Abstract
This study investigates the impact of several types of exposure to terror attacks on adolescents’ psychological outcomes in the context of ongoing terror. A total of 913 adolescents (51% girls) aged 12 to 18 years (12–13.6 = 33%; 13.7–15.6 = 38%; 15.7–18 = 28%) took part in the study. Detailed data were collected concerning objective, subjective and “mixed” types of exposure to terror, as well as demographics, post-traumatic stress symptoms (PTSS), emotional and behavioral problems and overall psychological and psychiatric difficulties. Subjective exposure was found to be the most important contributor to adolescents’ post-traumatic stress and other mental health problems in this context. Gender also had important effects. The effects of objective and mixed types of exposure, as well as age, were less prominent. We did find, however, that the more adolescents consulted media, the less they experienced behavioral and emotional problems. Given that subjective experiences appear to be the best factor in explaining mental health outcomes when adolescents are confronted with persistent terror, the cognitive and emotional dynamics along with the coping behavior linked to such experiences merit further investigation.
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Aber, J. L., Gershoff, E. T., Ware, A., & Kotler, J. A. (2004). Estimating the effects of September 11th and other forms of violence on the mental health and social development of New York City’s youth: A matter of context. Applied Developmental Science, 8(3), 111–129. doi:10.1207/s1532480xads0803_2.
Achenbach, T. M., & Rescorla, L. A. (2001). Manual for the ASEBA school-age forms and profiles. Burlington, VT: University of Vermont, Research Center for Children, Youth & Families.
Butler, L. D. (2007). Growing pains: Commentary on the field of posttraumatic growth and Hobfoll and colleagues’ recent contributions to it. Applied Psychology, 56(3), 367–378. doi:10.1111/j.1464-0597.2007.00293.x.
Celestin, L. P., & Celestin-Westreich, S. (2008). How to FACE© polydrug use: Pathways toward an integrative structured care model to facilitate adjustment of cognitions and emotions. European Psychiatry, 23(2), S244–S245. doi:10.1016/j.eurpsy.2008.01.468.
Celestin-Westreich, S., & Celestin, L. P. (2008a). Observeren en Rapporteren [Observing and reporting]. Amsterdam: Pearson Education Benelux.
Celestin-Westreich, S., & Celestin, L. P. (2008b). Processus d’ajustements cognitivo-émotionnels familiaux face au TDAH. Annales Medico-Psychologiques, 166(5), 343–349. Families’ cognitive-emotional adjustment processes when facing Attention-Deficit/Hyperactivity Disorder (ADHD). doi:10.1016/j.amp.2005.06.008.
Celestin-Westreich, S., & Celestin, L. P. (2008, in press). Kind, Jeugd-en Gezinsdiagnostiek in FACE © -perspectief [Child, youth and family assessment in FACE©-perspective]. Leuven: ACCO.
Celestin-Westreich, S., Petillo, M., van den Broeck, W., & Celestin, L. P. (2007). How to FACE © developmental trauma and loss: Coping and mental health outcomes among refugee adolescents in a Belgian Federal Refugee Centre. Abstract Book of the Belgian Cognitive Psychopathology Meeting, Leuven, Belgium.
Derogatis, L. R. (1993). Brief symptom inventory administration, scoring and procedure manual. NCS Pearson, Inc: Minneapolis.
Fremont, W. P., Pataki, C., & Beresin, E. V. (2005). The impact of terrorism on children and adolescents: Terror in the skies, terror on television. Child and Adolescent Psychiatric Clinics of North America, 14(3), 429–451. doi:10.1016/j.chc.2005.02.001.
Gil, S. (2005). Coping style in predicting posttraumatic stress among Israeli students. Anxiety, Stress, and Coping, 18(4), 351–359. doi:10.1080/10615800500392732.
Hoven, C. W., Duarte, C. S., Lucas, C. P., Mandel, D. J., Wu, P., & Rosen, C. (2002). Effects of the World Trade Center attack on NYC Public School students: Initial Report of the New York Board of Education. New York: Applied Research and Consulting, LLC & Columbia University Mailman School of Public Health & New York State Psychiatric Institute.
