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Abstract
The recent wave of terrorism affecting the United States and other countries raises
concerns about the welfare of children and adolescents. This review is designed to
address such concerns by summarizing data from two scientific areas. First, a series
of recent studies examine psychiatric outcomes over time in children exposed to various
forms of trauma. This review summarizes data on the various psychiatric consequences
of childhood exposure to trauma, with specific emphasis on identifying factors that
predict psychiatric outcome. Prior studies suggest that level of exposure, evidence
of psychopathology before trauma exposure, and disruption in social support networks
consistently emerge as strong predictors of psychopathology following exposure to
trauma. Hence, clinicians might monitor children exposed to trauma most closely when
they present with these risk factors. Second, a series of randomized controlled trials
documents the beneficial effects of cognitive behavioral therapy (CBT) in children
exposed to sexual abuse. When combined with other data from open studies and controlled
trials in nontraumatized children, these studies suggest that CBT represents a logical
therapeutic option for children developing anxiety symptoms following the recent wave
of terrorism. In terms of psychopharmacological treatments, data from randomized controlled
trials in traumatized children have not been generated, but recent studies in other
groups of children exhibiting symptoms of anxiety or depression suggest the utility
of selective serotonin reuptake inhibitors.