Children's Mental Health in the Context of Terrorist Attacks, Ongoing Threats, and Possibilities of Future Terrorism

Understanding the impact of extreme terrorist events on evacuees and non-evacuees: A study on child aggression and social problems

This study aimed to examine differences between evacuee and non-evacuee parents regarding their experiences following the October 7th terror attack in Israel, and to assess how parental factors-such as exposure, PTS, functioning, resilience, and trust in authorities-were related to perceived behavioral problems in children. The study included 221 evacuee parents and 262 non-evacuee parents, recruited online through a professional survey company. We hypothesized that perceived child aggression and social problems would increase following the terrorist events, with evacuee parents reporting a greater increase in symptoms due to heightened instability and stress. Additionally, we expected higher levels of parental exposure, PTS, impaired functioning, lower resilience, and lower trust in authorities to be associated with increased child aggression and social problems. Results indicated that evacuee parents reported significantly more perceived aggression and social problems in their children, along with lower functioning, higher PTS, and lower trust in authorities. However, regression analysis revealed that higher parental exposure, PTS, and lower functioning were associated with increased perceived child aggression and social problems, regardless of evacuee status. These findings highlight the need for targeted interventions to support evacuated families, rebuild trust in authorities, and strengthen community resilience to mitigate long-term impacts.

Terrorism and post-traumatic stress disorder: a historical review

Terror is a psychological state. Historically, most studies of terrorism focused on its societal purpose and structural consequences rather than mental health effects. That emphasis began to change shortly before the Sept 11, 2001, terrorist attacks. A vast expansion of research into post-traumatic stress disorder accompanied revisions to the classification of mental health disorders. The effect of terrorist incidents on those people now deemed vulnerable, both directly and indirectly, was actively sought. However, a review of more than 400 research articles (mostly published after Sept 11) on the association between terrorism and mental health reached the largely overlooked conclusion that terrorism is not terrorising-at least not in a way that causes a greater than expected frequency of post-traumatic stress disorder than other traumatic events. This conclusion is surprising given the emphasis on the psychological effects of terrorism in political discourse, media commentary, contemporary culture, and academic inquiry. Authorities might prefer to encourage an interpretation of terrorist incidents that highlights fortitude and courage rather than psychological vulnerability.

Early Phase Psychiatric Response for Children and Adolescents After Mass Trauma: Lessons Learned From the Truck-Ramming Attack in Nice on July 14th, 2016

Recent years have seen a multiplication of terrorist attacks in public places across European and North American countries, thus heightening the need for public mental health planning and response strategies focused on the special needs of children and their families. The present article retrospectively analyzes the early phase psychiatric response for children and adolescents after the truck attack in Nice on July 14th, 2016. In addition, lessons which can be drawn from it will be discussed, with a focus on organizational challenges in the early phase. During the first 2 weeks after the attack, 668 individuals have been registered at the medico-psychological emergency unit of the Children's Hospitals of Nice, including 365 (54.6%) children and adolescents of all ages. Overall, 146 child and adolescent mental health care professionals participated in this specific facility, including 75 psychiatrists and psychologists. The implementation of the medico-psychological emergency unit dedicated to the pediatric population has been an indispensable and unprecedented public health challenge in our country. Future studies are needed in order to evaluate and to improve the efficiency of the individual as well as collective impact of early phase psychiatric interventions dedicated for children and adolescents after mass trauma.

A latent profile analysis of co-occurring youth posttraumatic stress and conduct problems following community trauma

Although most research with youth exposed to violent manmade disasters has focused on internalizing problems, recent work suggests conduct problems (CPs) may also manifest in exposed youth. However, the extent to which youth postevent CPs present independently, versus co-present in conjunction with PTSD symptoms, remains unclear. The present study examined PTS and CP symptom profiles among affected Boston-area youth following the 2013 Boston Marathon bombing. This study used latent profile analysis to identify distinct PTS and CP symptom profiles among Boston-area youth ages 4-19 years (N=344) affected by the Boston Marathon bombing events. PTS and CPs were measured using the UCLA-PTSD-RI and the SDQ parent reports, respectively. Analyses identified 3 distinct profiles: presentations characterized by (a) low PTS, low CPs, (b) moderate PTS, low CPs, and (c) high PTS, elevated CPs. The profile characterized by the highest PTS was the only profile with elevated CPs; hyperarousal and emotional numbing/avoidance symptoms showed the greatest distinguishing properties among profiles with and without elevated CP. Types of traumatic exposure experienced by youth were differentially associated with profiles. Specifically, direct (but not relational) exposure distinguished youth classified in the profile showing elevated CPs. Findings suggest interventions following violent manmade disasters may do well to incorporate CP modules when working with youth showing the greatest hyperarousal and emotional numbing, and/or who have directly witnessed the most violence.