Terrorism in Algeria during the last ten years has serious repercussions on subjects and their families. Families of victims and of terrorists are both concerned. Three cases of patients are reported in this work. All examined individuals are related to a terrorist. Parents or children of terrorists, they present a deep psychological distress, a blend of anxiety, culpability and moral pain. However, beyond the psychic disorders of subjects, their families are stigmatised and assimilated by social group to "terrorist families". This shameful and ignominious "social status" threatens the internal cohesiveness of those families. The rise of violence, of which our subjects are notably victims, is symptomatic of the family's imbalance and of the unexpected serious change of the relationships between individuals. "Guilty by proxy", the subject undergoes physical and/or psychological aggressions from other members of his family. This subject is the "scapegoat" and the "expiatory victim" selected to expiate the fault and then to assume the responsibility of the prejudice caused by the terrorism on the society. That "symbolic" violence inflicted by social group on the families of terrorists and that physical and psychological violence of which our patients are victims, are closely related. [Author Summary] KEY WORDS: terrorism, violence, psychological trauma, social bind

Terrorism is an extreme form of violent trauma made worse by being of human design. Following the terrorist attacks of September 11, 2001, the United States and the entire world entered into a new era in history. As much as adults seek to protect children from harm, their lives are too often touched by trauma, including terrorism. It is essential to examine and synthesize the findings of previous research regarding terrorism and trauma in order to guide our mental health work with children and families, particularly in the aftermath of recent terrorist events. PTSD symptoms in children affected by terrorism are high, with other common long-term consequences such as depression, anxiety, behavior, and developmental problems. Terrorism also raises unique trauma consequences for children. How children responded after the bombing of the Murrah Federal Building in Oklahoma City is reviewed in this paper. Although children of all ages had and have reactions to the terrorist traumas, these may be mediated by different variables. Furthermore, the new threat of invisible agent attacks may further complicate trauma reactions in children. Research and interventions with children must be conducted on all levels (individual, family, school, community, and public policy) to effectively meet the needs of our next generation. [Author Summary] KEY WORDS: terrorism, violent trauma, attacks, September 11, United States, children, research, mental health, families, harm, PTSD, depression, anxiety, behavior problems, developmental problems, Murrah Federal Building, Oklahoma City, threat, trauma reactions, interventions, school, community, public policy

In searching for information on the effects of living with the ongoing threat of terrorism, Israel was an obvious place to turn. For several years now, reports of acts of terrorism and violence occurring in Israel have appeared in the news media as frequently as several times a week. Moreover, one of the more common types of terrorist acts regularly taking place there, suicide bombing, coincides with the method used in the September 11th attacks in the U.S. The impact of ongoing terrorism on children and their families has been an area of expertise of Israeli psychologist Ofra Ayalon for many years now. Dr Ayalon was interviewed by Frances Waters, a clinical social worker and licensed marriage and family therapist in independent practice in Marquette, Michigan. The interview was conducted via telephone on 12 January 2002. [Author Summary] KEY WORDS: terrorism, Israel, violence, trauma, interpersonal violence, family, political violence, attacks, impact, intervention, adults, children, threat, psychosocial programs, traumatic effects

This study explored the impact of the 1995 Oklahoma City, Oklahoma, bombing on the spouses and significant others of a volunteer sample of Oklahoma City firefighters who participated in the bombing rescue effort. 27 partners of Oklahoma City firefighters participated in this study, conducted 42 to 44 months after the bombing. These partners were assessed using a structured diagnostic interview and a companion interview to examine exposure, rates of psychiatric disorders and symptoms, functioning, health, and relationships. Coping and perception of the firefighter partner's response were also examined. Some of the women were exposed directly; most knew someone who had been involved in the disaster, and all reported exposure through the media. The rate of psychiatric disorders in the women following the disaster was 22%, essentially unchanged from before the incident. One developed bomb-related PTSD. Most were satisfied with their work performance; 15% reported that their health had worsened since the bombing, and more than one third reported permanent changes in relationships as a result of the bombing. Most coped by turning to friends or relatives, with less than 10% seeking professional help. Many described symptoms in their firefighter mate; all reported that their mate had been affected by the experience, and one half said their mate had fully recovered. The mates of these firefighters fared relatively well in terms of psychiatric disorders, symptoms, and ability to function. The prevalence of bomb-related PTSD was considerably lower in this sample than in samples of individuals more directly exposed to the bombing, although some reported changes in relationships and health. The results suggest the need for further study of the impact of interpersonal exposure in those who provide support for rescue-and-recovery workers in major terrorist incidents. [Author Abstract]

This report describes a 3-year follow-up study of survivors of a mass shooting incident. Acute-phase and 1-year follow-up data from this incident have been previously reported. The Diagnostic Interview Schedule/Disaster Supplement was used to assess 116 survivors at 1-2 months and again 1 and 3 years later, with an 85% reinterview rate. Examining the course of postdisaster PTSD and major depression in individuals allowed detailed consideration of remissions and delayed detection of disorders not possible from data presenting overall rates across different time frames. Only about one half of the PTSD cases identified at any time over 3 years were in remission at the 3-year follow-up. Those who did not recover from PTSD diverged from those who recovered at 3 years by reporting increased numbers of symptoms over time, especially avoidance and numbing symptoms. Although women and people with preexisting disorders were at greater risk for the development of PTSD, these variables did not predict chronicity. Chronicity of PTSD was predicted by functional impairment and seeking mental health treatment at baseline. Chronicity of major depression was predicted by report of family history of depression and treatment for paternal alcohol problems. No delayed cases of PTSD were identified. Studies are needed to compare these characteristics of the course of PTSD with other populations, using consistent methodology to allow valid comparison. [Author Abstract]

