiver behaviors intended to reassure a child of his or her safety, limit access to violent news, and encourage safety behaviors by instilling fear of situations covered in the media. A total of 5 items were dropped to improve model fit. Concurrent validity and discriminant validity of the 3 scales were supported by differential associations with measures of family functioning, family accommodation of child anxiety, and caregiver anxiety. Test–retest reliability was acceptable for 2 of the scales. Conclusions: The revised Caregiver Responses to Youth Media Exposure (CRYME-R) is a valid and reliable measure that can be used to identify caregiver practices for regulating violent news consumption and/or buffering its impact following violent/tragic events.
... 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. ...
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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.
... 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.
... 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.
... 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.
Article
Background The research-practice gap has not been explored within civics education, and in particular the role of evidence-based civics curriculum in times of political trauma. Such research is critical in equipping educators with evidence-based resources to help mitigate political trauma experienced by students. Here, we explore the types of resources teachers access as well as the role of Brokers, Intermediaries and Boundary Spanners (BIBS) in connecting teachers to such sources after the historic 6 January 2021 US Capitol insurrection. Aims and objectives This study poses the following research questions: (1) what resources did teachers utilise to support their students following the 6 January 2021 Capitol insurrection; and (2) who were key BIBS in connecting teachers to such information and what role did research evidence have in the generation of such materials? Methods Using cross-sectional survey data, we analyse the open-ended text-based responses from educators reflecting on the days after 6 January 2021. Findings The study illuminates’ trends in: (1) the type of resources teachers utilise to address students’ needs (educational curricula, social media, news outlets); and (2) the role of BIBS in connecting them to such information (media platforms, mass media, educational non-profit organisations). Discussion and conclusion In the face of political trauma, educators present civics crises as ‘open issues’ and struggle to access frameworks to support research-based pedagogy. Findings illuminate the potential of a BIBS framework that works to further support educators in facilitating conversations and evidence-based pedagogies with their students that rebuke such injustices.
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Anxiety disorders are found to be the most prevalent psychological problems among children and adolescents. Cognitive behaviour therapy (CBT) was found to be effective at reducing anxiety. The purpose of this study was to assess the effectiveness of a universal school-based intervention for reducing anxiety among Grade 9 schoolchildren. A randomized controlled cluster trial was conducted by randomly assigning 36 schools in the Colombo district in Sri Lanka into study and control arms, each comprising 18 schools with 360 students. The levels of anxiety, self-esteem and depression status were assessed using the validated Screen for Child Anxiety Related Disorders (SCARED) tool and the Rosenberg self-esteem scale, respectively, and the Depression, Anxiety and Stress Scale 21 (DASS-21) at baseline, after intervention, and after 3 months. A CBT-based universal intervention package was administered weekly by a trained teacher for eight weeks with a one-month self-practice period to a randomly selected Grade 9 class in each school in the study arm. The control arm received routine care. Anxiety and self-esteem scores and depression status were compared between the two arms after the intervention and at 3 months of follow-up using the generalized estimation equation (GEE), controlling for confounding and clustering. The nonresponse and loss to follow-up rates were < 1%. When comparing the study arm with the control arm using GEE, anxiety levels were significantly lower (β = 0.024, 95% CI = 0.055 − 0.006, p = 0.115) but not postintervention (β = 0.024, 95% CI = 0.055 − 0.006, p = 0.115). There were no significant differences in depression status after intervention (OR = 0.256, 95% CI 0.052–1.286; p = 0.098) or follow-up (OR = 0.42, 95% CI 0.117–1.008; p = 0.052), and self-esteem significantly increased after intervention (β = 0.453, 95% CI = 0.264–1.145; p = 0.2321) but not at follow-up. This study revealed that the universal package based on CBT is effective at reducing anxiety and improving self-esteem among adolescents. The trial registration number and date were SLCTR/2018/018 and 19th of June 2018 respectively.
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Objective We aimed to investigate the influence of media on college students’ mental health during the COVID-19 pandemic. Methods After the COVID-19 outbreak, we used cross-sectional surveys through online questionnaires to investigate the mental health of college students in lockdown at home. We identified the influencing factors of PTSD symptoms using the Chi-Square test and ordinal logistic regression analysis. Results In 10,989 valid questionnaires, 9,906 college students with no PTSD symptoms, 947 college students with subclinical PTSD symptoms (1–3 items), and 136 college students with four or more PTSD symptoms were screened out. The results showed that media content impacted the mental health of college students in lockdown at home. Positive media content was negatively correlated with PTSD symptoms among college students. PTSD symptoms were not associated with sources of information. Moreover, College students with PTSD symptoms would reduce their willingness to learn and could not complete online learning efficiently. Conclusion PTSD symptoms are related to media exposure and excessive information involvement of COVID-19 in college students, which influences the willingness to attend online classes.
