RNSurveyThe Journal of school nursing : the official publication of the National Association of School Nurses2026

Drills or Distress? Understanding the Psychological Effects of Active Shooter Drills on Adolescents.

Jeff R Temple, Elizabeth Baumler, Christian Paige Owen and 1 others

PMID 40920079

WHAT IT FOUND

Most students who had active shooter drills did not feel anxious afterward, but female students, students with anxiety, suicidal thoughts, disability, or more childhood trauma were more likely to feel anxious afterward.

More frequent drills were linked to lower reported anxiety.

Key findings

0173.4% of surveyed students reported experiencing an active shooter drill in high school; among 1,465 analysed for reactions, 71.4% said it did not impact them and 17.9% felt anxious or scared.

02Female students and students with probable anxiety, lifetime suicidal ideation, or disability were more likely to report feeling anxious after an active shooter drill.

03More adverse childhood experiences were associated with more anxiety after a drill, while more frequent drills were associated with lower reported anxiety.

STILL TO COME

How it was doneWhat they foundWhat it means for RNs

Read the rest of this summary

You get three full summaries a month, free, and we do not ask for a card. Search, the TL;DRs and your library stay unlimited either way.

Already have one?

What it does not show

The design was cross-sectional and retrospective, so it cannot show that drills caused anxiety or that more drills reduced anxiety. The authors could not determine whether students with anxiety, suicidal ideation, or more adverse childhood experiences became more anxious after drills or simply remembered drills as more anxiety provoking. The measures were brief: one yes/no item for lifetime suicidal ideation, three items for anxiety, and two self-reported items for drill number and typical reaction. The study did not assess when drills happened or how many times across high school. The sample came from students enrolled in a randomized trial of a healthy relationships program, and retention was 71% of baseline participants, so it may not represent all schools. The paper reports 2,033 surveyed, 530 excluded for no drill exposure, and 1,465 analysed for drill reactions, without explaining the difference between these counts.

Declared interests

Funding: Eunice Kennedy Shriver National Institute of Child Health and Human Development and National Institute of Mental Health (grant numbers 2R01HD083445, R01HD083445, R01MH129354). The authors declared no potential conflicts of interest.

The easy way to misread this

Do not read these associations as proof that active shooter drills cause anxiety or that more drills reduce anxiety. The study was cross-sectional and retrospective, and the authors could not determine whether anxious students actually became more anxious after drills or simply remembered them as more anxiety provoking.

Read it on PubMed →


The study

Participants
1,465 students analysed for drill reactions; 2,033 surveyed in year 6; 530 excluded for no drill exposure
Certainty of evidence
Low

Related papers

Browse

Cite

Jeff R Temple, Elizabeth Baumler, Christian Paige Owen, et al. Drills or Distress? Understanding the Psychological Effects of Active Shooter Drills on Adolescents. The Journal of school nursing : the official publication of the National Association of School Nurses. 2026.

Read the original