Comments on the concepts of the roles of distant trauma and mass media in the nosology of PTSD. [VB]

Forty-five adult Asian and Middle Eastern immigrants living in Oklahoma City at the time of the 1995 bombing were surveyed 1.5 to 2 years later as part of a disaster mental health outreach program. Demographic variables, physical and interpersonal exposure, initial physiologic and emotional responses to the bombing, and posttraumatic stress symptoms associated with this disaster and with earlier trauma were measured. Most participants had experienced prior trauma in their homeland. PTSD symptomatology from prior trauma was most predictive of initial physiologic and emotional response and of later bomb-related PTSD symptoms. Bomb-related PTSD symptoms increased with current age and were inversely related to age at the time of prior trauma. Results underscore the importance of providing long-term disaster assistance to immigrants with prior trauma. (PsycINFO Database Record (c) 2016 APA, all rights reserved)

Empirical data from research studies are vital to guiding mental health interventions following disasters. However, few data are available for this purpose. Important advances in policy and procedures for the conduct of organized research emerged from the Oklahoma City bombing, yielding cooperative working relationships among researchers and culminating in the ethical attainment of informative research data. However, the academic community was again caught off guard after the September 11, 2001, terrorist attacks. Suggestions to surmount these obstacles include incorporating research infrastructures into disaster preparedness plans in advance; organizing the community of researchers; and working closely with major funding organizations. Methodological issues pertaining to measurement of psychopathology include the importance of obtaining diagnostic data; interpreting the meaning of symptoms in the absence of a psychiatric disorder; differentiating preexisting symptoms from those that emerged after the disaster, and optimal timing of postdisaster assessment. [Author Abstract]

BACKGROUND: The victims of terrorist attacks have a lower level of mental health than general population. However this effect has been only demonstrated in short term after the terrorist attack. METHODS: 2998 people from 544 families who have suffered a terrorist attack. General Health Questionnaire-28 (GHQ-28) as a psychopathological screening was used in 1094 people. This sample was divided into direct victims (DV), direct victims' relatives (DVR), and people who meet these two conditions (DVRDV). RESULTS: 39.6% of the sample were probable psychiatric cases. Psychiatric prevalence was higher in DVRDV (54.5%) and DV (52.0%) than in DVR and general population (10-25%). The sample presented worse level of mental health than the general population in short term (0-2 years) (DVR 40%, DV 66.7%, DVRDV 75%) and in long term 18-20 years) (DVR 35.70%, DV 37%, DVRDV 37.5%). CONCLUSION: Both those suffering a terrorist attack as well as their family members have worse levels of mental health than the general population in both the short and long term. [Author Abstract] KEY WORDS: terrorism; terrorist attacks; mental health; long-term; primary victims; secondary victims

The September 11, 2001, terrorist attacks were the largest human-made disaster in the United States since the Civil War. Studies after earlier disasters have reported rates of psychological disorders in the acute postdisaster period. However, data on postdisaster increases in substance use are sparse. A random digit dial telephone survey was conducted to estimate the prevalence of increased cigarette smoking, alcohol consumption, and marijuana use among residents of Manhattan, New York City, 5-8 weeks after the attacks. Among 988 persons included, 28.8% reported an increase in use of any of these three substances, 9.7% reported an increase in smoking, 24.6% reported an increase in alcohol consumption, and 3.2% reported an increase in marijuana use. Persons who increased smoking of cigarettes and marijuana were more likely to experience PTSD than were those who did not (24.2% vs. 5.6% PTSD for cigarettes; 36.0% vs. 6.6% for marijuana). Depression was more common among those who increased than for those who did not increase cigarette smoking (22.1 vs. 8.2%), alcohol consumption (15.5 vs. 8.3%), and marijuana smoking (22.3 vs. 9.4%). The results of this study suggest a substantial increase in substance use in the acute postdisaster period after the September 11th attacks. Increase in use of different substances may be associated with the presence of different comorbid psychiatric conditions. [Author Abstract] KEY WORDS: Alcohol drinking; Disasters; marijuana smoking; PTSD; Substance-related disorders

In October 2001, the New York State Office of Mental Health and the Department of Epidemiology of the Mailman School of Public Health of Columbia University conducted a rapid assessment of the nature and magnitude of mental health needs in the state resulting from the September 11th terrorist attacks on the World Trade Center. This effort was carried out during a period of great turmoil and uncertainty as New Yorkers responded to the shocking events of this unprecedented disaster. Using the limited data available at the time, we estimated that over 520,000 persons in New York City and the surrounding counties would experience PTSD resulting from exposure to the attacks, and that more than 129,000 would seek treatment for this disorder during 2002. This assessment is part of an ongoing collaborative process between public and academic partners; the effort is designed to strengthen the capacity of the mental health system to respond to current and future terrorism. Estimates from this initial assessment will be refined over time as further data concerning the impact of the September 11th attacks become available. [Author Abstract]

