What happens to children and teenagers exposed to violence in their own neighborhoods.

By Lois Beckett / ProPublica

Updated Sept. 19, 2014 with new stories; originally published June 24, 2014.

When people think of post-traumatic stress disorder, they often focus on military veterans. But there’s  growing evidence that PTSD is also a serious problem for American civilians, especially those exposed to violence in their own neighborhoods. Researchers in Atlanta found that  1 out of 3 inner-city residents they interviewed had experienced symptoms consistent with PTSD at some point in their lives. Earlier this month, we published a new story on an Oakland family struggling with PTSD after two young children, ages six and one, witnessed their mother being shot.

We’ve put together an updated collection of some of the best reporting on PTSD in children and teenagers exposed to community violence. The stories here take a nuanced look at the intersection of trauma, poverty and racism. Not all stories about PTSD in high-violence neighborhoods meet that standard. This May, a local CBS affiliate released a segment on trauma in Oakland youth that  referred to PTSD as “hood disease.” The anchor who used that term on air  later apologized.

Among our recommendations here are magazine stories, radio segments, a book based on a doctor’s interviews with shooting victims, and a documentary film. You can also see our selection of the best reporting on  PTSD and the U.S. military.

Please include your suggestions for other stories in the comments.

Social workers join the ER team, Chicago Tribune, September 2014

A look at an innovative program in Chicago’s public hospital that provides victims of violence with support for trauma and PTSD — right at their hospital bedsides.

In Chicago’s war zones, the tragedy extends beyond the kids who die, Chicago Reader, August 2014

A profile of a young Chicago woman whose life has been marked by violence, and who is now working to help local kids deal with the trauma they experience. After an 11-year-old girl is shot at a sleepover, “They want to know, ‘Why was that girl killed at that party? She wasn’t doing anything wrong,'” she says. “Who would think that you aren’t safe inside a house, doing little girl things?”

Trauma in the trenches of gun-weary Chicago, MSNBC, August 2014

In 2012, when Chicago had the nation’s highest number of murders, Mayor Rahm Emmanuel closed half of the city’s 12 mental health clinics to cut costs. The clinics were one of the few resources available to local residents dealing with high levels of violence, trauma, and PTSD.

How Childhood Trauma Could Be Mistaken for ADHD, The Atlantic, July 2014

The symptoms of ADHD and those of trauma exposure can look very similar. Are low-income kids who have been exposed to traumatic events being misdiagnosed?

Giving Traumatized Kids a Head Start in Healing, PBS Newshour, July 2014

A look at Head Start Trauma Smart, a program in Kansas City that works with very young children who struggle with behavioral issues because of the trauma they’ve experienced. Kids dealing with trauma often act out—and traditional disciplinary methods may only make things worse, setting in motion a vicious cycle of suspensions and expulsions. By educating teachers, parents and other caregivers about how trauma affects children, the program helps them respond in more supportive, and effective, ways.  Head Start Trauma Smart has also been featured in The New York Times’ Fixes column.

Harper High School, Parts  One and  Two, This American Life, February 2013

At Chicago’s Harper High School, 29 current students and recent alumni were shot over the course of a single year. Starting in late summer 2012, reporters from This American Life spent five months at Harper. They documented how teachers, students and parents dealt with the constant threat of violence, how students tried to heal from past tragedies — and how the school worked to prevent more shootings. PTSD is not a central focus of the story, but it’s very much in the background.

In Country, In City, This American Life, January 2013

Reporter Alex Kotlowitz interviews two men with post-traumatic stress: an Afghanistan war veteran and a young man who was shot in one of Philadelphia’s most dangerous neighborhoods.

Welcome to the City of Post-Traumatic Stress Disorder, Philadelphia Magazine, August 2012

Between Jan. 1, 2001 and May 29, 2012, a total of 18,042 people were shot in Philadelphia—and 3,852 were murdered. That’s more than the number of Americans killed in the war in Afghanistan. This story looks at the burden of violence on a single city, tracing personal stories, along with the emerging research from Philadelphia’s trauma experts. The East Bay Express also did a broad look at PTSD in Oakland.

The Poverty Clinic, The New Yorker, March 2011

Experiencing traumatic events at a young age doesn’t simply affect a child’s emotional health. There’s increasing evidence that childhood trauma is linked to serious medical problems in adulthood. A look at how a clinic in San Francisco’s Bayview neighborhood is trying to treat “toxic stress” in children and transform how we think about pediatric care.

The Interrupters, Kartemquin Films, 2011

In Chicago’s most dangerous neighborhoods, “violence interrupters” try to understand the unfolding conflicts between local teenagers and prevent them from escalating into killings. The role of trauma is one of the themes of the film. The full documentary is worth watching. You can also  start with the trailer, or read an  Essence Magazine profile of Ameena Matthews, one of the violence interrupters featured.

Doctor Works to Get Young Men Out of ‘Wrong Place,’ NPR, February 2010

In the early 1990s, as violence in America reached unprecedented heights, Dr. John Rich watched as young black men returned repeatedly to Boston City Hospital’s emergency room with life-threatening wounds. Many doctors and nurses assumed that the young men were doing something to get themselves shot. Trying to understand how to prevent more violence, Rich began interviewing the young men after they had left the hospital. He found that many of the patients were suffering from post-traumatic stress — and that the reasons they had been shot were not what he had expected. NPR interviews Rich, who was awarded a  2006 MacArthur genius grant, and includes an excerpt from his book, Wrong Place, Wrong Time: Violence in the Lives of Young Black Men.

Children Who Survive Urban Warfare Suffer from PTSD, Too, San Francisco Chronicle, August 2007

Eleven-year-old Tierra’s brother was murdered two weeks before she began sixth grade. She wrote her brother’s name on the cover of her notebooks. Her grades dropped. She started getting into fights. And she wasn’t the only one: At her San Francisco middle school, a third of students said they had seen or knew someone killed with a gun. A look at how post-traumatic stress affects children’s school performance — and at the difficulties of getting treatment.

Brain Development Altered by Violence, Washington Post, May 1999

After the Columbine shootings, this article looked broadly at post-traumatic stress among American children. “The Columbine students are the lucky ones,” the story concluded. “Most child witnesses to violence in America live in inner cities, where shootings occur repeatedly, and where parents often are as traumatized by them as children. And counselors rarely come calling on them in the aftermath of horrors, as they have in Littleton.”

Children of Violence, Los Angeles Times, September 1989

What happens to children who have to step over dead bodies on their way to school? Four years before gun violence in America reached its peak, the Los Angeles Times did an in-depth story about the impact of shootings on children in South-Central Los Angeles. The story looks at early interventions, including what may have been the nation’s first “grief and loss” program for elementary children.

For resources on understanding the symptoms of PTSD and finding treatment you can consult the National Center for PTSD’s  guide to helping children and teenagers, and their guide to PTSD  caused by community violence.