PURPOSE OF REVIEW: This paper draws on articles and chapters published mainly in 2006 and 2007 to identify implications for designing sustainable programmes of psychosocial care for children and young people who are affected by disasters and terrorism. RECENT FINDINGS: Recent research confirms previous knowledge that most children and young people are resilient, but also very vulnerable to the psychosocial effects of disasters. Most children are distressed in the immediate aftermath when they gain their sense of safety from adults, predictable routines, and consistent support systems. Others may develop serious mental disorders though post-traumatic mental disorders may not develop until weeks, months, or years later. Research instruments may be sensitive to cultural variability; simply translating measures into other languages is insufficient. SUMMARY: International experience of different types of disaster and terrorist incidents suggests that the broad principles of good service design include integrating responses to the psychosocial needs of children and adolescents into general disaster preparedness and recovery plans; working with families rather than individual children to address their needs; identifying professionals who specialize in responding to disasters and are skilled in working with children prior to events; and focusing resources on increasing the capabilities of staff of community facilities to recognize and respond to children's common reactions to trauma and provide assistance. [Author Abstract] KEY WORDS: disasters; mental disorders; PTSD; psychosocial responses; terrorism

Although a considerable number of people either witnessed directly or in the mass media the traumatic scenes of the terrorist attack that took place on March 11th, 2004 in Madrid, only a fraction of Madrid citizens developed posttraumatic symptoms. In this study, posttraumatic stress-related symptoms, degree of exposure, coping strategies related to the attack, and chronic attempts to avoid intrusive thoughts (i.e., thought suppression) were assessed in a general population Madrid sample (N = 503) 2-3 weeks after the attacks. Our results showed that participants with higher scores in chronic thought suppression exhibited higher levels of PTSD symptoms. Higher scores in chronic thought suppression also correlated positively with the use of avoidant coping strategies after the attacks. We discuss the possible common roots of avoidance of intrusive thoughts and avoidant coping strategies and the implications of this relationship for the emergence of stress-related symptoms as well as for public health policies. (PsycINFO Database Record (c) 2012 APA, all rights reserved)(journal abstract)

Given the personal and societal costs associated with acute impairment and enduring PTSD, the mental health response to disasters is an integral component of disaster response planning. The purpose of this paper is to explore the compatibility between cognitive-behavioral psychology and the disaster mental health model, and explicate how cognitive-behavioral perspectives and intervention methods can enhance the effectiveness of disaster mental health services. It is argued that cognitive-behavioral methods, if matched to the contexts of the disaster and the needs of individuals, will improve efforts to prevent the development of PTSD and other trauma-related problems in survivors of disaster or terrorist events. First, the similarities between models of care underlying both disaster mental health services and cognitive-behavioral therapies are described. Second, examples of prior cognitive-behavioral therapy-informed work with persons exposed to disaster and terrorism are provided, potential cognitive-behavioral therapy applications to disaster and terrorism are explored, and implications of cognitive-behavioral therapy for common challenges in disaster mental health is discussed. Finally, steps that can be taken to integrate cognitive-behavioral therapy into disaster mental health are outlined. The aim is to prompt disaster mental health agencies and workers to consider using cognitive-behavioral therapy to improve services and training, and to motivate cognitive-behavioral researchers and practitioners to develop and support disaster mental health response. [Author Abstract] KEY WORDS: cognitive-behavioral therapy; disaster mental health; disaster response planning; immediate response; PTSD; psychotherapy integration; terrorism; trauma

Terrorism creates a ripple of fear and uncertainty. Although most individuals are resilient and recover over time, a minority remains functionally and psychologically impaired. In this paper, we examine research on coping strategies employed in the aftermath of terrorist events, theories and empirical findings related to appraisal processes that influence individuals' primary attributions of risk, and normative processes that shape secondary appraisals, which predict specific coping behaviors. We also describe individual diatheses and factors promoting resilience that may influence coping and functioning in the face of terrorism. Finally, we offer suggestions for future research. [Author Abstract] KEY WORDS: terrorism; coping; mental health

The current study examined anniversary reactions in mental health disaster relief workers following traumatic exposure at the site of the World Trade Center terrorist attacks. Despite relatively low levels of symptom reporting, workers endorsed an increase in both negative mood symptoms and functional impairment at the one-year anniversary of their traumatic exposure (compared to 6 months postexposure). For those individuals who met at least partial criteria for PTSD immediately following exposure, overall self-reported PTSD symptoms tended to increase from 6 to 12 months. This tendency resulted specifically from an increase in hyperarousal symptoms. Although few endorsed symptoms at clinical levels, our results demonstrate that disaster relief workers may experience an increase in symptomatology at the anniversary of their traumatic exposure. [Author Abstract]

