Responding to the Psychological Needs of Children after 9/11: A Review of the Literature (original) (raw)
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Determinants of Counseling for Children in Manhattan After the September 11 Attacks
Psychiatric Services, 2002
C hildren were not spared from the September 11 terrorist attacks on the World Trade Center and the Pentagon. Eight children died on the airplanes that crashed into the World Trade Center and in the Pennsylvania countryside. Thousands of children were directly affected-by losing a parent or other family member, being displaced from their home, or being evacuated from their school. All told, 6,000 children experienced significant disruptions to their daily routines as a result of school closures (1). A considerable number of children witnessed the events directly (2), and countless more watched the replaying of dramatic footage in news broadcasts. Although studies of the impact of trauma typically examine the effect on direct victims (3,4), the unprecedented magnitude of the September 11 attacks has led to concerns that the psychological sequelae will be substantial and enduring in the general population of New York City (5). Studies suggest that the psychological sequelae among children is pronounced (6,7). Disaster mental health models emphasize the importance of early crisis intervention and supportive services (8). Although data on the effects of the September 11 attacks on adults' and children's mental health are being reported (5,6,9), data on the use of services after the attacks are sparse. It is not known what effect parents' reac
Young children's responses to September 11th: The New York City experience
Infant Mental Health Journal, 2009
Although the knowledge base regarding very young children's responses to trauma has been expanding, descriptions of their responses to terrorism remain sparse. Yet, their vulnerability makes this an important group to study. Recent events in the United States (9/11, Hurricane Katrina) make this question highly relevant. This study aims to provide extensive descriptions of how children 5 years or younger on September 11th who were living in close proximity to Ground Zero responded that day and in the following months. Sixty-seven New York City parents (with 104 children) participated in focus groups between November 2001 and May 2002. Focus groups also provided a foundation for an in-depth study examining young children's adaptation following 9/11 and changes in parenting behaviors after the disaster. Findings on children's behavioral and emotional reactions on 9/11 and in the 8 months after as well as their need to return to normalcy are reported. Consistent with current understanding of trauma symptoms in young children, parents reported behaviors including chronic sleep disruptions, fearful reactions, development of new fears, and increased clinginess and separation anxiety following the disaster. On the actual day, children's responses were described as ranging from calm and cooperative to difficult and panicky. Implications for working with parents and young children affected by terrorism or community-level trauma and directions for future research are discussed. RESUMEN: Aunque se ha expandido el conocimiento básico acerca de las respuestas de los niños muy pequeños al trauma, las descripciones de sus respuestas al terrorismo son escasas. Y a pesar de todo, su vulnerabilidad hace deéste un importante grupo para el estudio. Eventos recientes en los Estados Unidos (el 11 de septiembre, el huracán Katrina) hacen que esta pregunta resulte altamente relevante. Este estudio This research was funded by a Barnard College Faculty Grant and by the National Institute of Mental Health RO1 MH66462-01. The authors acknowledge and thank the families and preschools involved in this study for their time, willingness to participate, and openness during a particularly difficult time following the events of 9/11.
Disaster in Context: The Effects of 9/11 on Youth Distant from the Attacks
Community Mental Health Journal, 2010
Although an increasing amount of community mental health research has investigated the deleterious effects of disasters and the targeting and efficacy of treatment in their aftermath, little research has sought to identify preexisting characteristics of the social environment that are predictive of post-disaster distress. A national US telephone survey fielded before and after September 11, 2001, was used to investigate the psychological distress among American adolescents related to the attacks, and to identify environmental and other characteristics that predisposed youth to experience higher or lower levels of post-disaster distress. The study found that widespread characteristics of children’s school environments—school disorder and physical threats—were at least as strongly associated with a proxy for psychological distress as exposure to the events of 9/11. Further, children exposed to physical threats at school appeared to be more vulnerable to the psychological effects of disasters than children in safer school environments.
