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Stories of Route 91

Our first set of analyses compared the rates of post-traumatic stress symptoms between the people who were at the Route 91 festival when the mass shooting occurred and the people who were in the broader Las Vegas community and learned about the shooting within 24 hours of it happening. Below, I’ve graphed the range of scores in each group so that you can see how variable people’s reactions to trauma are. Click on the graph to walk through its layers.

Scores to the right of the cut line represent people at strong risk for being diagnosed with PTSD assuming they have the same scores 1 month after Route 91. For comparison, I also simulated the range of scores we would expect from the college students whose data were used to develop the measure of post-traumatic stress we used in this study (the PCL-5).

Post-traumatic stress distributions
Distributions of post-traumatic stress symptoms by group location when the Route 91 shooting occurred. The dashed line represents a simulated distribution based on the mean and standard deviation of undergraduate scores.

You can see that people at the festival are three times as likely to have elevated post-traumatic stress scores as people who were in the broader Las Vegas community. However, both groups have higher overall scores than the college students, suggesting that even learning about this trauma could make people in the community feel post-traumatic stress right after a mass shooting.

We also found that people at the festival during the shooting had substantially higher levels of post-traumatic symptoms in three diagnostic clusters compared to people in the Las Vegas community. Intrusive symptoms involve having unwanted dreams, memories, or flashbacks to the trauma. Negative alterations to mood and thoughts entail feeling detached, fearful, and believing that you’re no longer safe. Hyperarousal refers both to being easily startled and unable to sleep as well as being more irritable and doing reckless things.

In fact, the only cluster of post-traumatic symptoms that didn’t differ strongly between the two groups involved avoidance of reminders of the trauma, in which both groups had relatively low scores.

Now, this is largely good news for the community, as most people who weren’t there won’t see their symptoms increase over time and may even have them decrease. The same is true for people who were at the festival, though on average, they’ll have further for their symptoms to go down, so it’ll take longer (3-6 months, on average) for those most strongly affected to decline below the cutpoint for PTSD. Nevertheless, we would expect that within 3-4 months, about 70% of people at the festival will have symptoms below that cutpoint, so there’s hope that over time, things will improve.

If they don’t, I recommend seeing a treatment professional who specializes in prolonged exposure (PE) or cognitive processing therapy (CPT). You may also find that some clinicians offer eye movement desensitization and reprocessing (EMDR), which combines the mental exposure to trauma that PE uses with following some kind of synchronized stimuli. Following stimuli doesn’t seem to add anything to the effectiveness of the treatment, but it also doesn’t seem to harm people, either. Thus, if that’s what’s available to you, seek it out.

Furthermore, even if you didn’t have a lot of post-traumatic stress symptoms at first, it’s still possible you can develop more symptoms as time goes on (again, usually between 3-6 months after the trauma). If you notice that kind of increase, seek out professional help so that you reduce the impact the symptoms have on you – and eventually, reduce the symptoms themselves.

In the end, humans are surprisingly resilient creatures, which these data confirm. However, even those who experience a number of symptoms can recover from them, especially with professional help. As you can see from the graph, there’s a wide range of reactions people had to Route 91, and those reactions may be continuing right now.