Behavioral Problems Among Preschool Children Linked To Exposure To World Trade Center Attacks

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Main Category: Pediatrics / Children's Health
Also Included In: Anxiety / Stress;  Aid / Disasters;  Mental Health
Article Date: 08 Feb 2008 - 0:00 PDT

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A study published by the Archives of Pediatrics & Adolescent Medicine reports that exposure to both the World Trade Center attacks and another traumatic event is associated with behavioral problems among preschool children when compared to exposure to one event or to none.

Researcher Claude M. Chemtob of the Mount Sinai School of Medicine in New York and his colleagues note that there is a paucity of research regarding the effects of terrorism on preschoolers. It is possible that young children may be especially defenseless to the adverse psychological consequences of such trauma.

The authors studied 116 preschool children (average age of 3.9) who were directly exposed to the World Trade Center (WTC) attacks of 2001 and who lived or attended in preschool in lower Manhattan. Parents filled out a survey about their children between March 2003 and December 2005 - averaging about 35 months after the attacks. The questionnaires provided information on demographics, as well as the exposure level to the attacks and information on the occurrence of other traumatic events such as death of a family member, exposure to a natural disaster, or witnessing a serious accident. The researchers also assessed emotional and behavioral factors.

Twenty-three percent of participants experienced one or more high-intensity WTC events - the towers collapsing, injured or dead bodies, or people jumping out of buildings. Compared to children who were not exposed, these exposed preschoolers had almost five times the odds of sleeping difficulties and nearly three times the odds of experiencing depression or anxiety.

The authors found that for children who also experienced another traumatic event, behavior problems appeared more severe. Those who were exposed to the WTC attacks and another traumatic event had 21 times the odds of having emotional problems or being anxious or depressed and 16 times the odds of having attention problems compared with children who were not exposed to high-intensity WTC events or to other trauma. Comparing children who were exposed only to high-intensity WTC events but not to other traumatic events and children who had less intense exposure to attacks, no significant difference was found in the likelihood of behavioral problems.

The researcher's findings are consistent with what is known as an allostatic load hypothesis of stress - as exposure to traumatic events is accrued over time, the risk of psychological effects increased. They conclude by advising that, "physicians seeking to assess the impact of terrorism and disaster on very young children should assess for disaster-related exposure and for other trauma." In addition, Chemtob and colleagues suggest that public health policy after disasters should include "more vigorous outreach to trauma-exposed preschool children."

Impact of Conjoined Exposure to the World Trade Center Attacks and to Other Traumatic Events on the Behavioral Problems of Preschool Children
Claude M. Chemtob, Yoko Nomura, Robert A. Abramovitz
Archives of Pediatrics & Adolescent Medicine, Volume 162, No. 2, pp. 126-133, February 2008
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Written by: Peter M Crosta
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