F 

Office of Communications and 


Public Liaison


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Web site: www.nimh.nih.gov


September 2001 

NIH Publication No. 01-3518 

Helping 

Children and 

Adolescents 

Cope with 

Violence and 

Disasters 

From the National Institute of 

Mental Health 

Helping young people avoid or overcome 

emotional problems in the wake of 

violence or disaster is one of the most 

important challenges a parent, teacher, or 

mental health professional can face. The 

National Institute of Mental Health and 

other Federal agencies are working to 

address the issue of assisting children and 

adolescents who have been victims of or 

witnesses to violent and/or catastrophic 

events. The purpose of this fact sheet is to 

tell what is known about the impact of 

violence and disasters on children and 

adolescents and suggest steps to minimize 

long-term emotional harm. 

In the aftermath of the terrorist 

attacks on New York City and Washington, 

DC, both adults and children are struggling 

with the emotional impact of such largescale damage and losses of life. Other 

major acts of violence that have been felt 

across the country include the 1995 

bombing of the Alfred P. Murrah Federal 

Building in Oklahoma City and the 1999 

shootings at Columbine High School in 

Littleton, Colorado. While these disastrous 

events have caught the Nation’s attention, 

they are only a fraction of the many tragic 

episodes that affect children’s lives. Each 

year many children and adolescents 

sustain injuries from violence, lose friends 

or family members, or are adversely 

NIM

National Institute 

I•I 

of Mental Health 

An NIMH Snapshot The National Institute of Mental Health 

(NIMH) is a component of the National 

Institutes of Health (NIH), the Government’s 

principal biomedical and behavioral research 

agency. NIH is part of the U.S. Department of 

Health and Human Services. The actual total 

fiscal year 2000 NIMH budget was $974 

million. 

NIMH Mission 

To reduce the burden of mental illness through 

research on mind, brain, and behavior. 

■ NIMH conducts research on mental 

disorders and the underlying basic science 

of brain and behavior. 

■ NIMH supports research on these topics at 

universities and hospitals around the 

United States. 

■ NIMH collects, analyzes, and disseminates 

information on the causes, occurrence, and 

treatment of mental illnesses. 

■ NIMH supports the training of more than 

1,000 scientists to carry out basic and 

clinical research. 

■ NIMH communicates information to 

scientists, the public, the news media, and 

primary care and mental health professionals about mental illnesses, the brain, 

mental health, and research in these areas. 

DEPARTMENT OF HEALTH AND HUMAN SERVICES • PUBLIC HEALTH SERVICE • NATIONAL INSTITUTES OF HEALTH


F ACT SHEET 
affected by witnessing a violent or 

catastrophic event. Each situation is 

unique, whether it centers upon a plane 

crash where many people are killed, 

automobile accidents involving friends or 

family members, or natural disasters such 

as the Northridge, California Earthquake 

(1994) or Hurricane Floyd (1999) where 

deaths occur and homes are lost—but 

these events have similarities as well and 

cause similar reactions in children. Even in 

the course of everyday life, exposure to 

violence in the home or on the streets can 

lead to emotional harm. 

Research has shown that both adults 

and children who experience catastrophic 

events show a wide range of reactions.1,2 

Some suffer only worries and bad 

memories that fade with emotional support 

and the passage of time. Others are more 

deeply affected and experience long-term 

problems. Research on post-traumatic 

stress disorder (PTSD) shows that some 

soldiers, survivors of criminal victimization, torture and other violence, and 

survivors of natural and human-made 

catastrophes suffer long-term effects from 

their experiences. Children who have 

witnessed violence in their families, 

schools, or communities are also 

vulnerable to serious long-term problems. 

Their emotional reactions, including fear, 

depression, withdrawal or anger, can occur 

immediately or some time after the tragic 

event. Youngsters who have experienced a 

catastrophic event often need support from 

parents and teachers to avoid long-term 

emotional harm. Most will recover in a 

short time, but the few who develop PTSD 

or other persistent problems need 

treatment. 

Trauma—What Is It? 

“Trauma” has both a medical and a 

psychiatric definition. Medically, “trauma” 

refers to a serious or critical bodily injury, 

wound, or shock. This definition is often 

associated with trauma medicine practiced 

in emergency rooms and represents a 

popular view of the term. Psychiatrically, 

“trauma” has assumed a different meaning 

and refers to an experience that is 

emotionally painful, distressful, or 

shocking, which often results in lasting 

mental and physical effects. 

