Objective: Selective serotonin reuptake inhibitors (SSRIs) are often recommended in combination with established cognitive-behavioral therapies (CBTs) for posttraumatic stress disorder (PTSD), but combined initial treatment of PTSD has not been studied under controlled conditions. There are also few studies of either SSRIs or CBT in treating PTSD related to terrorism. The authors compared prolonged exposure therapy (a CBT) plus paroxetine (an SSRI) with prolonged exposure plus placebo in the treatment of terrorism-related PTSD. Method: Adult survivors of the World Trade Center attack of September 11, 2001, with PTSD were randomly assigned to 10 weeks of treatment with prolonged exposure (10 sessions) plus paroxetine (N = 19) or prolonged exposure plus placebo (N = 18). After week 10, patients discontinued prolonged exposure and were offered 12 additional weeks of continued randomized treatment. Results: Patients treated with prolonged exposure plus paroxetine experienced significantly greater improvement in PTSD symptoms (incidence rate ratio = 0.50, 95% Cl = 0.30-0.85) and remission status (odds ratio = 12.6, 95% Cl = 1.23-129) during 10 weeks of combined treatment than patients treated with prolonged exposure plus placebo. Response rate and quality of life were also significantly more improved with combined treatment. The subset of patients who continued randomized treatment for 12 additional weeks showed no group differences. Conclusions: Initial treatment with paroxetine plus prolonged exposure was more efficacious than prolonged exposure plus placebo for PTSD related to the World Trade Center attack. Combined treatment medication and prolonged exposure therapy deserves further study in larger samples with diverse forms of PTSD and over longer follow-up periods. (PsycINFO Database Record (c) 2012 APA, all rights reserved)(journal abstract)

Relatively little is known about how people cope with the chronic threat of terrorism or how coping behaviors relate to mental health outcomes within this context. Through the use of exploratory factor analysis, we identified seven latent coping factors among Israeli citizens living near the Gaza border, a region that has been regularly subjected to rocket and mortar attacks. Moderation analysis revealed that three coping factors (substance use coping, denial/disengagement, and social support seeking) exacerbated the relationship between terror-related exposure and psychological functioning, and that one factor (acceptance/positive reframing) protected against psychological distress. These findings help elucidate the types of coping strategies employed by individuals living with the chronic threat of terror and their impact on mental health. In addition, they underscore the need for researchers and clinicians to consider coping behaviors differently when they occur in an environment of chronic terrorist threat. [Author Abstract] KEY WORDS: coping; terrorism; Israel; PTSD

Using both college students and a national sample of adults, the authors report evidence linking the ideology of masculine honor in the U.S. with militant responses to terrorism. In Study 1, individuals' honor ideology endorsement predicted, among other outcomes, open-ended hostile responses to a fictitious attack on the Statue of Liberty and support for the use of extreme counterterrorism measures (e.g., severe interrogations), controlling for right-wing authoritarianism, social dominance orientation, and other covariates. In Study 2, the authors used a regional classification to distinguish honor state respondents from nonhonor state respondents, as has traditionally been done in the literature, and showed that students attending a southwestern university desired the death of the terrorists responsible for 9/11 more than did their northern counterparts. These studies are the first to show that masculine honor ideology in the U.S. has implications for the intergroup phenomenon of people's responses to terrorism. (PsycINFO Database Record (c) 2016 APA, all rights reserved) (Source: journal abstract)

