Traumatic events can shatter faith and beliefs. The responses of Ultra-Orthodox survivors of deadly terrorist attacks illustrate an effort to reconcile dreadful experiences with deeply embedded beliefs. Qualified clinicians prospectively evaluated self-reported and interviewer-generated posttraumatic stress disorder (PTSD) symptoms and cognitive appraisal in Ultra-Orthodox ( n = 20) and non-Ultra-Orthodox ( n = 33) survivors of suicide bus-bombing incidents in Jerusalem. Ultra- Orthodox survivors reported higher levels of PTSD symptoms and more personal guilt. Their narratives reflected an unshaken belief in Just Providence, within which being a victim of terror was perceived as a Just retribution for known or unknown wrongdoing. Survivors' reactions to trauma often reflect an effort to reconcile incongruous experiences with previously held beliefs. When treating strict believers, helpers should be sensitive to the identity-preserving function of posttraumatic cognitions. (PsycINFO Database Record (c) 2016 APA, all rights reserved) (Source: journal abstract)

This study described participation, health-related quality of life, and PTSD in survivors of terrorist attacks and examined the relationships among these outcomes. Participants were 35 survivors of terrorist attacks, an average of 2 years after the injury, with a mean age of 32.1 (± 13.8) years. Most of the participants suffered multiple traumatic injuries. 40% to 60% of the sample reported restrictions in participation in the areas of employment, leisure, and homemaking. The patterns of time use indicated a relatively small amount of time devoted to work and more to rest. Survivors who resumed their participation in work and leisure reported high percentages of perceived competence and enjoyment from these occupations. The survivors scored below the norm on the Medical Outcome Study 36-Item Short-Form Health Survey (SF-36) scales, indicating low health-related quality of life. A significant moderate correlation in the expected direction was found between the Participation Index total score and the SF-36 total score (r = -.560, p < .01). PTSD was found in 39% of the survivors. No significant difference was found between the group with PTSD versus the group without PTSD on the Participation Index total score (Z = -.481, p = .650); however, subjects without PTSD achieved significantly higher mean scores on the SF-36 total score than those with PTSD (Z = -2.85, p = .003). Further research is required to examine the possible qualitative effect of PTSD on participation in work, leisure, and home management. [Author Abstract] KEY WORDS: health-related quality of life; PTSD; terrorism

Reviews the book, 9/11: Mental health in the wake of terrorist attacks edited by Yuval Neria, Raz Gross & Randall Marshall (see record 2006-21181-000). The editors set up the context of the book in the introductory chapters, highlighting the aims of the book: to examine whether research into the impact of the 9/11 attacks is unique; how these impact upon individuals and communities; how professionals respond to the emerging needs post-disaster; and what the lessons and implications are for future research and preparedness. The editors point out that a major aim of contemporary terrorism (especially in its suicidal form) is to ignite a worldwide clash between ideological and religious groups; to create a division between good and evil; and to stigmatise those who do not believe in a specific divinity. Interestingly, the current political masters in Washington have responded in exactly the same way. (PsycINFO Database Record (c) 2016 APA, all rights reserved)

OBJECTIVE: To characterize the experience of volunteer disaster psychiatrists who provided pro bono psychiatric services to 9/11 survivors in New York City, from September 12, 2001 to November 20, 2001. METHOD: Disaster Psychiatry Outreach (DPO) is a non-profit organization founded in 1998 to provide volunteer psychiatric care to people affected by disasters and to promote education and research in support of this mission. Data for this study were collected from 1-page clinical encounter forms completed by 268 DPO psychiatrists for 2 months after 9/11 concerning 848 patients served by the DPO 9/11 response program at the New York City Family Assistance Center. RESULTS: In this endeavor, 268 psychiatrist volunteers evaluated 848 individuals and provided appropriate interventions. The most commonly recorded clinical impressions indicated stress-related and adjustment disorders, but other conditions such as bereavement, major depression, and substance abuse/dependence were also observed. Free samples were available for one sedative and one anxiolytic agent; not surprisingly, these were the most commonly prescribed medications. Nearly half of those evaluated received psychotropic medications. CONCLUSIONS: In the acute aftermath of the attacks of September 11, 2001, volunteer psychiatrists were able to provide services in a disaster response setting, in which they were co-located with other disaster responders. These services included psychiatric assessment, provision of medication, psychological first aid, and referrals for ongoing care. Although systematic diagnoses could not be confirmed, the fact that most patients were perceived to have a psychiatric diagnosis and a substantial proportion received psychotropic medication suggests potential specific roles for psychiatrists that are unique and different from roles of other mental health professionals in the early post-disaster setting. In addition to further characterizing post-disaster mental health needs and pattern

