Those with PTSD often have trouble sleeping and may become emotionally numb, continuously on edge or easily startled, she said. The world will often feel unsafe to them, and upsetting memories may intrude on their daily thoughts. Some people may try to avoid things that remind them of their trauma. Teens and adults might turn to substance abuse.
Younger children may experience stomachaches or headaches, and lower-grade anxiety that causes them to misbehave or have trouble concentrating. They may also engage in “traumatic play,” acting out the trauma they experienced, Dr. Nugent added. If the behavior persists, she said, “then we start to worry that it could be signaling something significant like PTSD.”
Proximity to violence
Much like those who experience gun violence, those who live near it may also suffer.
Dr. Aditi Vasan, a general pediatrician at Children’s Hospital of Philadelphia, decided to investigate how children in her community were psychologically affected by nearby shootings after speaking with patients who had anxiety, depression or difficulty sleeping.
“When I asked them when these symptoms started, they told me it was after a classmate or a friend or a neighbor was shot,” she said.
The resulting study, published in JAMA Pediatrics in 2021, examined emergency department admissions between 2014 and 2018 and found that children and teenagers in west and southwest Philadelphia who lived within about four to six blocks of where a shooting had occurred were more likely than other children to use an emergency room for mental health reasons during the two months after the shooting. The odds rose among children who were exposed to multiple shootings and among those who lived closest to a shooting’s location, within two or three blocks. Their symptoms included anxiety, panic attacks, suicidal ideation and self-harm behavior, Dr. Vasan said.
Another study, in California, looked at the effects of police killings on several communities in Los Angeles. It showed decreases in high school students’ academic performance, learning deficiencies related to PTSD and higher levels of depression and school dropouts that correlated to how close students lived to where the shootings occurred. These problems were most pronounced among Black and Latino students who lived near the locations of police shootings of Black and Latino people.
“The fear overcomes the need to connect with other people, and that’s the real tragedy of what violence does to communities,” said Dr. Joel Fein, an emergency medicine physician at Children’s Hospital Philadelphia, where he co-directs the Center for Violence Prevention .