An 18-Month Longitudinal Study of Posttraumatic Disorders in Children Who Were Taken Hostage in Their School

Objective: The objective of our investigation was to study the course of direct and indirect posttraumatic disorders over 18 months in children after they were taken hostage in their school. Methods: Twenty-six young hostages were evaluated by using standardized clinical interviews and self-administered questionnaires (State and Trait Anxiety Inventory for Children [STAIC]and Revised Impact of Event Scale [IES]) 2, 4, 7, and 18 months after the event. They were compared with 21 children from the same school who were not taken hostage (indirect exposure). Results: Symptoms of acute stress were observed in 25 (96%) of the children who were directly involved in the traumatic event. After 2 months, 18 children had developed disorders according to criteria of the Diagnostic and Statistical Manual of Mental Disorders, fourth edition, including 7 cases of full posttraumatic stress disorder (PTSD), 11 cases of subclinical PTSD, 3 cases of separation anxiety, 1 case of specific phobia, and 2 cases of major depressive disorder. Anxiety scores (STAIC) decreased between 2 and 4 months and then stabilized, whereas symptoms of avoidance (IES-avoidance) decreased gradually throughout the follow-up period, and symptoms of repetition (IES-intrusion) decreased less markedly. Children who were indirectly exposed to the trauma also manifested protracted posttraumatic symptomatology (two full cases of PTSD and six cases of subclinical PTSD), but their IES-intrusion scores were significantly lower at 7 months than those of children who were directly exposed, and the severity of their symptoms diminished over time. Girls tended to show a higher level of anxiety and more feature