In 1995-96 several terrorist attacks struck Paris. After that, the French government decided to optimize the service claimed to treat psychological repercussions of attacks 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 attacks victims by a prospective study and to identify predictive factors of posttraumatic stress disorder (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 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 the inclusion: the main criteria of the Watson's PTSD Inventory for the specific post-traumatic symptoms were used; the 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 18th months. The mean age at 6 months was 38.4 years: 41% of participants met PTSD criteria

Examined the influence of bomb-related television viewing in the context of physical and emotional exposure on posttraumatic stress symptoms'”intrusion, avoidance, and arousal'”in middle school students following the 1995 Oklahoma City bombing. Over 2,000 middle school students in Oklahoma City were surveyed 7 wks after the incident. The primary outcome measures were the total posttraumatic stress symptom score and symptom cluster scores at the time of assessment. Bomb-related television viewing in the aftermath of the disaster was extensive. Both emotional and television exposure were associated with posttraumatic stress at 7 wks. Among children with no physical or emotional exposure, the degree of television exposure was directly related to posttraumatic stress symptomatology. These findings suggest that television viewing in the aftermath of a disaster may make a small contribution to subsequent posttraumatic stress symptomatology in children or that increased television viewing may be a sign of current distress and that it should be monitored. Future research should examine further whether early symptoms predict increased television viewing and/or whether television viewing predicts subsequent symptoms. (PsycINFO Database Record (c) 2016 APA, all rights reserved)

An Ancillary Meeting on the topic of "Terrorist Victimization: Prevention, Control, and Recovery" was held at the United Nations Center in Vienna, Austria on Wednesday, April 12, 2000 in conjunction with the Tenth United Nations Congress on the Prevention of Crime and the Treatment of Offenders. The Congress focused on "Crime and Justice: Meeting the Challenges of the 21 Century." The Ancillary Meeting was sponsored by the State University of New York, Plattsburgh, USA and chaired by Dr. Dilip K. Das, Professor in the Department of Sociology and Criminal Justice at that University... In the presentations by speakers from Europe, North America, North Africa, the Middle East, Asia and South America and in the ensuing discussions, a wide variety of issues, concerns, and prevention strategies were covered in a global framework, and also applied to situations in specific countries and continents. The papers and the sessions focused on a number of themes, including an assessment of the main contemporary trends in terrorism, the politicalization of terrorism, the effects that terrorism has on primary and secondary victims, the linkage of terrorism with organized crime, and the measures that governments, international organizations, and justice agencies can take to curtail and eradicate terrorism, including international cooperative efforts. [Adapted from Author Abstract]

BACKGROUND: Terrorism represents a major public health threat throughout the world. Bombings of the United States Embassies in East Africa in 1998 resulted in extensive physical and emotional casualties. METHODS: This study examined posttraumatic stress reactions, worry, and feelings of safety in the workplace in the context of injury in a convenience sample of 21 individuals directly exposed to the bombing in Dar es Salaam, Tanzania. Eight months postbombing, participants completed a self-report instrument examining demographics, exposure, injury, initial reaction, posttraumatic stress, worry, and feelings of safety in the workplace. Descriptive statistics and multiple regression were used to analyze the data. The "Impact of Event Scale-Revised" measured current posttraumatic stress. RESULTS: Report of injury predicted posttraumatic stress, intrusion, and arousal but not avoidance/numbing. Injury and intrusion were significant predictors of ongoing worry. CONCLUSIONS: Even relatively minor injury may be associated with ongoing posttraumatic stress and worry. The participants in the sample were all highly exposed which, along with the small sample size, may have limited the ability to establish other expected relationships. [Author Abstract] KEY WORDS: injury; PTSD; terrorism; trauma

This report describes traumatic grief in 40 individuals (21'“73 yrs old) who suffered losses in the 1995 bombing of the Alfred P. Murrah Federal Building in Oklahoma City. The authors administered a self-report instrument 6 months after the bombing to assess demographics; exposure; injury; retrospective report of initial emotional and physiological reaction; and current posttraumatic stress symptoms, grief, safety concerns, and functioning. A strong association was found between posttraumatic stress symptoms and grief. The relationship between grief and difficulty functioning was stronger at higher levels of posttraumatic stress than at lower levels. The results support the construct of traumatic grief and have important implications for the treatment of people exposed to large-scale traumatic events and for the training of mental health professionals. (PsycINFO Database Record (c) 2016 APA, all rights reserved)