To assess mental health utilization in Manhattan following the September 11th terrorist attacks, a random-digit-dial telephone survey was conducted 5 to 8 weeks afterwards, among 988 randomly selected adult householders over 17 years old (females = 52%; whites = 72%; mean age = 42). 16.9% (95% confidence interval [CI] = 14.4-19.5) of residents reported using mental health services 30 days before the attacks and 19.4% (95% CI = 16.7-22.2) reported using these services 30 days afterwards (pre/post NcMemar's chi-squared = 8.0, df = 1, p = 0.005, odds ratio [OR] = 2.0). 10.0% (95% CI = 7.9-12.0) increased mental health utilization 30 days after the attacks, compared to 30 days before and 5.3% (95% CI = 3.7-6.9) decreased utilization. Risk factors associated with increased mental health utilization in multivariate analyses included: being 45-64 years of age (vs. 65+; OR = 8.3, p = 0.011) female gender (OR = 2.3, p = 0.004), experiencing 4+ lifetime traumatic events (vs. none; OR = 3.5, p = 0.002), experiencing 2+ stressful life events in the past 12 months (vs. none; OR = 3.3, p < 0.001), and experiencing an acute panic attack during the disaster (OR = 3.3, p < 0.001). Neither current PTSD nor current depression was predictive of increased post-disaster utilization when panic attack was included in the multivariate analysis. While we did find a statistically significant increase in pre- vs. post-disaster utilization among the general population in Manhattan this increase was not substantial, except among specific subgroups, including those who had a perievent panic attack, among those exposed to previous stressors, among women, and among those less than 65 years old. [Author Abstract] KEY WORDS: PTSD; depression; panic disorder; disasters; service utilization; mental health services

In the months since September 11, many conferences and presentations have included discussions of aftereffects of the terrorist attacks including PTSD, grief, and loss. In efforts to understand how best to respond, experts have drawn on experiences and information gained during responses to other disasters. The author briefly discusses what therapists have been hearing from survivors and how they themselves have reacted both directly to the terrorism and indirectly through their clients. [Adapted from Text, p. 561]

On September 11, 2001 terrorist attacks caused the catastrophic collapse of the twin towers of the World Trade Center in New York City. Approximately 40 minutes after the World Trade Center was attacked, a similar terrorist attack was perpetrated against the Pentagon in Washington, D.C. Although the resultant physical devastation was beyond anything this nation has ever experienced, the psychological devastation may not be known for months, or even years. This paper discusses, not only a structure for understanding the phases of terrorism, but offers 10 recommendations for responding to acts of terrorism.

In 1995-96 several terrorist attacks struck Paris. After that, the French government decided to optimize the service claimed to treat psychological repercussions of attack victims. For this reason we need to better understand the psychopathology developing after these traumatic events in order to adjust the various steps of the treatment. In December 1996, a terrorist attack occurred in a Paris subway. Medical and medico-psychological teams intervened immediately on the site to help victims. Among 115 victims, 4 persons died and 35 were seriously injured. The aim of our study was to evaluate the psychological impact among a population of terrorist attack victims by a prospective study and to identify predictive factors of PTSD. We evaluated PTSD rates at 6 and 18 months, the relationship between coping style and PTSD, and whether PTSD increased health care utilization. Two follow up evaluations were performed in the 6th and 7th month respectively, by means of self-questionnaires sent by mail. Among 115 victims of the bombing attack [that] occurred in December 1996, the 111 survivors were asked to participate to the study. The subjects who accepted and could use French questionnaires were considered eligible for inclusion: the main criteria of Watson's PTSD Inventory for the specific post-traumatic symptoms were used; Goldberg's General Health Questionnaire was used to measure the general psychopathology; to identify coping styles we used the questionnaire "Ways of Coping Check List" of Vitaliano at 6 months and the "Coping Inventory for Stressful Situations (CISS)" by Endler at 18 months; a small questionnaire was proposed to evaluate injuries, hospitalization, and specific treatment immediately or after the event. Among 70 subjects who accepted to participate, 56 (33 females) could be evaluated at 6 months and 32 (14 females) subjects at 18 months. The mean age at 6 months was 38.4 years: 41% of participants met PTSD criteria at 6 months, 34.4% still had PTSD at 18

Research examining alcohol use in disaster victims has yielded conflicting results. This study of 43 acknowledged alcohol users, taken from a nonrandom volunteer sample of Oklahoma City bombing victims receiving support services, revealed relationships between increased alcohol use and a number of variables--injury, retrospectively reported initial reaction to the explosion, grief, and posttraumatic stress symptomatology. The findings suggest that if alcohol use was motivated by an attempt to alleviate symptoms, it was not effective, as evidenced by an association between increased alcohol use and functional impairment. Increased alcohol consumption may present a problem in disaster victims months after exposure to trauma. Therefore, the use of alcohol should be routinely assessed in those who remain symptomatic over time. (PsycINFO Database Record (c) 2016 APA, all rights reserved) (Source: journal abstract)