Children and Media Coverage of Trauma

An overview of current research on the short- and long-term impacts of media coverage of tragedy on children, as well as aggravating risk factors and suggestions for future research.

The relationship between news consumption and psychological distress among children is a vital public health concern (e.g., Libow, 1992). Although researchers have delineated the psychological consequences of trauma on child victims, including posttraumatic stress disorder, less is known about the short- and long-term impact of media coverage of tragedy on child victims and bystanders. The purpose of this fact sheet is to synthesize the existing research on this topic so that journalists, editors, publishers, and caregivers of children can form evidence-based decisions. It may serve as background information for reporting. Although not explicitly written for parents and children, information may help families and clinicians make choices about news consumption.

Note: Accessing news about atrocities, disasters, and crimes certainly may bother most people. Children’s experience of tolerable but unpleasant feelings (e.g., sadness, anger, helplessness, fear, worry, and concern) in response to such news indicates a compassionate and empathetic stance to the world. It is not necessarily problematic unless it interferes with functioning, or becomes unbearable.

Children are attentive to media coverage of mass tragedy

Children and their parents retrospectively report that children access more news after a tragedy than during other time periods:

  • Three to five days after the September 11 attacks, 560 adults were contacted via random digit dialing (Schuster et al., 2001). One hundred seventy of them were identified as primary caregivers of children between the ages of five and eighteen. The parents reported that their children viewed attack coverage a mean of three hours on September 11, with 8% not watching any, 33% watching for one hour or less, 36% watching for two to four hours, and 23% watching for five hours or more. Older children were said to have watched more attack coverage than younger children. Only 34% of the parents stated that they restricted their children’s television viewing of the attacks.
  • One to two months after the September 11 attacks, 1,008 adults were contacted via random digit dialing (Stuber et al., 2002). One hundred twelve of them were identified as primary caregivers of children between the ages of four and seventeen. Eighty one percent of the parents reportedly believed that their children watched television coverage of the September 11 attacks in the week following the tragedy. Twenty six percent of the parents reportedly estimated this exposure to be more than four hours a day.
  • Two years after the Oklahoma City bombing, 69 children retrospectively reported changes in their news consumption as time elapsed since the tragedy (Pfefferbaum et al., 2000). According to their recollections, 10% viewed broadcast coverage and 6% viewed print coverage in the seven days prior to the survey, whereas 55% viewed broadcast coverage and 26% viewed print coverage in the aftermath of the bombing.
  • Interviews with 80 elementary school children one month after the Gulf War cease-fire revealed that children watched a moderate amount of news coverage of casualty, partly to remain informed about the war (Hoffner & Haefner, 1994). Those who felt more personally vulnerable and upset expressed more interest in neutral/background news about the war, but not news coverage of casualties. Furthermore, this group was more likely to avoid news coverage of the war altogether than those who felt less vulnerable and upset. These results suggest that children selectively viewed the type of news coverage that helped them understand the war and gain an increased sense of safety.
  • A survey of 1,349 children conducted 21 days after the assassination of President Kennedy documented an increase in television viewing related to the tragedy (Sigel, 1965). According to their recollections, 98% of the children watched television the weekend of the assassination, and 82% of them watched it much more than usual. The greatest increases were observed among older children and girls. Television viewing seemed to help the children acquire knowledge about events occurring the day of the assassination.

Among children, trauma-related distress and news consumption appear related both in the immediate and long-lasting aftermath of a disaster:

