Risk factors associated with PTSD in a paediatric population exposed to the 14 July 2016, Nice terrorist attack: results from a 2-year longitudinal study.

Gindt, Morgane; Auby, Philippe; Robert, Philippe; Zeghari, Radia; Bodeau, Nicolas; Askenazy, Florence; Fernandez, Arnaud · Br J Psychiatry · 2025

prospective_cohort · Level II

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Abstract

The risk factors for post-traumatic stress disorder (PTSD) in children and adolescents following mass violence incidents, such as terrorist attacks, remain incompletely understood. In the aftermath of the 14 July 2016, terrorist attack in Nice, France, a dedicated paediatric consultation centre was established at the Children's University Hospital, the Nice Pediatric Psychotrauma Center (NPPC). This 2-year longitudinal study aims to identify and understand the influence of pre-trauma, trauma-related and post-trauma risk factors associated with the development of PTSD in children and adolescents following the 2016 terrorist attack in Nice. Participants under 18 years of age at the time of the attack were recruited from the NPPC over 2 years, between 21 November 2017 and 22 November 2019. Assessments included semi-structured diagnostic interviews with children and/or parents, standardised clinical questionnaires for both parents and children and cognitive tests exclusively for children. Two hundred and seventy-one children (mean age 8.10 years; 48.7% female) directly impacted by the terrorist attack, were assessed. Pre-traumatic factors (age, gender assigned at birth and cognitive functioning) failed to predict PTSD. Two trauma-related factors, subjective fear intensity and lifetime number of traumatic events emerged as significant predictors. Concerning post-trauma factors, maternal symptoms (anxiety, depression and PTSD), child somatic symptoms and comorbid DSM-5 diagnoses played a crucial role in child PTSD. The final regression model demonstrated an 84% accuracy in predicting PTSD in children and adolescents (<i>χ</i><sup>2</sup>[3] = 2.4, <i>P</i> < 0.001). These findings highlight the importance of assessing specific risk factors for PTSD in children and adolescents to deliver specialised and targeted care to young people and their parents following a terrorist attack.