The September 11, 2001 terrorist attacks were watched on television by millions. Using data from a telephone survey of New York City residents in January 2002 (N = 2001), we examined the relations between television watching and probable PTSD after the attacks. Among those who were directly affected by the attacks or had prior traumatic experiences, watching television was associated with probable PTSD. Experiencing a peri-event panic reaction accounted for some of the association between television watching and probable PTSD. Future research directions are suggested for better understanding the mechanisms behind observed associations between television watching and PTSD. [Author Abstract] KEY WORDS: PTSD; television; panic; trauma; September 11; World Trade Center

The consequences of terrorist threat and terrorist acts for mental health of the individual, groups of individuals and community in general are analyzed. Mental disorders emerging in the victims of terrorism is described. The problem of terrorist threats use as a psychic weapon is discussed. Tolerance of population to terrorism can be divided into two types--psychophysiological and socio-psychological. The ways for elevating tolerability to terrorist threat and terrorist acts are suggested. Help in the centers of terrorist act must be of the complex character, being provided by different specialists including psychologists and psychiatrists. The importance of state structures and community support in this work is emphasized.

The objective of this study was to assess occupational health professionals' terrorism preparedness and perceptions of worksite readiness. Questionnaire data were collected at the conclusion of an educational workshop on disaster response. Participants reported increased confidence in clinical skills and the ability to avoid exposure while providing care to victims of terrorist attacks as a result of the workshop. Fewer than one third (32%) of participants reported that their employer was prepared for a bioterrorism attack, and a large percentage (75%) reported feeling unprepared to provide mental health counseling after a terrorist attack. Relatively brief training in terrorism preparedness can increase the confidence of occupational health professionals in their ability to respond to terrorism. Adequate preparedness for the broad range of potential terrorist events may require much more intensive training than is currently being provided to occupational health professionals.

BACKGROUND: The course of PTSD in populations directly exposed to terrorist attacks is of major importance in the post-9/11 era. Because no systematic diagnostic studies of the most highly exposed individuals of the 9/11 terrorist attacks have yet been done, the Oklahoma City bombing remains a unique opportunity to examine PTSD over time in high-exposure terrorist victims. METHODS: This study assessed 137 survivors in the direct path of the explosion at approximately 6 and 17 months postdisaster, using the Diagnostic Interview Schedule. RESULTS: Combined index and follow-up data yielded a higher (41%) incidence of PTSD than detected at index (32%) or follow-up (31%). All PTSD was chronic (89% unremitted at 17 months) with no delayed-onset cases. The avoidance and numbing symptom group C, unlike groups B and D alone, was pivotal to current PTSD status and was associated with indicators of functioning at index and follow-up. The findings at index were sustainable. CONCLUSIONS: This follow-up study confirmed the immediacy of onset of PTSD and its persistence over time, pointing to the need for early interventions that continue over the long term. Group C avoidance and numbing symptoms may aid in early recognition of PTSD and in predicting long-term functioning. [Author Abstract] KEY WORDS: PTSD; Oklahoma City bombing; onset; persistence

Biological and chemical terrorism can frighten and threaten thousands of people. Biological and chemical weapons are invisible, and yet deadly. Biological weapons are imperceptible, have delayed reactions, and can be highly contagious. Both chemical and biological weapons can cause massive psychological/behavioral reactions in individuals and groups, even when they have not actually been contaminated. Past studies have shown that frightened individuals may easily attribute irrelevant physical symptoms to bodily attacks, resulting in outbreak of psychological and behavioral casualties. In case of terrorist events, accurate and prompt risk communication to individuals and communities is needed. This is one aspect of public education in order to provide adequate knowledge to the public. Effective risk communication can enhance individual control as well as prevent adverse group reactions, such as confusions, fear behaviors, and rumors. Mental health professionals require roles that go beyond their traditional tasks; collaborations with other specialists are essential and are an integral part of the public health management system. Mental health specialists are needed to support first responders and to be involved in the triage process to screen those who are distressed from those who are physical casualties. Educational programs, simulations, and trainings are recommended for disaster planning to construct regional mental health networks which link public health authorities and agencies with mental health resources. [Author Abstract] KEY WORDS: biological-chemical weapons, bioterrorism, PTSD, public health, risk communication

