The October 2001 anthrax attacks heralded a new era of bioterrorism threat in the U.S. At the time, little systematic data on mental health effects were available to guide authorities' response. For this study, which was conducted 7 months after the anthrax attacks, structured diagnostic interviews were conducted with 137 Capitol Hill staff workers, including 56 who had been directly exposed to areas independently determined to have been contaminated. Postdisaster psychopathology was associated with exposure; of those with positive nasal swab tests, PTSD was diagnosed in 27% and any post-anthrax psychiatric disorder in 55%. Fewer than half of those who were prescribed antibiotics completed the entire course, and only one-fourth had flawless antibiotic adherence. 30% of those not exposed believed they had been exposed; 18% of all study participants had symptoms they suspected were symptoms of anthrax infection, and most of them sought medical care. Extrapolation of raw numbers to large future disasters from proportions with incorrect belief in exposure in this limited study indicates a potential for important public health consequences, to the degree that people alter their healthcare behavior based on incorrect exposure beliefs. Incorrect belief in exposure was associated with being very upset, losing trust in health authorities, having concerns about mortality, taking antibiotics, and being male. Those who incorrectly believe they were exposed may warrant concern and potential interventions as well as those exposed. Treatment adherence and maintenance of trust for public health authorities may be areas of special concern, warranting further study to inform authorities in future disasters involving biological, chemical, and radiological agents. [Author Abstract]

Individuals frequently perceive positive changes in themselves following adversity; after a collective trauma, they may perceive such benefits in others or in their society as well. We examined perceived benefits of the September 11, 2001 (9/11) terrorist attacks in a 3-year study of a national sample of adults (N = 1382). Many individuals (57.8%) perceived social benefits of 9/11, including increased prosocial behavior, religiousness, or political engagement. Individuals who found increased national religiosity as a benefit 2 months post-9/11 reported greater positive affect and life satisfaction and lower distress and posttraumatic stress up to 3 years post-9/11. Pre-9/11 religiousness and Republican political affiliation predicted perceiving religion-related social benefits post-9/11. Perceptions of social change are important but understudied responses to stressful events. [Author Abstract]

Three studies tested predictions derived from terror management theory (TMT) about the effects of terrorism news on prejudice. Exposure to terrorism news should confront receivers with thoughts about their own death, which, in turn, should increase prejudice toward outgroup members. Non-Muslim (Studies 1'“3) and Muslim (Study 3) participants were exposed to news about either Islamic terrorist acts or to control news. When Dutch filmmaker Theo van Gogh was murdered in Amsterdam by an Islamic extremist during data collection of Study 1, this event was included as a naturally occurring factor in the design. Consistent with TMT, terrorism news and Van Gogh's murder increased death-related thoughts. Death-related thoughts, in turn, increased prejudiced attitudes toward outgroup members, especially when participants had low self-esteem, and when terrorism was psychologically close. Terrorism news may inadvertently increase prejudiced attitudes towards outgroups when it reminds viewers of their own mortality. (PsycINFO Database Record (c) 2016 APA, all rights reserved) (Source: journal abstract)

Comments on an article by Moscardino U. Scrimin S (see record 2009-03024-020). The important study by Moscardino et al. showed that adolescents who survived the Beslan terrorist attack (North Ossetia) did not report more overall levels of psychological distress 18 months after the event than a group of adolescents who were not in the school during the attack. The authors conclude that these findings are in line with previous research suggesting that both directly and indirectly exposed children are at risk of developing adverse psychological symptoms after terrorism-induced trauma. Although the nature of the trauma exposure was not comparable with that in the Beslan case, a 5-year longitudinal study of health effects among adolescents in a discotheque fire showed that in the first year youth both with and without burns presented many symptoms, psychological as well as physical. According to the researchers, this study is part of an ongoing project on the mental health of Beslan's children and families. As stated in the article, the number of studies examining the long-term psychological effects of such attacks is limited. (PsycINFO Database Record (c) 2016 APA, all rights reserved)

Reply made by the current author to the comment made by Moscardino et al. (see record 2009-03024-020). Van der Velden and Yzermans have raised several issues regarding the long-term psychological effects of the 2004 terrorist attack in Beslan on directly and indirectly exposed adolescent survivors. Although we agree that comparing the 2 groups of Beslan adolescents without sampling youth located geographically distant from the attack is not an exhaustive approach, we do believe that our data are informative and could function as possible starting points for future research on adolescents affected by terrorism. Furthermore, we recently conducted a follow-up study to assess adolescents' psychological symptoms 1 year after the first evaluation. Interestingly, preliminary findings suggest that problems seem to diverge in time between directly and indirectly exposed groups as well as between girls and boys, thus supporting the idea that the initial comparable levels of psychological distress among both groups could follow different developmental trajectories. In conclusion, we acknowledge that the cross-sectional design of the study and the lack of a comparison group residing in a city that has not experienced the attack limit inferences about the developmental course of psychological distress among adolescents surviving terrorism. (PsycINFO Database Record (c) 2016 APA, all rights reserved) (Source: journal abstract)

