When Peggy Lindholm heard about the school shootings in Newtown, Conn., on Friday, she thought back to April 20, 1999, when 12 students and a teacher were murdered at her daughter's school in Columbine, Colo.
Lindholm's daughter, Margorie, survived the massacre at Columbine High School that day, but couldn't set foot in a classroom for years afterward. She struggled with depression and addictions.
Her mother went on to work as a licensed counselor for patients with post-traumatic stress disorder. "Something like this does a lot of things to your mind," Peggy Lindholm said.
Although the news of the latest school massacre is still fresh, psychologists and experts in child development have already begun drawing conclusions about the psychological toll that the shooting might take on survivors. Lindholm boiled it down to this: "You're looking at a lot of trauma."
Russell T. Jones, a clinical psychologist and psychology professor at Virginia Tech, has studied and worked extensively with traumatized children, and he said the Newtown massacre is likely to have a long-lasting impact on the kids who survived it. "They're likely to have difficulty concentrating, difficulty with trust, difficulty with dealing with the losses they've incurred," Jones said. "Many of these kids will never be the same kids."
Jones, like Lindholm, has firsthand memories of the aftershock of a massacre. In 2007, he arrived on campus at Virginia Tech, just hours after Seung-Hui Cho shot and killed 32 people. He helped coordinate the school's efforts to provide counseling to students in the aftermath, and in 2011, he and eight other researchers published a widely cited study of post-traumatic stress on campus.
Using an online survey, the authors found that 15 percent of students developed symptoms of post-traumatic stress -- a smaller percentage than they expected. “We like to say it was due to the resilience of the Hokie Nation,” Jones said, referring to the school football team's famously tight-knit fans.
How well the children in Newtown do in the coming months and years will likewise depend partly on the closeness of the community, Jones said. "After a fire, the Red Cross is there and the friends are there, but four or five days after that, you're on your own," he said
Dr. Steven Berkowitz, the director of the Penn Center for Youth and Family Trauma Response and Recovery at the University of Pennsylvania, also stressed the importance of the community response. "Unfortunately, one of the things that we saw in Columbine is a situation where experts flew in from all over country, offering their services and leaving," Berkowitz said. "What really needs to happen is that people who are local need to be trained up to provide the kinds of interventions children need, because we need people to be able to sustain these efforts over time."
Like several other experts, Berkowitz noted that the kids in Columbine who were either injured or were close to those who died had the highest risk of psychological scars, followed by those who came from families that were not "functional."
Dr. Frank Ochberg, a former FBI psychiatrist who guided counseling teams in the aftermath of Columbine, echoed this observation. "My sense is that the good ones do well," he said. “The kids who have certain problems to begin with, it's those problems that affect them.”
Dr. Lloyd Sederer, the medical director of the New York State Office of Mental Health (and HuffPost's Mental Health editor), pointed out that the children in the Newtown shooting are particularly young.
“Distress is rendered differently by different age groups,” Sederer said. “The less verbal a person can be, the more they're apt to express their troubles behaviorally or physically. So a 4-year-old isn't going to be able to articulate very well what's happened, or even a 6-year-old. But they may show sleep problems, they may be anxious and avoidant, they may have tummy aches or headaches or non-specific pains. The distress is expressed through the body, many times.”
Jones, the Virginia Tech professor, said the university did a good job of reaching out to traumatized students in the aftermath of that shooting -- a task made easier, perhaps, by the fact that Virgina Tech, like most colleges, already had a mental-health infrastructure.
In the days after the mayhem, Jones said, he and other counselors encouraged students to think of their psychological symptoms as normal. “It's normal to feel frightened, it's normal to have nightmares, it's normal to not want to go outside and that sort of thing,” he said. “But what we shared with them was that, over time, things typically get better.”
Joy Resmovits contributed reporting.