Are Beslan's children learning to cope? A 3-year prospective study of youths exposed to terrorism.

Objective: This longitudinal study aimed to assess the course of psychological symptoms and coping behaviors in 33 adolescents directly and indirectly exposed to the 2004 terrorist attack in Beslan, Russia. We also investigated the role of coping in the development of posttraumatic stress.

Method: At 1.5 and 3 years postattack, youths' psychological distress was measured using the Brief Symptom Inventory 18; emotional and behavioral difficulties were assessed via the Strength and Difficulties Questionnaire; and coping behaviors were measured using the Brief COPE. Three years after the attack, posttraumatic stress symptoms were evaluated via the UCLA Posttraumatic Stress Disorder Reaction Index.

Results: Directly exposed youths showed a significant increase in psychological distress (P = .05) and a decrease in active coping (P = .042), whereas indirectly exposed youths reported better mental health and more active coping over time. Compared to girls, boys showed a disproportionate increase in psychological distress, emotional and behavioral problems, and avoidant coping. Direct exposure to the attack and the endorsement of avoidant coping behaviors significantly predicted the severity of posttraumatic symptoms at follow-up (P < .05 for both).

Conclusions: Our findings highlight the importance of conducting follow-up studies to monitor long-term psychological functioning and to screen for adolescents who may need additional referral for trauma treatment. The long-term detrimental effects of avoidant coping on youths' psychological well-being underscore the need to implement early psychoeducational interventions to minimize adverse outcomes and prevent the chronicity of posttraumatic reactions.