As the 25th anniversary of the attacks of September 11 approaches, University of Tennessee College of Social Work (UTCSW) Associate Professor Dr. Anne Conway recalls exactly where she was and her first thoughts on that morning of the day that changed America forever.
“That morning I turned on the television and stood in shock. Feeling a desire to help and being 500 miles away from the sites of the attack, I dove into research to examine and work to inform behavioral health efforts into what I had suspected based on professional experience…that even young children would be emotionally affected by the events of 9/11,” said Conway.
Unlike other disasters, terrorism is not confined to one time or event as it is designed to provoke ongoing fear. Immediately after the attacks on September 11, United States citizens lived under a period of heightened threat of additional terrorist attacks. Color-coated alerts reflecting varying levels of severity were issued daily– orange, yellow, etc. Many were watching the television continuously searching for information or signs of safety which can be retraumatizing and can elevate stress.
US citizens at home and abroad experienced reduced emotional well-being and a sense of safety. As many as 90% of adults reported at least one symptom of stress, and more than 50% reported severe stress reactions, depression, and difficulty sleeping. Cardiac events and depressive symptoms rose nationally and 35% of school-aged children and adolescents experienced stress-related or mental health symptoms.
Little was known, however, about the effects on toddlers. Perhaps it was assumed that because toddlers did not understand what was occurring, they would not be affected. Yet, clinical reports and findings from interviews with parents within 100 miles of the attacks revealed fear, aggression, and separation problems in children, particularly if their mother experienced mental health symptoms.
Because one does not know when a disaster will occur, research on the effects is predominately based on reports of one’s state and behavioral problems after the event has occurred. Rarely is there information about an individual’s stress or behavioral health problems before a disaster to examine changes and the impact of the event.
“We were in a unique position because we were conducting an ongoing longitudinal study,” Conway explained. “Mothers and their 33-month-old toddlers had been participating in the study since they were seven months old. By 9/11, some of the mothers and 33-month-old toddlers had completed all their assessments, whereas others would be completing their final assessment after 9/11. This allowed us to compare the two groups to determine whether their stress-related symptoms differed from each other and from prior visits. This quasi-experimental design allowed us to have a clearer assessment of whether stress-related symptoms may have been due to the attacks of 9/11 and the continued threat of terrorism. And we were also able to test these in mothers and toddlers 500 miles from the site of the attacks.”
Conway and her colleagues examined whether mothers had more mental health problems and parenting stress and whether their toddlers cried more and slept less following the attack. Based on data from Drs. Susan McDonough and Arnold Sameroff’s Michigan Longitudinal Study, findings were that mothers had poorer health, lower acceptance of their child, and reported more anxiety, and that their 33-month-old toddlers cried more and slept less than they did at 15-months. This increase was only found among the group of mother and toddlers that were assessed after 9/11. The group that was assessed before 9/11, did not show increased stress-related symptoms.
“These findings are consistent with other studies documenting stress-related symptoms and that 9/11 and the continuing threat of terrorism had effects that extended even beyond the place and time of the attack and demonstrated that even toddlers were affected. Perhaps the most important message from this study is that terrorism and the threat of terrorism does affect our youngest citizens and that behavioral health efforts are needed to address the impact. This work also needs to be expanded here at home to understand and address the impacts of disasters on our youngest Tennesseans,” said Conway.
Click here to read the entire study:
https://psycnet.apa.org/doiLanding?doi=10.1111%2Fajop.12055
Dr. Anne Conway is an associate professor of Social Work and Director of the Child and Youth Development Lab at the University of Tennessee, Knoxville. Her research interests include maternal and child development and mental health. https://faculty.utk.edu/Anne.Conway