Hostname: page-component-8448b6f56d-t5pn6 Total loading time: 0 Render date: 2024-04-18T22:30:19.486Z Has data issue: false hasContentIssue false
  • English
  • Français

Parent-Reported Child Reactions to the September 11, 2001 World Trade Center Attacks (New York USA) in Relation to Parent Post-Disaster Psychopathology Three Years After the Event

Published online by Cambridge University Press:  08 October 2018

Betty Pfefferbaum Open the ORCID record for Betty Pfefferbaum [Opens in a new window] ,
Zorica Simic  and
Carol S. North
Betty Pfefferbaum*
Affiliation:
Department of Psychiatry and Behavioral Sciences, College of Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, OklahomaUSA
Zorica Simic
Affiliation:
Department of Psychiatry, The University of Texas Southwestern Medical Center, Dallas, TexasUSA
Carol S. North
Affiliation:
Metrocare Services and Department of Psychiatry, The University of Texas Southwestern Medical Center, Dallas, TexasUSA
*
Correspondence: Betty Pfefferbaum, MD, JD Department of Psychiatry and Behavioral Sciences College of Medicine University of Oklahoma Health Sciences Center 920 Stanton L. Young Boulevard, WP 3417 Oklahoma City, Oklahoma USA 73126-0901 E-mail: betty-pfefferbaum@ouhsc.edu
Get access Rights & Permissions [Opens in a new window]

Abstract

Introduction

Parents are a primary support for children following disasters, even though they face numerous challenges in addressing the physical and social consequences of an event. Parents who are directly exposed to a disaster and those who develop psychiatric disorders post-event are likely to be especially challenged and may be limited in their ability to support their children. This Brief Report describes a pilot study of survivors of the September 11, 2001 World Trade Center (New York USA) attacks who reported their own psychosocial consequences and the reactions of their children three years post-event.

Hypotheses

The primary hypothesis of the study was that children’s September 11th reactions would be associated with their parents’ psychiatric status. Secondary hypotheses were that the children’s disaster reactions would be associated with direct exposure to the disaster in children and/or their parents, parent-child separation due to the disaster, and disaster-related school absence.

Methods

Approximately three years after the 2001 World Trade Center attacks, 116 parents recruited from disaster-affected or disaster-related organizations were assessed using structured diagnostic interviews and queried about their children’s (188 youths, aged three to 17 years at the time of the attacks) posttraumatic stress symptoms and behavioral changes.

Results

Almost one-half of the parents had a post-disaster psychiatric disorder, including major depression in 27% and disaster-related posttraumatic stress disorder (PTSD) in 11%. More than three-fourths of the children had at least one disaster-related posttraumatic stress symptom, and more than one-half experienced at least one post-disaster behavior change. A minority of the children were reported to have increased school behavior problems or a decline in their grades. Key correlates of children’s disaster-related posttraumatic stress symptoms and post-disaster behavior changes were parent-child separation due to the disaster and parental post-disaster psychiatric disorders.

Conclusion

Because parents provide primary caretaking and support for children post-disaster, addressing the needs of parents is critical to their ability to assist their children. Reducing parents’ symptoms should increase their emotional availability and enhance their ability to address the needs of their children. Given the challenges in providing disaster interventions directly to children, especially when resources are limited, addressing parent psychopathology and distress (even in the absence of focusing on children’s symptoms) may benefit children.

PfefferbaumB, SimicZ, NorthCS. Parent-Reported Child Reactions to the September 11, 2001 World Trade Center Attacks (New York USA) in Relation to Parent Post-Disaster Psychopathology Three Years After the Event. Prehosp Disaster Med. 2018;33(5):558–564.

