Psychological sequelae of remote exposure to the September 11th terrorist attacks in Canadians with and without panic

The purpose of the present investigation was to examine the psychological impact of remote exposure to the events and aftermath of the terrorist attacks in the USA on September 11th, 2001, and to assess what differences, if any, exist between individuals classified with probable panic disorder and those without. Telephone interviews were conducted with 122 residents of the capital city of the Canadian prairie province of Saskatchewan in spring 2002 in order to gather information regarding current mood, fears and avoidance behaviours as well as current post‐traumatic stress disorder symptoms specific to September 11th. Consistent with previous findings and despite the remote nature of exposure, results indicated that the psychological well‐being and behaviour of participants with probable panic disorder was more adversely affected by the events and aftermath of September 11th than those without panic disorder. These results suggest that remote viewing of traumatic events can have a significant and lingering impact on psychological well‐being and behaviour and that these effects are more pronounced in those with panic disorder. Implications of the findings and future research directions are discussed.     

The relationship between emotional clarity and suicidal ideation among trauma-exposed adolescents in inpatient psychiatric care: does distress tolerance matter?

ABSTRACT

The present investigation examined associations between low emotional clarity (the extent to which individuals are confused about the specific emotions they are experiencing) and suicidal ideation in a diverse sample of trauma-exposed inpatient adolescents, as well as the moderating role of distress tolerance (DT) in this association. Participants (N = 50; 52.0% female; M = 15.1 years, SD = .51; 44% White) completed measures of emotion dysregulation, posttraumatic stress disorder (PTSD), and suicidal ideation/attempts, as well as a behavioral measure of DT. Controlling for age, gender, presence of mood disorder, and past history of attempts, results revealed a significant interaction between DT and low emotional clarity in relation to suicidal ideation. Specifically, lower emotional clarity was related to suicidal ideation at higher, but not lower, levels of DT. Findings suggest that presence of suicidal ideation among traumatized youth with low emotion clarity is most likely when these emotional deficits are coupled with a high tolerance for cognitive/psychological distress. Given that the ability to withstand distress is arguably a key factor in transitioning individuals from ideation to lethal suicidal behavior, attention to the presence of this construct in the context of clinical practice may be warranted.     

Perception of threat and safety at work among employees in the Norwegian ministries after the 2011 Oslo bombing

Background and objectives: Terrorism can heighten fears and undermine the feeling of safety. Little is known, however, about the factors that influence threat and safety perception after terrorism. The aim of the present study was to explore how proximity to terror and posttraumatic stress reactions are associated with perceived threat and safety after a workplace terrorist attack. Design and methods: A cross-sectional questionnaire survey was administered to employees in 14 of 17 Norwegian ministries 9–10 months after the 2011 bombing of the government headquarters in Oslo (n = 3520). Results: About 198 of 1881 employees completing the survey were at work when the bomb exploded. Regression analysis showed that this high-exposed group had elevated perceived threat (β = 0.36; 95% CI = 0.19 to 0.53) and reduced perceived safety (β = ?0.42; 95% CI = ?0.62 to ?0.23) compared to a reference group of employees not at work. After adjusting for posttraumatic stress reactions, however, proximity to the explosion no longer mattered, whereas posttraumatic stress was associated with both high perceived threat (β = 0.55; 95% CI = 0.48 to 0.63) and low perceived safety (β = ?0.71; 95% CI, ?0.80 to ?0.63). Conclusion: Terror-exposed employees feel more threatened and less safe after a workplace terrorist attack, and this is closely linked to elevated levels of posttraumatic stress reactions.     

Traumatic stress: A theory based on rapid loss of resources

Abstract

Applied Hobfoll's (1988; 1989) Conservation of Resources (COR) stress theory to the instance of traumatic stress. COR theory posits that stress occurs when resources are threatened, when resources are lost, or when individuals invest resources without gaining adequate resources in return. Traumatic stress is seen as particularly threatening to resources and results in rapid resource depletion when it occurs. The rapidness of resource loss is related to the fact that traumatic stressors (1) often attack people's basic values, (2) often occur unexpectedly, (3) make excessive demands, (4) are outside of the realm for which resource utilization strategies have been developed, and (5) leave a powerful mental image that is easily evoked by cues associated with the event. Results from research on traumatic stress are used to illustrate these points and implications for treatment are discussed.     

