Returning to school after a terror attack: a longitudinal study of school functioning and health in terror-exposed youth

Abstract

Terrorist attacks and mass shootings often involve youth. Knowledge is needed on how this may impact their health and functioning. This study investigates perceived academic performance and school wellbeing in 237 terror-exposed survivors of the Utøya youth camp attack according to their sociodemographic characteristics, health and mental health service (MHS) utilization. Semi-structured interviews were conducted after 4-5 and 14-15 months. The year following the attack, 143 (61%) survivors reported impaired academic performance and 66 (29%) impaired school wellbeing. Female survivors more often reported impaired performance. Non-Norwegian origin, being financially disadvantaged and less social support were associated with impaired wellbeing. Sleep problems, posttraumatic stress, anxiety/depression, somatic symptoms, and lower life satisfaction were associated with both impaired performance and impaired wellbeing. Survivors who had received MHS were more likely to report impaired or improved academic performance and school wellbeing. Higher age and posttraumatic stress reactions were associated with impaired academic performance after multivariate logistic regression adjustments for gender, somatic symptoms and social support. When additionally adjusting for impaired school wellbeing, age and impaired wellbeing were associated with impaired performance. Only posttraumatic stress reactions were associated with impaired wellbeing after similar adjustments. Non-Norwegian origin and being financially disadvantaged were not significantly associated with impaired wellbeing after adjusting for posttraumatic stress reactions, age and gender. Our findings demonstrate how a terrorist attack can considerably deteriorate young survivors' performance and wellbeing at school, which is associated with poorer health. Consequently, it is important to provide appropriate school support, and coordinate MHS with follow-up at school.

Psychosocial care responses to terrorist attacks: a country case study of Norway, France and Belgium

“…Since many survivors were adolescents and young adults on the brink of moving away from their family to begin their studies some weeks after the attack, the responsibility of the follow-up could change between different municipalities. The schools and educational institutions may be important in the long-term follow-up of youth, both to identify those in need of help and to provide psychosocial and educational support [ 9 ]. Indeed, recommendations on facilitating the return to school through practical and psychosocial support measures were sent to the schools after the Norway attacks [ 59 , 60 ].…”

I’m not as bright as I used to be – pupils’ meaning-making of reduced academic performance after trauma

“…Sleep problems, post-traumatic stress, anxiety/depression, somatic symptoms, and lower life satisfaction were associated with both impaired academic performance and impaired wellbeing. The findings demonstrate how severe trauma can affect young survivors' academic performance and wellbeing at school (Stene et al, 2018). Another study investigated academic performance in survivors (N = 64) who had successfully completed their threeyear senior high school program.…”

Attacks on Educational Institutions

“…11,12 The psychosocial sequelae such traumatic events have on children and young adults can be significant, needing more robust institutional recovery support. 13,14 There is also general consensus amongst the medical community that more training and education is needed to better improve pediatric mass-casualty response, as well as better education and training in Counter-Terrorism Medicine. [15][16][17][18] Tin © 2022 Prehospital and Disaster Medicine…”