Impact of a Terrorist Attack on the Mental Health of Directly Exposed French Adolescents: Study Protocol for the First Step of the AVAL Cohort Study

Marion Grenon, Maëlys Consigny, Christophe Lemey, Jean-Pierre Simson, Nathalie Coulon, Marion Grenon, Maëlys Consigny, Christophe Lemey, Jean-Pierre Simson, Nathalie Coulon

Abstract

Background: Several terrorist attacks have recently taken place in France and Europe. Various studies have shown a high prevalence of Post-Traumatic Stress Disorder (PTSD) and other psychiatric disorders among the victims of these attacks. Nevertheless, research in this field is scarce and no cohort study has been conducted yet to evaluate the impact of a terrorist attack on teenagers directly exposed to this type of events. Therefore, we decided to work on the AVAL (Adolescents Victimes de l'Attentat de Londres) cohort study in order to measure the psycho-traumatic impact of this attack and to describe these adolescents' health care pathways. Material and method: The 53 students of a French high school who were directly exposed (criterion A1 of PTSD in DSM-5) to the terrorist attack perpetrated in London on March 22, 2017 constitute the target population of this monocentric cross-sectional observational study. We decided not to include the three students who were physically wounded and, therefore, didn't have the same sensorial exposition. The primary endpoint will be the prevalence of PTSD 12 to 15 months after the attack, measured by the PCL-5 (Post-traumatic stress disorder Check-List for DSM-5) global severity score: the diagnosis of PTSD will be retained when the score is > 32. We will also use an extensive battery of clinical tests to assess the prevalence of anxiety disorders, mood disorders, sleep disorders, addictions, suicide risk, and alterations in social, family, and school functioning 12 to 15 months after the attack. We will also describe these adolescents' health care pathways since the attack and collect data from the clinical evaluation performed during the initial intervention of the medico-psychological emergency cell within 10 days after the attack. Discussion: The findings of this study are intended to provide epidemiological data about the psycho-traumatic impact of a terrorist attack on the mental health of directly exposed adolescents and to describe these adolescents' health care pathways, thus contributing to improve the immediate, post-immediate, and delayed response strategies after a major psycho-traumatic event involving adolescents (and in particular after terrorist attacks), as well as the identification and psychiatric care of the young survivors requiring specialized care. Clinical Trial Registration: www.ClinicalTrials.gov, identifier NCT03493243. Ethics and Dissemination: The regional ethics committee (Comité de Protection des Personnes Ouest IV-Nantes) approved the study protocol (Reference 10/18_3). All participants (and their legal guardians, for minors) must sign the informed consent to participate. The protocol was presented at the French congress of psychiatry in Nantes (France) in November 2018. After study completion, the results will be published and detailed in Marion Grenon's MD thesis in psychiatry.

Keywords: PTSD; adolescent psychiatry; crisis intervention; post-traumatic stress disorders; teenagers; terrorism.

Copyright © 2019 Grenon, Consigny, Lemey, Simson and Coulon.