Keywords

childrendisasterparentsSeptember 11 attacksterrorism
Type
Brief Report
Information
Prehospital and Disaster Medicine , Volume 33 , Issue 5 , October 2018 , pp. 558 - 564
Copyright
© World Association for Disaster and Emergency Medicine 2018 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Footnotes

Conflicts of interest/funding: This research was supported in part by the Oklahoma City National Memorial Institute for the Prevention of Terrorism (MIPT; Oklahoma City, Oklahoma USA) and Office of Justice Programs, National Institute of Justice (Washington, DC USA), Department of Justice award MIPT106-113-2000-020 (Dr. Pfefferbaum); and by the National Institute of Mental Health (NIMH; Bethesda, Maryland USA) grant MH68853 (Dr. North). The authors report no conflicts of interest which might be interpreted as influencing the research or compromising ethical standards. Points of view in this document are those of the authors and do not necessarily represent the official position of MIPT, NIMH, US Department of Justice, University of Oklahoma Health Sciences Center (Oklahoma City, Oklahoma USA), Metrocare Services (Dallas, Texas USA), or The University of Texas Southwestern Medical Center (Dallas, Texas USA).

References

1. Fremont, WP. Childhood reactions to terrorism-induced trauma: a review of the past 10 years. J Am Acad Child Adolesc Psychiatry. 2004;43(4):381-392.Google Scholar
2. Norris, FH, Friedman, MJ, Watson, PJ, Byrne, CM, Diaz, E, Kaniasty, K. 60,000 disaster victims speak: Part I. An empirical review of the empirical literature, 1981-2001. Psychiatry 2002;65(3):207-239.Google Scholar
3. Bonanno, GA, Brewin, CR, Kaniasty, K, La Greca, AM. Weighing the costs of disaster: consequences, risks, and resilience in individuals, families, and communities. Psychol Sci Public Interest. 2010;11(1):1-49.Google Scholar
4. North, CS, Pollio, DE, Smith, RP, et al. Trauma exposure and posttraumatic stress disorder among employees of New York City companies affected by the September 11, 2001 attacks on the World Trade Center. Disaster Med Public Health Prep. 2011;5:S205-S213.Google Scholar
5. Robins, LN, Cottler, LB, Compton, WM, Bucholz, K, North, CS, Rourke, KM. Diagnostic Interview Schedule for the DSM-IV (DIS-IV). St. Louis, Missouri USA: Washington University; 2000.Google Scholar
6. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders. Fourth Edition, Text Revision. Washington DC, USA: American Psychiatric Association; 2000.Google Scholar
7. North, CS, Pfefferbaum, B, Robins, LN, Smith, EM. The Disaster Supplement to the Diagnostic Interview Schedule for DSM-IV (DIS-IV/DS). St. Louis, Missouri USA: Washington University; 2001.Google Scholar
8. Lambert, JE, Holzer, J, Hasbun, A. Association between parents’ PTSD severity and children’s psychological distress: a meta-analysis. J Trauma Stress. 2014;27(1):9-17.Google Scholar
9. Leen-Feldner, EW, Feldner, MT, Knapp, A, Bunaciu, L, Blumenthal, H, Amstadter, AB. Offspring psychological and biological correlates of parental posttraumatic stress: review of the literature and research agenda. Clin Psychol Rev. 2013;33(8):1106-1133.Google Scholar
10. Cobham, VE, McDermott, B, Haslam, D, Sanders, MR. The role of parents, parenting and the family environment in children’s post-disaster mental health. Curr Psychiatry Rep. 2016;18(6):53.Google Scholar
11. Mann, M, Li, J, Farfel, MR, Maslow, CB, Osahan, S, Stellman, SD. Adolescent behavior and PTSD 6-7 years after the World Trade Center terrorist attacks of September 11, 2001. Disaster Health. 2015;2(3-4):1-9.Google Scholar
