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Dec 1 2005

Fact Sheet

Covering Trauma: Impact on the Public

An overview of current research on how news coverage of traumatic event effects the public and the risk factors that exascerbate reactions of distress.

People who have been directly or indirectly exposed to tragedy can develop trauma-related symptoms or post-traumatic stress disorder. Therefore, it is possible, in theory, for a person to develop trauma-related symptoms after merely viewing media coverage of a traumatic event.

But is it really? Does watching trauma-related news induce or worsen psychological reactions in some people? What do journalists need to know about the evidence regarding the impact of trauma-related news coverage? What is the status of evidence about the effects of trauma-related news coverage?

This fact sheet reviews what we know about effects of media coverage from various tragedies, what we still need to learn, and practical implications of what we know.

Current Knowledge on How of Media Coverage of Trauma Affects the Public

We have very limited empirical information about the effects of media coverage of tragic events, although the field is rapidly expanding. Thus far almost all the information is based on mass-casualty situations and not single events. Most studies have been based on visual broadcasting media, especially television.

Adults are attentive to media coverage of mass tragedy:

  • Three to five days after the September 11 attacks, 1,008 adults in Manhattan reported viewing television images of the tragedy more than daily (Ahern et al., 2002). For example, the image of “an airplane hitting the WTC” was seen most frequently, with 87 percent of participants viewing it more than seven times. The image of “people falling or jumping from the towers of the WTC” was seen least frequently, with 19.5 percent of participants viewing it more than seven times.
  • In the week following the September 11 attacks, 63 percent of 1,200 American adults polled reported that they “could not stop watching” news about the terrorist attacks ( Pew Research Center, 2001). In fact, 81 percent reported keeping a television or radio tuned to the news for updates on the crisis and 46 percent reported that they read the newspaper more closely.
  • Summary: The research confirms what people in the news business know—the public tunes in to the news during massive catastrophes early on and attend to it more carefully.

In the immediate aftermath of a disaster, distress and news viewing appear related, especially among people who experienced loss because of the event:

  • A poll of Americans conducted 3-5 days after the September 11 attacks documented that extensive television viewing was associated with stress reactions (Schuster et al., 2001).
  • In the week following the September 11 attacks, a poll of 1,200 American adults indicated that although Americans accessed news frequently, while watching such news: 92 percent reported experiencing feelings of sadness, 77 percent reported feelings of fright, and 45 percent reported feeling “tired out” (Pew Research Center, 2001).
  • In a laboratory study of 237 Israeli adults, those who watched terrorism-related news endorsed higher levels of anxiety that than who watched other types of news. The level of anxiety was not in the clinically elevated range and was only tested for an immediate post-viewing effect (Slone, 2000).
  • In a survey of 1,008 adults in Manhattan conducted three to five days after the September 11 attacks, there was a trend between number of images viewed (e.g., “an airplane hitting the WTC,” “people running away from a cloud of smoke,” and “people falling or jumping from the towers of the WTC) and prevalence of trauma-related and depressive symptoms (Ahern et al., 2002). This association was strongest among those who saw images of people plummeting from the towers, and further analyses indicated that it only existed among those who were directly exposed to the tragedy.
  • One case report described two clients who after television exposure to the September 11 attacks developed severe psychotic reactions that remitted within a month (Rushing & John-Baptiste, 2003). It is possible that such coverage induces such episodes in the vulnerable, but this appears rare.
  • Summary: Viewing news about tragedy can certainly be upsetting. Experiencing such negative feelings in the face of such messages may indicate that a person is compassionate, empathetic, and pro-social and is not necessarily problematic unless it interferes with functioning. At least one study suggests that for most, distress is common and not intense; nevertheless, future research needs to examine the intensity and duration of such distress and whether it leads to pathological responses. One study suggests that the relationship exists only for those directly affected. Furthermore, it is unknown if people who are more distressed choose to consume more disaster-related news, or if news of the disaster causes distress, or if there is some other causal mechanism.

After a month, self-reported trauma-related psychological distress and reported trauma-related news-viewing is related for some:

  • In a survey of 2,273 adults in the United States conducted two months after the September 11 attacks, hours of television coverage of the attacks watched and prevalence of probable PTSD were positively correlated (Schlenger et al., 2002). When direct exposure was statistically controlled, prevalence of clinically significant psychological distress symptoms was positively associated with hours of television coverage of the attacks watched and number of different kinds of graphic events seen on television. The prevalence of probable PTSD was significantly higher among residents of New York City, as compared to those in the rest of the country. The overall distress level across the country, including New York state, was within normal limits.
  • Hours of viewing television coverage of the 1995 Murrah Building bombing in Oklahoma City was not related to increased PTSD symptomatology in 85 adults seeking mental health services at a local clinic. (Tucker et al., 2000).
  • Summary: Although the literature is scant, it appears that sub-clinical distress and media viewing may be related for those adults who were not directly affected by the tragedy.