The World Trade Center (WTC) attacks exposed thousands of workers to hazardous environmental conditions and psychological trauma. In 2002, to assess the health of these workers, Congress directed the National Institute for Occupational Safety and Health to establish the WTC Medical Monitoring and Treatment Program. This program has established a large cohort of WTC rescue, recovery, and cleanup workers. We previously documented extensive pulmonary dysfunction in this cohort related to toxic environmental exposures. Our objective in this study was to describe mental health outcomes, social function impairment, and psychiatric comorbidity in the WTC worker cohort, as well as perceived symptomatology in workers' children. Ten to 61 months after the WTC attack, 10,132 WTC workers completed a self-administered mental health questionnaire. Of the workers who completd the questionnaire, 11.1% met criteria for probable post-traumatic stress disorder (PTSD), 8.8% met criteria for probable depression, 5.0% met criteria for probable panic disorder, and 62% met criteria for substantial stress reaction. PTSD prevalence was comparable to that seen in returning Afghanistan war veterans and was much higher than in the U.S. general population. Point prevalence declined from 13.5% to 9.7% over the 5 years of observation. Comorbidity was extensive and included extremely high risks for impairment of social function. PTSD was significantly associated with loss of family members and friends, disruption of family, work, and social life, and higher rates of behavioral symptoms in children of workers. Working in 9/11 recovery operations is associated with chronic impairment of mental health and social functioning. Psychological distress and psychopathology in WTC workers greatly exceed population norms. Surveillance and treatment programs continue to be needed.

Collective traumas can negatively affect large numbers of people who ostensibly did not experience events directly, making it particularly important to identify which people are most vulnerable to developing mental and physical health problems as a result of such events. It is commonly believed that successful coping with a traumatic event requires expressing one's thoughts and feelings about the experience, suggesting that people who choose not to do so would be at high risk for poor adjustment. To test this idea in the context of collective trauma, 2,138 members of a nationally representative Web-enabled survey panel were given the opportunity to express their reactions to the terrorist attacks of September 11, 2001, on that day and those following. Follow-up surveys assessing mental and physical health outcomes were completed over the next 2 years. Contrary to common belief, participants who chose not to express any initial reaction reported better outcomes over time than did those who expressed an initial reaction. Among those who chose to express their immediate reactions, longer responses predicted worse outcomes over time. Implications for myths of coping, posttrauma interventions, and psychology in the media are discussed. [Author Abstract] KEY WORDS: collective trauma; coping; expression; September 11 terrorist attacks/ terrorism

This study assessed women's vulnerability to the threats of terrorism; 326 Israeli citizens (198 women and 128 men) from cities that were hit hard by terrorist violence were interviewed to identify their level of exposure to terrorist events, symptoms of posttraumatic distress, and coping styles. Although the women were less exposed to terrorist events than were the men, they reported higher levels of indirect and subjective exposure (such as helping survivors or having the sense of a lucky escape). They suffered higher levels of negative mood and posttraumatic distress and reported using coping behaviors, particularly problem-solving strategies, more intensely than did the men. The results are discussed from the sociological and feminist perspectives. [Author Abstract] KEY WORDS: coping; Israel; terror; women

Since the 9/11 attacks in the United States (2001) and the two bombing events in Bali (2002, 2005), there has been renewed interest in emergency prevention policies in many organizations around the world. Functional terrorism preparedness requires changes in organizational thinking about external environmental threats. This shift in organizational thinking could be led by human resource departments. In order to achieve this goal, HR departments must redefine their role in terms of crisis management, and then four key planning measures for insuring postemergency operations should be observed. Using system dynamics (SD) methodology, this article examines the causes of states in which organizations operate after terrorist attacks. Based on the qualitative analytic approach of causal loops, this article explores the major challenges for HR development prompted by terrorism. Specifically, we focus on changes both to organizational communication and to workforce planning and succession. These activities are a tremendous challenge immediately following a disaster. A functional HR plan must include elements for proactive alertness, the ability to dispatch inventory, evacuation plans, and record preservation coupled with dissemination to employees and explicit employee training and cross-cultural management. (PsycINFO Database Record (c) 2016 APA, all rights reserved) (Source: journal abstract)

We examined to what extent children in The Netherlands are affected by the threat of terrorism. For this purpose, a sample of school children living in Rotterdam or adjacent satellites (N = 216) completed a fear survey that included a number of terrorism-related items, and were confronted with ambiguous vignettes to measure threat-related interpretation bias. The results demonstrated that although a number of terrorism-related items (i.e., bombing attacks, explosions in a bus or subway) listed high in a ranking of most intense childhood fears, very few children made terrorist-related interpretations of ambiguous situations. (PsycINFO Database Record (c) 2016 APA, all rights reserved) (Source: journal abstract)