Skip to main content

Posttraumatic Stress in the Aftermath of Mass Shootings

  • Chapter
  • First Online:
Traumatic Stress and Long-Term Recovery

Abstract

Recent mass shooting incidents in the USA include the 2007 shooting at Virginia Tech and the 2012 shootings at the Aurora, Colorado movie theatre and Sandy Hook elementary school in Newtown, Connecticut. Although these events generated much national attention, surprisingly, little research has evaluated mental health impacts of mass shootings, and no efforts to our knowledge have been made to synthesize the empirical findings. In this chapter, we review the extant literature on posttraumatic stress in the aftermath mass shootings. We identified 35 peer-reviewed articles, comprised of 19 independent samples in the aftermath of 14 mass shooting incidents. The prevalence of posttraumatic stress disorder in these studies ranged from 3 to 91 %. Several factors could underlie this wide variation, including differences in the assessment measures, criteria used to define cases, timing of assessment, and sample characteristics. Risk factors for more severe posttraumatic stress symptoms have been identified, including demographic and pre-incident characteristics (e.g., female gender, pre-incident psychological symptoms), event exposure (e.g., greater proximity to the attack, acquaintance with the deceased), and fewer psychosocial resources (e.g., emotion regulation difficulties, lower social support). Further research that draws on pre-incident and longitudinal data will yield important insights into the processes that exacerbate or sustain posttraumatic stress over time and provide important information for crisis preparedness and post-incident mental health interventions.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 84.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 129.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 109.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  • Bardeen, J. R., Kumpula, M. J., & Orcutt, H. K. (2013). Emotion regulation difficulties as a prospective predictor of posttraumatic stress symptoms following a mass shooting. Journal of Anxiety Disorders, 27, 188–196. doi:10.1016/j.janxdis.2013.01.003.

    Article  PubMed Central  PubMed  Google Scholar 

  • Classen, C., Coopman, C., Hales, R., & Spiegel, D. (1998). Acute stress disorder as a predictor of posttraumatic stress symptoms. American Journal of Psychiatry, 155, 620–624.

    Article  PubMed  Google Scholar 

  • Cornell, D., & Allen, K. (2011).Development, evaluation, and future directions of the Virginia Student Threat Assessment Guidelines. Journal of School Violence, 10, 88–106. doi:10.1080/15388220.2010.519432.

    Article  Google Scholar 

  • Crepeau-Hobson, F., Sievering, K. S., Armstrong, C., & Stonis, J. (2012). A coordinated mental health crisis response: Lessons learned from three Colorado school shootings. Journal of School Violence, 11, 207–225. doi:10.1080/15388220.2012.682002.

    Article  Google Scholar 

  • Fergus, T. A., Rabenhorst, M. M., Orcutt, H. K., & Valentiner, D. P. (2011). Reactions to trauma research among women recently exposed to a campus shooting. Journal of Traumatic Stress, 24, 596–600. doi:10.1002/jts.20682.

    Article  PubMed Central  PubMed  Google Scholar 

  • Follman, M., Aronsen, G., & Pan, D. (2014). A guide to mass shootings in America. http://www.motherjones.com/politics/2012/07/mass-shootings-map. Accessed 23 Aug 2014.

  • Griffin, M. G., Resick, P. A., Waldorp, A. E., & Mechanic, M. B. (2003). Participation in trauma research: Is there evidence of harm? Journal of Traumatic Stress, 16, 221–227. doi:10.1023/A:1023735821900.

    Article  PubMed  Google Scholar 

  • Henricksen, C. A., Bolton, J. M., & Sareen, J. (2010). The psychological impact of terrorist ­attacks: Examining a dose-response relationship between exposure to 9/11 and Axis I mental disorders. Depression & Anxiety, 27, 993–1000. doi:10.1002/da.20742.

    Article  Google Scholar 

  • Hobfoll, S. E. (1989). Conservation of resources: A new attempt at conceptualizing stress. American Psychologist, 44, 513–524. doi:10.1037//0003-066X.44.3.513.