Factors Correlated with Distress and News Consumption

The relationship between news consumption and trauma-related symptoms seems stronger among individuals who are personally affected by the event both early on and later. However, the data pool is small and much more research needs to be done to determine this relationship:

  • Five to eight weeks after the September 11 attacks, the association between number of images of people jumping or falling from the World Trade Center towers seen and symptoms of PTSD and depression only existed among those who were directly exposed to the tragedy, but not among those who were not directly exposed to the tragedy (Ahern et al., 2002).

Particular images may be upsetting:

  • In a survey of 1,008 adults in Manhattan conducted three to five days after the September 11 attacks, there was a trend between number of images viewed of “an airplane hitting the WTC,” “people running away from a cloud of smoke,” and “people falling or jumping from the towers of the WTC” and prevalence of PTSD and depression (Ahern et al., 2002). This association was strongest for the image of “people falling or jumping from the towers of the WTC.” Direct victims of the tragedy who frequently viewed this image were more likely to have probable PTSD (22.5 percent) and probable depression (21.3 percent) than those who did not.
  • In a survey of 2,273 adults in the United States conducted two months after the September 11 attacks, prevalence of clinically significant psychological distress symptoms was positively associated with hours of television coverage of the attacks watched and number of different kinds of graphic events seen on television (Schlenger et al., 2002).

Conclusions:

  • Adults seem attentive to media coverage of tragedy, particularly early on.
  • Exposure to media coverage of tragedy appears to have the most detrimental effect on adults who were directly exposed to the event.
  • Research in the immediate aftermath indicates that:
    • Among adults directly exposed to a tragedy, there is a positive relationship between exposure to media coverage of the event and symptoms of PTSD and depression.
    • For adults not directly exposed to a tragedy, there is a positive relationship between exposure to media coverage of the event and symptoms of anxiety and distress.
  • Research later on indicates that:
    • Among adults directly exposed to a tragedy, there is a positive relationship between exposure to media coverage of the event and prevalence of probable PTSD.
    • For adults not directly exposed to a tragedy, there is a positive relationship between exposure to media coverage of the event and symptoms of distress.
  • Viewing a tragedy live on television appears to strengthen the relationship between media exposure and symptoms of PTSD.
  • Some images of tragedy seem more distressing than others. For example, among direct victims of the September 11 attacks, those who frequently viewed images of people falling or jumping from the WTC reported more symptoms of PTSD and depression. It is unclear however, how long this effect lasts.
  • Given the sparse research literature, it is difficult to make generalizations. Furthermore, it is unknown if people who are more distressed choose to consume more disaster-related news, or if news of the disaster causes distress, or if there is some other causal mechanism. It is important to note that media coverage may serve as a traumatic reminder to those affected by the event.

References

Ahern, J., Galea, S., Resnick, H., Kilpatrick, D., Bucuvalas, M., Gold, J., & Vlahov, D. (2002). Television images and psychological symptoms after the September 11 terrorist attacks. Psychiatry, 65, 289-300.

Pew (September 19, 2001). American Psyche Reeling From Terror Attacks. Pew Research Center for the People and the Press.

Rushing, S. & Jean-Baptiste, M. (2003). Two cases of brief psychotic disorder related to media coverage of the September 11, 2001 events. Journal of Psychiatric Practice, 9, 87-90.

Schlenger, W. E., Caddell, J. M., Ebert, L., Jordan, B. K., Rourke, K. M., Wilson, D., Thalji, L., Dennis, J. M., Fairbank, J. A., & Kulka, R. A. (2002). Psychological reactions to terrorist attacks: Findings from the national study of Americans’ reactions to September 11. Journal of the American Medical Association, 288, 581-588.

Schuster, M. A., Stein, B. D., Jaycox, L. H., Collins, R. L., Marshall, G. N., Elliott, M.N., Zhou, A. J., Kanouse, D. E., Morrison, J. L., & Berry, S. H. (2001). A national survey of stress reactions after the September 11, 2001, terrorist attacks. New England Journal of Medicine, 345, 1507-1512.

Slone, M. (2000). Responses to media coverage of terrorism. Journal of Conflict Resolution, 44, 508-522.

Tucker, P., Pfefferbaum, B., Nixon, S. J., & Dickson, W. (2000). Predictors of post-traumatic stress symptoms in Oklahoma City: Exposure, social support, peri-traumatic response. Journal of Behavioral Health Services and Research, 27, 406-416.

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