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Psychological Adjustment of Adolescents 18 Months After the Terrorist Attack in Beslan, Russia: A Cross-Sectional Study

Ughetta Moscardino, Ph.D.; Sara Scrimin, Ph.D.; Fabia Capello, M.A.; Gianmarco Altoč, M.Sc.; and Giovanna Axia, Ph.D.†

Objective: Children exposed to terrorism are at high risk for developing emotional and behavioral problems, but only a few studies have examined adolescents' long-term psychological adjustment after a terrorist attack. We aimed to assess psychological distress, problem behaviors, and coping in adolescents who survived the terrorist attack on School No. 1 in Beslan, Russia.

Method: Seventy-one youths aged 14 to 17 years held as hostages by terrorists completed self-reported measures of psychological symptoms, emotional and behavioral difficulties, and coping behaviors 18 months after the traumatic event. They were compared with 100 adolescents who were not directly exposed to the attack. Data were collected during a 1-month period in May 2006.

Results: No significant differences were found between the 2 groups in overall levels of psychological symptoms as well as in emotional and behavioral problems. Girls in both groups reported significantly more psychological distress (p = .0001) and total difficulties (p = .0001) than boys. In the directly exposed group, avoidant coping was related to worse psychological functioning for girls (r = 0.54, p < .001) and boys (r = 0.50, p < .01), whereas in the indirectly exposed group this strategy was associated with psychological distress (r = 0.43, p < .01) and total difficulties (r = 0.40, p < .01) for girls only.

Conclusions: More than 1 year after a terrorist attack, adolescents may experience psychological distress regardless of being directly or indirectly exposed. Professionals working with adolescents affected by terrorism should be sensitive to developmental level and gender, consider the cultural context, and foster coping skills that may be differentially effective for girls and boys.


(J Clin Psychiatry 2008;69:854-859. Online Ahead of Print March 25, 2008.)

Received April 11, 2007; accepted Oct. 23, 2007. From the Department of Developmental and Social Psychology, University of Padua, Italy.


This study was supported in part by the nongovernmental organization "Help Us Save the Children," Rovereto, Italy, and by the Faculty of Psychology, University of Padua, Italy.

Giovanna Axia died on June 2, 2007. The rare spirit she brought to children and families will forever inspire all of us who knew and worked with her. The authors thank all the adolescents who participated in the study.

The authors report no additional financial or other relationships relevant to the subject of this article.

Corresponding author and reprints: Ughetta Moscardino, Ph.D., Department of Developmental and Social Psychology, University of Padova, Via Venezia 8, 35131 Padova, Italy (e-mail: