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The San Diego East County School Shootings: A Qualitative Study of Community-Level Post-traumatic Stress

Published online by Cambridge University Press:  28 June 2012

Lawrence A. Palinkas*
Affiliation:
Department of Family and Preventive Medicine, University of California-San Diego, San Diego, California, USA
Erica Prussing
Affiliation:
Department of Family and Preventive Medicine, University of California-San Diego, San Diego, California, USA Child and Adolescent Services Research Center, Children's Hospital, San Diego, California, USA
Vivian M. Reznik
Affiliation:
Department of Family and Preventive Medicine, University of California-San Diego, San Diego, California, USA Department of Pediatrics, University of California-San Diego, San Diego, California, USA
John A. Landsverk
Affiliation:
Child and Adolescent Services Research Center, Children's Hospital, San Diego, California, USA School of Social Work, San Diego State University, San Diego, California USA
*
Department of Family and Preventive Medicine, University of California, San Diego, 9500 Gilman Drive, La Jolla, CA 92093-0807USA E-mail: [email protected]

Abstract

Introduction:

Within one month (March 2001), two separate incidents of school shootings occurred at two different high schools within the same school district in San Diego's East County.

Objective:

To examine community-wide expressions of post-traumatic distress resulting from the shootings that may or may not fulfill DSM-IV criteria for post-traumatic stress disorder (PTSD), but which might interfere with treatment and the prevention of youth violence.

Methods:

A qualitative study was undertaken using Rapid Assessment Procedures (RAP) in four East San Diego County communities over a six-month period following the two events. Semi-structured interviews were conducted with 85 community residents identified through a maximum variation sampling technique. Interview transcripts were analyzed by coding consensus, co-occurrence, and comparison, using text analysis software.

Results:

Three community-wide patterns of response to the two events were identified: (1) 52.9% of respondents reported intrusive reminders of the trauma associated with intense media coverage and subsequent rumors, hoaxes, and threats of additional acts of school violence; (2) 44.7% reported efforts to avoid thoughts, feelings, conversations, or places (i.e., schools) associated with the events; negative assessment of media coverage; and belief that such events in general cannot be prevented; and (3) 30.6% reported anger, hyper-vigilance, and other forms of increased arousal. Twenty-three (27.1%) respondents reported symptoms of fear, anxiety, depression, drug use, and psychosomatic symptoms in themselves or others.

Conclusions:

School shootings can precipitate symptoms of post-traumatic stress disorder at the community level. Such symptoms hinder the treatment of individuals with PTSD and the implementation of effective prevention strategies and programs.

Type
Special Reports
Copyright
Copyright © World Association for Disaster and Emergency Medicine 2004