    Article  PubMed  Google Scholar 

  • Hobfoll, S. E., Watson, P., Bell, C. C., Bryan, R. A., Brymer, M. J., Friedman, M. J., et al. (2007). Five essential elements of immediate and mid-term mass trauma intervention: Empirical evidence. Psychiatry, 70, 283–315. doi:10.1521/psyc.2007.70.4.283.

    Article  PubMed  Google Scholar 

  • Hough, R. L., Vega, W., Valle, R., Kolody, B., Griswalddel Castillo, R., & Tarke, H. (1990). Mental health consequences of the San Ysidro McDonald’s massacre: A community study. Journal of Traumatic Stress, 3, 71–92. doi:10.1007/BF00975136.

    Article  Google Scholar 

  • Hughes, M., Brymer, M., Chiu, W. T., Fairbank, J. A., Jones, R. T., Pynoos, R. S., et al. (2011). Posttraumatic stress among students after the shootings at Virginia Tech. Psychological Trauma: Theory, Research, Practice, and Policy, 3, 403–411. doi:10.1037/a0024565.

    Article  Google Scholar 

  • Johnson, S. D., North, C. S., & Smith, E. M. (2002). Psychiatric disorders among victims of a courthouse shooting spree: A three-year follow-up study. Community Mental Health, 38, 181–194.

    Article  Google Scholar 

  • Kumpula, M. J., Orcutt, H. K., Bardeen, J. R., & Varkovitzky, R. L. (2011). Peritraumatic dissociation and experiential avoidance as prospective predictors of posttraumatic stress symptoms. Journal of Abnormal Psychology, 120, 617–627. doi:10.1037/a0023927.

    Article  PubMed Central  PubMed  Google Scholar 

  • Littleton, H., Grills-Taquechel, A., & Axsom, D. (2009). Resource loss as a predictor of posttrauma symptoms among college women following the mass shooting at Virginia Tech. Violence and Victims, 24, 669–686. doi:10.1891/0886-6708.24.5.669.

    Article  PubMed  Google Scholar 

  • Littleton, H., Axsom, D., & Grills-Taquechel, A. E. (2011a). Longitudinal evaluation of the relationship between maladaptive trauma coping and distress: Examination following the mass shooting at Virginia Tech. Anxiety, Stress, and Coping, 3, 273–290. doi:10.1080/10615806.2010.500722.

    Article  Google Scholar 

  • Littleton, H., Kumpula, M., & Orcutt, H. (2011b). Posttraumatic symptoms following a campus shooting: The role of psychosocial resource loss. Violence and Victims, 26, 461–476. doi:10.1891/0886-6708.26.4.461.

    Article  PubMed Central  PubMed  Google Scholar 

  • Littleton, H., Grills-Taquechel, A. E., Axsom, D., Bye, K., & Buck, K. S. (2012). Prior sexual trauma and adjustment following the Virginia Tech campus shootings: Examination of the mediating role of schemas and social support. Psychological Trauma: Theory, Research, Practice, and Policy, 4, 578–586. doi:10.1037/a0025270.

    Article  Google Scholar 

  • McIntyre, J. J., Spence, P. R., & Lachlan, K. A. (2011). Media use and gender differences in negative psychological responses to a shooting on a university campus. Journal of School Violence, 10, 299–313. doi:10.1080/15388220.2011.578555.

    Article  Google Scholar 

  • Mercer, K. B., Orcutt, H. K., Quinn, J. F., Fitzgerald, C. A., Conneely, K. N., Barfield, R. T., et al. (2012). Acute and posttraumatic stress symptoms in a prospective gene x environment study of a university campus shooting. Archives of General Psychiatry, 69, 89–97. doi:10.1001/archgenpsychiatry.2011.109.

    Article  PubMed Central  PubMed  Google Scholar 

  • Metz, S. M., Frank, J. L., Reibel, D., Cantrell, T., Sanders, R., & Broderick, P. C. (2013).The effectiveness of the Learning to BREATHE program on adolescent emotion regulation. Research in Human Development, 10, 252–272. doi:10.1080/15427609.2013.818488.

