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PTSD more common among children who experienced traumatic event

Children who attended the 2013 Boston marathon were 5.7 times more likely to have attack/manhunt-related posttraumatic stress disorder compared with children who did not attend, according to recent study findings published in Pediatrics.

Jonathan S. Comer, PhD, associate professor of psychology and psychiatry at Florida International University in Miami, and colleagues conducted a survey among 460 parents of children aged 4 to 19 years living within 25 miles of the attack site or Watertown to determine experiences in the week of and following the attack and their psychosocial functioning across the following 2 to 6 months.

On the day of attack, children watched an average of 1.54 hours, and 21% watched more than 3 hours. Thirty-one percent of parents attempted to restrict children’s exposure to coverage of the attack compared with 37.7% who attempted to restrict exposure to coverage of the manhunt.

Attack exposure included attending the marathon; being injured in the attack; directly witnessing injured people; directly witnessing dead bodies; being evacuated during the attack; knowing a person who was injured; and/or knowing a person who was killed. Manhunt exposure included being under the shelter-in-place warning; seeing a heavier police presence in their neighborhood during the manhunt; seeing uniformed service personnel in their neighborhood; seeing officers with guns drawn; hearing manhunt-related gunshots/explosions; seeing manhunt-related gunshots/explosions; seeing manhunt-related blood; having an officer knock on their door related to the manhunt; having an officer enter or search their home; knowing the slain officer; and/or knowing the injured transit officer.

Among children attending the marathon, 25% saw injured people, and the most common attack experience among children present at the marathon was being evacuated. Outcomes were strongly associated with directly witnessing dead bodies.

PTSD symptoms were most commonly associated with seeing dead bodies (P<.001), knowing someone killed (P<.01), knowing someone injured (P<.01), and seeing injured people (P<.05).

Of manhunt-related exposures, PTSD was most commonly associated with seeing or hearing gunshots/explosions (P<.01); seeing manhunt-related blood (P<.05); having an officer enter or search the home (P<.01); and knowing the slain officer (P<.01).

Researchers concluded that attack and manhunt experiences each predicted 9% of the variance in post-attack posttraumatic stress. However, manhunt exposures had a greater association with other psychosocial outcomes compared with attack-related exposures.

“Furthermore, this study demonstrates that the reach of terror and associated fear is not confined to the boundaries of an attack itself; events and community responses that follow can also have considerable impacts on children’s psychological well-being,” they wrote. 

Jonathan S. Comer, PhD, can be reached at 11200 S.W. 8th Street, Center for Children and Families, Department of Psychology, Florida International University, Miami, FL 33199.

Disclosure: The study was funded in part by the Center for Anxiety and Related Disorders Research Fund, the Barlow Research Fund, the Department of Psychology at Boston University and NIH.