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Along with the Covid-19 pandemic, a new type of 'disease' has spread just as rapidly, affecting the world of journalism and information. In addition to the concept of 'infodemic', first proposed by David J. Rothkopf in 2003 in relation to SARS, then taken up by a World Economic Forum study in 2006 to explain the fairness of information in emergencies, and finally used by the World Health Organisation itself to refer to the spread of false, tendentious or incorrect information during the Covid-19 pandemic. 2020 was also the year of a new word: doom scrolling.This term refers to when a person constantly reads and searches for negative news online, and the consequences this has on our mental health. It is still a relatively new phenomenon, but several experts have already pointed out that doom scrolling is predictably detrimental to a person's mental well-being.The pandemic has thus confirmed the already known risks of overexposure to a constant flow of information, a problem that affects media professionals, their audiences and institutions, and that can trigger social and psychophysical pathologies such as depression, mood swings, isolation and paranoia.An attempt will be made here to discuss the issue from a critical point of view and to reconstruct the phenomenon of 'doom scrolling'. Finally, an attempt will be made to define the main lines of public discussion based on the most recent literature available in this period of global crisis.
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Purpose The study aims to explore the current experiences of Ukrainian adolescents affected by the Russia-Ukraine war. The study focused on the changes in adolescents’ lives caused by the war, adolescents’ emotional reactions to the disruptions caused by the war, coping strategies employed by adolescents in dealing with disruptions and the role of information technology in supporting new realities and coping strategies of adolescents. Design/methodology/approach This study relied on semi-structured interviews conducted on Zoom with 27 Ukrainian adolescents ages 10-18. Participants were recruited using the snowball sample and came from various regions of Ukraine. The interview notes and partial transcripts were analyzed using thematic analysis to identify the common and unique patterns in participant responses. Findings The interview data revealed the signs of traumatic experiences and various stages and methods of coping with them. Participants’ resilience was supported by external factors, including families, communities, continuous schooling, ability to talk to friends, information technology, as well as internal skills, including social competence, problem-solving, critical consciousness, autonomy and a sense of purpose. Participants shared specific recommendations for improving information platforms and online content, e.g. making them more accessible and affordable for Ukrainian users, improving content curation and personalization, creating and promoting Ukrainian content and others. Research limitations/implications Research relied on convenience sample of participants who had access to information communication technology (ICT), were aware and had an ability to participate. Field work is needed to reach out to participants without access to ICT. Practical implications This study contains broad recommendations for improving information technologies for the use of Ukrainian adolescents. Social implications This research offers three timely account of the first-hand experiences of Ukrainian adolescents affected by the Russia-Ukraine war and can inform future work aimed at improving life conditions for teen population. Originality/value This study relied on first-hand reports of Ukrainian adolescents’ experiences, feelings and coping strategies during the first three months of Russia-Ukraine war. The study applied war trauma and resilience frameworks to interpret the findings and translate some of the findings into practical recommendations for the information science community.
Chapter
Behavioral inhibition is the temperamental tendency, identifiable as early as toddlerhood, to display restraint, fearfulness or withdrawal when faced with unfamiliar people, situations, and objects. Behavioral inhibition has been shown to be a risk factor for childhood anxiety disorders, particularly social anxiety disorder. We review studies focused on behavioral inhibition’s neurobiology and genetics, on factors that contribute to its stability, examine its outcomes across different cultures, and delineate its specific association with social anxiety disorder, and possibly with other anxiety disorders or depression. As a temporal risk factor for later social anxiety, behavioral inhibition is a useful target for preventive intervention. We also review both screening tools and intervention protocols that can be used to identify and intervene with children with behavioral inhibition. Finally, we discuss future areas for research on the outcomes and optimal intervention approaches to children with behavioral inhibition.
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Background: Rapid technological developments enable the immediate transmission of armed conflict events through a variety of media channels, inducing mass anxiety, fear, and helplessness. Youth are particularly vulnerable and face new challenges as a result of this exposure. The effects of media exposure to such events on psychological distress and post-traumatic symptoms were examined. Methods: A total of 161 participants aged 13-18 years completed a questionnaire battery that included measures of media exposure to armed conflict events, previous direct exposure to armed conflict events, psychological distress, post-traumatic symptoms, dispositional optimism, and self-mastery. A structural equation model (SEM) approach was employed for data analysis. Results: The extent of media exposure to armed conflict was directly associated with psychological distress and post-traumatic symptoms. Dispositional optimism moderated the association between media exposure and psychological distress, while self-mastery moderated the association between media exposure and post-traumatic symptoms. The effects of the Internet factor of media exposure, which included social media, were particularly disturbing as neither of the resilience factors moderated negative outcomes. Conclusions: The findings suggest that clinical interventions to enhance dispositional optimism and self-mastery as well as other potential resilience factors can protect adolescents from the severe effects of media exposure to violent armed conflict events. Developmental and public health implications related to vulnerabilities and resilience during adolescence are discussed.