Hoven, C. W., Duarte, C. S., Ping, W., Erickson, E. A., Musa, G. J., & Mandell, D. J. (2004). Exposure to trauma and separation anxiety in children after the WTC attack. Applied Developmental Science, 8(4), 172–183. doi:10.1207/s1532480xads0804_1.
Joshi, P. T., & O’Donnell, D. A. (2003). Consequences of child exposure to war and terrorism. Clinical Child and Family Psychiatry Review, 6(4), 275–292. doi:10.1023/B:CCFP.0000006294.88201.68.
Koplewicz, H. S., Vogel, J. M., Solanto, M. V., Morrissey, R. F., Alonso, C. M., Abikoff, H. A., et al. (2002). Child and parent response to the 1993 World Trade Center bombing. Journal of Traumatic Stress, 15(1), 77–85. doi:10.1023/A:1014339513128.
Laufer, A., & Solomon, Z. (2003). Coping of Israeli children with the events of terror. The role of values and the social support in the area of the stressful events. In M. Caspi (Ed.), Children’s anxiety as a result of the terror events (pp. 4–7). Jerusalem: Israeli Knesset, research and information center (Hebrew).
Lengua, L. J., Long, A. C., Smith, K. I., & Meltzoff, A. N. (2005). Pre-attack symptomatology and temperament as predictors of children’s responses to the September 11 terror attacks. Journal of Child Psychology and Psychiatry, and Allied Disciplines, 46(6), 631–645. doi:10.1111/j.1469-7610.2004.00378.x.
Pat Horenczyk, R. (2003). The impact of ongoing terror attacks on the adolescent population in Jerusalem and the Jerusalem area. In M. Caspi (Ed.), Children’s anxiety as a result of the terror events (pp. 8–10). Jerusalem: Israeli Knesset, Research and Information Center (Hebrew).
Pat Horenczyk, R. (2005). Post-traumatic distress in adolescents exposed to ongoing terror: Findings from school-based screening project in the Jerusalem Area. In Y. Daniely & D. Brom (Eds.), The trauma of terrorism: sharing knowledge and shared care. Haworth Press.
Pat Horenczyk, R., & Doppelt, O. (2005). Screening for post traumatic distress among adolescents who are exposed to ongoing terror in Israel. In E. Somer & A. Bleich (Eds.), Mental health in terror’s shadow: The Israeli experience (pp. 55–76). Ramot Press. Tel-Aviv University (Hebrew).
Pat-Horenczyk, R., Peled, O., Miron, T., Brom, D., Villa, Y., & Chemtob, C. M. (2007). Risk-taking behaviors among Israeli adolescents exposed to recurrent terrorism: Provoking danger under continuous threat? The American Journal of Psychiatry, 164, 66–72. doi:10.1176/appi.ajp.164.1.66.
Pfefferbaum, B., Nixon, S., Krug, R., Tivis, R., Moore, V., Brown, J., et al. (1999a). Clinical needs assessment of middle and high school students following the 1995 Oklahoma City bombing. The American Journal of Psychiatry, 156, 1069–1074.
Pfefferbaum, B., Nixon, S., Tucker, P., Tivis, R., Moore, V., Gurwitch, R. H., et al. (1999b). Posttraumatic stress responses in bereaved children after the Oklahoma City bombing. Journal of the American Academy of Child and Adolescent Psychiatry, 38, 1372–1379. doi:10.1097/00004583-199911000-00011.
Pfefferbaum, B., Nixon, S. J., Tivis, R. D., Doughty, D. E., Pynoos, R. S., Gurwitch, R. H., et al. (2001). Television exposure in children after a terror incident. Psychiatry, 64(3), 202–211.
Pfefferbaum, B., Doughty, D. E., Peddy, C., Patel, N., Gurwitch, R., Nixon, S. J., et al. (2002). Exposure and peritraumatic response as predictors of posttraumatic stress in children following the 1995 Oklahoma City bombing. Journal of Urban Health, 79(3), 354–361. doi:10.1093/jurban/79.3.354.
