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A controlled follow-up study of adolescents exposed to a school shooting – Psychological consequences after four months

Published online by Cambridge University Press:  16 April 2020

L. Suomalainen*
Affiliation:
Department of Mental Health and Substance Abuse Services, National Institute for Health and Welfare (MIPO/LAMI), PO Box 30, 00271Helsinki, Finland Helsinki University and Department of Adolescent Psychiatry, Helsinki University Central Hospital, Helsinki, Finland
H. Haravuori
Affiliation:
Department of Mental Health and Substance Abuse Services, National Institute for Health and Welfare (MIPO/LAMI), PO Box 30, 00271Helsinki, Finland Kellokoski Hospital, Hospital District of Helsinki and Uusimaa, Helsinki, Finland
N. Berg
Affiliation:
Department of Mental Health and Substance Abuse Services, National Institute for Health and Welfare (MIPO/LAMI), PO Box 30, 00271Helsinki, Finland
O. Kiviruusu
Affiliation:
Department of Mental Health and Substance Abuse Services, National Institute for Health and Welfare (MIPO/LAMI), PO Box 30, 00271Helsinki, Finland
M. Marttunen
Affiliation:
Department of Mental Health and Substance Abuse Services, National Institute for Health and Welfare (MIPO/LAMI), PO Box 30, 00271Helsinki, Finland Helsinki University and Department of Adolescent Psychiatry, Helsinki University Central Hospital, Helsinki, Finland
*
*Corresponding author. Tel.: +358 20 610 6000; fax: +358 20 610 7191. E-mail address: [email protected] (L. Suomalainen).
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Abstract

Background

In November 2007, a student shot eight people and himself at Jokela High School, Finland. This study aims to evaluate the long-term effects of exposure to a school shooting among adolescents.

Method

Associations between psychological outcomes and background factors were analysed and compared with “comparison students” four months after the incident. A questionnaire including Impact of Event Scale (IES) and General Health Questionnaire (GHQ-36) was used.

Results

Half of the females and a third of the males suffered from posttraumatic distress. High level of posttraumatic distress (IES ≥ 35), predicting PTSD, was observed in 27% of the females and 7% of the males. The odds ratio was 6.4 (95% confidence interval 3.5–10.5) for having high levels of posttraumatic distress. Severe or extreme exposure and female gender were found to increase the risk. Forty-two percent of the females and 16% of the males had psychiatric disturbance (GHQ ≥ 9). Severe or extreme exposure, older age and female gender increased the risk. Perceived support from family and friends was found to be protective.

Conclusions

The observed risk and protective factors were similar to earlier studies. Follow-up will be essential in identifying factors predicting persisting trauma-related symptoms in adolescence.