References

    1. Bui E, Ohye B, Palitz S, Olliac B, Goutaudier N, Raynaud J-P, et al. Acute and chronic reactions to trauma in children and adolescents. IACAPAP (International Association for Child and Adolescents Psychiatry and Allied Professions) textbook., Geneva: International Association for Child and Adolescent Psychiatry and Allied Professions; (2014).
    1. Wang C-W, Chan CLW, Ho RTH. Prevalence and trajectory of psychopathology among child and adolescent survivors of disasters: A systematic review of epidemiological studies across 1987-2011. Soc Psychiatry Psychiatr Epidemiol (2013) 48(11):1697–720. 10.1007/s00127-013-0731-x
    1. Comer JS, Kendall PC. Terrorism: The psychological impact on youth. Clin Psychol Sci Pract (2007) 14(3):179–212. 10.1111/j.1468-2850.2007.00078.x
    1. Silverman WK, La Greca AM. Children experiencing disasters: Definitions, reactions, and predictors of outcomes. Helping children cope with disasters and terrorism. Washington, DC, U.S.:American Psychological Association; (2002). p. 11–33. 10.1037/10454-001
    1. Santiago PN, Ursano RJ, Gray CL, Pynoos RS, Spiegel D, Lewis-Fernandez R, et al. A systematic review of PTSD prevalence and trajectories in DSM-5 defined trauma exposed populations: Intentional and non-intentional traumatic events. PloS One (2013) 8(4):e59236. 10.1371/journal.pone.0059236
    1. Nordanger DØ, Hysing M, Posserud M-B, Lundervold AJ, Jakobsen R, Olff M, et al. Posttraumatic responses to the July 22, 2011 Oslo Terror among Norwegian high school students. J Trauma Stress (2013) 26(6):679–85. 10.1002/jts.21856
    1. Trickey D, Siddaway AP, Meiser-Stedman R, Serpell L, Field AP. A meta-analysis of risk factors for post-traumatic stress disorder in children and adolescents. Clin Psychol Rev. (2012) 32(2):122–38. 10.1016/j.cpr.2011.12.001
    1. Neria Y, DiGrande L, Adams BG. Posttraumatic stress disorder following the September 11, 2001, terrorist attacks: A review of the literature among highly exposed populations. Am Psychol (2011) 66(6):429–46. 10.1037/a0024791
    1. Whalley MG, Brewin CR. Mental health following terrorist attacks. Br J Psychiatry J Ment Sci (2007) 190:94–6. 10.1192/bjp.bp.106.026427
    1. Dyb G, TK Jensen, Nygaard E, Ekeberg O, Diseth TH, Wentzel-Larsen T, et al. Post-traumatic stress reactions in survivors of the 2011 massacre on Utøya Island, Norway. Br J Psychiatry J Ment Sci (2014) 204:361–7. 10.1192/bjp.bp.113.133157
    1. Saraiya A, Garakani A, Billick SB. Mental health approaches to child victims of acts of terrorism. Psychiatr Q (2013) 84(1):115–24. 10.1007/s11126-012-9232-4
    1. Chemtob CM, Madan A, Berger P, Abramovitz R. Adolescent exposure to the World Trade Center attacks, PTSD symptomatology, and suicidal ideation. J Trauma Stress (2011) 24(5):526–9. 10.1002/jts.20670
    1. Wu P, Duarte CS, Mandell DJ, Fan B, Liu X, Fuller CJ, et al. Exposure to the world trade center attack and the use of cigarettes and alcohol among New York city public high-school students. Am J Public Health (2006) 96(5):804–7. 10.2105/AJPH.2004.058925
    1. Chemtob CM, Nomura Y, Josephson L, Adams RE, Sederer L. Substance use and functional impairment among adolescents directly exposed to the 2001 World Trade Center attacks. Disasters (2009) 33(3):337–52. 10.1111/j.1467-7717.2008.01077.x
    1. Hoven CW, Duarte CS, Lucas CP, Wu P, Mandell DJ, Goodwin RD, et al. Psychopathology among New York city public school children 6 months after September 11. Arch Gen Psychiatry (2005) 62(5):545–52. 10.1001/archpsyc.62.5.545
    1. Schiff M, Zweig HH, Benbenishty R, Hasin DS. Exposure to terrorism and Israeli youths’ cigarette, alcohol, and cannabis use. Am J Public Health (2007) 97(10):1852–8. 10.2105/AJPH.2006.090514
    1. Ozer EJ, Best SR, Lipsey TL, Weiss DS. Predictors of posttraumatic stress disorder and symptoms in adults: a meta-analysis. Psychol Bull (2003) 129(1):52–73. 10.1037//0033-2909.129.1.52
    1. Breslau N, Peterson EL, Schultz LR. A second look at prior trauma and the posttraumatic stress disorder effects of subsequent trauma: A prospective epidemiological study. Arch Gen Psychiatry (2008) 65(4):431–7. 10.1001/archpsyc.65.4.431
