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Terrorism is the unlawful use of force or violence against persons or property to intimidate or coerce a government, the civilian population, or any segment thereof, in furtherance of political or social objectives. -- FBI Definition On Tuesday September 11 th, 2001 our Nation was forever changed. Following the single largest terrorist attack ever experienced by this country, thousands are dead or missing, tens of thousands of people in this country know someone who was killed or injured, and many more have witnessed or heard about the attack through the media. The impact of this magnitude of terrorist attack will affect people at all levels of involvement: victims, bereaved family members, friends, rescue workers, emergency medical and mental health care providers, witnesses to the event, volunteers, members of the media, the United States of America, and the entire World. Terrorism takes away a sense of security and safety at both the individual and community level, which effects society.
It can challenge the natural need of humans for this world to be predictable, orderly and controllable. Studies have shown that deliberate violence creates longer lasting mental health effects than natural disasters or accidents. 1 1 Scott, R. , Brooks, N. & McKinlay, W. (1995). Post-traumatic morbidity in a civilian community: A follow-up at 3 years. Journal of Traumatic Stress, 8, p. 412.
Consequences both for individuals and the community are prolonged, and survivors often feel that injustice has been done to them. This can lead to prejudice, anger, frustration, helplessness, fear, and a strong desire for revenge. Acting on these feelings and need for revenge can increase feelings of anger and guilt, rather than decreasing them. Society's ability to naturally recover from traumatic events are strong. 2 For people directly involved, fear, anxiety, re-experiencing, and urges to avoid, will gradually decrease over time. Research has shown that those who are most at risk for more severe traumatic stress reactions such as Post Traumatic Stress Disorder (PTSD) are those who have experienced the greatest magnitude of exposure to the traumatic event, such as victims and their families. 3 Many surviving rescue workers will also have direct relationships, or indirect exposure to those who are missing or killed, and will therefore be coping with their own losses as well as with the demands of the rescue mission. A particularly difficult task for these rescue workers will be the removal of the casualties and other aspects of body identification and removal, which have been shown to be particularly traumatic and associated with higher rates of PTSD. 2 Ibid. , p. 414 3 Pfefferbaum, B. , Gurwitch, R. , McDonald, N. , Leftwih, M. , Sconzo, G. , Messenbaugh, A. , Schultz, R. (2000).
Posttraumatic stress among children after the death of a friend or acquaintance in a terrorist bombing. Psychiatric Services, 51, 386 - 388. There have been very few terrorist attacks in the United States, as opposed to some nations and there is documented information known about how people are affected. In my opinion it appears that mental healing occurs over time, although people most directly exposed to terrorist attacks are at a higher risk to develop PTSD.
Problems with anxiety, depression, and substance abuse are also commonly reported. 4 Predictors include being closer to the attacks, being injured, or knowing someone who was killed or injured. Those who watch more media coverage on attacks are also at higher risk for PTSD and associated problems. Research from both domestic and international terrorist events sheds some light on the heightened risk for traumatic stress reactions in individuals exposed to those events. Following are some specific examples: Oklahoma City Bombing. Almost half of survivors directly exposed to the blast reported developing problems with anxiety, depression, and alcohol and over a third reported (PTSD). People who reported trying to avoid reminders of the bombing and who felt numb afterwards were more likely to develop PTSD and other disorders than people who did not avoid and 4 Tucker, P. , Dickson, W. , Pfefferbaum, B. , McDonald, N. , & Allen, G. (1997).
Traumatic reactions as predictors of posttraumatic stress six months after the Oklahoma City bombing. Psychiatric Services, 48, 1191 - 1194. who were able to experience a range of emotions. Predictors of PTSD, anxiety, and depression included more severe exposure, female gender, and having a psychiatric disorder before the bombing (North, Nixon, Shariat, Mallonee, McMillen, Spitzanagel, & Smith, 1999)... Over a year after the bombing, Oklahomans reported increased rates of alcohol use, smoking, stress, and PTSD symptoms as compared to citizens of another metropolitan city (Smith, Christiansen, Vincent, & Hann, 1999)... In a group of adults who sought mental health services, reactions of being nervous and being upset by how other people acted when the bombing occurred was predictive of PTSD (Tucker, Dickson, Pfefferbaum, McDonald, & Allen, 1997)...
Children who lost an immediate family member, friend, or relative were more likely to report immediate symptoms of PTSD than children who had not lost a loved one (Pfefferbaum, 1999)... Two years after the bombing, 16 % of children and adolescents who lived approximately 100 miles from Oklahoma City reported significant PTSD symptoms related to the event (Pfefferbaum, 2000). This is an important finding because these youth were not directly exposed to the trauma and were not related to killed or injured victims... PTSD symptomatology was higher in those with greater media exposure and those with indirect interpersonal exposure, such as having a friend who knew someone killed or injured (Pfefferbaum, 2000). Lockerbie Disaster: The Crash of Pan Am Flight 103. Almost 3 / 4 of a group of people seeking psychological damages following the crash of Pan Am Flight 103 reported.
Over 50 % continued to have PTSD 3 years after the crash PTSD (Brooks & McKinlay, 1992). Subway Attack in Japan. Common experiences of those who were exposed to poisonous gas in the subway included anxiety, fear, nightmares, insomnia, depression and fear of subways (Di Giovanni, 1999). Rates of anger, distress and post-traumatic symptoms have been found to be high in individuals studied, following terrorist attacks. Post-traumatic stress is just one of many ways in which people and society have been effected by terrorist attacks. Security levels at numerous installations and businesses across the world have been heightened since the 9 - 11 attacks, thus causing people many day-to-day time consuming delays.
This is a prime example of how our society and the way we live are affected. Thanks to our active government, by conducting telecaster memorials, recognizing heroes and rallying support from the rest of the world our society is better dealing with the problem of terrorism. The best way to reduce the risk of traumatic stress reactions on our society is to abolishing trauma in the first place by preventing war, terrorism, or any other violent event. Will this ever happen?
I believe not; however our society is slowly learning to change and accept the fact that there are radical organizations in the world in which we are forced to deal with at extremely high costs. References: Brooks, N. & McKinlay, W, (1992). Mental health consequences of the Lockerbie disaster. Journal of Traumatic Stress, 5. Di Giovanni, C. (1999). Domestic terrorism with chemical or biological agents: psychiatric aspects.
American Journal of Psychiatry, 156. North, C. , Nixon S. , Shariat, S. , Mallonee, S. , McMillen, J. , Spitzanagel, E. , & Smith, E. (1999). Psychiatric disorders among survivors of the Oklahoma City bombing. Journal of the American Medical Association, 282. Pfefferbaum, B. , Nixon, S. , Tucker, P. , This, R. , Moore, V. , Gurwitch, R. , Pynoos, R. , & Geis, H. (1999). Posttraumatic stress responses in bereaved children after the Oklahoma City bombing.
Journal of the American Academy Child and Adolescent Psychiatry, 38. Pfefferbaum, B. , Gurwitch, R. , McDonald, N. , Leftwih, M. , Sconzo, G. , Messenbaugh, A. , Schultz, R. (2000). Posttraumatic stress among children after the death of a friend or acquaintance in a terrorist bombing. Psychiatric Services, 51. Smith, D. , Christiansen, E. , Vincent, R. , & Hann, N. (1999).
Population effects of the bombing of Oklahoma City. Journal of the Oklahoma State Medical Association, 92. Tucker, P. , Dickson, W. , Pfefferbaum, B. , McDonald, N. , & Allen, G. (1997). Traumatic reactions as predictors of posttraumatic stress six months after the Oklahoma City bombing.
Psychiatric Services, 48.
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