12. Kiliҫ, C, Kiliҫ, EZ, Aydin, IO. Effect of relocation and parental psychopathology on earthquake survivor-children’s mental health. J Nerv Ment Dis.2011;199(5):335-341.Google Scholar
13. North, CS, Mendoza, S, Simic, Z, Pfefferbaum, B. Parent-reported behavioral and emotional responses of children to disaster and parental psychopathology. J Loss Trauma. 2018;23(4):303-316.Google Scholar
14. Shi, X, Zhou, Y, Geng, F, et al. Posttraumatic stress disorders symptoms in parents and adolescents after the Wenchuan earthquake: a longitudinal actor-partner interdependence model. J Affect Disord. 2018;226:301-306.Google Scholar
15. Masten, AS, Narayan, AJ. Child development in the context of disaster, war, and terrorism: pathways of risk and resilience. Ann Rev Psychol. 2012;63:227-257.Google Scholar
16. Kerns, CE, Elkins, RM, Carpenter, AL, Chou, T, Green, JG, Comer, JS. Caregiver distress, shared traumatic exposure, and child adjustment among area youth following the 2013 Boston Marathon bombing. J Affect Disord. 2014;167:50-55.Google Scholar
17. Compas, BE, Epping, JE. “Stress and coping in children and families.” In: Saylor CF, (ed). Children and Disasters. New York, New York USA: Plenum Press; 1993:11-28.Google Scholar
18. Samuelson, KW, Wilson, CK, Padrón, E, Lee, S, Gavron, L. Maternal PTSD and children’s adjustment: parenting stress and emotional availability as proposed mediators. J Clin Psychol. 2017;73(6):693-706.Google Scholar
19. Costa, NM, Weems, CF, Pina, AA. Hurricane Katrina and youth anxiety: the role of perceived attachment beliefs and parenting behaviors. J Anxiety Disord. 2009;23(7):935-941.Google Scholar
20. Gargano, LM, Locke, S, Brackbill, RM. Parent physical and mental health comorbidity and adolescent behavior. Int J Emerg Ment Health Human Resilience. 2017;19(2):1-8.Google Scholar
21. Gil-Rivas, V, Kilmer, RP, Hypes, AW, Roof, KA. “The caregiver-child relationship and children’s adjustment following Hurricane Katrina.” In: Kilmer RP, Gil-Rivas V, Tedeschi RG, Calhoun LG, (eds). Helping Families and Communities Recover from Disaster: Lessons Learned from Hurricane Katrina and Its Aftermath. Washington, DC USA: American Psychological Association; 2010:55-76.Google Scholar
22. Gil-Rivas, V, Kilmer, RP. Children’s adjustment following Hurricane Katrina: the role of primary caregivers. Am J Orthopsychiatry. 2013;83(2):413-421.Google Scholar
23. Gunlicks, ML, Weissman, MM. Change in child psychopathology with improvement in parental depression: a systematic review. J Am Acad Child Adolesc Psychiatry. 2008;47(4):379-389.Google Scholar
24. Scheeringa, MS, Zeanah, CH. A relational perspective on PTSD in early childhood. J Trauma Stress. 2001;14(4):799-815.Google Scholar
25. Osofsky, J, Kronenberg, M, Bocknek, E, Hansel, TC. Longitudinal impact of attachment-related risk and exposure to trauma among young children after Hurricane Katrina. Child Youth Care Forum. 2015;44:493-510.Google Scholar
26. De Los Reyes, A, Kazdin, AE. Informant discrepancies in the assessment of childhood psychopathology: a critical review, theoretical framework, and recommendations for further study. Psychol Bull 2005;131(4):483-509.Google Scholar
27. Valentino, K, Berkowitz, S, Stover, CS. Parenting behaviors and posttraumatic symptoms in relation to children’s symptomatology following a traumatic event. J Trauma Stress. 2010;23(3):403-407.Google Scholar
28. Schreier, H, Ladakakos, C, Morabito, D, Chapman, L, Knudson, MM. Posttraumatic stress symptoms in children after mild to moderate pediatric trauma: a longitudinal examination of symptom prevalence, correlates, and parent-child symptom reporting. J Trauma 2005;58(2):353-363.Google Scholar