title: Posttraumatic stress symptoms in London school children following September 11, 2001: an exploratory investigation of peri-traumatic reactions and intrusive imagery.
abstract: Threatening intrusive images are central to posttraumatic stress disorder. It has been suggested that intrusive imagery in the context of a sense of threat leads to the development and persistence of posttraumatic stress symptoms. This study investigates London school children's (N=76; age 10-11 years) self-reported posttraumatic stress symptoms in response to viewing the attacks of September 11, 2001 on television. Assessments were made at two time points. A minority of participants reported moderate-severe symptoms with functional impairment at 2 months (14.5%) and 6 months (9.2%) after viewing the September 11 events. After controlling for symptom stability, persistent symptoms were associated with peri-traumatic factors, notably perceiving that one's life was in danger. The combined effect of intrusive imagery and peri-traumatic life threat was associated with symptom persistence. Assessments of intrusive image content via checklist and free-report indicated that the images were directly related to September 11 and were fairly stable over time. Implications for treating children's intrusive images following stressful events are explored.
authors.affiliation: Department of Psychiatry, University of Oxford, Warneford Hospital, Oxford OX3 7JK, UK. emily.holmes@psych.ox.ac.uk
authors.forename: Emily A
authors.initials: EA
authors.lastname: Holmes
authors.forename: Cathy
authors.initials: C
authors.lastname: Creswell
authors.forename: Thomas G
authors.initials: TG
authors.lastname: O'Connor
mesh_terms: D001143:Arousal; D002648:Child; D002653:Child Behavior Disorders / Q000209:etiology / Q000523:psychology; D005260:Female; D006801:Humans; D007092:Imagination; D008131:London; D008297:Male; D008402:Mass Media; D008568:Memory; D009519:New York City; D012574:Schools; D013313:Stress Disorders, Post-Traumatic / Q000150:complications / Q000523:psychology*; D011795:Surveys and Questionnaires; D013690:Television; D023481:Terrorism / Q000523:psychology*