Psychiatric trauma, or emotional harm, 

is essentially a normal response to an 

extreme event. It involves the creation of 

emotional memories about the distressful 

event that are stored in structures deep 

within the brain. In general, it is believed 

that the more direct the exposure to the 

traumatic event, the higher the risk for 

emotional harm.3 Thus in a school 

shooting, for example, the student who is 

injured probably will be most severely 

affected emotionally; and the student who 

sees a classmate shot, even killed, is likely 

to be more emotionally affected than the 

student who was in another part of the 

school when the violence occurred. But 

even second-hand exposure to violence can 

be traumatic. For this reason, all children 

and adolescents exposed to violence or a 

disaster, even if only through graphic 

media reports, should be watched for signs 

of emotional distress. 

How Children and Adolescents 

React to Trauma 

Reactions to trauma may appear 

immediately after the traumatic event or 

days and even weeks later. Loss of trust in 

adults and fear of the event occurring 

again are responses seen in many children 

and adolescents who have been exposed to 

traumatic events. Other reactions vary 

according to age:4-7 

For children 5 years of age and 

younger, typical reactions can include a 

fear of being separated from the parent, 

crying, whimpering, screaming, immobility 

and/or aimless motion, trembling, 

frightened facial expressions and excessive 

clinging. Parents may also notice children 

returning to behaviors exhibited at earlier 

ages (these are called regressive 

behaviors), such as thumb-sucking, 

bedwetting, and fear of darkness. Children 

in this age bracket tend to be strongly 

affected by the parents’ reactions to the 

traumatic event. 

Children 6 to 11 years old may show 

extreme withdrawal, disruptive behavior, 

and/or inability to pay attention. 

Regressive behaviors, nightmares, sleep 

problems, irrational fears, irritability, 

refusal to attend school, outbursts of anger 

and fighting are also common in 
traumatized children of this age. Also the 

child may complain of stomachaches or 

other bodily symptoms that have no 

medical basis. Schoolwork often suffers. 

Depression, anxiety, feelings of guilt and 

emotional numbing or “flatness” are often 

present as well. 

Adolescents 12 to 17 years old may 

exhibit responses similar to those of 

adults, including flashbacks, nightmares, 

emotional numbing, avoidance of any 

reminders of the traumatic event, 

depression, substance abuse, problems 

with peers, and antisocial behavior. Also 

common are withdrawal and isolation, 

physical complaints, suicidal thoughts, 

school avoidance, academic decline, sleep 

disturbances, and confusion. The 

adolescent may feel extreme guilt over his 

or her failure to prevent injury or loss of 

life, and may harbor revenge fantasies that 

interfere with recovery from the trauma. 

Some youngsters are more vulnerable to 

the effects of trauma than others, for 

reasons scientists do not fully understand. 

It has been shown that the impact of a 

traumatic event is likely to be greatest in 

the child or adolescent who previously has 

been the victim of child abuse or some 

other form of trauma, or who already had 

a mental health problem.8-11 In addition, 

the youngster who lacks family support is 

more at risk for a poor recovery.

12 

Helping the Child or Adolescent 

Trauma Survivor 

Early intervention to help children and 

adolescents who have suffered trauma due 

to violence or a disaster is critical. Parents, 

teachers and mental health professionals 

can do a great deal to help these 

youngsters recover. Help should begin at 

the scene of the traumatic event. 

According to the National Center for 

Post-Traumatic Stress Disorder of the 

Department of Veterans Affairs, workers in 

charge of a disaster scene should: 

■ Find ways to protect children from 

further harm and from further exposure to 

traumatic stimuli. If possible, create a safe 

haven for them. Protect children from 

onlookers and the media covering the 

story. 

■ When possible, direct children who are 

able to walk away from the site of violence 

or destruction, away from severely injured 

survivors, and away from continuing 

danger. Kind but firm direction is needed. 

■ Identify children in acute distress and 

stay with them until initial stabilization 

occurs. Acute distress includes panic 

(marked by trembling, agitation, rambling 

speech, becoming mute, or erratic 

behavior) and intense grief (signs include 

loud crying, rage, or immobility). 

■ Use a supportive and compassionate 

verbal or non-verbal exchange (such as a 

hug, if appropriate) with the child to help 

him or her feel safe. However brief the 

exchange, or however temporary, such 

reassurances are important to children. 