The traumatism that is generated by the terrorist violence in Algeria is affecting the victims' mental health and the social balance. The gravity of the psychic disorders observed in victims is in proportion with the lack of comprehension of those unexpected aggressions. Moreover, the terrorists are not safe from psychic troubles. The monstrous acts they are responsible for obviously have an impact on their psychic balance. Society has to prepare itself to help victims but also executioners, and to provide them a medical and psychological assistance. Agents of security services are concerned too, because of the threat to their life and their family. Torn between their desire to accomplish a work they are not trained to do and the suspicion they are facing they display behaviors that increase their rejection. Everybody is suspect, social balance is in pain. "Civil concord", that aims at bringing about a national reconciliation and at initiating a process of peace, could have perverse effects and constitute a factor of aggravation of the observed social disorder. A feeling of injustice could arise if the terrorists' amnesty is perceived as an absolution that disqualifies the victims' mental suffering. The latter would be victimized again. In this case, the restoration of the social bond would be jeopardised. [Abstract Supplied by Publisher] KEY WORDS: violence, terrorism, psychic traumatism, social disorder

In the past decade, there have been significant increases in disaster mental health (DMH) planning and preparedness for natural, technologic, and transportation accidents. This preparedness continues to be challenged, and in the process modified, by the recent spate of terrorist attacks in or against the United States. Some examples of these incidents include the bombings of Pan Am Flight 103, the World Trade Center, Olympic Park, and the Murrah Federal Building in Oklahoma City. Terrorism is an entirely different class of disasters. These disasters are intentional and have the purpose of intimidation and coercion, as well as a goal of inducing a sense of helplessness and chaos among those targeted. Terrorism has a potential for consequences that could overwhelm existing disaster response plans. This is particularly true for nuclear, biological, and chemical events. This article addresses general principles for DMH interventions, characteristics of terrorist incidents, and the roles of DMH in various stages of disaster. Finally, a proposed strategy for response to terrorist disasters is presented. [Text, p. 376]

CONTEXT: Disasters expose unselected populations to traumatic events and can be used to study the mental health effects. The Oklahoma City bombing is particularly significant for the study of mental health sequelae of trauma because its extreme magnitude and scope have been predicted to render profound psychiatric effects on survivors. OBJECTIVE: To measure the psychiatric impact of the bombing of the Alfred P. Murrah Federal Building in Oklahoma City on survivors of the direct blast, specifically examining rates of PTSD, diagnostic comorbidity, functional impairment, and predictors of postdisaster psychopathology. DESIGN, SETTING, AND PARTICIPANTS: Of 255 eligible adult survivors selected from a confidential registry, 182 (71%) were assessed systematically by interviews approximately 6 months after the disaster, between August and December 1995. MAIN OUTCOME MEASURES: Diagnosis of 8 psychiatric disorders, demographic data, level of functioning, treatment, exposure to the event, involvement of family and friends, and physical injuries, as ascertained by the Diagnostic Interview Schedule/Disaster Supplement. RESULTS: 45% of the subjects had a postdisaster psychiatric disorder and 34.3% had PTSD. Predictors included disaster exposure, female sex (for any postdisaster diagnosis, 55% vs 34% for men; chi-square (1) = 8.27; P=.004), and predisaster psychiatric disorder (for PTSD, 45% vs 26% for those without predisaster disorder; chi-square (1) = 6.86; P=.009). Onset of PTSD was swift, with 76% reporting same-day onset. The relatively uncommon avoidance and numbing symptoms virtually dictated the diagnosis of PTSD (94% meeting avoidance and numbing criteria had full PTSD diagnosis) and were further associated with psychiatric comorbidity, functional impairment, and treatment received. Intrusive reexperience and hyperarousal symptoms were nearly universal, but by themselves were generally unassociated with other psychopathology or impairment in functioning. CONCLUSIONS: Ou

Describes the psychological response provided by the liaison psychiatry and clinical psychology services in a teaching hospital in Manchester [the Manchester Royal Infirmary] to the Manchester bombing in June 1996. 102 patients attended the hospital on the day of the bombing. A decision was made not to offer these patients debriefing, but to screen them 8 wks later and provide psychological treatment for high scorers on the Impact of Events Scale and a modified PTSD symptom measure. 74 patients were sent screening questionnaires and 25 patients returned them. 12 scored above threshold. 2 were children who were referred to local child psychiatry services, 2 patients declined further help and 8 were offered psychological treatment. 2 patients improved before treatment was actually started and 1 other patient severed all contact with the department. 5 patients completed treatment, all showing a good response. Rather than providing all patients with debriefing shortly after the bombing, by screening patients and providing treatment to a small percentage (those who most needed it), relatively scarce psychiatric services were used in an efficient and effective manner. In view of the potential harmful effects of debriefing, this paper provides a model for service intervention following major disasters. [Author Abstract]

Acts of terrorism will most likely continue to affect innocent victims, including members of the military, for the foreseeable future. This article presents the findings of a mental health team that intervened with a unit after a terrorist car-bombing. Contact with those individuals wounded in the attack revealed a distinct pattern of psychosocial disturbance. Most enlightening, however, are the characteristics described by many as having facilitated the development of effective coping and adaptation. The value of incorporating critical incident debriefings and command consultation by mental health professionals into a comprehensive counterterrorist program is underscored.