What will the future bring? Thoughts of children after missile bombardment

Abstract

We examined how cognitive views of the future relate to degree of exposure to trauma and to posttraumatic stress reactions in children. Following the experience of Scud missile bombardment during the Persian Gulf war, 492 Israeli pupils from grades 5, 7, and 10 from regions actually hit and from regions under threat but not hit, described what they thought life would be like next year for children of their age. Based on recent cognitive theories, it was expected that children who experienced higher levels of stress would also express more pessimistic views of the future. We found that children's dominant perception of the future was positive. However, children who expressed stronger postwar reactions also tended to have more pessimistic future views, especially in areas that were hit by missiles. Discussion focused upon views of the future as a direct consequence of the stress as well as a means of coping with stress.     

Religious Care in Coping with Terrorism

Abstract

Spiritual care has taken an important role in the aftermath of 9/11. The shattering of numerous basic assumptions by this attack has created many spiritual and existential questions. In this article, we explore different aspects of spiritual care after major disasters and the different roles that clergy can fulfill. As the field of spiritual trauma care is in a rudimentary stage, best practices for spiritual care need to be developed. In the second part of the article, different elements of the training for spiritual caregivers are described. In order to assure appropriate caregiving, guidelines for training of clergy need to be developed.     

Responding to Terrorism in the USA

Abstract

In this article, career firefighters from Oklahoma City, New York City, and Arlington County, VA, and volunteer firefighters from Pennsylvania, share their on-site experiences and the emotional aftermath of responding to terrorism. The authors acted as facilitators, compilers, and organizers so that major themes firefighters have raised are presented to inform the work of first responders and others seeking to understand the experiences of firefighters during and after terrorist incidents. The authors conclude by presenting survey data indicating high levels of firefighter job satisfaction and the major sources of emotional support they use following exposure to terrorism.     

Vicarious Trauma in Social Workers: The Role of Trauma History,Social Support,and Years of Experience

Vicarious trauma, a disruption in schemas and worldview often accompanied by symptoms similar to those of posttraumatic stress disorder, occurs as a result of chronic secondary exposure to traumatic material. The aim of this study was to examine the role of personal trauma history, social support, and experience level in the development of vicarious trauma among licensed social workers in Maryland (N = 160). Results indicated an increase in social support and in experience level of social workers predicted less severe vicarious trauma. In addition, an interaction effect between trauma history and social support trending on significance indicated higher levels of social support might help protect those without a trauma history but not those with a trauma history against vicarious trauma. Research and clinical implications are discussed.     

Risk and Protective Factors for Comorbid Posttraumatic Stress Disorder among Homeless Individuals in Treatment for Substance-Related Problems

Homeless individuals undergoing treatment for substance use disorders (SUD) can pose clinical challenges. Posttraumatic stress disorder (PTSD) symptoms have been observed in the most difficult clients. The study sample consisted of 51 homeless individuals, 9 women and 42 men, undergoing consultation for SUD in Montreal. The mean age was 46 years (SD = 7.19). Of the sample, 49% had a potential PTSD diagnosis. Most participants had the following characteristics: an alcoholic parent, a history of an early trauma, and little social support. The participants with a potential PTSD diagnosis were significantly more likely to have had an alcoholic parent, to have experienced an early trauma, and to use more maladaptive coping strategies. The study results and limits are discussed.     

Health Outcomes by Closeness of Sexual Abuse Perpetrator: A Test of Betrayal Trauma Theory

Summary

In this chapter, practicing attorney Brooks Cooper illuminates how the legal tradition of applying different standards to the ad-missibility of expert and lay opinions as evidence in litigation complicates delayed-discovery sexual abuse cases. Admissibility standards have long been a source of controversy, and recent developments in law, such as the pre-trial evidentiary hearings that invoke the “gatekeeper” function of the judge under the standard enunciated in Daubert v. Mer-rell-Dow Pharmaceuticals, have become a favored strategy by the defense in an effort to bar delayed memory testimony by characterizing it as the product of unreliable science. To overcome this litigation hurdle, Mr. Cooper contextualizes the present controversy in the history of scientific evidence admissibility, tracing emerging trends in judicial opinion on scientific evidence from expert witnesses from the 1923 case Frye v. United States through the present, and offers strategies and techniques to maintain admissibility of the evidence before and during all phases of the trial.