After violence or a disaster occurs, the 

family is the first-line resource for helping. 

Among the things that parents and other 

caring adults can do are: 

■ Explain the episode of violence or 

disaster as well as you are able. 

■ Encourage the children to express their 

feelings and listen without passing 

judgment. Help younger children learn to 

use words that express their feelings. 

However, do not force discussion of the 

traumatic event. 

■ Let children and adolescents know 

that it is normal to feel upset after 

something bad happens. 

■ Allow time for the youngsters to 

experience and talk about their feelings. At 

home, however, a gradual return to routine 

can be reassuring to the child. 

■ If your children are fearful, reassure 

them that you love them and will take care 

of them. Stay together as a family as much 

as possible. 

■ If behavior at bedtime is a problem, 

give the child extra time and reassurance. 

Let him or her sleep with a light on or in 

your room for a limited time if necessary. 

■ Reassure children and adolescents that 

the traumatic event was not their fault. 

■ Do not criticize regressive behavior or 

shame the child with words like “babyish.” 

■ Allow children to cry or be sad. Don’t 

expect them to be brave or tough. 
■ Encourage children and adolescents to 

feel in control. Let them make some 

decisions about meals, what to wear, etc. 

■ Take care of yourself so you can take 

care of the children. 

When violence or disaster affects a 

whole school or community, teachers and 

school administrators can play a major 

role in the healing process. Some of the 

things educators can do are: 

■ If possible, give yourself a bit of time 

to come to terms with the event before you 

attempt to reassure the children. This may 

not be possible in the case of a violent 

episode that occurs at school, but 

sometimes in a natural disaster there will 

be several days before schools reopen and 

teachers can take the time to prepare 

themselves emotionally. 

■ Don’t try to rush back to ordinary 

school routines too soon. Give the children 

or adolescents time to talk over the 

traumatic event and express their feelings 

about it. 

■ Respect the preferences of children 

who do not want to participate in class 

discussions about the traumatic event. Do 

not force discussion or repeatedly bring up 

the catastrophic event; doing so may retraumatize children. 

■ Hold in-school sessions with entire 

classes, with smaller groups of students, 

or with individual students. These sessions 

can be very useful in letting students know 

that their fears and concerns are normal 

reactions. Many counties and school 

districts have teams that will go into 

schools to hold such sessions after a 

disaster or episode of violence. Involve 

mental health professionals in these 

activities if possible. 

■ Offer art and play therapy for young 

children in school. 

■ Be sensitive to cultural differences 

among the children. In some cultures, for 

example, it is not acceptable to express 

negative emotions. Also, the child who is 

reluctant to make eye contact with a 

teacher may not be depressed, but may 

simply be exhibiting behavior appropriate 

to his or her culture. 

■ Encourage children to develop coping 

and problem-solving skills and ageappropriate methods for managing anxiety. 

■ Hold meetings for parents to discuss 

the traumatic event, their children’s 

response to it, and how they and you can 

help. Involve mental health professionals 

in these meetings if possible. 

Most children and adolescents, if given 

support such as that described above, will 

recover almost completely from the fear 

and anxiety caused by a traumatic 

experience within a few weeks. However, 

some children and adolescents will need 

more help perhaps over a longer period of 

time in order to heal. Grief over the loss of 

a loved one, teacher, friend, or pet may 

take months to resolve, and may be 

reawakened by reminders such as media 

reports or the anniversary of the death. 

In the immediate aftermath of a 

traumatic event, and in the weeks 

following, it is important to identify the 

youngsters who are in need of more 

intensive support and therapy because of 

profound grief or some other extreme 

emotion. Children and adolescents who 

may require the help of a mental health 

professional include those who show 

avoidance behavior, such as resisting or 

refusing to go places that remind them of 

the place where the traumatic event 

occurred, and emotional numbing, a 

diminished emotional response or lack of 

feeling toward the event. Youngsters who 

have more common reactions including reexperiencing the trauma, or reliving it in 

the form of nightmares and disturbing 

recollections during the day, and hyperarousal, including sleep disturbances and 

a tendency to be easily startled, may 

respond well to supportive reassurance 

from parents and teachers. 

