After acts of violence, terrorism and other disasters, children are particularly vulnerable to developing mental health problems, due to both their own exposure and to the additional, indirect effect of their parent's exposure. First Responders to these events have extremely high levels of work-related exposure to violent acts, thus putting their children at elevated risk for mental health problems in general, and at additional increased risk following a major act of terrorism or mass violence. Insufficient attention, however, has focused on the needs of First Responders'children, who may routinely experience such indirect exposure to violence through their parent's work-related exposure. The impact on children of indirect exposure to violent events must be understood in order to formulate appropriate public health interventions for all children, especially following acts of terrorism. A major goal of the proposed study is to assess the impact of parental (First Responder) exposure to work-related violent incidents on their children over time, both in Israel and in New York City. The proposed study design will permit, (a) an understanding of the impact of parental exposure to violence and terrorism on children;(b) an understanding of why some children of parents who have been found to be particularly resilient to mental health disorders after violent incidents may be at elevated risk for specific types of mental health problems;(c) an identification of risk and protective factors related to children's indirect exposure to violence that can potentially be modified through post-disaster interventions. In addition to the main objectives, this study will allow us to have in place, with the assistance of the Centers of Disease Control and Prevention, collaborators on this project, an emergency assessment strategy for this important and vulnerable population in the event of a major terrorist attack.
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