Mental Health Services Preparing for the Psychological Consequences of Terrorism

Summary

The Israeli population has been subjected to the stresses of war and terrorist attacks since long before the state was founded. Confronting this extensive experience of terrorism-related psychological trauma, the Mental Health Services of the Ministry of Health designed and implemented a comprehensive emergency response system that operates in general hospitals and community settings to meet the psychological needs resulting from terrorism at both the individual and the population levels. This article describes general premises, basic elements, administrative structure and functioning of this system, as well as training programs for various service providers working with the victims.     

A Preventive Coping Perspective of Individual Response to Terrorism in Canada

A plethora of studies on terrorism underscores the challenges of managing the psychological and behavioural impacts of terrorist events. This literature also emphasizes the idea that the global pending threat of terrorism, prior to the occurrence of any event, may also give rise to significant reactions among members of the public. Drawing from the literature on proactive coping, the current study presents the results of factor analyses performed on sections of a national survey that assessed appraisals of as well as actual responses to the threat of terrorism in Canada (N = 1,502). Findings revealed that items assessing individual response to terrorism were represented by three factors in this context: Individual Preparedness, Information Seeking, and Avoidance Behaviour. Further analyses demonstrated a tendency for actual preparedness behaviours to be associated with decreased psychological stress, and actual avoidance behaviours to be associated with heightened psychological stress. Furthermore, the divergent patterns of relationships of terrorism response appraisals and corresponding actual responses with psychological stress emphasized the need to distinguish different stages in the process of preventive coping with terrorism. Theoretical and practical implications of findings for individual preparedness in Canada are discussed.

Psychological Impact of Terrorism on Children and Families in the United States

Summary

This article reviews the literature on the psychological impact of terrorism on children and families in the United States. It includes studies of the 1993 World Trade Center bombing in New York City and the 1995 bombing of the Alfred P. Murrah Federal Building in Oklahoma City, as well as the September 11 attacks. These studies explore the impact of various forms and degrees of exposure to terrorism on children across the development spectrum and on the relationships between parental and child reactions. The article concludes with a framework for future research on children's adaptation following mass trauma.     

Training Therapists to Treat the Psychological Consequences of Terrorism

Abstract

In the wake of 9/11, the mental health community began to develop a model for recovery and preparedness. A public information campaign regarding the psychological consequences of terrorism was launched, and it succeeded in reducing the stigma of utilizing mental health services. However, as this campaign began to succeed, it became clear that most clinicians in the community had little training in evidence-based assessment and treatment procedures for the psychological sequelae of terrorism. This article describes the development, delivery, and initial assessment of one attempt to correct this problem by broadly disseminating an effective treatment for Post Traumatic Stress Disorder (PTSD). Using models of behavior change, we were able to study trainee attitudes and the training process in ways that will help improve training effectiveness beyond what traditional Continuing Professional Education (CPE) has been able to do.     

Americans respond politically to 9/11: understanding the impact of the terrorist attacks and their aftermath

The 9/11 terrorist attacks have had profound effect on U.S. domestic and foreign security policy, leading to several expensive wars and the erosion of civil liberties (under the USA PATRIOT Act). We review evidence on political reactions to the 9/11 attacks and conclude that subjective reactions to terrorism played an important role in shaping support for national security policy in the wake of 9/11. Support for a strong national security policy was most pronounced among Americans who perceived the nation as at threat from terrorism and felt angry at terrorists. In contrast, Americans who were personally affected by the attacks were more likely to feel anxious about terrorism, and this anxiety translated into less support for overseas military action. In addition, Americans who felt insecure after the 9/11 attacks and perceived a high future threat of terrorism were more likely than others to support strong foreign and domestic national security policies. Overall, research on American political reactions to 9/11 suggests that support for a strong government response to terrorism is most likely when members of a population perceive a high risk of future terrorism and feel angry at terrorists.     

The Theater of Terror

Summary

Modern terrorists became aware of the new opportunities for exerting mass psychological impact using the latest means of mass communications. Academic observers remarked increasingly on the theater-like nature of terrorist operations. According to this notion, modern terrorism can be understood in terms of the production requirements of theatrical engagements. Several terrorist organizations realized the potentials of media-oriented terror, in terms of effectively reaching huge audiences. This article examines the strategies and tactics of this new pattern of media-oriented terrorism and their impact on the audiences who, through the media's mediation, join the widening circles of victims of terrorism.     

