While America wages the "war" on terrorism and endeavors to protect the physical safety of its citizens, it is imperative to plan for the population's mental health needs in future terrorist/disaster scenarios. The importance of psychiatry's potential role in preparing the community for the psychological impact of terrorism is underscored against the historical backdrop of the field being "carved out" from the organization, delivery, and financing of health services in our society. A practical framework is offered for designing an organization's mental health disaster plan, including recommendations for strategic infrastructure and tactical response capabilities. Finally, the unique features of clinical practice with disaster victims are noted, including intra-clinician conflicts between professional/community interests and personal/family obligations during acute disaster events. [Author Abstract] KEY WORDS: terrorism; disaster psychiatry; disaster planning; disaster response

The terrorist attacks in the US on September 11, 2001 stimulated an unprecedented rapid response by the social and health research communities into the aftermath. This article summarizes the findings of the major studies that assessed various types of "psychological distress", and identifies some of the important gaps that remain in our understanding of the nature and etiology of human distress following purposeful, unpredictable mass violence. [Author Abstract] KEY WORDS: terrorism; PTSD; adults; epidemiology; September 11; psychological distress

The authors explore the psychological reactions and functional coping responses of American Airlines (AA) flight attendants, a unique at-risk group of people in the war on terrorism, in the aftermath of the September 11 attacks. Demographic characteristics and standardized questionnaires, including the Posttraumatic Stress Disorder Checklist and the Psychotherapy Outcome Assessment and Monitoring System--Trauma Version, were sent in June 2002 to approximately 26,000 AA flight attendants. Of the 2050 respondents, 18.2% reported symptoms consistent with probable posttraumatic stress disorder (PTSD). Those living alone were 1.48 times more likely to have a probable PTSD diagnosis than those living with someone else. Age or years of service as a flight attendant did not predict probable PTSD; however, marital status did. Substance abuse was not endorsed as a coping strategy. Given the traumatic events experienced by AA flight attendants, and persistent threats of future terrorist attacks, these results reveal that additional assessment and treatment interventions for stress-related symptoms in this population seem warranted.

The urgency of the need to assess the impact of the September 11th attacks and to communicate the findings is reflected in the fact that several papers were published very quickly following the attacks. The scope and nature of the attacks suggested that there would be substantial mental health problems in New York City after the attacks and that these problems would extend beyond the direct victims of the attacks. [Adapted from Text, p. 1]

The purpose of this paper is to describe the implementation of a school-based trauma-specific mental health program in New York City following the terrorist attacks on September 11, 2001. This program aimed to serve children most at risk for developing mental health problems as a result of physical proximity (e.g., evacuation from schools surrounding the World Trade Center) to the trauma. As we present the components of the program, we will review the literature that guided our decision making. The ongoing struggle between searching for answers from established science and immediate needs in a crisis is highlighted. Lastly, a discussion of the lessons learned and recommended next steps is presented. [Author Abstract] KEY WORDS: trauma; terrorism; intervention; school-based; September 11; mental health

On September 11, 2001, 343 fire fighters died in the line of duty responding to the terrorist attacks, explosions, fires, and collapse of the World Trade Center Towers. Coincidentally, a convenience sample of professional urban fire fighters in a northwestern state was participating in a leadership intervention demonstration project and completed survey measures including a measure of posttraumatic stress symptomatology. The purpose of this study was to assess secondary traumatic stress symptoms in separate cohorts drawn from this convenience sample of the fire fighters, who completed surveys either prior to or in the days and weeks following the events of 9/11/01. The results suggest that elevations in posttraumatic stress symptoms reported by the fire-fighter cohort completing surveys at one-week post-9/11 represented an acute secondary traumatic stress reaction to the events of 9/11/01. [Author Abstract] KEY WORDS: secondary traumatic stress; fire fighters; terrorism; acute posttraumatic stress

This article illustrates the effects of terrorism on its victims. We conducted a study on a sample of 2,998 Spanish victims of terrorism (1997-2001). Victims were evaluated with the General Health Questionnaire (28-item version). A much higher prevalence of psychiatric symptoms (mainly anxiety and psychosomatic symptoms) among the victims than in the general population was found. This was maintained over time. There was a correlation between the degree of harm due to the attack and the severity of the psychopathology. We conclude that terrorist attacks are risk factors that will affect some of their victims for a lifetime. [Author Abstract] KEY WORDS: terrorism; violence; psychopathological sequelae; comorbidity; victims; PTSD

Few systematic data pertaining to somatization following terrorism are available to guide intervention workers and policymakers in response to terrorist events. Somatization is a well-known but poorly understood phenomenon presenting enormous difficulties in clinical management as well as research investigation. It is a heterogeneous concept that is inconsistently defined in research on traumatic events. This article summarizes the somatization field and applies the principles to recommendations for disasters and terrorism research and interventions related to somatization in the postdisaster setting. [Author Abstract] KEY WORDS: somatization; disasters; terrorism; bioterrorism; medically unexplained complaints; diagnostic validation

Teachers are frequently expected to support children psychologically in the aftermath of mass casualty events, yet they have not been trained to do so. This study of a small private school in New York City reports the reactions, needs, and interest in preparedness training among teachers in the response to the September 11, 2001 terrorist attacks. By and large, teachers coped by talking to others and/or a health professional, but felt ill-equipped to intervene with students and expressed substantial need for assistance. [Author Abstract] KEY WORDS: posttraumatic stress preparedness training, PTSD, September 11, teacher preparedness, terrorism, terrorism preparedness, terrorism response

This study assessed teachers' reactions to the Oklahoma City bombing. Peritraumatic reactions, the interaction of media exposure with stress from media coverage, feelings toward the perpetrators, and worry about safety predicted posttraumatic stress. Twenty percent reported difficulty handling demands; 5% sought counseling. Outreach efforts should assess and assist teachers. (PsycINFO Database Record (c) 2016 APA, all rights reserved) (Source: journal abstract)