Taking advantage of two large, population-based, and longitudinal datasets collected after the 1999 floods in Mexico (n = 561) and the September 11, 2001 terrorist attacks in New York (n = 1267), we examined the notion that resilience may be best understood and measured as one member of a set of trajectories that may follow exposure to trauma or severe stress. We hypothesized that resistance, resilience, recovery, relapsing/remitting, delayed dysfunction, and chronic dysfunction trajectories were all possible in the aftermath of major disasters. Semi-parametric group-based modeling yielded the strongest evidence for resistance (no or mild and stable symptoms), resilience (initially moderate or severe symptoms followed by a sharp decrease), recovery (initially moderate or severe symptoms followed by a gradual decrease), and chronic dysfunction (moderate or severe and stable symptoms), as these trajectories were prevalent in both samples. Neither Mexico nor New York showed a relapsing/remitting trajectory, and only New York showed a delayed dysfunction trajectory. Understanding patterns of psychological distress over time may present opportunities for interventions that aim to increase resilience, and decrease more adverse trajectories, after mass traumatic events. [Author Abstract] KEY WORDS: resilience; disaster; terrorism; PTSD; Mexico; USA

Children's reactions after being exposed to mass violence may be influenced by a spectrum of factors. Relatively unexplored is the extent to which family exposure to mass violence may affect child mental health, even when these children have not been directly exposed. In a representative sample of NYC public school children assessed 6 months after the September 11, 2001 attack on the World Trade Center (WTC), seemingly elevated rates of psychopathology were recorded among children of WTC evacuees. Children of NYC First Responders (police officers, EMTs, and fire fighters) displayed a complex pattern of response to the WTC attack. Overall, the findings from this previous study support putative transmission of trauma to children whose parents were exposed to the WTC attack. The "Children of First Responder and WTC Evacuee Study"-a two-site longitudinal study-is currently underway in the United States (New York City) and in Israel (Tel Aviv area) in an effort to understand the impact of different patterns of mass violence. The NYC sample permits us to examine the impact of a rare instance of mass violence (e.g., WTC attack), while the Israeli sample provides information about repeated and frequent exposure to mass violence brought about by acts of terrorism. In addition, children's exposure to mass violence is considered in the context of their exposure to other potentially traumatic events. This study aims to improve our general understanding of the impact of mass violence on children, especially the psychological effects on children whose parents' work experiences are by nature stressful. Knowledge generated by this study has implications for guiding efforts to meet the needs of children who have, directly or through a family member, been subjected to rare or infrequent mass violent event as well as to children whose exposure to mass violence is part of daily life.

PURPOSE: To identify and understand the patterns and predictors of depressive symptom trajectories over time after mass traumatic events. METHODS: Data were used from a prospective, representative sample of adult residents of the New York City metropolitan area (N = 2,282) followed up across four survey waves between 2001 (after the September 11 attacks) and 2004. Semi-parametric group-based modeling was used to identify trajectories, as well as the time-fixed and time-varying predictors of distinct depressive trajectories. RESULTS: Five distinct trajectories of depression were characterized: minimal symptomatology at all time points (group 1, 39% of sample), mild delayed depression (group 2, 34% of sample), recovery (group 3, 6% of sample), severe delayed depression (group 4, 13% of sample), and chronic severe depression (group 5, 8% of sample). Among members of distinct trajectories, lower household income, exposure to ongoing stressors, and exposure to traumatic events were commonly associated with an increased number of depressive symptoms. CONCLUSIONS: Ongoing socioeconomic adversity appears to be centrally associated with a worse course of depression after exposure to traumatic events. Identifying distinct trajectories of depression and the preventable factors that are associated with them may facilitate the development of interventions that aim to promote better mental health. [Author Abstract] KEY WORDS: depression; mental disorders; disasters

This study investigated posttraumatic stress and depression reactions among survivors of the Istanbul November 2003 terrorist bombings that destroyed synagogues, an HSBC bank, and the British General Consulate. 149 survivors completed a questionnaire measuring exposure, current posttraumatic stress, and depression responses 6 months after the blasts. This study showed that the prevalence rate of PTSD among survivors was 35.6% and the rate of depression was 23.5%. PTSD was strongly predicted by perceived life threat, whereas depression was strongly predicted by death of a close friend. Overall, female survivors were found to be more vulnerable to developing posttraumatic stress as well as depression after the terrorist bombings. [Author Abstract] KEY WORDS: terrorist bombing; terrorism; community disaster; bomb explosion; PTSD; depression

OBJECTIVE: To document the socio-demographic characteristics and psychiatric profiles of the survivors of the Nairobi United States Embassy terrorist bomb blast referred to a psychiatric and psychotherapy (counselling) service. METHOD: This was a descriptive cross-sectional study. Clinical interviews and structured questionnaires for PTSD and stress were administered. Survivors of the bomb blast referred to a psychiatric and psychotherapy service one year or more after the bombing were included in this study. These survivors had been treated using psychopharmacotherapy and individualised (not group) therapy/counselling. RESULTS: 83 consecutive referrals to a psychiatric service participated in this study. There were more males and the sample was generally well educated. The referrals made contact with the referring agency for a number of reasons including seeking psychological, financial, and medical assistance. All the patients reported varying degrees of psychiatric symptoms and functional impairment on various aspects of social occupational functioning. High scores for PTSD and other related stress were recorded one or more years after the bombing. CONCLUSION: Although the survivors indicated that initial counselling following the blast had helped them, they still scored high on PTSD suggesting that clinically, the initial counselling had little, if any impact on the development of PTSD. There is need for a holistic approach to the management of psychotrauma in individuals. [Author Abstract] KEY WORDS: terrorism; Kenya; stress disorders; post traumatic