Reports an error in "Efficacy of eclectic group counseling in addressing stress among Thai police officers in terrorist situations" by Doungmani Chongruksa, Penprapa Parinyapol, Sayan Sawatsri and Chanya Pansomboon (Counselling Psychology Quarterly, 2012[Mar], Vol 25[1], 83-96). In the original article, the acknowledgments for the article were not included. The acknowledgments for the article is present in the erratum. (The following abstract of the original article appeared in record 2012-07738-007). This study aims to develop the eclectic group counseling intervention for Thai police officers to reduce the risk of developing symptoms of poor mental health while deploying in terrorist situations. We predicted that eclectic group counseling would significantly reduce high scores of anxiety, depression, social dysfunction, physical symptoms, hostility, phobic anxiety, and interpersonal sensitivity. Our eclectic group counseling included the interactive model of Cognitive Behavioral Therapy, religious interventions, mandala drawing, and Reality Therapy. The design is an experiment-controlled trial with 42 participants (The experiment = 20, the control = 22; Thai-Buddhists = 32, Thai-Muslims = 10). Their mean age was 35.64 ± 9.99 ranging from 23 to 54 year olds. They were selected from 416 police officers derived by cluster random sampling using Beck Depression Inventory Second Edition, the General Health Questionnaire Thai version, and the Symptom Checklist 90. The data were analyzed by two-way MANOVA and ANOVA. The results supported the hypothesis. (PsycINFO Database Record (c) 2012 APA, all rights reserved)

The objective of this study was to examine terrorism media coverage and psychiatric outcomes in directly-exposed terrorism survivors. The study used (1) self-report questionnaires to retrospectively assess event-related media behaviors and reactions in a cross sectional design and (2) longitudinal structured diagnostic interviews to assess psychopathologic outcomes. The participants were 99 directly-exposed Oklahoma City bombing survivors who were initially studied six months after the 1995 incident. Though a fear reaction to bombing-related television coverage and fear-driven discontinuation of bombing-related media contact were associated with diagnostic outcomes, the number of hours viewing bombing-related television coverage in the first week after the event was not associated with the prevalence of bombing-related PTSD or post-bombing major depressive disorder during the seven years post event. The results raise doubt about the effects of quantified incident-related television viewing on clinically-significant emotional outcomes in directly-exposed terrorism survivors. [Author Abstract] KEY WORDS: disaster; fear; media; Oklahoma City bombing; PTSD; television viewing; terrorism

The present study was to identify the quality of life (QOL), the needs of help and the mode of coping among the health personnel of Naradhiwasrajana garindra Hospital in a terrorism situation, the first research in Thailand. The chaos of separatist insurgency in the southern part of Thailand has been re-emerged since 2004. The present study was seeking for ways the health personnel coped with the situation while their quality of life and needs that were affected how they had handled the events were explored. General questionnaire, quality of life rand 36 SF-36 questionnaires, help seeking questionnaire and Mode of coping with the terrorism questionnaire were sent to all health personnel in the hospital in November 2007. 392 (65.3%) complete questionnaire were received from 600 distributed papers. They were female 328 (83.7%) and male 64 (16.3%), at the age of 21-59 years old (the mean age of 39.05 SD +/- 9.82), with three different religions, Buddhist 269 (68.6%), Muslim 122 (31.1%) and Christian 1 (0.30%). Thirty nine responses (9.9%) had been directly exposed to a terrorist attack, while 353 responses (90.1%) had a family member or friends who had been exposed. The results revealed that the overall mean scores of QOL were 73.1 +/- SD 15.5. Mean scores of male were significantly lower than female in general health, social functioning and role-emotional subscales. QOL mean scores of those with no terrorism exposure were significantly higher than those with terrorism exposure in role-physical, social functioning and mental health subscales. The most need of help for the personnel was safety of life and belongings (30.6%) followed by the need of money (23.0%). To cope with the terrorist attack, people (81.7%) would always resort to religious beliefs (72.0%) talk it out with coworkers, friends about their feelings, and (68.7%) inquire about the safety of their families and friends after the incident. Certainly, terrorism affected QOL and the most need of people in viol