  • In a survey of 51 children and adolescents conducted during the war in Kuwait, those who viewed more graphic images of mutilation on television endorsed more symptoms of posttraumatic stress disorder (Thabet, Abed, & Vostanis, 2004).
  • Seven weeks after the Oklahoma City bombing, a survey of over 2,000 children revealed a positive association between exposure to television coverage of the tragedy and symptoms of posttraumatic stress disorder (Pfefferbaum et al., 2001).
  • Seven weeks after the Oklahoma City bombing, a clinical needs assessment of 3,218 children and teenagers revealed a positive association between exposure to television coverage of the tragedy and symptoms of posttraumatic stress disorder (Pfefferbaum et al., 1999b).
  • In a survey of 88 children within 100 miles of Oklahoma City conducted two years after the bombing, those who viewed more television or print coverage of the tragedy reported more symptoms of posttraumatic stress disorder (Pfefferbaum et al., 2003).
  • In a survey of 69 children within 100 miles of Oklahoma City conducted two years after the bombing, extent of exposure to media coverage of the tragedy via television/radio or print predicted symptoms of posttraumatic stress disorder (Pfefferbaum et al., 2000).
  • Three to five days after the September 11 attacks, 560 adults were contacted via random digit dialing (Schuster et al., 2001). One hundred seventy of them were identified as primary caregivers of children between the ages of five and eighteen. Among children whose parents did not limit their television viewing, a positive relationship was observed between the number of hours of television watched and the number of stress symptoms experienced. Interestingly, there was a positive association between the number of hours of television watched and the number of hours of family discussion about the attacks.
  • In a survey of 176 parents and 47 children in kindergarten through sixth grade conducted in Washington DC in the month following the September 11 th attacks, there was an association between amount of exposure to media coverage and distress among the children (Phillips, Scheibelhut, & Prince, 2003).
  • Four to five months after the September 11 attacks, 2001 adults in New York City were contacted via random digit dialing (Fairbrother, Stuber, Galea, Fleischman, & Pfefferbaum, 2003). Four hundred thirty four of them were identified as primary caregivers of children between the ages of four and seventeen. According to the parents, 86% of the children saw airplanes hitting the towers, 87% of the children saw the towers collapsing, 87% of the children saw people running from a cloud of smoke or debris, 48% of the children saw people falling or jumping from the towers, and 77% of the children saw at least three of these four images. There was a positive association between seeing at least three of these four images and having a severe or very severe posttraumatic stress reaction.
  • One case report discussed an 11-year old boy who developed posttraumatic stress disorder and major depression after viewing television coverage of the September 11 th attacks (Duggal, Berezkin, & John, 2002).

Summary

There is a positive relationship between exposure to media coverage of tragedy and symptoms of posttraumatic stress disorder among children. However, it is unknown if upset children seek out media coverage of tragedy, have distressed parents who seek out such news, if the news causes distress, if the news acts as a traumatic reminder to elicit pre-existing distress, or if there is some other causal mechanism to account for this association.

Related Factors

Children who are “personally connected” to the event may be at greater risk:

  • Children in Oklahoma who knew someone killed in the bombing had more difficulty calming down after watching bomb-related television than those who did not experience a personal loss (Pfefferbaum et al., 1999a; Pfefferbaum et al., 1999c).
  • Children who fear that a loved one was harmed in a tragedy may be at increased risk of experiencing distress when exposed to media coverage of it. According to parental reports of 179 children one month after the September 11 attacks, those who feared that a loved one died in the tragedy had more media exposure and more symptoms of posttraumatic stress disorder (Saylor, Cowart, Lipovsky, Jackson, & Finch, 2003).
  • Additional support may be derived, albeit not clear, from a survey of 153 children conducted five to seven weeks after the Challenger space shuttle explosion. Those on the East Coast reported more symptoms of posttraumatic stress disorder than those on the West Coast (Terr et al., 1999). It is postulated that given that students on the East Coast watched it live and the teacher on board was from New Hampshire, personal connection may have played a role.
  • In a survey of children following the assassination of President Kennedy, symptoms of distress were most prevalent among African American children, whom President Kennedy had advocated for, and children who said that they would vote Democratic if they were old enough (Sigel, 1965).

Age may affect exposure and response:

  • According to parental reports of 179 children one month after the September 11 th attacks, children who were older and male had more media exposure of the tragedy and more symptoms of posttraumatic stress disorder (Saylor et al., 2003).
  • Interviews with 125 elementary school children revealed that older boys were most likely to watch television news, but older girls were most likely to consider television news frightening (Smith & Wilson, 2002). Older children were more able than their younger counterparts to describe the purpose of television news and differentiate between a picture of a newscaster and a picture of an actor. There was a positive association between exposure to television news and children’s estimates of homicides occurring in a distant city. The findings suggest that television news is more frightening for older children than younger children because they understand news stories better and make greater risk appraisals of crime after watching them.