    Article  Google Scholar 

  • Mulvey, E. P., & Cauffman, E. (2001). The inherent limits of predicting school violence. American Psychologist, 56, 797–802. doi:10.IO.17//0O03-066X.56.10.797.

    Article  PubMed  Google Scholar 

  • Murtonen, K., Suomalainen, L., Haravuori, H., & Marttunen, M. (2012). Adolescents’ experiences of psychosocial support after traumatisation in a school shooting. Child and Adolescent Mental Health, 17, 23–30. doi:10.1111/j.1475–3588.2011.00612.x.

    Article  Google Scholar 

  • Nader, K., Pynoos, R., Fairbanks, L., & Frederick, C. (1990). Children’s PTSD reactions one year after a sniper attack at their school. American Journal of Psychiatry, 147, 1526–1530.

    Article  PubMed  Google Scholar 

  • North, C. S., Smith, E. M., McCool, R. E, & McShea, J. M. (1989). Short-term psychopathology in eyewitnesses to mass murder. Hospital & Community Psychiatry, 40, 1293–1295.

    Google Scholar 

  • North, C. S., Smith, E. M., & Spitznagel, E. L. (1994). Posttraumatic stress disorder in survivors of a mass shooting. American Journal of Psychiatry, 151, 82–88.

    Article  PubMed  Google Scholar 

  • North, C. S., Smith, E. M., & Spitznagel, E. L. (1997). One-year follow-up of survivors of a mass shooting. American Journal of Psychiatry, 154, 1696–1702.

    Article  PubMed  Google Scholar 

  • North, C. S., Spitznagel, E. L., & Smith, E. M. (2001).A prospective study of coping after exposure to a mass murder episode. Annals of Clinical Psychiatry, 13, 81–86. doi:10.3109/10401230109148952.

    Article  PubMed  Google Scholar 

  • North, C. S., McCutcheon, V., Spitznagel, E. L., & Smith, E. (2002). Three-year follow-up of survivors of a mass shooting episode. Journal of Urban Health, 79, 383–391. doi:10.1093/jurban/79.3.383.

    Article  PubMed Central  PubMed  Google Scholar 

  • Orcutt, H. K., Bonanno, G. A., Hanna, S. M., & Miron, L. R. (2014). Prospective trajectories of posttraumatic stress in college women following a campus mass shooting. Journal of Traumatic Stress, 27, 1–8. doi:10.1002/jts.21914.

    Article  Google Scholar 

  • Palus, S. R., Fang, S. S., & Prawitz, A. D. (2012). Forward, together forward: Coping strategies of students following the 2008 mass shootings at Northern Illinois University. Traumatology, 18, 13–26. doi:10.1177/1534765612437381.

    Article  Google Scholar 

  • Pynoos, R. S., Frederick, C., Nader, K., Arroyo, W., Steinberg, A., Eth, S., et al. (1987). Life threat and posttraumatic stress in school-age children. Archives of General Psychiatry, 44, 1057–1063. doi:10.1001/archpsyc.1987.01800240031005.

    Article  PubMed  Google Scholar 

  • Reddy, M., Borum, R., Berglund, J., Vossekuil, B., Fein, R., & Modzeleski, W. (2001). Evaluating risk for targeted violence in schools: Comparing risk assessment, threat assessment, and other approaches. Psychology in the Schools, 38, 157–172.

    Article  Google Scholar 

  • Schwarz, E. D., & Kowalski, J. M. (1991a). Malignant memories: PTSD in children and adults after a school shooting. Journal of the American Academy of Child and Adolescent Psychiatry, 30, 936–944. doi:10.1097/00004583-199111000-00011.

    Article  PubMed  Google Scholar 

  • Schwarz, E. D., & Kowalski, J. M. (1991b). Posttraumatic stress disorder after a school shooting: Effects of symptom threshold selection and diagnosis by DSM-III, DSM-III-R, or proposed DSM-IV. American Journal of Psychiatry, 148, 592–597.

    Article  PubMed  Google Scholar 

  • Schwarz, E. D., & Kowalski, J. M. (1992a). Personality characteristics and posttraumatic stress symptoms after a school shooting. Journal of Nervous and Mental Disease, 180, 735–737. doi:10.1097/00005053-199211000-00013.