This cross-sectional retrospective study examined self-perceived changes in importance of religious beliefs (RBs) following the attacks of September 11, 2001, and assessed their associations with complicated grief (CG), PTSD, and major depressive disorder (MDD). Data were collected from 608 participants 2.5 to 3.5 years after the attacks. Whereas the majority of the participants reported no change in importance of RBs, 11% reported increased importance and 10% reported decreased importance of RBs after 9/11. Decreased, but no increased, importance of RBs was found to be associated with severity of loss and trauma (i.e., loss of a child, direct exposure to the attacks, watching the attacks unfold live on TV). In addition, decreased RBs after 9/11, as compared with no change, was significantly associated with all mental health outcomes, namely CG, PTSD, and MDD. Theoretical and clinical implications are discussed. [Author Abstract] KEY WORDS: religious beliefs; PTSD; complicated grief; major depressive disorder; 9/11 attacks

On 4 February 2008, two terrorists armed with suicide bombs arrived atthe open market in the southern Israeli city of Dimona. One detonated his bomb at approximately 10:30 a.m. causing multiple casualties. Short-term emotional effects and acute stress reactions usually appear among survivors after such incidents. To compare the differences in emotions and in disturbances of daily life activities that emerge a couple of days following such an event and to identify patterns of stress development among resilient and low-resilient members of the population in Dimona and in the general population of Israel. A telephone survey of two randomly selected representative samples of adults (428 Israeli residents and 250 Dimona residents) was conducted 2 days afterthe event. A higher prevalence of stress and fear and a lower prevalence of joy were reported among the population of Dimona compared to the general population in Israel (P < 0.05). Differences were also recorded when the population of Dimona was categorized by its personal degree of resilience (P < 0.05). A higher prevalence of disturbances in daily life activities and changes in leisure activity was found in the low-resilient population in Dimona (P < 0.01). This study demonstrates that following a public terror event, self-reported low-resilient subjects have a higher prevalence of disturbances in daily life activities, as well as adverse emotional responses. These differences must be addressed by the relevant social service agencies for immediate public intervention.

Reviews the book, Terrorism and Public Health: A Balanced Approach to Strengthening Systems and Protecting People by Barry S. Levy and Victor W. Sidel (2002). This book provides new information on emergency preparedness planning, lessons learned from responses to terrorist attacks, descriptions of challenges faced, opportunities to strengthen public health systems, as well as promoting domestic and international law responses to terrorism. Apart from providing a public health response to terrorist incidents, agencies are urged to adopt a balanced approach to prevent inappropriate responses to such threats diverting resources and attention away from other urgent public health needs. The book is thoroughly referenced from a variety of sources ranging from peer reviewed work to relevant media articles. The material is up-to-date, including a commentary on the potential adverse implications of repeated reorganizations of the UK NHS albeit without covering the subtle but significant differences between the various systems which comprise the UK's NHS. The book notes the huge impact and major resulting changes in incident responses in the US after the 9/11 attacks and the Anthrax Incidents linked to the US Postal Service in 2001. The book is of value to public health responders, Emergency and Service planners and provides a greater than usual emphasis on the mental health service implications of terrorism. The book bravely discusses a range of important political issues with an emphasis towards the US, namely gun control and Guantanamo Bay; the adverse effects of the 'war on terror; the changes in political approach to these threats in recent years; impacts on civil liberties of the draconian powers encompassed in emergency powers legislation. (PsycINFO Database Record (c) 2016 APA, all rights reserved)

After the London bombings on 7 July 2005, trauma-focused cognitive behavioral therapy (TF-CBT) was provided for survivors with PTSD. A "screen and treat" approach was used. The transcripts of 18 audiotaped CBT treatment sessions with these patients were analyzed using the qualitative method of thematic analysis. Interviews comprised participants' direct experiences of the terrorist attack and its impact on their lives. Themes identified were shock and disorientation, horror, getting out, reorientation and reconnecting with the outside world (on the day of the bombings); and posttraumatic stress and depression, feeling different, and recovery and resilience (following the day of the bombings). Services may be part of wider political responses to terrorism but this did not preoccupy participants. In CBT, during elaboration of traumatic memories, attention might usefully be paid to clients' experiences of collective action taken during a terrorist attack. [Author Abstract] KEY WORDS: terrorism; 7/7 London bombings; PTSD; CBT; qualitative analysis