The unique vulnerabilities and needs of teen survivors of mass shootings

The tragic deaths of Sydney Aiello and Calvin Desir, teen survivors of the mass shooting at Marjory Stoneman Douglas High School in Parkland, Florida, remind us that for too many survivors, the pain and suffering endure and do not diminish. Instead, they are left reeling in the aftermath with no sense of closure. This is especially true of teens.

As a specialist in emotional and behavioral disorders of children and adolescents, I receive many inquiries from concerned parents, students, school officials, pediatricians and the news media about this issue and the harm violence has on our children and their families.

Although school shootings do not account for most child and adolescent deaths, there is something uniquely horrifying about random attacks without warning committed in our children’s schools. The resulting 24/7 media coverage and attention adds further to our collective unease.

The sadness of desensitization

Many in American society have become desensitized and unsurprised when a mass shooting occurs.

Similar to the way that individuals respond to personal tragedy by entering the cycle of the five stages of grief identified by the eminent psychologist, Elisabeth Kübler-Ross, Americans have developed a similar predictable reaction cycle in the aftermath of a mass shooting.

The first stage starts with community disbelief, feeling awful and coming together. However, in the United States, the second stage involves a quick shift to political posturing, finger pointing and special interest groups yelling at each other.

And just as people progress through denial, anger, bargaining, depression and acceptance of the Kübler-Ross grief cycle, many Americans have become desensitized and quickly reach the “acceptance” stage after the most recent mass shooting and go back to business as usual. While many continue to feel awful about it, there is a sense of impotence in terms of effecting real change that leads to a further sense of normalization and resignation following each horrifying event.

Delaney Tarr, a survivor of the Marjory Stoneman Douglas High School shootings, speaks at the ‘March for our Lives’ rally in Washington, D.C., on March 30, 2018. Andrew Harnik/AP Photo
For all too many survivors, however, their pain and suffering does not diminish. Many feel their power and sense of control have been taken away, and they continue to suffer from anxiety, agitation emotional numbness, flashbacks of the event or the desire to withdraw socially. There is often no closure for them.

Survivors of mass shootings and their families often remain diagnostic and therapeutic orphans. In a system that rewards political posturing, gamesmanship and brinksmanship, survivors and their families are too often shortchanged and left to fend for themselves.

Some will be more harmed than others, studies suggest

Those of us in the field of adolescent psychiatry are learning more about how to better recognize, diagnose and treat those at highest risk of developing long-term mental health problems. Grete Dyb and others studied traumatic stress reactions in youth 13 years and older who had survived the 2011 massacre on Utoya Island, Norway.

Survivor characteristics early after the attack robustly predicted post-traumatic stress reactions, anxiety, depression and lower satisfaction with life. Survivors also had feelings of shame and guilt that were also commonly experienced in the aftermath of a terror attack.

Nearly 30 percent of those who witnessed a mass shooting developed post-traumatic stress disorder, which manifests in adolescents as symptoms such as avoidance of reminders of the traumatic event, experiencing involuntary and intrusive flashbacks or nightmares about the event, impulsive or aggressive behavior, nervousness, restlessness, anxiety, trouble focusing in school, and/or emotional numbness.