CONTEXT: The September 11, 2001, attacks against the United States provide a unique opportunity to examine longitudinally the process of adjustment to a traumatic event on a national scale. OBJECTIVE: To examine the degree to which demographic factors, mental and physical health history, lifetime exposure to stressful events, September 11-related experiences, and coping strategies used shortly after the attacks predict psychological outcomes over time. DESIGN, SETTING, and PARTICIPANTS: A national probability sample of 3496 adults received a Web-based survey; 2729 individuals (78% participation rate) completed it between 9 and 23 days (75% within 9 to 14 days) after the terrorist attacks. A random sample of 1069 panelists residing outside New York, NY, were drawn from the wave 1 sample (n = 2729) and received a second survey; 933 (87% participation rate) completed it approximately 2 months following the attacks. A third survey (n = 787) was completed approximately 6 months after the attacks. MAIN OUTCOME MEASURES: September 11-related symptoms of acute stress, PTSD, and global distress. RESULTS: 17% of the US population outside of New York City reported symptoms of September 11-related posttraumatic stress 2 months after the attacks; 5.8% did so at 6 months. High levels of posttraumatic stress symptoms were associated with female sex (odds ratio [OR], 1.64; 95% confidence interval [CI], 1.17-2.31), marital separation (OR, 2.55; 95% CI, 1.06-6.14), pre-September 11 physician-diagnosed depression or anxiety disorder (OR, 1.84; 95% CI, 1.33-2.56) or physical illness (OR, 0.93; 95% CI, 0.88-0.99), severity of exposure to the attacks (OR, 1.31; 95% CI, 1.11-1.55), and early disengagement from coping efforts (eg, giving up: OR, 1.68; 95% CI, 1.27-2.20; denial: OR, 1.33; 95% CI, 1.07-1.64; and self-distraction: OR, 1.31; 95% CI, 1.07-1.59). In addition to demographic and pre-September 11 health variables, global distress was associated with severity of loss due to the atta

Discusses the short-term and lingering effects of the Sept. 11, 2001 attack on New York City and the subsequent anthrax attacks. [VB]

PURPOSE OF REVIEW: Terrorist attacks are increasing in different parts of the world. The psychiatric consequences of terrorist attacks, particularly PTSD, are often underrated. Recent terrorist attacks, particularly the attacks of September 11, 2001 in the USA, focused attention on PTSD. This review examines the prevalence rates and characteristics of PTSD after terrorist attacks. RECENT FINDINGS: At least 28-35% of people exposed to a terrorist attack may develop PTSD. Whereas persons directly exposed to terrorist attacks have a greater risk of developing PTSD, the secondary effects of vicarious exposure on people not directly exposed are significant. Individuals with PTSD have higher healthcare utilization and medication use. More than 40% of people across the USA experienced substantial symptoms of stress after the attacks of September 11, 2001. The rates of acute PTSD and depression among residents of lower Manhattan, New York, were twice the baseline rate 5-8 weeks after the attacks. The presence of pre-existing stressors, levels of social support, female sex, and Hispanic ethnicity were important predictors of PTSD. Disaster-related television viewing could be harmful for children. The role of psychological debriefing in the prevention of PTSD is questionable. SUMMARY: Most suffers of PTSD are reluctant to see mental health professionals. Primary care physicians are best suited to identify and manage individuals with PTSD. There is a need to train primary care practitioners in the identification and management of the psychiatric consequences of trauma and terrorism. [Author Abstract] KEY WORDS: PTSD; stress; terrorism

Estimates of acute mental health symptoms in the general population after disasters are scarce. We assessed the prevalence and correlates of acute PTSD in residents of Manhattan 5-8 weeks after the terrorist attacks of September 11, 2001. We used random-digit dialing to contact a representative sample of adults living in Manhattan below 110th Street. Participants were interviewed about prior life events, personal characteristics, exposure to the events of September 11th, and psychological symptoms after the attack. Among 988 eligible adults, 19.3% reported symptoms consistent with PTSD at some point in their life, and 8.8% reported symptoms consistent with a diagnosis of current (within the past 30 days) PTSD. Overall, 57.8% of respondents reported at least one PTSD symptom in the past month. The most common past-month symptoms were intrusive memories (27.4%) and insomnia (24.5%). Predictors of current PTSD in a multivariable model were residence below Canal Street, low social support, life stressors 12 months prior to September 11th, perievent panic attack, losing possessions in the attacks, and involvement in the rescue efforts. These findings can help guide resource planning for future disasters in densely populated urban areas. [[Author Abstract]