Chapter
This encyclopedia entry provides a brief history of the ways in which researchers have defined, conceptualized, and measured stress and provides recommended definitions and conceptualizations of stress for use in research and practice with children and adolescents. The entry also describes some of the most prevalent types of stressors experienced by young people and common effects of stress exposure. Both mental health and other types of outcomes, such as physical health and learning outcomes, are described. Finally, this entry summarizes what researchers have discovered about the processes through which stressors affect children and adolescents, as well as potential factors that might protect young people from the negative effects of stress.
Article
In recent years, there has been a barrage of social media posts about police brutality toward Black Americans. While the posting of police brutality videos on social media can certainly have a positive impact on legal cases and public policies, what effect does the exposure have on the mental health of Black Americans? This article uses a review of the literature to investigate the reasons why Black Americans can be significantly impacted by exposure to police brutality videos. It also includes a case study of a Black American male who developed posttraumatic stress disorder in response to such videos in the context of a forensic evaluation.
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.
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.
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Objective: Exposure to police violence is a public health concern for Black emerging adults ages 18-29 given its prevalence and association with negative health outcomes. However, research examining the role of police legitimacy in the relationship between exposure to police use-of-force and personal safety interventions is scant. This study investigated the mediating role of perceived police legitimacy in the relationship between exposure to police use-of-force and personal safety interventions (reliance on police, self, or others) in a sample of Black emerging adults. Method: Computer assisted surveys were administered to English-speaking, Black, and emerging adult college students (n = 300) with a history of exposure to police use-of-force. Results: Findings from a bivariate analysis showed that all three types of exposures to police use-of-force were significantly associated with perceptions of police as being less legitimate. In addition, findings from a path analysis revealed an indirect-only mediation effect of perceptions of police as being less legitimate in the relationship between seeing videos of police use-of-force in media and less reliance on police for personal safety. Conclusions: Attenuating gratuitous police use-of-force toward Black emerging adults is paramount for improving perceived legitimacy and trust in police to ensure personal safety for this population.
Article
There has been a widespread increase in affective disorders after the emergence of the COVID-19 pandemic. In the current study, we investigated the effects of exposure to and perceived accuracy of news media and demographic characteristics on anxiety and depressive symptoms. We conducted an online survey of US adults (N = 480) using hierarchical linear regression models to understand the predictive roles of duration and frequency of news media exposure, as well as the perceived accuracy of COVID-19 portrayal by the news media, on anxiety and depression. Increased exposure duration predicted greater anxiety, and decreased frequency of exposure and perceived overreaction in the news media coverage of COVID-19 were linked to greater anxiety and depression. Perceived accuracy moderated the relationship of exposure frequency to both affective outcomes. Accordingly, our data support the importance of adequate levels of accurate and trusted information to help mitigate the overall mental health burden of the pandemic.
Article
There is evidence from earlier studies that the probability to be traumatized by pictures of disasters is associated with a high level of exposure, the traumatic significance of the pictured event, prior exposure to similar real-life events, and personality variables. Preexisting symptoms of posttraumatic stress disorder, depression, and anxiety are predictors of the higher impact of mass media (MM) and social media (SM) contributing to a vicious cycle. We aimed to discuss mechanisms through which MM and SM may cause massive indirect traumatization of populations and that may be relevant for the psychosocial conditions that emerged during COVID-19 pandemic news bombardment. The current pandemic is an example of a serious and deadly disease with extremely enhanced representation in the MM and SM and high rates of unverified, false, and sometimes apocalyptic information. Both mass as well as social medial tendencies to select their news according to their controversial and often negatively affective load contribute to this. This phenomenon is characterized as “infodemic” – a situation that may have profound consequences for mental health due to undermining feelings of personal safety, corroding social cohesion, and inducing conflicts and bitterness. Pandemic-infodemic situation has shown that complicated but inevitable turn to higher transparency including ethically motivated restrictions of anonymity and the contents of the web – measures that, however, have to be sensitively balanced with the demands guaranteeing the freedom of opinion, the freedom of speech and the avoidance of censorship. In general, there is a need for complex solutions, difficult decisions, and intricate balances.
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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.
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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.
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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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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.
