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Air Today . . . Gone Tomorrow Article Response of New York public school children
to September 11
Medical News Today, May 3, 2005
Six months after the September 11, 2001 attack on the World Trade Center, a high
proportion of New York City school children had one or more probable
anxiety/depressive disorders, according to an article in the May issue of
Archives of General Psychiatry, one of the JAMA/Archives journals.
The psychological consequences of a terror attack may be particularly great for
children who are exposed to the traumatic event, according to background
information in the article. Previous studies have shown that children exposed to
mass trauma have elevated post-traumatic stress disorder (PTSD) symptoms as well
as symptoms of anxiety and depression.
Christina W. Hoven, Dr.P.H., of the Columbia University Medical Center-New York
State Psychiatric Institute, New York, and colleagues interviewed a large
representative sample of New York City public school children enrolled in fourth
through 12th grade, six months following the World Trade Center (WTC) attack,
determining their level of exposure to the event as well as assessing them for
eight probable mental disorders. Level of exposure was divided into the
following categories: attendance at a ground zero school; severe exposure,
defined as having two or more direct or one or more family exposures; moderate
exposure, one direct and no family exposure; mild exposure, no direct or family
exposure; and media exposure, having spent "a lot of time" watching television
coverage. Direct exposure consisted of witnessing the attack, being hurt in the
attack, in or near the cloud of dust and smoke, evacuated to safety or being
extremely worried about a loved one. Family exposure was having one or more
family member killed or injured in the attack or witnessing the attack but
escaping unharmed.
One or more of six probable anxiety or depressive disorders were identified in
28.6 percent of the 8,236 children assessed, the researchers found. The most
prevalent were probable agoraphobia (14.8 percent, fear of public places where
escape may be difficult), probable separation anxiety (12.3 percent, fear of
being away from parents or family) and probable post-traumatic stress disorder
(10.6 percent). Higher levels of exposure corresponded to higher prevalence for
all probable anxiety/depressive disorders.
"This study had six main findings," the authors report. First, six months after
the WTC attack, a high proportion of New York City public school children had a
probable mental disorder. Second, the severity of exposure to September 11 was
related to the likelihood of having one or more of the eight probable disorders
assessed. Third, that a wide range of probable mental disorders was elevated, in
addition to PTSD. Fourth, that family exposure to the WTC attack was associated
with probable mental disorder, even more strongly than direct exposure. The
authors suggest some children may experience greater emotional impact from
having a family member exposed than from being directly exposed themselves.
"The fifth main finding was that going to a school near the place of the near
the place of the attack was associated with lower rates of probable mental
disorder," the authors write. "This somewhat surprising finding may possibly be
explained by a combination of factors, such as worldwide attention to their
situation, increased social support, and the fact that students in the ground
zero area schools were the recipients of significant mental health intervention
immediately after September 11, 2001."
"The sixth main finding was that exposure to trauma prior to the WTC attack was
a major risk factor for a post-September 11 probable mental disorder," the
researchers found. "Thinking prospectively, this finding is of considerable
public health significance since a significant proportion of New York City
children have now experienced a major trauma (September 11), rendering them more
vulnerable to mental disorders in the future, especially following any new
disaster. Interventions to mitigate the effects of prior trauma, including
September 11, have now, therefore, become substantially more important."
(Arch Gen Psychiatry. 2005; 62:545-552. Available post-embargo at http://www.archgenpsychiatry.com)
Editor's Note: The U.S. Department of Education School Emergency Response to
Violence (SERV) Project funded the data collection. The Epidemiology Department,
Mailman School of Public Health, Columbia University; the New York State
Psychiatric Institute; and the Centers for Disease Control and Prevention
provided personnel and material support pro bono.
http://www.medicalnewstoday.com/medicalnews.php?newsid=23710
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