Psychological and behavioral post-trauma outcomes among adolescent survivors of aps Peshawar massacre: the role of exposure, coping and perceived social support

Abstract

In a world of ever-increasing man-made violence, adolescents are spared neither the trauma nor its consequences. Exposure to trauma has been found to be more detrimental to adolescent, since they are still in transitional years of their lives and any traumatic exposure can have last impact. Exposure to traumatic events can result in psychological, behavioral, emotional problems among adolescents. Unfortunately, little is known about post-trauma psychological and behavioral implications among adolescents within Pakistani context. Current study aimed at examining the impact of exposure to APS Peshawar massacre of 16th December, 2014 among the direct victims of Army Public School for Boys (Warsack Road, Peshawar) massacre, in terms of resulting post-traumatic stress and problem behaviors, six months later. The present research aimed to further investigate the influence of coping strategies and perceived social support among the victims. In the absence of baseline prevalence, an adolescent comparison group, separated from actual site by around 145 miles, was used. The participants of comparison group had indirect media-exposure to visuals and details of APS Peshawar massacre. A total of 237 students completed Brief-COPE, Impact of Events Scale revised (IES-R), Strength and Difficulty Questionnaire (SDQ) and Perceived Social Support Survey. The sample included 109 directly exposed adolescents and 128 adolescents with indirect media-based exposure. Results showed significantly elevated post-traumatic stress (82.6%), behavioral problems (64.2%) among directly exposed victims as compared to indirectly exposed counterparts (14% & 2%, respectively). Directly exposed participants also reported significantly higher levels of perceived social support. Perceived social support also exhibited significant positive association between post-traumatic stress among the directly exposed participants while no significance was observed PSYCHOLOGICAL & BEHAVIORAL POST-TRAUMA OUTCOMES OF APS PESHAWAR MASSACRE xix for behavioral problems. The results also showed a negative association between post-traumatic stress/behavioral problems and approach coping strategies, namely; problem-focused and active emotional coping strategies in addition, positive association between avoidant coping strategies, post-traumatic stress and behavioral problems was also observed. Regression analysis revealed degree of exposure to be the most significant predictor of post-traumatic stress and behavioral problems while coping strategies also had significant contribution. Further mediation analyses revealed that coping strategies (Problem-focused, active emotional & avoidant) significantly mediated and explained the relationship between degree of exposure and post-traumatic stress and behavioral problems. Problem-focused and active emotional coping strategies were identified as protective factors while avoidant coping strategies emerged as significant risk factor for post-trauma psychopathology (PTS & behavioral problems). The implications of these findings are discussed.