The Mental Health Impact of 9/11 on Inner-City High School Students 20 Miles North of Ground Zero
Journal of Adolescent Health, 2006
Purpose: To determine the rate of post-traumatic stress disorder (PTSD) after 9/11 in a sample of New York City high school students and associations among personal exposure, loss of psychosocial resources, prior mental health treatment, and PTSD. Methods: A total of 1214 students (grades 9 through 12) attending a large community high school in Bronx County, 20 miles north of "Ground Zero," completed a 45-item questionnaire during gym class on one day eight months after 9/11. Students were primarily Hispanic (62%) and African American (29%) and lived in the surrounding neighborhood. The questionnaire included the PCL-T, a 17-item PTSD checklist supplied by the Office of Behavioral and Social Science Research of the National Institutes of Health (NIH). The PCL-T was scored following the DSM-IV criteria for PTSD requiring endorsement of at least one repeating symptom, two hyperarousal symptoms, and three avoidance symptoms. Bivariate analysis comparing PTSD with personal exposure, loss of psychosocial resources, and mental health variables was done and multiple logistic regression was used to identify significant associations. Results: There were 7.4 % of students with the PTSD symptom cluster. Bivariate analysis showed a trend for females to have higher rates of PTSD (males [6%] vs. females [9%], p ϭ .06] with no overall ethnic differences. Five of the six personal exposure variables, and both of the loss of psychosocial resources and mental health variables were significantly associated with PTSD symptom cluster. Multiple logistic regression analysis found one personal exposure variable (having financial difficulties after 9/11, odds ratio [OR] ϭ 5.27; 95% confidence interval [CI] 2.9 -9.7); both the loss of psychosocial resources variables (currently feeling less safe, OR ϭ 3.58; 95% CI 1.9 -6.8) and currently feeling less protected by the government, (OR ϭ 4.04; 95% CI 2.1-7.7); and one mental health variable (use of psychotropic medication before 9/11, OR ϭ 3.95; 95% CI 1.2-13.0) were significantly associated with PTSD symptom cluster. Conclusions: We found a rate of PTSD in Bronx students after 9/11 that was much higher than other large studies of PTSD in adolescents done before 9/11. Adolescents living in inner cities with high poverty and violence rates may be at high risk for PTSD after a terrorist attack. Students who still felt vulnerable and less safe eight months later and those with prior mental health treatment were four times more likely to have PTSD than those without such characteristics, highlighting the influence of personality and mental health on development of PTSD after a traumatic event.
Journal of Clinical Child & Adolescent Psychology, 2010
In the aftermath of disasters, understanding relationships between disaster-related life disruption and children's functioning is key to informing future postdisaster intervention efforts. The present study examined attack-related life disruptions and psychopathology in a representative sample (N = 8,236) of New York City public schoolchildren (Grades 4-12) surveyed 6 months after September 11, 2001. One in 5 youth reported a family member lost their job because of the attacks, and 1 in 3 reported their parents restricted their postattack travel. These forms of disruption were, in turn, associated with elevated rates of probable posttraumatic stress disorder and other anxiety disorders (and major depressive disorder in the case of restricted travel). Results indicate that adverse disaster-related experiences extend beyond traumatic exposure and include
Children’s response to terrorism: A critical review of the literature
Current Psychiatry Reports, 2003
The advent of major terrorist assaults has ushered in a sense of insecurity and vulnerability heretofore unknown in the US. There is information about the impact of disasters and trauma on children, but relatively little data on the effects of terrorism. The events of September 11, 2001 have underscored the need to examine this issue. This report summarizes recent studies that address the impact of terrorist incidents on children, and examines issues related to mental health services for children in the post-attack environment. Work related to the 1993 bombing of the World Trade Center, the 1995 bombing of the Alfred P. Murrah Federal Building in Oklahoma City, the 1998 bombing of the American Embassy in Nairobi, Kenya, and the September 11 attacks are reviewed. This article indicates significant challenges in the identification, evaluation, and treatment of children potentially in need of attention.
Pediatrics, 2004
The objectives of this study were to describe the prevalence of counseling services, contrasted with the need after the terrorist attacks of September 11, 2001, the types of counseling received, and the predictors of receipt of counseling services. A cross-sectional, random-digit-dial survey was conducted in New York City (NYC) of parents (N = 434) of children who were 4 to 17 years of age 4 months after the September 11th terrorist attacks on the World Trade Center. Overall, 10% of NYC children received some type of counseling after the September 11th attacks, according to parental report. Among these, 44% received counseling in schools, 36% received counseling from medical or professional providers, and 20% received counseling from other sources. However, only 27% of the children who had severe/very severe posttraumatic stress reactions (PTSR) after the attacks received counseling services. In a multivariate model, receipt of counseling before the September 11th attacks (odds rati...