Type
Original article
Copyright
Copyright © Elsevier Masson SAS 2011

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References

Aalto-Setälä, T, Marttunen, M, Tuulio-Henriksson, A, Poikolainen, K, Lönnqvist, JDepressive symptoms in adolescence as predictors of early adulthood depressive disorders and maladjustment. Am J Psychiatry 2002; 159: 12351237.CrossRefGoogle ScholarPubMed
Becker, DF, Daley M, Gadbaille, WJ, Green, MR, Flaherty, LT, Harper, G, et al. Trauma and adolescence I: the nature and scope of trauma. In: Flaherty, LT(chair). Committee on adolescence of the Group for the Advancement of Psychiatry. Adolescent psychiatry: developmental and clinical studies. New York, NY: The Analytic Press/Taylor & Francis Group; 2003. p.143–63.Google Scholar
Becker, DF, Grilo, CMPrediction of drug and alcohol abuse in hospitalized adolescents: comparisons by gender and substance type. Behav Res Ther 2006; 44: 14311440.CrossRefGoogle ScholarPubMed
Blumenthal, JA, Burg, MM, Barefoot, J, Williams, RB, Haney, T, Zimet, GSocial support, type A behavior, and coronary artery disease. Psychosom Med 1987; 49: 331340.CrossRefGoogle ScholarPubMed
Bolton, D, O’Ryan, D, Udwin, O, Boyle, S, Yule, WThe long-term psychological effects of a disaster experienced in adolescence: II: general psychopathology. J Child Psychol Psychiatry 2000; 41: 513523.CrossRefGoogle ScholarPubMed
Breslau, N, Davis, GC, Schultz, LRPosttraumatic stress disorder and the incidence of nicotine, alcohol, and other drug disorders in persons who have experienced trauma. Arch Gen Psychiatry 2003; 60: 289294.CrossRefGoogle ScholarPubMed
Broberg, AG, Dyregrov, A, Lilled, LThe Goteborg discotheque fire: posttraumatic stress, and school adjustment as reported by the primary victims 18 months later. J Child Psychol Psychiatry 2005; 46: 12791286.CrossRefGoogle ScholarPubMed
Copeland, WE, Keeler, G, Angold, A, Costello, EJTraumatic events and posttraumatic stress in childhood. Arch Gen Psychiatry 2007; 64: 577584.CrossRefGoogle ScholarPubMed
Curle, CE, Williams, CPost-traumatic stress reactions in children: gender differences in the incidence of trauma reactions at two years and examination of factors influencing adjustment. Br J Clin Psychol 35Pt 21996 297309.CrossRefGoogle ScholarPubMed
Danielson, CK, Amstadter, AB, Dangelmaier, RE, Resnick, HS, Saunders, BE, Kilpatrick, DGTrauma-related risk factors for substance abuse among male versus female young adults. Addict Behav 2009; 34: 395399.CrossRefGoogle ScholarPubMed
Dyregrov, A, Frykholm, AM, Lilled, L, Broberg, AG, Holmberg, IThe Goteborg discotheque fire, 1998. Scand J Psychol 2003; 44: 449457.CrossRefGoogle ScholarPubMed
Fletcher, KEChildhood posttraumatic stress disorder.Mash, EJ, Barkley, RAChild psychopathology 2nd ed.New York, NY: Guilford Press; 2003p. 330–71Google Scholar
Fremont, WPChildhood reactions to terrorism-induced trauma: a review of the past 10 years. J Am Acad Child Adolesc Psychiatry 2004; 43: 381392.Google ScholarPubMed
Fröjd, SA, Nissinen, ES, Pelkonen, MU, Marttunen, MJ, Koivisto, AM, Kaltiala-Heino, RDepression and school performance in middle adolescent boys and girls. J Adolesc 2008; 31: 485498.CrossRefGoogle ScholarPubMed
Giaconia, RM, Reinherz, HZ, Silverman, AB, Pakiz, B, Frost, AK, Cohen, ETraumas and posttraumatic stress disorder in a community population of older adolescents. J Am Acad Child Adolesc Psychiatry 1995; 34: 13691380.CrossRefGoogle Scholar
Gil-Rivas, V, Silver, RC, Holman, EA, McIntosh, DN, Poulin, MParental response and adolescent adjustment to the September 11, 2001 terrorist attacks. J Trauma Stress 2007; 20: 10631068.CrossRefGoogle ScholarPubMed
Goenjian, AK, Pynoos, RS, Steinberg, AM, Najarian, LMPsychiatric comorbidity in children after the 1988 earthquake in Armenia. J Am Acad Child Adolesc Psychiatry 1995; 34: 11741184.CrossRefGoogle ScholarPubMed
Goldberg, DP. The detection of psychiatric illness by questionnaire; a technique for the identification and assessment of non-psychotic psychiatric illness. Maudsley monographs, vol.21. London/New York: Oxford University Press; 1972.Google Scholar
Holi, MM, Marttunen, M, Aalberg, VComparison of the GHQ-36, the GHQ-12 and the SCL-90 as psychiatric screening instruments in the Finnish population. Nord J Psychiatry 2003; 57: 233238.CrossRefGoogle ScholarPubMed
Horowitz, MJStress response syndromes and their treatment.Goldberger, LBreznitz, SHandbook of stress: theoretical and clinical aspects 1982 Free Press New York711732.Google Scholar
Horowitz, MJ, Wilner, N, Alvarez, WImpact of Event Scale: a measure of subjective stress. Psychosom Med 1979; 41: 209218.CrossRefGoogle ScholarPubMed
