Psychometric properties of the Impact of Event Scale - Revised.

Background People who are not present at a traumatic event may experience stress reactions. We assessed the immediate mental health effects of the terrorist attacks on September 11, 2001. Methods Using random-digit dialing three to five days after September 11, we interviewed a nationally representative sample of 560 U.S. adults about their reactions to the terrorist attacks and their perceptions of their children's reactions. Results Forty-four percent of the adults reported one or more substantial symptoms of stress; 90 percent had one or more symptoms to at least some degree. Respondents throughout the country reported stress symptoms. They coped by talking with others (98 percent), turning to religion (90 percent), participating in group activities (60 percent), and making donations (36 percent). Eighty-four percent of parents reported that they or other adults in the household had talked to their children about the attacks for an hour or more; 34 percent restricted their children's television viewing...

https://www.nejm.org/doi/pdf/10.1056/NEJM200111153452024

A national survey of stress reactions after the September 11, 2001, terrorist attacks.

Objective:We examined the psychological impact of the 2003 outbreak of severe acute respiratory syndrome (SARS) on hospital employees in Beijing, China.Methods:In 2006, randomly selected employees ...

https://journals.sagepub.com/doi/pdf/10.1177/070674370905400504

The Psychological Impact of the SARS Epidemic on Hospital Employees in China: Exposure, Risk Perception, and Altruistic Acceptance of Risk

ContextThe terrorist attacks of September 11, 2001, represent an unprecedented
exposure to trauma in the United States.ObjectivesTo assess psychological symptom levels in the United States following
the events of September 11 and to examine the association between postattack
symptoms and a variety of indices of exposure to the events.DesignWeb-based epidemiological survey of a nationally representative cross-sectional
sample using the Posttraumatic Stress Disorder (PTSD) Checklist and the Brief
Symptom Inventory, administered 1 to 2 months following the attacks.Setting and ParticipantsSample of 2273 adults, including oversamples of the New York, NY, and
Washington, DC, metropolitan areas.Main Outcome MeasuresSelf-reports of the symptoms of PTSD and of clinically significant nonspecific
psychological distress; adult reports of symptoms of distress among children
living in their households.ResultsThe prevalence of probable PTSD was significantly higher in the New
York City metropolitan area (11.2%) than in Washington, DC (2.7%), other major
metropolitan areas (3.6%), and the rest of the country (4.0%). A broader measure
of clinically significant psychological distress suggests that overall distress
levels across the country, however, were within expected ranges for a general
community sample. In multivariate models, sex, age, direct exposure to the
attacks, and the amount of time spent viewing TV coverage of the attacks on
September 11 and the few days afterward were associated with PTSD symptom
levels; sex, the number of hours of television coverage viewed, and an index
of the content of that coverage were associated with the broader distress
measure. More than 60% of adults in New York City households with children
reported that 1 or more children were upset by the attacks.ConclusionsOne to 2 months following the events of September 11, probable PTSD
was associated with direct exposure to the terrorist attacks among adults,
and the prevalence in the New York City metropolitan area was substantially
higher than elsewhere in the country. However, overall distress levels in
the country were within normal ranges. Further research should document the
course of symptoms and recovery among adults following exposure to the events
of September 11 and further specify the types and severity of distress in
children.

/pdf/psychological-reactions-to-terrorist-attacks-findings-from-2j0ud9j189.pdf

Psychological reactions to terrorist attacks: findings from the National Study of Americans' Reactions to September 11.

Traumatic experiences are relatively common. More than two thirds of persons in the general population may experience a significant traumatic event at some point in their lives, and up to one fifth of people in the United States may experience such an event in any given year (1–5). Although comparable international data are limited, large proportions of populations in many countries have been exposed to terrorism, forced relocation, and violence, which suggests that the overall prevalence of exposure to traumatic events worldwide may be even higher than that in the United States (6, 7).

Disasters (e.g., floods, transportation accidents) are traumatic events that are experienced by many people and may result in a wide range of mental and physical health consequences (8). In one survey of US residents, 13 percent of the sample reported a lifetime exposure to natural or human-generated disaster (9). In the National Comorbidity Survey, 18.9 percent of men and 15.2 percent of women reported a lifetime experience of a natural disaster (4). Post-traumatic stress disorder (PTSD) is the most commonly studied and probably the most frequent and debilitating psychological disorder that occurs after traumatic events and disasters (8, 10).

The growing threat of terrorism worldwide has heightened our awareness of disasters as a potentially important determinant of population health and suggests a pressing need both to identify key areas of consensus in postdisaster research and to highlight areas that require additional study (11). It is our purpose in this review to contribute to this overall goal by comprehensively and systematically assessing the epidemiologic evidence about PTSD after disasters.

