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31.19d Impact of Terrorism
on Children
In recent years, exposure to mass trauma and terrorism has
become an increasing concern regarding the well-being of
youth. Mass trauma has occurred directly and by witness
through highly publicized traumatic events globally and in the
United States, pertaining to terrorism, war, mass killings, and
natural disasters.
On April 15, 2013, the first major terrorist attack in the
United States since 9/11 occurred at the finish line of the
Boston Marathon in the mid-afternoon. Two “improvised
explosive devices” (IEDs), that is, homemade bombs, deto-
nated 8 minutes apart in the middle of a densely packed crowd
of thousands of marathon runners and bystanders, killing three
people and injuring about 264 others. Within moments after
the blasts, the crowd’s panic and chaos turned to purposeful
attention to help others get to emergency medical teams arriv-
ing on the scene. Courageously, bystanders ran toward others
to give aid rather than dispersing away from the scene in all
directions. Runners tore off their own shirts to apply pressure
to fellow runners who were bleeding, or to use them as tour-
niquets. Boston’s emergency response medical teams worked
quickly, efficiently, and tirelessly to transport injured runners
to hospitals and into operating rooms in order to save limbs,
and stop bleeding. The fact that almost all the injured were
saved is a tribute to the emergency preparedness and collabo-
ration of law enforcement, medical, and surgical teams car-
rying out an emergency plan that they had previously been
briefed on, as a matter of course.
Additional situations in which youth are exposed to severe
trauma and terror involve armed conflict around the world, mul-
tiple mass school shootings that have taken place across the
United States in recent years, and hurricanes, devastating storms,
and tsunamis. Of course, more than a decade ago, the youth in
the United States experienced the large-scale domestic terrorist
attack on September 11, 2001, on the World Trade Center in
NewYork City and the Pentagon in Washington, DC.
There is an increasing body of literature on the impact of ter-
rorism on children as well as a variety of other forms of trauma.
One predominant and near universal symptom in children in
response to these stimuli is anxiety. Young children may cling
excessively to their parents, whereas older children may become
preoccupied with fear about unrelated issues. Some youth
express overt anger, and others experience a sense of hopeless-
ness, lack of control, and/or depression. Severe traumas, such
as experiencing a terrorist event, may be more likely to result
in posttraumatic stress syndromes among exposed youth, com-
pared to less severe forms of trauma. The number of traumas
experienced by a child, degree of family support provided after
the exposure, and the reactions of parents are all important fac-
tors in a child’s reaction.
According to a national survey after the terrorist attack of
September 11th, stress reactions to that disaster were increased
by watching repeated media coverage of those events. A similar
study evaluating the impact of media versus direct exposure to
collective trauma, on acute stress response was undertaken 2 to
4 weeks after the Boston Marathon bombings through surveying
846 people from Boston, 941 people from New York City, and
2,888 people through Internet means. Direct exposure, defined
as being at or near the bombings, was compared to media
exposure, including footage on television and bombing related
stories on the radio, in print, online, and other social media cov-
erage. Because acute stress responses appear within weeks of
a traumatic event, this study was able to capture acute stress
difference between the two groups. The study found that trauma
related to media exposure was associated with acute stress reac-
tions in people from all over the United States who were not
directly exposed to the event in Boston. Furthermore, respon-
dents reporting exposure to media coverage of the bombings for
six or more hours daily in the week following the bombings were
nine times more likely to report high acute stress than those who
had minimal exposure to media coverage of the events. In fact,
the group who engaged in extensive media coverage had higher
levels of acute stress than respondents who had direct exposure
in Boston, but who had minimal exposure to media coverage
of the bombings. These findings suggest that prolonged media
exposure to collective traumatic events may have a strong
negative impact on psychological symptoms and acute stress
syndromes. However, the study noted substantial resilience in
the surveyed population. Researchers have suggested that the
