Adjustment Among Area Youth After the Boston Marathon Bombing and Subsequent Manhunt

Abstract

WHAT'S KNOWN ON THIS SUBJECT: Research in the aftermath of large-scale terrorist attacks shows that exposed children experience numerous negative psychological sequelae, including increased emotional difficulties, posttraumatic stress, and significant attack-related life disruptions. WHAT THIS STUDY ADDS:Most research on terrorism-exposed youth examines large-scale terrorism. Limited work examines reactions to terrorism of the scope of the marathon attack, and the extraordinary manhunt and shelter-in-place warning was an unprecedented experience. Understanding adjustment after these events is critical.abstract BACKGROUND: The majority of research on terrorism-exposed youth has examined large-scale terrorism with mass casualties. Limited research has examined children' s reactions to terrorism of the scope of the Boston Marathon bombing. Furthermore, the extraordinary postattack interagency manhunt and shelter-in-place warning made for a truly unprecedented experience in its own right for families. Understanding the psychological adjustment of Boston-area youth in the aftermath of these events is critical for informing clinical efforts. METHODS: Survey of Boston-area parents/caretakers (N = 460) reporting on their child's experiences during the attack week, as well as psychosocial functioning in the first 6 attack months. RESULTS: There was heterogeneity across youth in attack-and manhuntrelated experiences and clinical outcomes. The proportion of youth with likely attack/manhunt-related posttraumatic stress disorder (PTSD) was roughly 6 times higher among Boston Marathon-attending youth than nonattending youth. Attack and manhunt experiences each uniquely predicted 9% of PTSD symptom variance, with manhunt exposures more robustly associated than attack-related exposures with a range of psychosocial outcomes, including emotional symptoms, conduct problems, hyperactivity/inattention, and peer problems. One-fifth of youth watched .3 hours of televised coverage on the attack day, which was linked to PTSD symptoms, conduct problems, and total difficulties. Prosocial behavior and positive peer functioning buffered the impact of exposure. CONCLUSIONS: Clinical efforts must maintain a broadened focus beyond simply youth present at the blasts and must also include youth highly exposed to the intense interagency pursuit and manhunt. Continued research is needed to understand the adjustment of youth after mass traumas and large-scale manhunts in residential communities.

Caregiver distress, shared traumatic exposure, and child adjustment among area youth following the 2013 Boston Marathon bombing

“…As reported elsewhere (Comer et al, in press), children’s clinical scores, on average, fell within normative ranges, although parents of Marathon-attending children reported greater posttraumatic stress, conduct problems, peer problems, and total difficulties, and the proportion of youth with likely PTSD was roughly 6 times higher among Marathon-attending, than non-attending, youth.…”

“…Indeed, the present study found caregiver distress significantly predicted greater child posttraumatic stress, overall difficulties, emotional problems, hyperactivity/inattention, peer problems, and lower prosocial behavior even after accounting for the extent to which children and caregivers were exposed to similar potentially traumatic events. These findings also help clarify evidence that children’s responses to disasters are heterogeneous (e.g., Comer et al, in press; Furr et al, 2010; Hoven et al, 2005; La Greca et al, 2013; Shahar, Cohen, Grogan, Barile, & Henrich, 2009). Family factors, such as caregiver distress, appear to explain some of the heterogeneity observed across children’s responses.…”

“…While PTSD is the most commonly assessed outcome following disasters, the present findings add to an emerging body of empirical work suggesting that child conduct can also be adversely affected following exposure to community disasters (e.g., Comer et al, in press; Hoven et al, 2005). Our findings suggest negative outcomes beyond PTSD symptoms are of particular concern among youth with highly distressed caregivers.…”

“…Media coverage was ubiquitous, and those not present at the actual events were repeatedly exposed to the carnage and violence through media-broadcast pictures and videos. One study of the impact of these events on area youth found that 11.3% of Marathon-attending youth exhibited clinically elevated posttraumatic symptoms, with seeing dead bodies or injured people or knowing someone injured or killed associated with the largest increases in PTSD symptoms (Comer et al, in press). In addition, Comer and colleagues found that exposures to potentially traumatic events during the manhunt were even more robustly associated than attack-related exposures with a range of children’s post-event outcomes, including emotional symptoms, conduct problems, hyperactivity/inattention, and peer problems.…”

Investigating the Aftermath of Terror: Fundamental Outcomes, Methodological Choices, and Future Directions

“…Communities should also host "town meetings" in which community members can ask questions to health experts who can respond with suggestions, which can be an effective strategy for dissemination of information (14). Special consideration should be taken when addressing concerns or problems experienced by young children, whose exposure to the incident through the media and constant retelling of events should be limited (15). An important aspect of successful recovery from traumatic events is resuming normal life as soon as possible and using social support to discuss reactions (14).…”