    1. Ford CA, Udry JR, Gleiter K, Chantala K. Reactions of young adults to September 11, 2001. Arch Pediatr Adolesc Med (2003) 157(6):572–8. 10.1001/archpedi.157.6.572
    1. Ray M, Malhi P. Reactions of Indian adolescents to the 9/11 terrorist attacks. Indian J Pediatr (2005) 72(3):217–21. 10.1007/BF02859259
    1. Olff M, Langeland W, Draijer N, Gersons BPR. Gender differences in posttraumatic stress disorder. Psychol Bull. (2007) 133(2):183–204. 10.1037/0033-2909.133.2.183
    1. Twaite JA, Rodriguez-Srednicki O. Childhood sexual and physical abuse and adult vulnerability to PTSD: The mediating effects of attachment and dissociation. J Child Sex Abuse (2004) 13(1):17–38. 10.1300/J070v13n01_02
    1. Bonanno GA, Galea S, Bucciarelli A, Vlahov D. What predicts psychological resilience after disaster? The role of demographics, resources, and life stress. J Consult Clin Psychol (2007) 75(5):671–82. 10.1037/0022-006X.75.5.671
    1. Brewin CR, Andrews B, Valentine JD. Meta-analysis of risk factors for posttraumatic stress disorder in trauma-exposed adults. J Consult Clin Psychol (2000) 68(5):748–66. 10.1037//0022-006X.68.5.748
    1. Blanchard EB, Rowell D, Kuhn E, Rogers R, Wittrock D. Posttraumatic stress and depressive symptoms in a college population one year after the September 11 attacks: the effect of proximity. Behav Res Ther (2005) 43(1):143–50. 10.1016/j.brat.2003.12.004
    1. Callahan KL, Hilsenroth MJ, Yonai T, Waehler CA. Longitudinal stress responses to the 9/11 terrorist attacks in a New York metropolitan college sample. Stress Trauma Crisis Int J (2005) 8(1):45–60. 10.1080/15434610590913621
    1. Bonanno GA, Brewin CR, Kaniasty K, Greca AML. Weighing the costs of disaster: Consequences, risks, and resilience in individuals, families, and communities. Psychol Sci Public Interest J Am Psychol Soc (2010) 11(1):1–49. 10.1177/1529100610387086
    1. Olff M. Bonding after trauma: on the role of social support and the oxytocin system in traumatic stress. Eur J Psychotraumatol (2012) 27:3. 10.3402/ejpt.v3i0.18597
    1. Rousseau C, Jamil U, Bhui K, Boudjarane M. Consequences of 9/11 and the war on terror on children’s and young adult’s mental health: A systematic review of the past 10 years. Clin Child Psychol Psychiatry (2015) 20(2):173–93. 10.1177/1359104513503354
    1. Stoddard FJ, Gold J, Henderson SW, Merlino JP, Norwood A, JM Post , et al. Psychiatry and terrorism. J Nerv Ment Dis (2011) 199(8):537–43. 10.1097/NMD.0b013e318225ee90
    1. Masten AS, Narayan AJ. Child development in the context of disaster, war, and terrorism: Pathways of risk and resilience. Annu Rev Psychol (2011) 63(1):227–57. 10.1146/annurev-psych-120710-100356
    1. Eisenberg N, Silver RC. Growing up in the shadow of terrorism: Youth in America after 9/11. Am Psychol (2011) 66(6):468–81. 10.1037/a0024619
    1. Stene Dyb G. Health service utilization after terrorism: a longitudinal study of survivors of the 2011 Utøya attack in Norway. BMC Health Serv Res. (2015) 15:158. 10.1186/s12913-015-0811-6
    1. Pfefferbaum B, Sconzo GM, Flynn BW, Kearns LJ, Doughty DE, Gurwitch RH, et al. Case finding and mental health services for children in the aftermath of the Oklahoma City bombing. J Behav Health Serv Res (2003) 30(2):215–27. 10.1007/BF02289809
    1. Fairbrother G, Stuber J, Galea S, Pfefferbaum B, Fleischman AR. Unmet need for counseling services by children in New York City after the September 11th attacks on the World Trade Center: implications for pediatricians. Pediatrics (2004) 113(5):1367–74. 10.1542/peds.113.5.1367
    1. Rodriguez JJ, Kohn R. Use of mental health services among disaster survivors. Curr Opin Psychiatry (2008) 21(4):370–8. 10.1097/YCO.0b013e328304d984
    1. Pfefferbaum B, Noffsinger MA, Sherrieb K, Norris FH. Framework for research on children’s reactions to disasters and terrorist events. Prehospital Disaster Med (2012) 27(6):567–76. 10.1017/S1049023X12001343
    1. Pat-Horenczyk R, Abramovitz R, Peled O, Brom D, Daie A, Chemtob CM. Adolescent exposure to recurrent terrorism in Israel: Posttraumatic distress and functional impairment. Am J Orthopsychiatry (2007) 77(1):76–85. 10.1037/0002-9432.77.1.76