Post-Traumatic Stress Disorder 

As mentioned earlier, some children and 

adolescents will have prolonged problems 

after a traumatic event. These potentially 

chronic conditions include depression and 

prolonged grief. Another serious and 

potentially long-lasting problem is posttraumatic stress disorder (PTSD). This 

condition is diagnosed when the following 
symptoms have been present for longer 

than one month: 

■ Re-experiencing the event through play 

or in trauma-specific nightmares or 

flashbacks, or distress over events that 

resemble or symbolize the trauma 

■ Routine avoidance of reminders of the 

event or a general lack of responsiveness 

(e.g., diminished interests or a sense of 

having a foreshortened future) 

■ Increased sleep disturbances, 

irritability, poor concentration, startle 

reaction and regressive behavior 

Rates of PTSD identified in child and 

adult survivors of violence and disasters 

vary widely. For example, estimates range 

from 2% after a natural disaster (tornado), 

28% after an episode of terrorism (mass 

shooting), and 29% after a plane crash.13 

The disorder may arise weeks or 

months after the traumatic event. PTSD 

may resolve without treatment, but some 

form of therapy by a mental health professional is often required in order for healing 

to occur. Fortunately, it is more common 

for traumatized individuals to have some 

of the symptoms of PTSD than to develop 14 the full-blown disorder. 

As noted above, people differ in their 

vulnerability to PTSD, and the source of 

this difference is not known in its entirety. 

Researchers have identified factors that 

interact to influence vulnerability to 

developing PTSD. These factors include: 

■ characteristics of the trauma exposure 

itself (e.g., proximity to trauma, severity, 

and duration), 

■ characteristics of the individual (e.g., 

prior trauma exposures, family 

history/prior psychiatric illness, and 

gender—women are at greatest risk for 

many of the most common assaultive 

traumas), and 

■ post-trauma factors (e.g., availability 

of social support, emergence of 

avoidance/numbing, hyperarousal and 

re-experiencing symptoms). 

Research has shown that PTSD clearly 

alters a number of fundamental brain 

mechanisms. Abnormal levels of brain 

chemicals that affect coping behavior, 

learning, and memory have been detected 

among people with the disorder. In 

addition, recent imaging studies have 

discovered altered metabolism and blood 

flow in the brain as well as structural 

brain changes in people with PTSD.15-19 

Treatment of PTSD 

People with PTSD are treated with 

specialized forms of psychotherapy and 

sometimes with medications or a 

combination of the two. One of the forms 

of psychotherapy shown to be effective is 

cognitive behavioral therapy, or CBT. In 

CBT, the patient is taught methods of 

overcoming anxiety or depression and 

modifying undesirable behaviors such as 

avoidance of reminders of the traumatic 

event. The therapist helps the patient 

examine and re-evaluate beliefs that are 

interfering with healing, such as the belief 

that the traumatic event will happen 

again. Children who undergo CBT are 

taught to avoid “catastrophizing.” For 

example, they are reassured that dark 

clouds do not necessarily mean another 

hurricane, that the fact that someone is 

angry does not necessarily mean that 

another shooting is imminent, etc. Play 

therapy and art therapy also can help 

younger children to remember the 

traumatic event safely and express their 

feelings about it. Other forms of 

psychotherapy that have been found to 

help persons with PTSD include group and 

exposure therapy. A reasonable period of 

time for treatment of PTSD is 6 to 12 

weeks with occasional follow-up sessions, 

but treatment may be longer depending on 

a patient’s particular circumstances. 

Research has shown that support from 

family and friends can be an important 

part of recovery. 

There has been a good deal of research 

on the use of medications for adults with 

PTSD, including research on the formation 

of emotionally charged memories and 

medications that may help block the 

development of symptoms.20-22 Medications 

appear to be useful in reducing 

overwhelming symptoms of arousal (such 

as sleep disturbances and an exaggerated 

startle reflex), intrusive thoughts, and 

avoidance; reducing accompanying 

conditions such as depression and panic; 

and improving impulse control and related 
behavioral problems. Research is just 

beginning on the use of medications to 

treat PTSD in children and adolescents. 

There is accumulating empirical 

evidence that trauma/grief-focused 

psychotherapy and selected pharmacologic 

interventions can be effective in alleviating 

PTSD symptoms and in addressing cooccurring depression.23-26 However, more 

medication treatment research is needed. 

A mental health professional with 

special expertise in the area of child and 

adolescent trauma is the best person to 

help a youngster with PTSD. Organizations 

on the accompanying resource list may 

help you to find such a specialist in your 

geographical area. 

What Are Scientists Learning 

About Trauma in Children and 

Adolescents? 

