Specialized Summaries :: Mass Shootings

IMPACT OF MASS SHOOTINGS ON SURVIVORS, FAMILIES, AND COMMUNITIES

Excerpt from: National Center for PTSD, PTSD Research Quarterly, Volume 18 #3, Summer 2007

On April 16, 2007, a student at Virginia Technological Institute shot and killed 32 people and wounded at least 25 others before taking his own life. The rampage in Norris Hall generated unthinkable horror and incredible heroism, as many faculty and students lost their lives trying to protect others. The incident rekindled national debates on mental illness and dangerousness, violence prevention and response, and the role of the media. Questions immediately arose about what the psychological impacts of the shootings would be on the survivors, witnesses, their families, first responders, and the entire Virginia Tech community.

Research on mass shootings is not extensive but is sufficient to allow preliminary conclusions about (1) the prevalence, persistence, and predictors of post-shooting PTSD; (2) the nature of survivor and community concerns; and (3) lessons learned for response. Fifteen events were identified whose consequences have been studied empirically or reviewed systematically. Within these three broad themes, this review is organized by event. There are three reasons for this choice. First, specific studies typically spanned multiple survivor groups, including the injured, eyewitnesses, parents, teachers and, occasionally, the community. Second, each event (and population studied) has unique elements that shape how well the findings may or may not generalize to other events (and populations), such as a shooting on a college campus. Third, the focus on events helped to illustrate how researchers have attempted to study these events Ð who was studied, how a control or comparison group was found, and why many (but not all) of these studies were small. The bibliography includes relevant examples from public spaces, workplaces, and schools, and it focuses on critical incidents rather than on ongoing school or community violence.

Prevalence, Persistence, and Predictors of Post-Shooting PTSD

Queen Street Shootings

On December 8, 1987, nine people died and five more were wounded by a gunman in a city office building in Melbourne, Australia. The gunman shot at many others, but the gun was not working properly. Some employees barricaded themselves into their offices, fearing for their lives. After he was captured, the man broke free, climbed out a window, and fell to his death. Creamer and colleagues (1993) collected self-report data from 447 employees 4, 8, and 14 months post-shooting (the trauma group). Employees from another office building in Melbourne served as the contrast group. The trauma group scored much higher than the contrast group on intrusion, avoidance, depression, anxiety, and other psychological symptoms. Symptoms lessened over time, but many of the effect sizes remained quite large.

Creamer and colleagues also analyzed the influence on symptoms of a variety of ÒvulnerabilityÓ and ÒrecoveryÓ factors. Vulnerability factors included gender, subjective experience of trauma, and other stressful life events. Recovery factors included perceived social support, receipt of individual counseling, and avoidance of the affected floors. In longitudinal analyses, early symptoms were strong predictors of later symptoms. This study was important for documenting the range of outcomes that can emerge after mass trauma, the persistence of symptoms for many, and the importance of subjective experience and subsequent stressors, findings that have since been replicated in a number of disaster studies (see Norris, Friedman & Watson, 2002a; Norris, Friedman, Watson, Byrne, et al., 2002b).

Cafeteria Shootings

On October 16, 1991, a man drove his truck into a cafeteria in Kileen, Texas and proceeded to shoot and kill 24 customers and injure many others. After being cornered by police, the gunman fatally shot himself. The impact of this event was studied by North and colleagues at points one month, one year, and three years after the disaster. North et al. (1994) described the initial results for 136 persons, including cafeteria employees, customers, and first responders. On the basis of the Diagnostic Interview Schedule (DIS) for DSM-III-R, 28% met criteria for current PTSD, which was the most prevalent disorder. Few had no symptoms of posttraumatic stress. Most of those suffering from PTSD related to the shooting had no prior history of psychiatric illness. However having had a prior history of PTSD or major depression did substantially increase the risk of shooting-related PTSD in women. Depression was often co-morbid with PTSD.

One year later, North and colleagues (1997) found the prevalence of current PTSD to have declined to 18%. Participants who recovered from PTSD by follow-up did not differ from those who had not recovered in number of symptoms at index or on any demographic variable. The prevalence of current PTSD did not change significantly between one and three years (North et al., 2002). North and colleagues (2001) found that talking about the incident, staying active, seeking social support, and seeking information about the event are all potentially helpful strategies for coping with the aftermath of a mass shooting.

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