A Web-based survey of adults who experienced loss during the September 11, 2001, terrorist attacks was conducted to examine the prevalence and correlates of complicated grief (CG) 2.5-3.5 years after the attacks. 43% of a study group of 704 bereaved adults across the United States screened positive for CG. In multivariate analyses, CG was associated with female gender, loss of a child, death of deceased at the World Trade Center, and live exposure to coverage of the attacks on television. PTSD, major depression, anxiety, suicidal ideation, and increase in post-9/11 smoking were common among participants with CG. A majority of the participants with CG reported receiving grief counseling and psychiatric medication after 9/11. Clinical and policy implications are discussed. [Author Abstract]

This study assessed the mental and physical health status and psychological problems related to the September 11th terrorist incidents among a representative sample of adults living near New York City, using continuously time-sampled data collected throughout 2001. Prevalence estimates for poor mental or physical health after September 11th (October through December) were comparable to those for the entire year of 2001 (i.e. approximately 33%). Psychological problems related to the terrorist incidents were reported by more than half of the respondents, and appeared to peak in prevalence approximately two to three months following the incidents, followed by a decline in the next month and subsequent year. Poor mental health, female gender, media re-exposure, and ongoing or increased alcohol use were risk factors for psychological problems, while older age (65+ years old) and being married were protective factors. Risk factors for poor physical and mental health or psychological problems were generally stable over the three-month period following September 11th, but some changes were identified consistent with stage models of post-disaster psychological adjustment. Implications are discussed for using continuous time-sampling as a strategy to research patterns of relatively acute stress-related sequelae of terrorism in populations whose members are affected despite primarily not having been at the disaster epicenter. [Author Abstract] KEY WORDS: terrorism; disaster; epidemiology; stress; substance use

To assess the prevalence and correlates of post-traumatic stress disorder (PTSD), major depression and anxiety disorders other than PTSD, among three samples with different level of exposure to the March 11, 2004 terrorist attacks in Madrid. We sampled three groups of persons-those injured in the attacks, the residents of Alcala de Henares, and police officers involved with the rescue effort-with different exposure to the March 11, 2004 terrorist attacks, using random sampling from comprehensive censuses of all three groups. In person interviews were conducted with all three groups between 5 and 12 weeks after March 11, 2004. Questionnaire included assessment of socio-demographic characteristics, of PTSD using the Davidson trauma scale, and of a range of psychiatric illnesses using the mini international neuropsychiatric interview (MINI). The overall sample included 127 persons injured in the attack, 485 residents of Alcalá de Henares, and 153 policemen involved in rescue. Of all three groups 57.5%, 25.9% and 3.9% of persons, respectively, reported symptoms consistent with any assessed psychiatric disorder. The use of psychoactive medication before March 11, 2004 was consistently the main predictor of PTSD and major depression among those injured and of major depression and anxiety disorders others than PTSD among residents of Alcala. There was a substantial burden of psychological consequences of the March 11, 2004 terrorist attacks two months after the event. Persons with prior mental illness are at higher risk of post-event psychopathology, across groups of exposure.

Objective: To describe the prevalence and correlates of post-traumatic stress disorder (PTSD), depressive and anxiety disorders, or any other mental disorder among adult victims treated in a hospital at different points in time after the 11 March 2004 terrorist attacks in Madrid. Design, Setting, and Participants: A random sample of 56 individuals injured in the attacks was interviewed in person at one, six, and twelve months after the attacks. Main Outcome Measures: Current DSM-IV mental disorders: depressive disorders and anxiety disorders (PTSD, generalised anxiety, agoraphobia, social phobia, and panic disorder) were assessed with the Spanish version of the MINI (Mini International Neuropsychiatric Interview), a structured, lay-administered psychiatric interview. Results: PTSD was the most prevalent psychiatric disorder (35.7% at month 1, 34.1% at month 6, and 28.6% at month 12), followed by major depression (28.6%, 22.7%, and 28.6%, respectively). Others relevant conditions were suicide risk, generalised anxiety disorder (GAD), agoraphobia, and panic disorder. No significant differences in the prevalence of the disorders were found between the different assessment times. Patients with a psychiatric history prior to 11 March had a higher prevalence of PTSD, major depression, GAD, and panic disorder at month 1. Females had higher prevalence of PTSD, agoraphobia, and panic disorder at month 1. The only predictive factor for PTSD at month 12 was PTSD at month 6 (OR = 14.007). The only predictive factor for major depression at month 12 was major depression at month 6 (OR = 15.847). Conclusion: The prevalence of PTSD and major depression was high and remained stable between month 1, month 6, and month 12. The only predictive factor for PTSD at month 12 was PTSD at month 6.