OBJECTIVE: A wave of bombings struck France in 1995 and 1996, killing 12 people and injuring more than 200. The authors conducted follow-up evaluations with the victims in 1998 to determine the prevalence of and factors associated with PTSD. METHOD: Victims directly exposed to the bombings (N = 228) were recruited into a retrospective, cross-sectional study. Computer-assisted telephone interviews were conducted to evaluate PTSD, per DSM-IV criteria, and to assess health status before the attack, initial injury severity and perceived threat at the time of attack, and psychological symptoms, cosmetic impairment, hearing problems, and health service use at the time of the follow-up evaluation. Factors associated with PTSD were investigated with univariate logistic regression followed by multiple logistic regression analyses. RESULTS: A total of 196 respondents (86%) participated in the study. Of these, 19% had severe initial physical injuries (hospitalization exceeding 1 week). Problems reported at the follow-up evaluation included attack-related hearing problems (51%), cosmetic impairment (33%), and PTSD (31%) (95% confidence interval = 24.5-37.5%). Results of logistic regression analyses indicated that the risk of PTSD was significantly higher among women (odds ratio = 2.54), participants age 35-54 (odds ratio = 2.83), and those who had severe initial injuries (odds ratio = 2.79) or cosmetic impairment (odds ratio = 2.74) or who perceived substantial threat during the attack (odds ratio = 3.99). CONCLUSIONS: The high prevalence of PTSD 2.6 years on average after a terrorist attack emphasizes the need for improved health services to address the intermediate and long-term consequences of terrorism. [Author Abstract]

This paper shows therapeutic results from the Complutense University Clinical and Health Psychology Unit, involving 40 March 11 patients with a variety of psychopathological disorders. Most cases (80 percent) showed stress disorders and were treated by means of psychological intervention stress programs with the highest experimental anchor (e.g., anxiety control technique, cognitive re-structuring and exposure). Treatment was successful in 90 percent of patients in general, 100 percent of patients with acute stress, and 67 percent of patients suffering from PTSD. This outcome suggests that interventions based on treatments that have proved effective with stress disorders in the ideal conditions of experimental studies, are also useful for usual clinical practice with people affected by terrorist attacks. In order to illustrate this conclusion, two additional studies are presented (both N=1) where the intervention program was used with a child an adult, both suffering from post-traumatic stress disorder. (PsycINFO Database Record (c) 2014 APA, all rights reserved)(journal abstract)

Following the events of September 11, 2001, mental health professionals throughout New York City were mobilized to create and implement programs for families suffering from trauma- and bereavement-related psychiatric problems. Since the attack was unlike any other human disaster in the history of the United States, there was little practical precedent to rely on in planning interventions. Instead, the available scientific literature was consulted with a view to developing hypotheses and building a sound clinical research program regarding childhood traumatic grief (CTG). In an attempt both to develop effective interventions for CTG and to address the mental health needs of the children of emergency service personnel, a randomized comparison study was undertaken of two psychotherapies for CTG: trauma-focused cognitive-behavioral therapy (CBT) adapted for CTG (TG-CBT) and client-centered therapy (CCT). The goal of the present study is to look at the two therapies as represented by the case studies in this issue, and to highlight the successes and challenges of designing, inmplementing, and evaluating the relative efficacy of interventions to address the emerging need for an effective treatment for CTG. [Adapted from Text]

This study examined the effects of vicarious exposure to the September 11 terrorist attacks in an academic community, just after the three-month period that delineates acute from chronic post-traumatic stress. An entire academic community of 1693 students, faculty, and staff was surveyed electronically regarding their perceived stress symptoms and coping behaviors. The survey yielded a 37% response rate. About 76% showed one or more substantial symptoms of stress, and 32% showed three or more. The most prominent symptom clusters involved persistent avoidance and persistent arousal. Respondents primarily relied on coping through optimism, reassessing priorities and relationships, giving and receiving support, and becoming better informed on terrorism-related topics. Differences in symptoms and coping preferences were found based on sex, group (student, faculty, staff), and exposure to previous crisis. This study indicates that despite time and distance from the site of the terrorism, all segments of a college community continue to experience some degree of distress. Such distress can interfere with academic performance, personal health, and relationship stability. Rather than rely on formal support service delivery, most appear to rely on established interpersonal relationships. This suggests that providing support to vicarious victims in the future might emphasize training for friends and family, rather than relying on established service delivery systems. [Author Abstract]

The Project Liberty program was established after the terrorist attacks of September 11, 2001, to offer free mental health services to New York City residents. The authors used data from a random-digit-dial telephone survey to assess public awareness of and willingness to make use of Project Liberty's services. They found that 24% of the New York City residents surveyed (480 of 2,001 respondents) had heard of Project Liberty four months after September 11. Persons with lower socioeconomic status and those who had psychological symptoms consistent with PTSD were more likely to say that they would contact Project Liberty. The results of the study suggest that although awareness of this public mental health services was low, Project Liberty was well received among the people who may be most likely to need its services. [Author Abstract]