/pdf/the-epidemiology-of-post-traumatic-stress-disorder-after-1mev06epc8.pdf

The Epidemiology of Post-Traumatic Stress Disorder after Disasters

This article describes Posttraumatic Stress Disorder (PTSD) symptomatology in 69 sixth-grade youths who resided within 100 miles of Oklahoma City at the time of the 1995 bombing of the Alfred P. Murrah Federal Building. These youths neither had any direct physical exposure nor personally knew anyone killed or injured in the explosion. A survey conducted two years after the bombing assessed exposure, PTSD symptoms, and functioning. PTSD symptom frequency was measured with the Impact of Event Scale--Revised. Our BCD criteria for defining PTSD caseness was modeled after DSM-IV B, C, and D criteria requiring one reexperiencing, three avoidance/numbing, and two arousal symptoms for diagnosis. Those who met our BCD criteria had significantly higher PTSD symptom scores than those who did not. Both increased mean PTSD symptom score and meeting our caseness definition were associated with increased functioning difficulties. Media exposure and indirect interpersonal exposure (having a friend who knew someone killed or injured) were significant predictors of symptomatology. These findings suggest that children geographically distant from disaster who have not directly experienced an interpersonal loss report PTSD symptoms and functional impairment associated with increased media exposure and indirect loss.

Posttraumatic stress two years after the Oklahoma City bombing in youths geographically distant from the explosion.

This study assessed indirect interpersonal exposure to the 1995 Oklahoma City bombing, broadcast and print media exposure in the aftermath of the explosion, emotional reactions to media coverage, and posttraumatic stress reactions in children distant from the explosion. A survey was administered to 88 sixth-grade students in the public middle school in a community 100 miles from Oklahoma City 2 years after the bombing. Many children reported indirect interpersonal exposure and most reported bomb-related media exposure. Print media exposure was more strongly associated with enduring posttraumatic stress than broadcast exposure. Indirect interpersonal exposure and the interaction of media exposure with emotional reaction to media coverage in the aftermath of the explosion each predicted ongoing posttraumatic stress. The results suggest that children may have lingering reactions to highly publicized terrorist incidents. Concern about the influence of television viewing has long been proclaimed. This study implicates print media exposure as well. Media exposure to terrorist incidents, therefore, should be monitored and those working with children should assess exposure and stress even in children not directly impacted.

Media exposure in children one hundred miles from a terrorist bombing

The curricular principles presented here arose from a national conference of experts in dealing with family violence from medicine, nursing, and dentistry. The conference, held in March 1994 in Oklahoma City, Oklahoma, was supported by The Robert Wood Johnson Foundation. The conference's work was based upon the premise that an integrated approach to health-professional education in family violence would be more effective than single approaches. The group developed a set of principles for identification of specific goals in knowledge, skills and practices. With those in mind, three levels of education were identified: knowledge, skills, and practices that should be taught to all health professionals (called "Family Violence 101"); advanced levels for primary care practitioners for comprehensive, longitudinal care; and knowledge, skills, and attitudes for specialty practitioners for specific, directed, intensive interventions appropriate to the specialties (called "Family Violence 201"); and additional education and training for those practitioners who wish to be consultants, investigators, and teachers of intervention in cases of family violence (called "Family Violence 301"). These recommendations are presented in the hope that health-professional schools and societies will implement them, thereby improving the health professions responses to this epidemic. Language: en

Curricular Principles for Health Professions Education About Family Violence.

The advent of major terrorist assaults has ushered in a sense of insecurity and vulnerability heretofore unknown in the US. There is information about the impact of disasters and trauma on children, but relatively little data on the effects of terrorism. The events of September 11, 2001 have underscored the need to examine this issue. This report summarizes recent studies that address the impact of terrorist incidents on children, and examines issues related to mental health services for children in the post-attack environment. Work related to the 1993 bombing of the World Trade Center, the 1995 bombing of the Alfred P. Murrah Federal Building in Oklahoma City, the 1998 bombing of the American Embassy in Nairobi, Kenya, and the September 11 attacks are reviewed. This article indicates significant challenges in the identification, evaluation, and treatment of children potentially in need of attention.

Children's response to terrorism: a critical review of the literature.

Teachers are frequently expected to support children psychologically in the aftermath of mass casualty events, yet they generally have not been trained to do so. This study of a small private school in New York City reports the reactions, needs, and interests in preparedness training among teachers in 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. Language: en

Edward N. Brandt

Papers

Posttraumatic stress two years after the Oklahoma City bombing in youths geographically distant from the explosion.

Media exposure in children one hundred miles from a terrorist bombing

Curricular Principles for Health Professions Education About Family Violence.

Children's response to terrorism: a critical review of the literature.

Teachers in the aftermath of terrorism: a case study of one New York City school.