Integrating Behavioral Aspects into Community Preparedness and Response Systems

Summary

This article examines the role of psychosocial and behavioral dimensions of terrorism that influence community preparedness and homeland defense efforts. Public health interventions will fail if people do not follow the recommendations. A broader public health model is applied to help identify the interactions between risk and safety appraisals, social factors, and behavioral response to uncertain and stressful situations. Community preparedness would benefit by linking disparate programmatic and advocacy initiatives that already exist. It stands to reason that improving the cohesiveness of existing systems of social organization would strengthen community resilience and serve as effective countermeasures for terrorism.     

Sharing Knowledge and Shared Care

Summary

This concluding article presents the main themes that emerged from this volume within a multidimensional, multidisciplinary integrative framework conceptualizing the consequences of the trauma of terrorism and informing optimal prevention and intervention methods. It reviews short- and long-term findings of the effects of terrorism on adults, children, families, communities, and societies and makes numerous research recommendations. Viewing terrorism as psychological warfare against the community, it advances community-based, culturally congruent interventions, with a public mental health approach, in an ongoing, integrated network of services promoting community and individual resilience, specialized training, international collaboration, and continued dialogue concerning the role of the media.     

Terrorism

Summary

This article examines the effect of terrorism on communities. Its specific point of view is that of resiliency rather than psychopathology. To this end, both a review of the literature on the impact of terrorism on communities in general and the close to home experience of communities in the north of Israel comprise this study. The conclusions drawn lead to practical recommendations for preparing communities both on the national level and at the local authority level to deal with the long-term psychological results of terror.     

Cultural Issues in Terrorism and in Response to Terrorism

Summary

Among the multiple causes of terrorism is a clash of cultures. Trauma and the destruction of culture may create fertile ground for violent cultures and future terrorists. Cultural differences are important elements in the prevention, assessment, and treatment of post-terrorism psychological sequelae. Cultural and spiritual practices have been used or adapted to reduce anxiety, enhance recovery, and provide supplemental interventions. Learning within a community and engaging community and religious leaders, community members, and the individual patient in order to be guided by the specific needs of a group or an individual is essential to effective interventions following terrorism.     

Terrorism as Collective Communication: The Collective Communication Model of Terrorism (CCMT)

This paper proposes that the psychological and behavioral effects of terrorist threat can be understood as a collective communication process that occurs between terrorists and their potential victims. Based on classic communication theory, terrorists are regarded as the senders of a specific collective message (such as ‘stop oppressing our culture’); a terrorist incident as the collective message itself (through its performance, modality and targets); and the potential victims as its collective receivers (who interpret the intention of the attack as a function of their pre-existing attributes, such as traits or salient social identities). The perception of terrorism as a dynamic and interactive process between collective senders, messages and receivers opens new theoretical perspectives regarding whether (a) terrorism can be successful in reaching its collective aim; (b) if it is interpreted as rational or irrational; and (c) how to counteract the vicious, cyclical relationship between terrorism and counter-terrorism. Previous findings on the psychology of terrorism can be organized within this theoretical framework, and the psychological impact of varying attributes of the perpetrators (senders), incident (message), and the reactions of the potential victims (receivers) systematically investigated. A series of self-conducted studies are also reviewed and found to provide direct support for the collective communication model of terrorism.     

Link between early maladaptive schemas and defense mechanisms

IntroductionDefense mechanism and early maladaptive schemas are two concepts distorting the perception of reality.ObjectiveThe aim of this study was to explore the link between two reality-distorting concepts from two theoretical models: early maladaptive schemas from the cognitive and behavioral model and defense mechanisms based on the psychoanalytic model.MethodTwo hundred thirty-two non-clinical participants completed the Defense Style Questionnaire and the Young Schema Questionnaire (short version). Then a Bravais Pearson correlation analysis connecting these two concepts, and a multiple regressions analysis using early maladaptive schemas as predictors for defense style mechanisms levels were conducted.ResultsThe results indicate that 2 early maladaptive schema domains (i.e. other-directedness as well as over-vigilance and inhibition) predict the frequency of use of the neurotic defense mechanism, and 3 schema domains (i.e. disconnection and rejection, impaired autonomy and performances as well as impaired limits) predict the frequency of use of the immature defense mechanism.ConclusionTo conclude, two psychological concepts based on two different theoretical models (psychoanalytic and cognitive and behavioral therapy) seem to share an important link justifying the use of integrative therapies such as schema therapy.     