The National Institute of Mental Health 

(NIMH), a part of the Federal Government’s 

National Institutes of Health, supports 

research on the brain and a wide range of 

mental disorders, including PTSD and 

related conditions. The Department of 

Veterans Affairs also conducts research in 

this area with adults and their family 

members. 

Recent research findings include: 

■ Some studies show that counseling 

children very soon after a catastrophic 

event may reduce some of the symptoms of 

PTSD. A study of trauma/grief-focused 

psychotherapy among early adolescents 

exposed to an earthquake found that brief 

psychotherapy was effective in alleviating 

PTSD symptoms and preventing the 

worsening of co-occurring depression.27 

■ Parents’ responses to a violent event 

or disaster strongly influence their 

children’s ability to recover. This is particularly true for mothers of young children. If 

the mother is depressed or highly anxious, 

she may need to get emotional support or 

counseling in order to be able to help her 

child.28-30 

■ Either being exposed to violence 

within the home for an extended period of 

time or exposure to a one-time event like 

an attack by a dog can cause PTSD in a 

child. 

■ Community violence can have a 

profound effect on teachers as well as 

students. One study of Head Start teachers 

who lived through the 1992 Los Angeles 

riots showed that 7% had severe posttraumatic stress symptoms, and 29% had 

moderate symptoms. Children also were 

acutely affected by the violence and 

anxiety around them. They were more 

aggressive and noisy and less likely to be 

obedient or get along with each other.

31 

■ Research has demonstrated that PTSD 

after exposure to a variety of traumatic 

events (family violence, child abuse, 

disasters, and community violence) is 

often accompanied by depression.3,32-35 

Depression must be treated along with 

PTSD, and early treatment is best. 

■ Inner-city children experience the 

greatest exposure to violence. A study of 

young adolescent boys from inner-city 

Chicago showed that 68% had seen 

someone beaten up and 22.5% had seen 

someone shot or killed. Youngsters who 

had been exposed to community violence 

were more likely to exhibit aggressive 

behavior or depression within the 

following year.

36,37 

NIMH-supported scientists are 

continuing to conduct research into the 

impact of violence and disaster on children 

and adolescents. For example, one study 

will follow 6,000 Chicago children from 80 

different neighborhoods over a period of 

several years.38 It will examine the 

emotional, social and academic effects of 

exposure to violence. In some of the 

children, the researchers will look at the 

role of stress hormones in the response to 

traumatic experiences. Another study will 

deal specifically with the victims of school 

violence, attempting to determine what 

places children at risk for victimization at 

school and what factors protect them.39 

It is particularly important to conduct 

research to discover which individual, 

family, school and community interventions work best for children and 

adolescents exposed to violence or disaster, 

and to find out whether a well-intended 

but ill-designed intervention could set the 

youngsters back by keeping the trauma 
alive in their minds. Through research, 

NIMH hopes to gain knowledge to lessen 

the suffering that violence and disasters 

impose on children and adolescents and 

their families. 

The General Public can obtain publications about PTSD and other anxiety 

disorders by calling NIMH’s toll-free 

information service, 1-88-88-ANXIETY, or 

calling the Institute’s public inquiries 

office at 301-443-4513. Information is also 

available online from NIMH’s Web site: 

http://www.nimh.nih.gov/anxiety/ 

anxietymenu.cfm. The accompanying 

resource list below indicates agencies or 

organizations that may have additional 

information about helping children and 

adolescents cope with violence and 

disasters. Reporters interested in PTSD 

and other anxiety disorders may contact 

the NIMH press office at 301-443-4536. 

Violence/Disasters/PTSD 

Resource List 

National Institute of Mental Health (NIMH) 

Information Resources and Inquiries Branch


6001 Executive Boulevard, Rm. 8184,


MSC 9663


Bethesda, MD 20892-9663


PTSD/Anxiety Disorders Publications:


1-88-88-ANXIETY


Public Inquiries: 301-443-4513


Media Inquiries: 301-443-4536


TTY: 301-443-8431


E-mail: nimhinfo@nih.gov


Web site: http://www.nimh.nih.gov 


Center for Mental Health Services (CMHS) 

Emergency Services and Disaster


Relief Branch


5600 Fishers Lane, Room 17C-20


Rockville, MD 20857


Phone: 301-443-4735


E-mail: ken@mentalhealth.org


Web site: http://www.mentalhealth.org/


cmhs/emergencyservices/index.htm 


U.S. Department of Education 

400 Maryland Avenue, SW


Washington, DC 20202


Phone: 1-800-USA-LEARN


TTY: 1-800-437-0833


E-mail: customerservice@inet.ed.gov


Web site: http://www.ed.gov 


Center for Mental Health Services (CMHS) 