    1. Scrimin S, Moscardino U, Capello F, Axia G. Attention memory in school-age children surviving the terrorist attack in Beslan, Russia. J Clin Child Adolesc Psychol Off J Soc Clin Child Adolesc Psychol Am Psychol Assoc Div 53 (2009) 38(3):402–14. 10.1080/15374410902851689
    1. Marmar CR, Weiss DS, Metzler TJ. The peritraumatic dissociative experiences questionnaire. Assessing psychological trauma and PTSD. New York, NY, US.:Guilford Press; (1997). p. 412–28. 10.1037/t07470-000
    1. Birmes P, Brunet A, Benoit M, Defer S, Hatton L, Sztulman H, et al. Validation of the peritraumatic dissociative experiences questionnaire self-report version in two samples of French-speaking individuals exposed to trauma. Eur Psychiatry J Assoc Eur Psychiatr (2005) 20(2):145–51. 10.1016/j.eurpsy.2004.06.033
    1. Bui E, Brunet A, Olliac B, Very E, Allenou C, Raynaud J-P, et al. Validation of the peritraumatic dissociative experiences questionnaire and peritraumatic distress inventory in school-aged victims of road traffic accidents. Eur Psychiatry (2011) 26(2):108–11. 10.1016/j.eurpsy.2010.09.007
    1. Gray MJ, Litz BT, Hsu JL, Lombardo TW. Psychometric properties of the life events checklist. Assessment (2004) 11(4):330–41. 10.1177/1073191104269954
    1. Yeaworth RC, McNamee MJ, Pozehl B. The adolescent life change event scale: its development and use. Adolescence (1992) 27(108):783–802.
    1. Sheehan KH, Sheehan DV. Assessing treatment effects in clinical trials with the discan metric of the sheehan disability scale. Int Clin Psychopharmacol (2008) 23(2):70–83. 10.1097/YIC.0b013e3282f2b4d6
    1. Leon AC, Olfson M, Portera L, Farber L, Sheehan DV. Assessing psychiatric impairment in primary care with the sheehan disability scale. Int J Psychiatry Med (1997) 27(2):93–105. 10.2190/T8EM-C8YH-373N-1UWD
    1. Caron J. Une validation de la forme abrégée de l’Échelle de provisions sociales: l’ÉPS-10 items. Sante Ment Que. (2013) 38(1):297–318. 10.7202/1019198ar
    1. Ashbaugh AR, Houle-Johnson S, Herbert C, El-Hage W, Brunet A. Psychometric validation of the English and French versions of the posttraumatic stress disorder Checklist for DSM-5 (PCL-5). PLoS ONE (2016) 11(10):e0161645. 10.1371/journal.pone.0161645
    1. Association of American Psychiatry Diagnostic and statistical manual of mental disorders (DSM-5®). Arlington, VA, US.:American Psychiatric Pub; (2013). p. 1679. 10.1176/appi.books.9780890425596
    1. Brunet A, Weiss DS, Metzler TJ, Best SR, Neylan TC, Rogers C, et al. The peritraumatic distress inventory: a proposed measure of PTSD criterion A2. Am J Psychiatry (2001) 158(9):1480–5. 10.1176/appi.ajp.158.9.1480
    1. Sheehan DV, Lecrubier Y, KH Sheehan, Amorim P, Janavs J, Weiller E, et al. The mini-international neuropsychiatric interview (M.I.N.I.): The development and validation of a structured diagnostic psychiatric interview for DSM-IV and ICD-10. J Clin Psychiatry (1998) 59 :22–3334–57.
    1. Gil-Rivas V, Holman EA, Silver RC. Adolescent vulnerability following the September 11th terrorist attacks: a study of parents and their children. Appl Dev Sci (2004) 8:130–42. 10.1207/s1532480xads0803_3
    1. Gil-Rivas V, Silver RC, Holman EA, McIntosh DN, Poulin M. 53Parental response and adolescent adjustment to the September 11, 2001 terrorist attacks. J Trauma Stress (2007) 20(6):1063–8. 10.1002/jts.20277
    1. Birmes P, Raynaud J-P, Daubisse L, Brunet A, Arbus C, Klein R, et al. Children’s enduring PTSD symptoms are related to their family’s adaptability and cohesion. Commun Ment Health J (2009) 45(4):290–9. 10.1007/s10597-008-9166-3
    1. Thoresen S, Jensen TK, Dyb G. Media participation and mental health in terrorist attack survivors. J Trauma Stress (2014) 27(6):639–46. 10.1002/jts.21971
    1. Aakvaag HF, Thoresen S, Wentzel-Larsen T, Røysamb E, Dyb G. Shame and guilt in the aftermath of terror: the Utøya island study. J Trauma Stress (2014) 27(5):618–21. 10.1002/jts.21957
    1. Thoresen S, Aakvaag HF, Wentzel-Larsen T, Dyb G, Hjemdal OK. The day Norway cried: proximity and distress in Norwegian citizens following the 22nd July 2011 terrorist attacks in Oslo and on Utøya Island. Eur J Psychotraumatol (2012), 3. 10.3402/ejpt.v3i0.19709

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