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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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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).
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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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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.
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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.
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• 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.
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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.
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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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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.
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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
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.
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.
Article
To examine the factors predisposing to posttraumatic stress disorder (PTSD) in peers of adolescent suicide victims. One hundred forty-six adolescents who were the friends of 26 suicide victims were studied. Five percent (n = 8) developed PTSD after exposure to suicide. These 8 subjects with PTSD were compared to the remainder of the exposed subjects (n = 138). Subjects with PTSD were more likely than those without PTSD to have had a history of substance abuse, agoraphobia, and suicide attempts. Subjects who developed PTSD were more likely to have developed a new-onset depression, to have more severe grief, and to have been closer to the suicide victim. Subjects with PTSD tended to have more severe exposure to suicide and came from discordant households with a history of disruptions in key relationships. The 8 subjects who developed PTSD were compared to 38 subjects who developed new-onset depression but not PTSD. Those with PTSD were more likely to have had past substance abuse, prior suicide attempts, family history of panic disorder, a history of parent-child disruption, and a history of loss. Symptoms of intrusive visual images, hypervigilance, and avoidance of reminders discriminated subjects who had PTSD from new-onset depressives without PTSD. PTSD is an expectable outcome in youth exposed to suicide. Further work is required to differentiate symptoms of depression from PTSD.
Article
The association between expressed emotion (EE) and psychiatric disorders was investigated in a community survey of 108 preadolescent children. Results indicated that the two components of EE, critical comments and emotional overinvolvement, identified non-overlapping subsets of families and displayed diagnostic specificity. Significantly higher rates of disruptive behavior diagnoses were observed in children of parents who expressed high levels of criticism, while children of parents who expressed high levels of emotional overinvolvement were significantly more likely to have an anxiety disorder when compared to the remaining sample. Findings support the utility of this brief measure of EE in epidemiologic samples.
Article
We report the findings of research conducted a year after an industrial disaster (PCB fire), which occurred on Montreal's South Shore in 1988. A total of 1,663 families were evacuated for a period of 18 days. The study evaluated 174 children between the ages of three and eleven years: 87 in the exposed group and 87 in the control sample. Structured questionnaires were administered to the children and their mothers and fathers during home visits. Based on the responses of the children and the mothers, children aged 6 to 11 years displayed more overall internalized and post-traumatic stress disorder (PTSD) symptoms than did those in the control group. The study demonstrates that the mental health of fathers as well as mothers correlates with children's symptoms and that parents are able to accurately observe their child's reaction to a disaster.
Article
Posttraumatic stress disorder (PTSD) is the most prevalent psychological disorder experienced by Vietnam veterans. However, there are many other disorders and problems of adjustment, like social anxiety and social phobia, that have not been fully investigated in this population. This study examined the prevalence of social phobia and the comorbidity of social phobia and PTSD, and tested out a theory of the etiology of social anxiety in trauma victims. Forty one Vietnam combat veterans were interviewed and completed self-report measures assessing PTSD and social phobia. Adversity of homecoming was also assessed. Using a conservative multi-method assessment approach, 32% of the sample were found to be positive for both social phobia and PTSD. Veterans with PTSD were significantly more likely to carry an additional diagnosis of social phobia as compared to veterans without PTSD. Adversity of homecoming and shame about one's experience in Vietnam were significant predictors of current level of social anxiety over and above the effects of pre-military anxiety and severity of combat exposure. These observations suggest that social anxiety and social phobia may be significant problems among individuals with PTSD. Further, these findings offer preliminary support for the theory that posttrauma environment may impact upon the later development of social anxiety.
Article
To examine the relationship between behavioral inhibition and child psychopathology and measures of family adversity indexed through "expressed emotion." Maternal expressed emotion was assessed via Five-Minute-Speech-Sample in two samples of children evaluated for prevalence of DSM-III disorders and assessed via laboratory observations for behavioral inhibition. The at-risk sample (N = 30) consisted of 4- to 10-year-old children of mothers with and without panic disorder (psychiatric controls). The Kagan sample (N = 41) consisted of children selected at age 21 months as behaviorally inhibited or uninhibited and followed through age 11. In the at-risk sample, child behavioral inhibition was associated with high/borderline maternal criticism, independent of other measures of child psychopathology. In both samples combined, high/borderline maternal criticism was associated with child externalizing symptoms and with the number of child mood and behavior disorders. Emotional overinvolvement was significantly associated with child separation anxiety disorder in the at-risk sample. Results suggest that child behavioral inhibition may be associated with maternal criticism/dissatisfaction and confirm other reports of associations between criticism and child behavior and mood disorders and between emotional overinvolvement and child separation anxiety.