AIM: A wave of bombings in North Iraq in 2007 killed 311 people and injured more than 600. The author conducted evaluations with the victims in 2009 to determine the prevalence of, and factors associated with, PTSD. All the victims belong to the non-Muslim religious community of the Yezidis in North Iraq. METHOD: Victims directly exposed to the bombings (N = 296) were recruited for a retrospective, cross-sectional study. Interviews in North Iraq were conducted by trained personnel to evaluate PTSD on the basis of DSM-IV criteria and to assess (a) health status before the attack, (b) initial injury severity (including mutilations) and perceived threat at the time of attack, (c) psychological symptoms, and (d) other health issues at the time of the study. Factors associated with PTSD were investigated with univariate logistic regression, followed by multiple logistic regression analyses. RESULTS: A total of 296 respondents participated in the study. Of these, 19% had severe initial physical injuries (hospitalization 3-6 weeks and longer). Problems reported at the evaluation stage included various multiple body pains (51%) and PTSD (41%) (95% confidence interval = 34.5%-47.5%). The results of the logistic regression analyses indicated that the risk of PTSD was significantly higher among (a) women (odds ratio = 2.54), (b) participants aged 35-54 (odds ratio = 2.83), (c) those who had suffered severe initial injuries (odds ratio = 2.79), and (d) those who had felt substantially threatened during the attack (odds ratio = 3.99). CONCLUSIONS: The high prevalence of PTSD two years after a terrorist attack emphasizes the need for an improved health care system able to address the medium- and long-term consequences of terrorism. [Author Abstract] KEY WORDS: terrorist attack; bomb explosion; Iraq; PTSD

BACKGROUND: Terrorism may create fear and stress reactions not only in the direct victims, but also in the general population. OBJECTIVE: This study investigated emotional responses in the Norwegian population following the 22nd July 2011 terrorist attacks. We hypothesized that Oslo residents would report a higher level of fear responses compared with people living outside Oslo and that proximity would be associated with early distress and later post-traumatic stress reactions. METHOD: Representative samples were drawn from the Norwegian Population Registry. Telephone interviews were conducted 4-5 months after the attacks. The response rate for the Oslo sample (N = 465) was 24% of the total sample, and 43% of those who were actually reached by phone and asked to participate. Corresponding figures for the sample living outside Oslo (N = 716) were 19% and 30%. RESULTS: Our results show strong immediate emotional responses, particularly sadness and a feeling of unreality, in both samples. Jumpiness and other fear responses were significantly higher among Oslo residents. Current level of risk perception was low 4-5 months after the attacks; however, a significant minority reported to feel less safe than before. Geographical and psychological proximity were associated with early emotional responses. Psychological proximity was significantly associated with post-traumatic stress reactions, while measures of geographical proximity were not. Immediate emotional responses, first-week reactions, and first-week jumpiness were uniquely and significantly associated with post-traumatic stress reactions. Post-traumatic stress reactions were elevated in ethnic minorities. CONCLUSIONS: The terrorist attacks seem to have had a significant effect on the Norwegian population, creating sadness and insecurity, at least in the short term. Proximity to the terrorist attacks was strongly associated with distress in the population, and early distress was strongly related to later post-trauma

Secondary Traumatic Stress (STS) symptoms experienced by mental health clinicians who treated clients for issues related to the terrorist attacks of 9/11 were intense and unprecedented. An exploratory study, using qualitative techniques as the primary information gathering method, was conducted to gain a better understanding about "indirect" exposure to terrorism. Twenty-six mental health clinicians participated in this research effort. As part of this study, questions regarding STS were explored. STS levels among clinicians who provided care to victims of 9/11 were high 30 months after the attacks. Most clinicians lacked experience providing disaster relief mental health care. Availability of supervision and agency support was described as "weak;" however, peer support was deemed helpful. Over the past decade, progress has been made in addressing STS issues. Implications are included for social work practice, disaster mental health administration, funding sources and policy. Recommendations for future research are identified. (PsycINFO Database Record (c) 2016 APA, all rights reserved) (Source: journal abstract)

Just world beliefs for students ( N = 413) from India and the United Kingdom were measured. The participants then read a scenario about the 2008 terrorist attacks on Mumbai. The participants were then assessed for terrorism distress and offered multiple strategies (revenge and denial) to restore their just world beliefs. The findings indicate that students resident in India along with those who hold strong just world beliefs felt more distress, held a greater desire for revenge, and demonstrated more denial than the British students and those who had weak beliefs in a just world. These results indicate the important role just world beliefs play in responding to the threat created by mass casualty terrorist attacks. The implications for just world theory are also discussed. (PsycINFO Database Record (c) 2016 APA, all rights reserved) (Source: journal abstract)