CMHS is a component of the Substance 

Abuse and Mental Health Services 

Administration, U.S. Department of 

Health and Human Services. The Federal 

Emergency Management Agency, 

working with the CMHS’ Emergency 

Services and Disaster Relief Branch 

(ESDRB), provides funding support for 

mental health services following a 

disaster. The Crisis Counseling 

Assistance and Training Program is 

implemented at the request of a state or 

territory when a “Major Disaster” has 

been declared by the President. Funding 

for the Crisis Counseling Program (CCP) 

is not automatic. Funding is provided if 

the need is beyond the means of state 

and local providers. Legislative authority 

is based on the Robert T. Stafford 

Disaster Assistance Act, Section 416 

(Public Law 100-707). There are three 

components to the CCP program: 

Immediate Services, Regular Services, 

and Training and Preparedness. The 60-

day Immediate Services Program (ISP) 

provides services from the date of the 

incident. The Regular Services Program 

(RSP) follows the ISP when there is a 

proven need and provides services for up 

to 9 months. A week-long training 

program is completed each year for state 

mental health authorities to assist in 

planning for mental health response to 

disasters. For more information about 

the CCP program, call the Emergency 

Services and Disaster Relief Branch, 

CMHS, at 301-443-4735. 

U.S. Department of Justice 

950 Pennsylvania Avenue, NW 

Washington, DC 20530-0001 

E-mail: AskDOJ@usdoj.gov 

Web site: http://www.usdoj.gov 

Federal Emergency Management Agency 

(Information for children and adolescents)


P.O. Box 2012


Jessup MD 20794-2012 


Publications: 1-800-480-2520 


Web site: http://www.fema.gov/kids 

International Society for Traumatic 

Stress Studies (ISTSS) 

60 Revere Drive, Suite 500


Northbrook, IL 60062


Phone: 847-480-9028


E-mail: istss@istss.org


Web site: http://www.istss.org 


National Center for PTSD 

215 N. Main Street


White River Junction, VT 05009


Phone: 802-296-5132


E-mail: ptsd@dartmouth.edu


Web site: http://www.ncptsd.org 


National Center for Victims of Crime 

2111 Wilson Boulevard, Suite 300


Arlington, VA 22201


Phone: 703-276-2880


E-mail: mail@ncvc.org


Web site: http://www.nvc.org 


National Organization for Victim 

Assistance (NOVA) 

1757 Park Road, NW


Washington, DC 20010


Phone: 1-800-879-6682 or 202-232-6682


E-mail: nova@try-nova.org


Web site: http://www.try-nova.org 


Office for Victims of Crime Resource Center 

National Criminal Justice Reference Service


P.O. Box 6000


Rockville, MD 20850


Phone: 1-800-627-6872


E-mail: askncjrs@ncjrs.org


Web site: http://www.ncjrs.org 


American Psychiatric Association 

1400 K Street, NW


Washington, DC 20005


Phone: 1-888-357-7924 or 202-682-6000


E-mail: apa@psych.org


Web site: http://www.psych.org 


American Psychological Association 

750 First Street, NE


Washington, DC 20002


Phone: 202-336-5500


Web site: http://www.apa.org 


American Academy of Child and 

Adolescent Psychiatry 

3615 Wisconsin Avenue, NW 

Washington, DC 20016-3007 

Phone: 202-966-7300


Web site: http://www.aacap.org 


Anxiety Disorders Association 

of America (ADAA) 

11900 Parklawn Drive, Suite 100


Rockville, MD 20852


Phone: 301-231-9350


E-mail: AnxDis@adaa.org


Web site: http://www.adaa.org


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Smith EM, North CS. Posttraumatic stress 

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March JS, Amaya-Jackson L, Terry R, 

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Osofsky JD. The effects of exposure to 

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Pynoos RS, Steinberg AM, Goenjian AK. 

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Marans S, Adelman A. Experiencing 

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Garbarino J, Kostelny K, Dubrow N. What 

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All material in this fact sheet is in the public 

domain and may be copied or reproduced 

without permission from the NIMH. Citation 

of NIMH as the source is appreciated. 

NIH Publication No. 01-3518 September 2001