Toddlers Exposed to Terror Develop More Emotional, Behavioral Problems
> 2/22/2008 11:32:53 AM

The after-effects of the horrendous destruction visited upon the United States on September 11, 2001 have yet to be fully assessed. Despite the absolute glut of stories that have appeared in nearly every single broadcast program or publication in the world in the subsequent 6 1/2 years, most of the information regarding the country's mental fitness following the terrible event has been of a speculative nature.

Many Americans were forced to perform the unfortunate task of explaining what had happened that day to their young children, most of whom realized that something monumental had occurred but could not quite process the details and all that they implied. But thousands of children were within miles of the attacks as they occurred; many in lower Manhattan had just arrived at school when the attacks began, and most first received the news from their teachers. Victims too young to rationalize unfolding tragedies may be even more vulnerable to their emotionally crippling impact, but clinical study has yet to fully explore this subject in relation to the 9/11 attacks despite a few very in-depth analytical reports. Researchers at New York's Mount Sinai School of Medicine recently attempted to remedy this dearth of data at a time when the political news cycle reminds Americans of these tragedies nearly every day and all aspects of the attacks and their lingering aftermath warrant serious ongoing study. By interviewing the parents of preschool children who had been living in downtown Manhattan on September 11 in the 35 months following the tragedy, the researchers attempted to construct a larger portrait of underaged Americans' response to terrorism and draw larger conclusions about the youngest victims of large-scale trauma.

Various reports stated that a majority of children living in the general vicinity experienced some form of stress reaction in the period immediately following 9/11, and almost half of the area parents surveyed in the weeks immediately following the attacks reported that their children feared for their own safety or that of loved ones regardless of their distance from the actual events. Diagnostic percentages obviously cannot capture the true toll of such events - whether children display symptoms sufficient for PTSD or depression, most have been profoundly affected by what they've seen. As the Department of Health and Human Services posits on their site, "no one who sees a disaster is untouched by it." And how could a thinking person not be?

Thanks, in large part, to the power of live television and other media outlets, thousands of citizens who were nowhere near the World Trade Center or the Pentagon on that horrific day reported increased anxiety, insomnia and disturbing dreams in its wake. At least half of the American population watched more than 8 hours of 9/11 coverage on television in the days immediately following the attacks. A considerable number of city dwellers receded into their apartments accompanied by little beyond than television and paranoia (14.7% of all Manhattan residents below 110th street displayed symptoms amounting to either PTSD or major depression diagnoses in the weeks after the attacks, but these numbers do not necessarily include the more severe late-onset forms of the condition. Among citizens living below Canal Street in closer vicinity to the WTC site, prevalence rates were as high as 20%). A significant number of citizens also reported more frequently using tobacco, alcohol and illicit drugs during that period. Among all citizens: "61 percent of those living within one hundred miles of the World Trade Center exhibited substantial stress reactions, compared to 36 percent of those living more than one thousand miles away."

As the most recent study showed, the WTC attacks led to considerably higher rates of behavioral and emotional problems on their own: of the 119 children involved in the study (average age approximately 4 years), nearly 1 in 4 had witnessed "high-intensity" events related to the attack (severely injured or deceased people, desperate victims leaping from the building, the structures themselves collapsing). Those kids were 5 times as likely to report sleep problems and 3 times as likely to experience notable symptoms of depression and anxiety than those who did not directly witness the most horrific elements of the attack. But when combined with other, unrelated traumas, these numbers  grew considerably larger: kids who witnessed the horrors of the WTC attack directly and also experienced some sort of independent trauma during the same period were 16 times more likely to experience attention problems and 21 times more likely to report symptoms of emotional instability, anxiety or depression than those who were not directly exposed.

How can we explain this pattern? The findings, according to researchers, fall under the allostatic load theory of stress: in summary, the burden of multiple traumas is far greater than the sum of their parts. Children reeling from, for example, the death of a grandparent, a parental separation, or a major move would therefore be far more susceptible to the influence of a terrorist attack, especially when they witness the devastation firsthand. We've addressed the issue of depression and PTSD in the wake of major tragedy, concluding that psychosocial health should be part of our national security investment; one does not need to be directly involved in a terrorist attack or field of combat to suffer from its adverse influence. And the most tragic victims of these senseless attacks are the most innocent: those too young to even begin to understand why.

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