A school based study of psychological disturbance in children following the Omagh bomb

Abstract

ObjectiveTo assess the extent and nature of psychiatric morbidity among children (aged 8 to 13 years) 15 months after a car bomb explosion in the town of Omagh, Northern Ireland.MethodA survey was conducted of 1945 school children attending 13 schools in the Omagh district. Questionnaires included demographic details, measures of exposure, the Horowitz Impact of Events Scale, the Birleson Self-Rating Depression Scale, and the Spence Children’s Anxiety Scale.ResultsChildren directly exposed to the bomb reported higher levels of probable PTSD (70%), and psychological distress than those not exposed. Direct exposure was more closely associated with an increase in PTSD symptoms than in general psychiatric distress. Significant predictors of increased IES scores included being male, witnessing people injured and reporting a perceived life threat but when co-morbid anxiety and depression are included as potential predictors anxiety remains the only significant predictor of PTSD scores.ConclusionsSchool-based studies are a potentially valuable means of screening and assessing for PTSD in children after large-scale tragedies. Assessment should consider type of exposure, perceived life threat and other co-morbid anxiety as risk factors for PTSD.

The effects of the Omagh bomb on adolescent mental health: a school-based study

“…The results suggest that level or type of exposure to potentially traumatic events predicts general emotional distress but more specifically predicts probable PTSD in young people. The difference can be observed in the chart (Figure 1 ) and is consistent with the findings in the Omagh bombing adult [ 3 ] and children studies [ 4 ] and other studies of adolescent PTSD after traumatic events [ 11 - 13 ]. An interesting question posed by Trickey and colleagues [ 5 ] is how to distinguish between different levels of trauma severity.…”

“…Our finding that “seeing people you thought were dying” was a significant predictor of PDS scores but “seeing people you thought were dead” was not significant suggests that there may be idiosyncratic features of a trauma that are more relevant to predicting risk. Interestingly, in the study of younger children after the Omagh bomb [ 4 ] the only exposure factor from a similar list that was found to be significant was “seeing people injured”.…”

“…Many more were exposed to the scenes of death, injury and destruction after the explosion. The local Health and Social Care Trust decided to assess the psychological effects of the bombing through three studies; an adult community study [ 3 ], a school based children study [ 4 ] and a school based adolescent study. This paper presents the findings of the adolescent study.…”

PROTOCOL: Psychosocial interventions for preventing PTSD in children exposed to war and conflict‐related violence: A systematic review

“…A systematic review of the effect of war or conflict related violence on young children (age 0–6) found that prevalence of either PTSD or PTSS ranged from 8% to 45% (Slone & Mann, 2016 ). PTSD is the most common mental‐health condition associated with exposure to war, conflict or political violence (Attanayake et al, 2009 ; Betancourt, Borisova, et al, 2013 ; Dimitry, 2012 ; McDermott, Duffy, Percy, Fitzgerald & Cole, 2013 ; Slone & Mann, 2016 ).…”

“…The exact nature of the relationship between age, gender and PTSD is unclear. There is some evidence suggesting that girls are at greater risk than boys because they may have higher levels of rumination or pre‐trauma anxiety (McDermott et al, 2013 ), girls may be more likely to experience greater subjective exposure than boys, but boys may exhibit more externalizing problems in response to trauma such as increased aggression (Dimitry, 2012 ). It may be that this different pattern of response in boys and girls reflects socially constructed gendered norms of appropriate behaviour and inequitable distribution of power and agency between boys and girls, but gender inequalities are understudied in the context of war and conflict and trauma more generally (Gilfus, 1999 ).…”