Particular images may be upsetting to children, whether positive or negative:

  • In a survey of 51 children and adolescents exposed to the military occupation of Kuwait, participants who viewed more graphic images of mutilation on television reported more symptoms of posttraumatic stress disorder (Nader et al., 1993).
  • According to parental reports of 179 children one month after the September 11 attacks, there was a positive relationship between exposure to television, print, or internet coverage of the tragedy and symptoms of posttraumatic stress disorder, regardless of whether the images were positive or negative (Saylor et al., 2003). Although the authors used extremely crude measures to assess negative and positive images (e.g. a positive image was defined as a picture of a celebrity helping out, President Bush addressing the nation, and images of rescues or rescuers), this preliminary finding raises some interesting questions about how the quality of images and reporting might affect the reactions of viewers.

News medium may affect response:

  • According to parental reports of 179 children one month after the September 11 attacks, children who viewed images of the attacks on the internet had more symptoms of posttraumatic stress disorder than those who saw images of the events on television or in print (Saylor et al., 2003).
  • In a survey of 88 children within 100 miles of Oklahoma City conducted two years after the bombing, there was a positive association between media exposure of the tragedy and enduring symptoms of posttraumatic stress disorder that was stronger for children who viewed print media than for those who viewed broadcast media (Pfefferbaum et al., 2003).

Summary

Although there are many questions left unanswered and evidence is limited, the existing research on media coverage of tragedy and children suggest the following:

  • Children appear to be an important audience for tragedy-related news, since they retrospectively report increases in their media consumption following tragedy. However, exact information about their viewing habits when tragedy occurs needs to be directly studied using precise methodology.
  • There is a positive relationship between reported exposure to media coverage of tragedy and reported symptoms of posttraumatic stress disorder among children. This is true in the immediate and long-term aftermath of a traumatic event regardless of whether the children were directly exposed to the traumatic event. However this effect is likely small, and other factors appear far more critical in their reported symptoms of PTSD.
  • Viewing a disaster live on television and feeling personally connected to someone involved appears to strengthen the relationship between exposure to media coverage of tragedy and symptoms of posttraumatic stress disorder among children.
  • The evidence base to understand how factors such as age, gender, specific content, and news medium affect children and adolescents’ trauma-related distress after viewing trauma-related news is in its infancy and very few studies inform these tentative conclusions.
    • In one study, witnessing heroic or positive images did not attenuate the relationship between exposure to media coverage of tragedy and symptoms of posttraumatic stress disorder among children. Therefore, these images may not comfort or benefit children, although replication of such findings is needed.
    • Research indicates that children who are older and male report more exposure to television news and media coverage of tragedy, as well as more symptoms of posttraumatic stress disorder. Parents may mistakenly believe that children who are older and male can handle viewing distressing images via television, internet, or print better than children who are younger and female. Alternatively, it may be that (a) older children communicate their distress more clearly to parents and researchers, (b) older children understand the news better and generate accurate or inaccurate implications of this information, or (c) older children are more vulnerable to distress from the news.
    • Images viewed on the internet or in print may be more problematic for children than those seen on television. This may be due to the length of time that they are viewed. Again, more knowledge is needed to make firm conclusions.

LIMITATIONS AND SUGGESTIONS FOR FURTHER RESEARCH

  • The studies reviewed required children to retrospectively report their media consumption and distress following tragedy, resulting in considerable bias. Studies that measure direct viewing habits rather than recalled habits are needed.
  • It may be easier for older children to communicate about their experiences watching and reacting to the news. More developmentally sensitive methodologies need to be applied to children’s news coverage habits.
  • Extent of distress needs to be clarified in research.
  • There is a positive relationship between exposure to media coverage of tragedy and symptoms of posttraumatic stress disorder among children. However it is unknown if upset children seek out media coverage of tragedy, have distressed parents who seek out such news, if the news causes distress, if the news acts as a traumatic reminder to elicit pre-existing distress, or if there is some other causal mechanism to account for this association. More research must address this relationship to inform reporting practice

References

Duggal, H. S., Berezkin, G., & John, V. (2002). PTSD and TV viewing of the World Trade Center. Journal of the American Academy of Child and Adolescent Psychiatry, 41, 494-495.

Fairbrother, G., Stuber, J., Galea, S., Fleischman, A. R., & Pfefferbaum, B. (2003). Posttraumatic stress reactions in New York City children after the September 11, 2001, terrorist attacks. Ambulatory Pediatrics, 3, 304-311.

Hoffner, C., & Haefner, M. J. (1994). Children’s news interest during the Gulf War: The role of negative affect. Journal of Broadcasting and Electronic Media, 38, 193-204.

