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In this study, conducted an average of 35 months after the World Trade Center attacks, Chemtob and colleagues interviewed families of 116 children who lived or attended preschool in lower Manhattan at the time of the attacks. About one-fourth of the children were exposed to high-intensity events associated with the attack, and about half had been previously exposed to other traumatic events in their lives. The combination of these exposures was additive and increased the odds of behavioral problems 18- to 26-fold. This study indicates the preschool children's vulnerability to the synergistic effects of repeated trauma and the need for identification and treatment with effective interventions in this group.
Impact of Conjoined Exposure to the World Trade Center Attacks and to Other Traumatic Events on the Behavioral Problems of Preschool Children
Main Exposures High-intensity WTC attack–related trauma exposure indexed by the child experiencing 1 or more of the following: seeing people jumping out of the towers, seeing dead bodies, seeing injured people, witnessing the towers collapsing, and lifetime history of other trauma exposure.
Results Preschool children exposed to high-intensity WTC attack–related events were at increased risk for the sleep problems and anxious/depressed behavioral symptom clusters. Conjoined exposure to high-intensity WTC attack–related events and to other trauma was associated with clinically significant emotionally reactive, anxious/depressed, and sleep-related behavioral problems. Children without a conjoined lifetime history of other trauma did not differ from nonexposed children. Risk of emotionally reactive, anxious/depressed, and attention problems in preschool children exposed to conjoined high-intensity WTC attack–related events and other trauma increased synergistically.