Visions of the future: social processes and terrorism in Europe1

Abstract: When we think of terrorism, we tend to think of Islamic terrorism but in fact most of the violent happenings in our societies are caused by ‘domestic terrorism’ and it has been suggested by authors such as Twemlow that there is a developmental continuum between social activism and terrorism. The generalized rise in what the author terms ‘a terrorist worldview’ has been linked to many different social, political, economic and psychological conflicts but the present paper suggests that this is not sufficient and that in order to understand it it is necessary to take into consideration certain processes in contemporary civilization. At present, I am suggesting that Western civilization is characterized by the generalized breakdown of values and of signifying structures and by the gradual weakening of the models of state power and institutions that previously guaranteed the unity and security of our societies. The result is a crisis of identity which is particularly evident among the youth of today and when this is exasperated by the failure of authority to provide an adequate explanatory system of contemporary reality and by the tendency to resort to repressive mechanisms, all too often the result is the degeneration of social activism into social violence. It is becoming urgent that our societies reflect on more efficient ways of preventing social activism degenerating into terrorism, both internationally and domestically.     

Inside the terrorist mind: The relevance of ideology

Abstract

The extremely violent activities perpetrated by terrorists initially led to attempts to analyse terrorism as a form of psychopathology. This approach has been quickly replaced by a perspective on terrorism as a group activity propelled to action by an ideology. Ideologies differ in their strength, in turn determined by ideological contents and the adherents' motivations in embracing those contents. Ideological strength may, in turn, determine the extremity of actions (including terrorism) warranted by the ideology in question. Based on this analysis, a broad view on counter-terrorist possibilities is offered related to (1) undermining the perception that terrorism is an effective tool for attaining the group's objectives, and (2) its replacement by a credible alternative (and peaceful) means for doing so.     

Stress related changes in immunological and psychological variables induced by the preparation and defense of a PhD-thesis

Abstract

Results are reported from a field study on 47 healthy subjects preparing and defending a PhD-thesis in the Netherlands. Measurements before, about and after thesis defense are used to quantify the temporal effects of this perceived stressor on immunological and psychological variables. Moreover, multivariate analysis of variance for repeated measurements was used to explore a potential causal relationship between changes in immune variables and changes in psychological variables. Significant temporal effects were observed for the immunological variables, percentage CD4 cells (p = 0.037), the proliferative response to pokeweed mitogen (p = 0.040), concanavalin A 10 μg/ml (p = 0.010) and concanavalin A 40 μg/ml (p = 0.005) and the psychological variables, average subjective distress (p = 0.002), highest subjective distress (p = 0.000) and the coping strategy depressive reaction pattern (p= 0.02). No evidence was obtained for a causal relation between the immunological and psychological variables.     

The Relationship of Parental Attachment and Psychological Separation to the Psychological Functioning of Young Adults

Abstract

The authors explored the interrelations between attachment patterns and psychological separation from parents as well as the contribution of these variables to adaptive psychological functioning. Among 153 university students in Greece, there was a positive association between security of attachment and freedom from guilt, anxiety, and resentment toward one's parents (conflictual independence); in contrast, there was an inverse relation between security of attachment and independence from parents in relation to emotional, functional, and attitudinal independence. Compared with the insecurely attached students, the securely attached students also scored higher on measures of self-esteem and lower on measures of anxiety and loneliness.     

Changing working life and the appeal of the extreme right

Abstract

This article addresses the role psychological contracts can play in human resources management. Differences between part-time and full-time workers, male and female employees, and supervisors and subordinates concerning the psychological contract are presented. The implications of using the psychological contract in human resources practices are discussed.     

Understanding the impact of HIV diagnosis amongst gay men in Scotland: An interpretative phenomenological analysis

Objectives: Although a wide literature details the psychological impact of human immunodeficiency virus (HIV) diagnosis, it predates the introduction of effective treatment for HIV (i.e. anti-retroviral therapies, ARTs). This article explores the psychological impact of HIV diagnosis in post-ART accounts. This is important, given the recent policy developments which focus upon increasing HIV testing and thus diagnoses.

Design: This study presents a qualitative exploration of the experiential accounts of HIV-positive gay men living in Scotland. A total of 14 HIV-positive gay men took part in open-ended interviews.

Methods: Interpretative phenomenological analysis was employed to identify recurrent themes across the interviews.

Results: Our analysis focuses upon the participants’ struggles in adjusting to their HIV status. Diagnosis was a deeply shocking and unexpected experience. Stigma and fear of prejudice dominated their accounts. HIV was understood, variously, as a shameful, fatal and life-changing condition. Overall, within these accounts there was little sense of HIV normalisation.

Conclusions: In Scotland, where HIV prevalence is low, and where no accessible HIV-positive sub-culture exists, there is on-going psychological distress and morbidity amongst gay men testing HIV positive. As HIV-related policy increasingly focuses on increasing rates of antibody testing, there is a need to reduce the psychosocial costs associated with HIV-positive diagnoses.