The author, a faculty member and supervisor at New York University's (NYU) postdoctoral program in psychotherapy and psychoanalysis, and a psychologist in private practice on Manhattan's Upper West Side, weaves together personal and clinical vignettes to give her views of how New York City and its residents were affected by the terrorist attack on September 11, 2001. In the process, she discovers tremendous difficulty writing, following her initial resistance to taking on the project. It seems that the chaotic, nonintegrative sense she has when trying to organize her thoughts somewhat mirrors the experience of trauma itself. The ways in which the NYU postdoctoral community mobilized in the immediate aftermath of the crisis are also discussed. These include providing support for its members and establishing and coordinating an elaborate network of psychologists to provide services wherever needed. It is suggested that the crisis of September 11 affected both the public perception of the value of mental health treatment and the growing psychoanalytic trend toward more relational practices. [Author Abstract] KEY WORDS: 9/11; trauma; terrorism; crisis intervention; personal recollection

Although cognitive behaviour therapy (CBT) is the treatment of choice for post-traumatic stress disorder (PTSD), there is no evidence of its success with PTSD patients still under direct threat of terrorist attacks. This study reports the first randomized controlled trial of CBT for PTSD terrorist-affected people. Twenty-eight survivors of terrorist attacks in southern Thailand were randomized to 8 sessions of either CBT or treatment as usual (TAU). CBT was modified to accommodate the realistic threats facing patients. There were independent assessments conducted before, immediately after, and 3 months following treatment. Main outcome measures included symptoms of PTSD (PTSD Symptom Scale Interview), depression (Beck Depression Inventory) and complicated grief (Inventory of Complicated Grief). CBT resulted in significantly greater reduction in symptoms, including PTSD, depression, and complicated grief, at follow-up than TAU. Relative to TAU, CBT had stronger effect sizes at follow-up for PTSD, depression, and complicated grief. More patients in the CBT condition (75%) achieved high end-state functioning than participants in the TAU (33%). This preliminary evidence suggests that PTSD, depression, and complicated grief can be effectively treated despite ongoing threats of terrorism. Further, it demonstrates that non-specialist mental health workers in a non-western setting can be efficiently trained in using CBT, and this training can translate into successful treatment gains in trauma-affected individuals.

This special issue of the American Psychologist summarizes much of the conceptual and empirical work that psychological science has offered when considering two closely related questions: What have we learned about the individual and societal impacts of 9/11 specifically, and what have we learned about understanding, preventing, and responding to the threat of terrorism more generally? (PsycINFO Database Record (c) 2016 APA, all rights reserved)

We use a storyteller perspective to examine how victims of terrorism perceive the way that organizations react and respond to their needs in the aftermath of terrorist attacks. Analysis of the data shows that organizations in Israel are often perceived as ineffective to respond in a humane or compassionate manner to the suffering caused by terrorism. Instead, victims perceive that a more bureaucratic approach is taken. However, to create optimal public value, compassionate responses on the part of organizations in times of trauma, such as terrorist attacks, may be required. We build a theoretical model to show how positive deviance can bring about such responses, as well as positive outcomes for victims. (PsycINFO Database Record (c) 2016 APA, all rights reserved) (Source: journal abstract)

Research conducted in the aftermath of the September 11th terrorist attacks (9/11) suggests that, except for those who directly witnessed or suffered loss from the attacks, for most children the emotional impact was relatively transitory. We review this literature as well as consider other ways in which the attacks may have played a role in the development of adolescents and young adults as they came of age in the shadow of 9/11 in the United States. Specifically, we discuss the potential impact of the collective trauma of 9/11 on children's coping and emotional regulation, their sociopolitical attitudes, and their general beliefs about the world. Developmental issues and the role of parents in shaping their children's responses to 9/11 are also addressed. Researchers interested in children's social, emotional, and psychological development have much to learn about children's reactions to events like 9/11 and factors that might mitigate the negative consequences of such events on children's development. [Author Abstract] KEY WORDS: terrorism; 9/11; youth; coping; self-regulation

AIMS: This study demonstrates that auxiliary and exclusion criteria variables increase the effectiveness of missing imputation in correcting underestimation of physiologic reactivity in relation to PTSD caused by deleting cases with missing physiologic data. METHODS: This study used data from survivors of the 1995 Oklahoma City bombing and imputed missing heart rate data using auxiliary and exclusion criteria variables. Logistic regression was used to examine heart rate reactivity in relation to current PTSD. RESULTS: Of 113 survivors who participated in the bombing study's 7-year follow-up interview, 42 (37%) had missing data on heart rate reactivity due to exclusion criteria (medical illness or use of cardiovascular or psychotropic medications) or non-participation. Logistic regression results based on imputed heart rate data using exclusion criteria and auxiliary (the presence of any current PTSD arousal symptoms) variables showed that survivors with current bombing-related PTSD had significantly higher heart rates at baseline and recovered more slowly back to baseline heart rate during resting periods than survivors without current PTSD, while results based on complete cases failed to show significant correlations between current PTSD and heart rates at any assessment points. CONCLUSIONS: Suggested methods yielded an otherwise undetectable link between physiology and current PTSD. [Author Abstract] KEY WORDS: auxiliary variable; exclusion criteria variable; heart rate; multiple imputations; PTSD