Libow, J. A. (1992). Traumatized children and the news media: Clinical considerations. American Journal of Orthopsychiatry, 62, 379-386.

Nader, K. O., Pynoos, R. S., Fairbanks, L. A., Al-Ajeel, M., et al. (1993). A preliminary study of PTSD and grief among the children of Kuwait following the Gulf crisis. British Journal of Clinical Psychology, 32, 407-416.

Pfefferbaum, B., Moore, V. L., McDonald, N. B., Maynard, B. T., Gurwitch, R. H., & Nixon, S. J. (1999a). The role of exposure in posttraumatic stress in youths following the 1995 bombing. Journal – Oklahoma State Medical Association, 92, 164-167.

Pfefferbaum, B., Nixon, S. J., Tivis, R. D., Doughty, D. E., Pynoos, R. S., Gurwitch, R., et al. (2001). Television exposure in children after a terrorist incident. Psychiatry: Interpersonal and Biological Processes, 64, 202-211.

Pfefferbaum, B., Seale, T. W., Brandt, E. N. Jr., Pfefferbaum, R. L., Doughty, D. E., & Rainwater, S. M. (2003). Media exposure in children one hundred miles from a terrorist bombing. Annals of Clinical Psychiatry, 15, 1-8.

Pfeferbaum, B., Seale, T., McDonald, N., Brandt, E., Rainwater, S., Maynard, B., et al. (2000). Posttraumatic stress two years after the Oklahoma City bombing in youths geographically distant from the explosion. Psychiatry, 63, 358-370.

Pfefferbaum, B., Nixon, S. J., Krug, R. S., Tivis, R. D., Moore, V. L., Brown, J. M., et al. (1999b). Clinical needs assessment of middle and high school students following the 1995 Oklahoma City bombing. American Journal of Psychiatry, 156, 1069-1074.

Pfefferbaum, B., Nixon, S. J., Tucker, P. M., Tivis, R. D., Moore, V. L., Gurwitch, R. H., et al. (1999c). Posttraumatic stress responses in bereaved children after the Oklahoma City bombing. Journal of the American Academy of Child and Adolescent Psychiatry, 38, 1372-1379.

Phillips, D., Scheibelhut, L., & Prince, S. (2003, April). Children’s responses to the terrorist attacks of September 11 th: An exploratory study. In J. Lawrence Aber & D. Phillips (Chairs), The aftermath of September 11 th, 2001: Developmental effects and policy implications. Symposium conducted at the Biennial Meetings of the Society for Research in Child Development, Tampa, FL.

Saylor, C. F., Cowart, B. L., Lipovsky, J. A., Jackson, C., & Finch, A. J. Jr. (2003). Media exposure to September 11: Elementary school students’ experiences and posttraumatic symptoms. American Behavioral Scientist, 46, 1622-1642.

Schuster, M. A., Stein, B. D., Jaycox, L. H., Collins, R. L., Marshall, G. N., Elliott, M., et al. (2001). A national survey of stress reactions after the September 11, 2001, terrorist attacks. New England Journal of Medicine, 345, 1507-1512.

Sigel, R. S. (1965). Television and the reactions of schoolchildren to the assassination. In B. S. Greenberg & E. B. Parker (Eds.), The Kennedy Assassination and the American Public: Social Communication in Crisis (pp. 199-219). Stanford, CA: Stanford University Press.

Smith, S. L. & Wilson, B. J. (2002). Children’s comprehension of and fear reactions to television news. Media Psychology, 4, 1-26.

Stuber, J., Fairbrother, G., Galea, S., Pfefferbaum, B., Wilson-Genderson, M., & Vlahov, D. (2002). Determinants of counseling for children in Manhattan after the September 11 attacks. Psychiatric Services, 53, 815-822.

Terr, L. C., Bloch, D. A., Michel, B. A., Hong, S., Reinhardt, J. A., & Metayer, S. (1999). Children’s symptoms in the wake of Challenger: A field study of distant traumatic effects and an outline of related conditions. American Journal of Psychiatry, 156, 1536-1544.

Thabet, A. A. M., Abed, Y., & Vostanis, P. (2004). Comorbidity of PTSD and depression among refugee children during war conflict. Journal of Child Psychology and Psychiatry, 45, 533-542.