title: Post-traumatic stress symptoms in adolescents after two murders in a school: a controlled follow-up study.
abstract: OBJECTIVE
  Two students were murdered by gunshot by another student. Among the classmates and the students in another school, we aimed to investigate the factors on the fifth day of trauma to be predictive of higher post-traumatic stress symptoms (PTSS) scores five months later.
  
  
  METHODS
  The adolescents attending the school (School A: acute phase n:41; second phase n:57; follow-up group n:35) where the event had occurred, and the adolescents attending a school (School B: acute phase n:98; second phase n:57) of similar statue were included. They had completed "Trauma Questionnaire" (TQ), "Childhood Post Traumatic Stress Disorder-Reaction Index" (CPTSD-RI), "Beck Depression Inventory" (BDI), and "State-Trait Anxiety Inventory" (STAI) both 5 days and 5 months after the event.
  
  
  RESULTS
  Both 5 days and 5 months after the trauma, students in school A, and the girls in both schools had significantly higher CPTSD-RI scores. Nine students (25.7%) in the follow-up group were found to have CPTSD-RI scores higher than 39, indicating severe PTSD symptoms. The CPTSD-RI scores of this group 5 months after the trauma were significantly correlated with the several scores of the acute term (CPTSD-RI [r: .76,p < .001]; BDI [r: .56, p: .001]; STAI-state [r:. 49, p: .004]).
  
  
  CONCLUSIONS
  Results reveal that a murder of a peer triggers post-traumatic stress symptoms in a vast majority of the 16-year-old adolescents even without directly witnessing the event. The severity of PTSS significantly increases as the adolescent is in closer relationship with the victim. The concomitant depression and/or anxiety with acute stress symptoms 5 days after the trauma, female gender, and worse school performance were found to be significantly related to the development of more severe PTSS 5 months later.
authors.affiliation: Dept. of Child and Adolescent Psychiatry, Ondokuz Mayis University, Samsun, Turkey. drkorayk@yahoo.com
authors.forename: Koray
authors.initials: K
authors.lastname: Karabekiroglu
authors.forename: Seher
authors.initials: S
authors.lastname: Akbas
authors.forename: Gokce Nur
authors.initials: GN
authors.lastname: Tasdemir
authors.forename: Melih Nuri
authors.initials: MN
authors.lastname: Karakurt
mesh_terms: D000293:Adolescent; D016022:Case-Control Studies; D005260:Female; D005500:Follow-Up Studies; D006708:Homicide / Q000523:psychology*; D006801:Humans; D008297:Male; D015999:Multivariate Analysis; D012044:Regression Analysis; D012307:Risk Factors; D013313:Stress Disorders, Post-Traumatic / Q000453:epidemiology* / Q000209:etiology / Q000523:psychology; D040701:Stress Disorders, Traumatic, Acute / Q000453:epidemiology* / Q000209:etiology / Q000523:psychology; D013334:Students / Q000523:psychology*; D014421:Turkey / Q000453:epidemiology