Hoven, CW, Duarte, CS, Lucas, CP, Wu, P, Mandell, DJ, Goodwin, RD, et al.Psychopathology among New York city public school children 6 months after September 11. Arch Gen Psychiatry 2005; 62: 545552.CrossRefGoogle ScholarPubMed
Joseph, S, Mynard, H, Mayall, MLife-events and post-traumatic stress in a sample of English adolescents. J Community Appl Soc Psychol 2000; 10: 475482.3.0.CO;2-F>CrossRefGoogle Scholar
Karlsson, L, Kiviruusu, O, Miettunen, J, Heila, H, Holi, M, Ruuttu, T, et al.One-year course and predictors of outcome of adolescent depression: a case-control study in Finland. J Clin Psychiatry 2008; 69: 844853.CrossRefGoogle ScholarPubMed
Leskela, US, Melartin, TK, Lestela-Mielonen, PS, Rytsala, HJ, Sokero, TP, Heikkinen, ME, et al.Life events, social support, and onset of major depressive episode in Finnish patients. J Nerv Ment Dis 2004; 192: 373381.CrossRefGoogle ScholarPubMed
Littleton, H, Grills-Taquechel, A, Axsom, DResource loss as a predictor of posttrauma symptoms among college women following the mass shooting at Virginia Tech. Violence Vict 2009; 24: 669686.CrossRefGoogle ScholarPubMed
Lonigan, CJ, Shannon, MP, Finch, AJ, Daugherty, TKChildren's reactions to a natural disaster: symptom severity and degree of exposure. Adv Behav Res Ther 1991; 13: 135154.CrossRefGoogle Scholar
Ministry of Justice, Finland. Jokela School Shooting on 7 November 2007 – Report of the Investigation Commission. Ministry of Justice Publications 2009:2. URL: http://www.om.fi/en/Etusivu/Julkaisut/1238674756100 [accessed June 23, 2010].Google Scholar
Nader, K, Pynoos, R, Fairbanks, L, Frederick, CChildren's PTSD reactions one year after a sniper attack at their school. Am J Psychiatry 1990; 147: 15261530.Google ScholarPubMed
Neal, LA, Busuttil, W, Rollins, J, Herepath, RConvergent validity of measures of post-traumatic stress disorder in a mixed military and civilian population. J Trauma Stress 1994; 7: 447455.CrossRefGoogle Scholar
Palmer, SC, Kagee, A, Coyne, JC, DeMichele, AExperience of trauma, distress, and posttraumatic stress among breast cancer patients. Psychosom Med 2004; 66: 258264.CrossRefGoogle ScholarPubMed
Pine, DS, Cohen, JATrauma in children and adolescents: risk and treatment of psychiatric sequelae. Biol Psych 2002; 51: 519531.CrossRefGoogle ScholarPubMed
Prinstein, MJ, La Greca, AM, Vernberg, EM, Silverman, WKChildren's coping assistance: how parents, teachers, and friends help children cope after a natural disaster. J Clin Child Psychol 1996; 25: 463475.CrossRefGoogle Scholar
Pynoos, RS, Frederick, C, Nader, K, Arroyo, W, Steinberg, A, Eth, S, et al.Life threat and posttraumatic stress in school-age children. Arch Gen Psychiatry 1987; 44: 10571063.CrossRefGoogle ScholarPubMed
Reijneveld, SA, Crone, MR, Verhulst, FC, Verloove-Vanhorick, SPThe effect of a severe disaster on the mental health of adolescents: a controlled study. Lancet 2003; 362: 691696.CrossRefGoogle ScholarPubMed
Räikkönen, K, Keskivaara, P, Keltikangas-Järvinen, LHostility and social support among Type A individuals. Psychol Health 1992; 7: 289299.CrossRefGoogle Scholar
Schwarz, ED, Kowalski, JMMalignant memories: PTSD in children and adults after a school shooting. J Am Acad Child Adolesc Psychiatry 1991; 30: 936944.CrossRefGoogle ScholarPubMed
Shapiro, FEMDR: level 1 training manual. Pacific Grove, CA: EMDR Institute; 1996Google Scholar
Shaw, JAChildren, adolescents and trauma. Psychiatr Q 2000; 71: 227243.CrossRefGoogle ScholarPubMed
SPSS Base 16.0 Users Guide. Chicago, IL: SPSS Inc.; 2007.Google Scholar
Tuisku, V, Pelkonen, M, Kiviruusu, O, Karlsson, L, Ruuttu, T, Marttunen, MFactors associated with deliberate self-harm behaviour among depressed adolescent outpatients. J Adolesc 2009; 32: 11251136.CrossRefGoogle ScholarPubMed
Udwin, O, Boyle, S, Yule, W, Bolton, D, O’Ryan, DRisk factors for long-term psychological effects of a disaster experienced in adolescence: predictors of Post-Traumatic Stress Disorder. J Child Psychol Psychiatry 2000; 41: 969979.CrossRefGoogle ScholarPubMed
Ursano, RJ, Fullerton, CS, Kao, TC, Bhartiya, VRLongitudinal assessment of posttraumatic stress disorders and depression after exposure to traumatic death. J Nerv Ment Dis 1995; 183: 3642.CrossRefGoogle ScholarPubMed
Yule, W, Bolton, D, Udwin, O, Boyle, S, O’Ryan, D, Nurrish, JThe long-term psychological effects of a disaster experienced in adolescence: I: the incidence and course of PTSD. J Child Psychol Psychiatry 2000; 41: 503511.CrossRefGoogle ScholarPubMed
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