This cross-sectional study aimed to investigate the influence of socio-contextual variables on depressive symptoms in 158 adolescent survivors of the 2004 terrorist attack in Beslan, Russia, based on an ecological perspective. Participants were assessed 18 months after the traumatic event. Adolescents aged 14'“17 years completed self-reported measures assessing depressive symptoms, social support, sense of community, and collectivism. The results of path analyses indicated that for both boys and girls, the endorsement of collectivistic values was related to increased family support, which in turn was associated with lower rates of depressive symptoms. In the male group, collectivism and sense of community were positively associated with peer support, which in turn was negatively related to depressive symptomatology. The findings suggest that social support and community connectedness may serve as protective resources in adolescents' psychological responses to terror-related stressors, and that gender differences as well as cultural values should be taken into consideration when implementing interventions with youths exposed to terrorism. (PsycINFO Database Record (c) 2016 APA, all rights reserved) (Source: journal abstract)

Previous studies concerned with the relation of proximity to the September 11, 2001 terrorist attacks and subsequent psychopathology have produced conflicting results. The goals of this analysis are to assess the appropriateness of using Bayesian hierarchical spatial techniques to answer the question of the role of proximity to a mass trauma as a risk factor for psychopathology. Using a set of individual-level Medicaid data for New York State, and controlling for age, gender, median household income, and employment-related exposures, we applied Bayesian hierarchical modeling methods for spatially aggregated data. We found that distance from the World Trade Center site in the post-attack time period was associated with increased risk of anxiety-related diagnoses. In the months following the attack, each 2-mile increment in distance closer to the World Trade Center site was associated with a 7% increase in anxiety-related diagnoses in the population. No similar association was found during a similar time period in the year prior to the attack. We conclude that spatial variables help more fully describe post-terrorism psychiatric risk and may help explain discrepancies in the existing literature about these attacks. These methods hold promise for the characterization of disease risk where spatial patterning of ecologic-level exposures and outcomes merits consideration. [Author Abstract] KEY WORDS: epidemiology; disasters; terrorism; anxiety; Bayes theorem; spatial analysis

This study investigated the role that social support plays in posttraumatic stress (PTS) and depressive symptoms among Israeli adolescents with high or low exposure to terrorist acts. Participants were 585 Jewish students (221 girls and 364 boys) in grades 7 to 12 from areas extensively versus slightly exposed to terrorist attacks. Results found that PTS levels and depressive symptoms were higher among adolescents residing in areas highly exposed to terrorism. Adolescents in high exposure areas reported lower perceived levels of support than adolescents in low exposure areas when gender, age, and religiosity were controlled. Social support was found to be a significant predictor for PTS and depressive symptoms, but no evidence for a buffering role of social support was obtained. We conclude that social support has a positive effect on a person's mental health regardless of the type and level of the stressor the individual is exposed to. [Author Abstract] KEY WORDS: terrorism; social support; posttraumatic stress; depressive symptoms; buffering effect; Israel

Exposure to adverse life events typically predicts subsequent negative effects on mental health and well-being, such that more adversity predicts worse outcomes. However, adverse experiences may also foster subsequent resilience, with resulting advantages for mental health and well-being. In a multiyear longitudinal study of a national sample, people with a history of some lifetime adversity reported better mental health and well-being outcomes than not only people with a high history of adversity but also than people with no history of adversity. Specifically, U-shaped quadratic relationships indicated that a history of some but nonzero lifetime adversity predicted relatively lower global distress, lower self-rated functional impairment, fewer posttraumatic stress symptoms, and higher life satisfaction over time. Furthermore, people with some prior lifetime adversity were the least affected by recent adverse events. These results suggest that, in moderation, whatever does not kill us may indeed make us stronger. [Author Abstract] KEY WORDS: cumulative lifetime adversity; resilience; stress inoculation; toughening; mental health and well-being

Belief in a just world theory (BJWT) restoration strategies were longitudinally examined after the September 11 terrorist attacks. Analyses examined the influence of terrorism-related distress, identification with victims, and the passage of time on levels of group- and individual-level blame. Initial levels of distress were associated with less blaming of the U.S. (group-level blame) but positively related to derogating victim compensation 5 months later. Psychological distancing from the victims increased individual-level blame, while prolonged identification with victims appeared to dampen this response. These results extend our understanding of BJWT by showing the importance of temporal variation in justice-restoring strategies in a dramatic real-world loss. [Author Abstract]

The London bombings on 7 July 2005 highlighted the prevailing terrorist threat to the UK. The present study addressed the psychological response of a community (n=294) indirectly exposed to the attacks to discern the broader impact and effects of terrorism. Qualitative content analysis was used to develop a profile of emotions and responses to the attacks. This was supplemented by the use of linguistic analysis demonstrating the enormous heterogeneity and complexity of responses to terrorism. In light of previous work on the wider impact of terrorism, the present study highlighted a relatively restrained impact of terrorism. Notwithstanding this observation, responses were marked by negative emotions, with increased use of references to others than for self. Responses also highlighted the use of psychological distancing more among white than Asian respondents, and the importance of religion, both as a supportive factor and perceived cause of the attacks, with references more prevalent among Asian respondents. Although the ubiquitous nature of negative emotions also slightly heightened reports of perceived risk, the ability of respondents to use methods of social orientation helped their ability to recover, and may be crucial in helping harness unified community-based responses to terrorism. (PsycINFO Database Record (c) 2016 APA, all rights reserved) (Source: journal abstract)