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References

references

1.Anderson, M, Kaufman, J, Simon, TR, et al. : School-associated violent deaths in the United States, 1994-1999. JAMA 2001;286:26952702.CrossRefGoogle ScholarPubMed
2.Pynoos, RS, Frederick, C, Nader, K, et al. : Life threat and post-traumatic stress in school-age children. Arch of Gen Psychiatry 1987;44:10571063.CrossRefGoogle ScholarPubMed
3.Nader, K, Pynoos, RS, Fairbanks, L, et al. : Children's PTSD reactions one year after a sniper attack at their school. Amer J of Psychiatry 1990;47:15261530.Google Scholar
4.Schwarz, ED, Kowalski, JM: Malignant memories: PTSD in children and adults after a school shooting. J Amer Acad of Child and Adolesc Psychiatry 1991;30:936944.CrossRefGoogle ScholarPubMed
5.Vila, G, Porche, LM, Mouren-Simeoni, MC: An 18-month longitudinal study of post-traumatic disorders in children who were taken hostage in their school. Psychosomatic Med 1999;61:746754.CrossRefGoogle ScholarPubMed
6.Kostinsky, S, Bixler, EO, Kettl, PA: Threats of school violence in Pennsylvania after media coverage of the Columbine High School massacre. Arch of Ped and Adolesc Med 2001;155:9941001.CrossRefGoogle ScholarPubMed
7.Sloan, IH, Rozensky, RH, Kaplan, L, et al. : A shooting incident in an elementary school: Effects of worker stress on public safety, mental health and medical personnel. J of Traumatic Stress 1994;7:565574.CrossRefGoogle Scholar
8.Hobfoll, SE: The Ecology of Stress. Washington, DC: Hemisphere, 1988.Google Scholar
9.Arata, CM, Picou, JS, Johnson, GD, et al. : Coping with technological disaster: An application of the conservation of resources model to the Exxon Valdez oil spill. J Traumatic Stress 2000;13:2339.CrossRefGoogle Scholar
10.Freedy, JR, Shaw, DL, Jarnell, MP, et al. : Towards an understanding of the psychological impact of natural disasters: An application of the conservation of resources stress model. J Traumatic Stress 1992;5:441455.CrossRefGoogle Scholar
11.Freedy, JR, Saladin, ME, Kilpatrick, DG, et al. : Understanding acute psychological distress following natural disaster. J Traumatic Stress 1994;7:257273.CrossRefGoogle ScholarPubMed
12.Freudenberg, WR, Jones, TR: Attitudes and stress in the presence of technological risks: Towards a sociological perspective. Social Forces 1991;69:11431168.CrossRefGoogle Scholar
13.Kleinman, A: Writing at the Margin: Discourse Between Anthropology and Medicine. Berkeley, CA: University of California Press, 1995.Google Scholar
14.Young, A: The Harmony of Illusions: Inventing Post-Traumatic Stress Disorder. Princeton, NJ: Princeton University Press, 1995.Google Scholar
15.Freudenberg, WR: Contamination, corrosion, and the social order: An overview. Current Sociology 1997;45:1939.CrossRefGoogle Scholar
16.Palinkas, LA, Downs, MA, Petterson, JS, et al. : Social, cultural and psychological impacts of the Exxon Valdez oil spill. Human Organization 1993;52:113.CrossRefGoogle Scholar
17.Scrimshaw, SCM, Hurtado, E: Rapid Assessment Procedures for Nutrition and Primary Health Care. Los Angeles: UCLA Latin American Center Publications, 1987.Google Scholar
18.Harris, KJ, Jerome, NW, Fawcett, SB: Rapid assessment procedures: A review and critique. Human Organization 1997;56:375378.CrossRefGoogle Scholar
19.Guba, EG, Lincoln, YS: Fourth Generation Evaluation. Newbury Park, CA:Sage, 1989.Google Scholar
20.Patton, MQ: Qualitative Evaluation and Research Methods, 2nd ed.Newbury Park, CA: Sage 1990.Google Scholar
21.Bernard, HR: Research Methods in Cultural Anthropology. Newbury Park, CA:Sage, 1988.Google Scholar
22.Willms, DG, Best, JA, Taylor, DW, et al. : A systematic approach for using qualitative methods in primary prevention research. Medical Anthropology Quarterly 1992;4:391409.CrossRefGoogle Scholar
23.Strauss, AL: Qualitative Analysis for the Social Scientist. New York: Cambridge University Press, 1987CrossRefGoogle Scholar
24.Fraser, D: QSR NVivo NUS*IST Vivo Reference Guide. Melbourne: QSR International, 2000.Google Scholar
25.American Psychiatric Association: Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition. Washington, DC: American Psychiatric Association, 1994.Google Scholar
26.Thornton, K: New threats raise alarm. San Diego Union Tribune, 09 March 2001:A1,A23.Google Scholar
27.Chacon, DJ: New shooting threat limits attendance at Santana High School. San Diego Union Tribune, 10 November 2001:B3.Google Scholar
28.Chacon, DJ: Granite Hills gunman kills self. San Diego Union Tribune, 30 October 2001:B1.Google Scholar
29.US Department of Health and Human Services, Office of the Surgeon General: Youth Violence: A Report of the Surgeon General. Washington, DC:Government Printing Office, 2001.Google Scholar
30.Palinkas, LA, Pickwell, SM, Brandstein, KM, et al. : The journey to wellness: Stages of refugee health promotion and disease prevention. J Immigrant Health 2003;5(1):1928.CrossRefGoogle ScholarPubMed