    Article  PubMed  Google Scholar 

  • Schwarz, E. D., & Kowalski, J. M. (1992b). Malignant memories: Reluctance to utilize mental health services after a disaster. Journal of Nervous and Mental Disease, 180, 767–772. doi:10.1097/00005053-199212000-00005.

    Article  PubMed  Google Scholar 

  • Schwarz, E. D., Kowalski, J. M., & McNally, R. J. (1993). Malignant memories: Post-traumatic changes in memory in adults after a school shooting. Journal of Traumatic Stress, 6, 545–553. doi:10.1007/BF00974322.

    Article  Google Scholar 

  • Séguin, M., Chawky, N., Lesage, A., Boyer, R., Guay, S., Bleau, P., … & Roy, D. (2013). Evaluation of the Dawson College Shooting Psychological Intervention: Moving toward a multimodal extensive plan. Psychological Trauma: Theory, Research, Practice, and Policy, 5, 268-276. doi: 10.1037/a0027745.

    Google Scholar 

  • Sewell, K. W. (1996). Constructional risk factors for post-traumatic stress response after mass murder. Journal of Constructivist Psychology, 9, 97–107. doi:10.1080/10720539608404657.

    Article  Google Scholar 

  • Shultz, J. M., Cohen, A. M., Muschert, G. W., & Flores de Apodaca, R. (2013). Fatal school shootings and the epidemiological context of firearm mortality in the United States. Disaster Health, 1, 84–101. doi:10.4161/dish.26897.

    Article  Google Scholar 

  • Sloan, I. H., Rozensky, R. H., Kaplan, L., & Sanders, S. M. (1994). A shooting incident in an elementary school: Effects of worker stress on public safety, mental health, and medical personnel. Journal of Traumatic Stress, 7, 565–574. doi:10.1007/BF02103007.

    Article  PubMed  Google Scholar 

  • Stephenson, K. L., Valentiner, D. P., Kumpula, M. J., & Orcutt, H. K. (2009). Anxiety sensitivity and posttrauma stress symptoms in female undergraduates following a campus shooting. Journal of Traumatic Stress, 22, 489–496. doi:10.1002/jts.20457.

    PubMed Central  PubMed  Google Scholar 

  • Suomalainen, L., Haravuori, H., Berg, N., Kiviruusu, O., & Marttunen, M. (2011). A controlled follow-up study of adolescents exposed to a school shooting—psychological consequences after four months. European Psychiatry, 26, 490–497. doi:10.1016/j.eurpsy.2010.07.007.

    Article  PubMed  Google Scholar 

  • Swanson, J. W. (2011). Explaining rare acts of violence: The limits of evidence from population research. Psychiatric Services, 62, 1369–1371. doi:10.1176/appi.ps.62.11.1369.

    Article  PubMed  Google Scholar 

  • Trappler, B., & Friednman, S. (1996). Posttraumatic stress disorder in survivors of the Brooklyn Bridge shooting. American Journal of Psychiatry, 153, 705–707.

    Article  PubMed  Google Scholar 

  • Turunen, T., Haravuori, H., Punamäki, R., Suomalainen, L., & Marttunen, N. (2014).The role of attachment in recovery after a school-shooting trauma. European Journal of Psychotraumatology, 5, 22728.doi:10.3402/ejpt.v5.22728.

    Google Scholar 

  • Vicary, A. M., & Fraley, R. C. (2010). Student reactions to the shootings at Virginia Tech and Northern Illinois University: Does sharing grief and support over the Internet affect recovery? Personality and Social Psychology Bulletin, 36, 1555–1563. doi:10.1177/0146167210384880.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Sarah R. Lowe PhD .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2015 Springer International Publishing Switzerland

About this chapter

Cite this chapter

Lowe, S., Galea, S. (2015). Posttraumatic Stress in the Aftermath of Mass Shootings. In: Cherry, K. (eds) Traumatic Stress and Long-Term Recovery. Springer, Cham. https://doi.org/10.1007/978-3-319-18866-9_6

Download citation

Publish with us

Policies and ethics