1 in 4 Adults in the Community Meet PTSD Criteria Following Mass Shooting

Credit: Angela D. Moreland, PhD

Medical University of South Carolina

A recent study found probable PTSD was prevalent among adults long after the mass violence incidents occurred in their community.¹

“The present findings also have important implications for identifying those at most risk for developing PTSD following [mass violence incidents],” wrote investigators, led by Angela D. Moreland, PhD, from the department of psychiatry and behavioral sciences at Medical University of South Carolina.

According to Brady United, every day 327 people are shot in the US, with an average of 117 dying.² Surviving a mass shooting can be traumatic, but it can also be traumatic for witnesses and people in the community who heard about it secondhand.¹ Although it is known direct survivors suffer long-lasting psychological consequences, the impact on the broader communities where the mass shooting took place is unknown.

Investigators conducted a cross-sectional survey study from February 2020 to September 2020 with a sample of adults from 6 communities who had most likely experienced a mass violence incidence between 2015 and 2019 at Dayton, Ohio; El Paso, Texas; Parkland, Florida; Pittsburgh, Pennsylvania; San Bernadino, California; and Virginia Beach, Virginia. The team used address-based sampling to identify randomly selected households, mail invitations, and select 1 adult per household to complete a self-administered print or online survey. Investigators analyzed the data from September to November 2023.

The primary outcome was a probable diagnostic-level past-year PTSD, and current (last month) PTSD determined using the American Psychiatric Association Diagnostic and Statistical Manual of Mental Disorders (Fifth Edition) (DSM-5) PTSD criteria.

Among 6867 adults aged ≥ 18 years who accessed the survey website, 5991 (87.2%) agreed to participate and completed the survey, 343 (6.3%) partially completed the survey, and 443 (6.5%) did not meet eligibility criteria or refused to participate. More than half of the respondents were female (53.5%), and the sample had a mean age of 45.56 years.

In the survey 21% of respondents reported high exposure to the mass violence incident, meaning either themselves, a close friend, or a family member was on site during the shooting. Nearly one-quarter (23.7%) of participants met probable DSM-5 diagnosis criteria for past-year PTSD, and 8.9% met the criteria for current PTSD. Among the sample, approximately 1 in 4 individuals met PTSD criteria for past-year and 1 in 10 met the criteria for a current PTSD diagnosis.

Regression analyses demonstrated being female (odds ratio [OR], 2.32; 95% confidence interval [CI], 2.01 – 2.68) and having a history of both physical or sexual assault and other potentially traumatic events (OR, 9.68; 95% CI, 7.48 – 12.52) were associated with the greatest risk of past-year PTSD. People who were younger and had low social support also were more likely to have PTSD.

The team added the results were consistent with previous research on PTSD risk factors. Numerous studies found females were more vulnerable to PTSD, but the reasons for this are not fully known. This may be because females have greater rates of assault, are more vulnerable to stressors, and are often more willing than males to disclose symptoms.

Investigators pointed out several limitations including the self-reported data to determine probable PTSD, the address-based sampling method which could have impacted the response rate and created nonresponse bias, and a small number of participants reported being on the site during the mass shooting.

“It is also important to consider that the rates of community PTSD may be influenced by unique features of each [mass violence incident] and vulnerabilities inherent to the community,” investigators wrote. “Although the majority of PTSD cases occurred in those with high exposure to the [mass violence incident], many respondents with no direct exposure met the criteria for past-year (21.0%) and current (8.9%) PTSD. Community-level factors may be especially important to consider for [mass violence incident] sites with an extensive history of community violence.”

References

1. ^{Moreland, A, Rancher, C, Davies, F. Posttraumatic Stress Disorder Among Adults in Communities with Mass Violence Incidents. JAMA Network Open. 2024;7(7):e2423539. doi:10.1001/jamanetworkopen.2024.23539}
2. ^{Statistics. Brady United. https://www.bradyunited.org/resources/statistics. Accessed July 25, 2024.}