Pfefferbaum, B., North, C. S., Doughty, D. E., Gurwitch, R. H., Fullerton, C. S., & Kyula, J. (2003). Posttraumatic stress and functional impairment in Kenyan children following the 1998 American embassy bombing. The American Journal of Orthopsychiatry, 73(2), 133–140. doi:10.1037/0002-9432.73.2.133.
Pynoos, R. S., & Eth, S. (1985). Children traumatized by witnessing acts of personal violence: Homicide, rape or suicide behavior. In S. Eth & R. S. Pynoos (Eds.), Post-traumatic stress disorder in children. Washington DC: American Psychiatric Press.
Ronen, T., Rahav, G., & Appel, N. (2003). Adolescent stress responses to a single acute stress and to continuous external stress: Terror attacks. Journal of Loss and Trauma, 8, 261–282. doi:10.1080/15325020305878.
Rosenberg, A., Heimberg, R. G., Solomon, Z., & Levin, L. (2008). Investigation of exposure–symptom relationships in a context of recurrent violence. Journal of Anxiety Disorders, 22(3), 416–428. doi:10.1016/j.janxdis.2007.05.003.
Schiff, M. (2005). Living in the shadow of terrorism: Psychological distress and alcohol use among religious and non-religious adolescents in Jerusalem. Social Science & Medicine, 62(9), 2301–2312. doi:10.1016/j.socscimed.2005.10.016.
Schiff, M., Zweig, H. H., Benbenishty, R., & Hasin, D. S. (2007). Exposure to terrorism and Israeli Youths’ cigarette, alcohol, and cannabis use. American Journal of Public Health, 97(10), 1852–1858. doi:10.2105/AJPH.2006.090514.
Sever, I., Somer, E., Ruvio, A., & Soref, E. (2008). Gender, distress, and coping in response to terrorism. Affilia, 23(2), 156–166. doi:10.1177/0886109908314317.
Solomon, Z., & Lavi, T. (2005). Israeli youth in the second Intifada: PTSD and future orientation. Journal of the American Academy of Child and Adolescent Psychiatry, 44(11), 1167–1175. doi:10.1097/01.chi.0000161650.97643.e1.
Solomon, Z., Laufer, A., & Lavi, T. (2005). In the shadow of the Intifada: Exposure and post traumatic reactions among adolescents in Israel. In E. Somer & A. Bleich, (Eds.), Mental health in terror’s shadow: The Israeli experience (pp.77–107). Ramot Press. Tel-Aviv University. (Hebrew)
Taylor, S. F., & Liberzon, I. (2007). Neural correlates of emotion regulation in psychopathology. Trends in Cognitive Sciences, 11(10), 413–418. doi:10.1016/j.tics.2007.08.006.
Tull, M. T., Barrett, H. M., McMillan, E. S., & Roemer, L. (2007). A Preliminary investigation of the relationship between emotion regulation difficulties and posttraumatic stress symptoms. Behavior Therapy, 38(3), 303–313. doi:10.1016/j.beth.2006.10.001.
Wooding, S., & Raphael, B. (2004). Psychological impact of disasters and terrorism on children and adolescents: Experiences from Australia. Prehospital and Disaster Medicine, 19(1), 10–20.
Zeidner, M. (2005). Contextual and personal predictors of adaptive outcomes under terror attack: The case of Israeli adolescents. Journal of Youth and Adolescence, 34(5), 459–470. doi:10.1007/s10964-005-7263-y.
Acknowledgments
A subset of the current findings was communicated at the 2004 World Congress of the International Association for Child and Adolescent Psychiatry and Allied Professions. This study was part of a doctoral dissertation conducted by Orna Braun-Lewensohn and supervised by Smadar Celestin-Westreich. This research was supported in part by Doctoral Funds of the Vrije Universiteit Brussel, Belgium. We wish to express our thanks to the adolescents and school administrators who participated in this project.
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Braun-Lewensohn, O., Celestin-Westreich, S., Celestin, LP. et al. Adolescents’ Mental Health Outcomes According to Different Types of Exposure to Ongoing Terror Attacks. J Youth Adolescence 38, 850–862 (2009). https://doi.org/10.1007/s10964-008-9305-8
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DOI: https://doi.org/10.1007/s10964-008-9305-8