We hypothesized that exposure to Type IV trauma (involving alteration in a person's basic relation to the environment), associated with prolonged terrorist threats, would impact posttraumatic distress and that exposure to terrorism would impact the intensity of coping. The relationships revealed by the data proved to be in line with this model. Our data suggested that the relationship of exposure and coping was not direct, but seemed to be mediated by posttraumatic distress, that demoralization at the height of an unrelenting terror campaign was unrelated to trauma exposure, and that acceptance was a distinct way of coping adopted by targeted Israelis. Acceptance showed the weakest association with posttraumatic distress and was related inversely to our index of low morale. (PsycINFO Database Record (c) 2016 APA, all rights reserved) (Source: journal abstract)

The authors examined reasoning following the terrorist attacks carried out in London in July 2005. They tested participants in London (United Kingdom), Manchester (United Kingdom), and London (Canada) within 1 week of the attacks and again 6 months later. Participants reasoned about syllogisms of 3 types: neutral, generally emotional, and emotionally related to terrorism. Participants also provided self-reports of emotion and risk estimates. Participants generally reasoned more accurately on neutral problems, compared with generally emotional and terrorism-related problems. However, participants in London (United Kingdom) provided more logically valid answers when reasoning about problems related to terrorism and were less likely to answer on the basis of beliefs, despite reporting higher levels of emotions. (PsycINFO Database Record (c) 2016 APA, all rights reserved) (Source: journal abstract)

OBJECTIVES: To describe the rehabilitation outcomes of terror victims with multiple traumas, and to compare those outcomes with those of patients with nonterror-related multiple traumas treated in the same rehabilitation facility over the same time period. DESIGN: Retrospective chart reviews. SETTING: Rehabilitation department in a university hospital in Jerusalem, Israel. PARTICIPANTS: Between September 2000 and September 2004, we treated 72 victims of terrorist attacks who had multiple traumas. Among them, 47 (65%) had multiple traumas without central nervous system involvement (MT subgroup), 19 (26%) had multiple traumas with traumatic brain injury (TBI subgroup), and 6 (8%) had multiple traumas with spinal cord injury (SCI subgroup). We matched, according to their types of injury and demographic data, each terror victim with a control patient treated in the same period in our rehabilitation department. INTERVENTION: Interdisciplinary inpatient and outpatient rehabilitation. MAIN OUTCOME MEASURES: Hospital length of stay (LOS) in acute care departments, inpatient and outpatient rehabilitation departments, functional outcome (FIM instrument score), occupational outcome (returning to previous occupation), and psychologic outcome (Solomon PTSD Inventory). RESULTS: The mean LOS of terror victims was 218 ± 131 days; for the nonterror group it was 152 ± 114 days (P < .01). In comparison with the control subgroups, the MT subgroup of terrorist victims had significantly longer LOS in the acute care and outpatient rehabilitation departments (P = .06) and the terror TBI subgroup had a longer LOS in outpatient department only (P < .05). The LOS of the SCI patients, both terror victims and control patients, was significantly longer than that of the other 2 subgroups. The difference between FIM value at entry and discharge ([delta]FIM) was significantly higher for terror victims than for the controls (41.1 ± 21.6 vs 30.8 ± 21.8, P = .002). This dif

Reviews the book, 9/11: Mental health in the wake of terrorist attacks by Yuval Neria, Raz Gross, and Randall Marshall (see record 2006-21181-000). This volume is an excellent compendium of a diverse set of attempts by mental health professionals to respond immediately to the non-life threatening social aftermath of the events. Although positively portraying efforts that were deployed using the traditional psychiatric research paradigm, the contributors of the book also expose the limits of that approach in structuring service provision following 9/11, providing a much needed evaluation of what happened when the American "can do" attitude did not quite get it done. The volume highlights the importance and the limitations of focusing on individual psychopathology. This timely collection of research articles, accounts of interventions, and unflinching critiques of both provides students and clinicians with an introduction to the field of terrorism trauma research, researchers with original findings and valuable reflections on the perievent research process, and policy makers with a critical asset with which to argue for the better allocation of training and preparation resources. (PsycINFO Database Record (c) 2016 APA, all rights reserved)

Reviews the book, 9/11: Mental health in the wake of terrorist attacks by Yuval Neria, Raz Gross, Randall Marshall, and Ezra Susser (2006). This is an impressive and substantial text on the impact of disaster and terrorism on health and mental well-being. Ninety contributors examine whether terrorism has a unique emotional and behavioral impact on adults and children, and the impact of terrorism within different communities and professional groups. Three papers are likely to be of particular interest to those of us working with children and young people in the community. This vital text should be in the hands of government and local officials; it should also be in our hands, as practitioners, so that we can be best placed to meet the needs of individual children and families, and be aware of the importance of creating resilient communities able to recreate and reconstruct the structures necessary to sustain us when the inevitable happens. (PsycINFO Database Record (c) 2016 APA, all rights reserved)

Reviews the book, In the moment of greatest calamity: Terrorism, grief and a victim's quest for justice by Susan F. Hirsch (see record 2006-20735-000). In this post-9/11 era, at a time when the U.S. government appears to be veering away from open trials toward more heavyhanded alternatives (incommunicado detention, military tribunals) to deal with the threat of terrorist violence, this book should prove to be a highly provocative read for a wideranging audience. The book begins with the 1998 Al Qaeda attacks in Kenya and Tanzania, and proceeds to address surrounding events and whether a trial by U.S. criminal courts is the best way to assuage a victim's pain, combat terrorism, and guarantee justice. (PsycINFO Database Record (c) 2016 APA, all rights reserved)