Learning From The Past and Planning For The Future
MENTAL HEALTH MOMENT December 6, 2003 "The problem in defense is how far you can go without destroying from within what you are trying to defend from without." - Dwight D. Eisenhower
Short Subjects
LINKS Rocky Mountain Region
Disaster Mental Health Institute
CONFERENCES AND WORKSHOPS:
CALL FOR PAPERS:
CONFERENCE ON RURAL CRISIS INTERVENTION
AND CURRENT STATE OF CISM/CISD
Middle East/North Africa Regional
Conference of Psychology
December 13 - 16, 2003
Location: Dubai, United Arab Emirates
Contact: Dr. Raymond H. Hamden
MENA RCP, PO Box 11806
Dubai, United Arab Emirates
Phone: +971-4- 331-4777
Fax: +971-4-331-4001
E-mail: menarcp@hotmail.comSociety of Australasian
Social Psychologists 33rd Annual Meeting
April 15 - 18, 2004
Location: Auckland, NEW ZEALAND
27th National AACBT Conference
(Australian Association for
Cognitive and Behavior Therapy)
May 15 - 19, 2004
Location: Perth, Western Australia
AUSTRALIA
5th Conference of the
European Academy of Occupational Health Psychology
November 20-21, 2003
Location: Berlin, Germany
Society of Australasian Social Psychologists
33rd Annual Meeting
April 15 - 18, 2004
Location: Auckland, NEW ZEALAND
Contact: SASP@auckland.ac.nz
Deadline for submissions: 1 February 2004WFPHA 10th International Congress on
Public Health: Sustaining Public Health
in a Changing World: Vision to Action
April 19-22, 2004
Location: Brighton, ENGLAND
Contact: Allen K. Jones, PhD
Secretary General World Federation of
Public Health Associations
Email: stacey.succop@apha.orgHawaii International Conference on Education
January 3-6, 2004
Location: Honolulu Hawaii, USA
Email: education@hiceducation.orgXIV. IFTA World Family Therapy Congress
March 24 - 27, 2004
Location: Istanbul, TURKEY
14th Biennial Meeting of the Society
for Research in Human Development
(formerly the Southwestern Society for
Research in Human Development -- SWSRHD)
April 1 - 3, 2004
Location: Park City, Utah, USA
7th European Conference on Psychological Assessment
April 1 - 4, 2004
Location: Malaga, SPAIN
Contact: Antonio Godoy
Facultad de Psicologia
Universidad de Malaga
29071 Malaga.( SPAIN)
Tel. (34) 952 13 25 32
Fax (34) 95213 11 00
Email: godoy@uma.esAnnual Conference Society for
Industrial/Organizational Psychology (SIOP)
April 2 - 4, 2004 Location: Chicago, Illinois, USA
Email: lhakel@siop.bgsu.edu
Seven More Puerto Rico Municipalities Designated For Federal Aid
The head of the U.S. Department of Homeland Security's Federal Emergency Management Agency (FEMA) today designated seven more Puerto Rico municipalities eligible for federal disaster aid to help homeowners, renters and businesses recover from the effects of severe storms, floods, mudslides and landslides that began on November 10. Michael D. Brown, Under Secretary of Homeland Security for Emergency Preparedness and Response, said the assistance was approved based on the results of further federal and Commonwealth damage assessments. Nine municipalities were initially designated for aid to affected residents and business owners under the major disaster declaration issued by President Bush on November 21. The seven additional eligible municipalities are Arroyo, Canóvanas, Fajardo, Loiza, Naguabo, Toa Baja and Yabucoa. The municipalities previously designated for assistance were Guánica, Guayama, Juana Diaz, Maunabo, Patillas, Rio Grande, Salinas, Santa Isabel and Yauco. For further information, go to: http://www.fema.gov/news/newsrelease.fema?id=8493
President Orders Disaster Aid For Puerto Rico Flood Victims
The head of the U.S. Department of Homeland Security's Federal Emergency Management Agency (FEMA) announced today that President Bush has authorized the use of federal disaster funds to help families and businesses in Puerto Rico recover from the effects of flooding rains that started early last week. Michael D. Brown, Under Secretary of Homeland Security for Emergency Preparedness and Response, said the President took the action under a major disaster declaration issued after a review of FEMA's analysis of the Commonwealth's request for federal relief. The declaration covers damage to private property from severe storms, flooding, mudslides and landslides that began on November 10. For more information, go to: http://www.fema.gov/news/newsrelease.fema?id=8460
UN Humanitarian Team Helps Micronesia Recover Following Tropical Storm
The United Nations agency for humanitarian coordination has sent a disaster assessment team to Micronesia after Typhoon Lupit struck the Pacific islands nation early last week, destroying food crops, contaminating water supplies and damaging homes and public facilities. For the full story, go to: http://www.un.org/apps/news/story.asp?NewsID=9071&Cr=humanitarian&Cr1=
Training Course To Help Safeguard Seniors And People With Disabilities Being Distributed By FEMA
The Department of Homeland Security’s Federal Emergency Management Agency (FEMA) is announcing today the dissemination of a new training course that helps ensure the needs of the nation’s most vulnerable residents are addressed during disasters. The course, G197 Emergency Planning and Special Needs Populations, will be available on CD Rom to assist local and state emergency planners, and organizations serving seniors and people with disabilities. For the full story, go to: http://www.fema.gov/news/newsrelease.fema?id=8545
FEMA Offers Multihazard Building Design Summer Institute For College And University Faculty
The Department of Homeland Security’s Federal Emergency Management Agency (FEMA) is announcing four seminars on hazard mitigation in building design to be held during a two-week-long institute in July 2004. The institute covers protective design for earthquakes, fires, flood and wind.
“Hazard mitigation is vitally important to this country to reduce the toll that disasters exact on our communities and neighborhoods,” said Under Secretary Michael D. Brown, Under Secretary of Homeland Security for Emergency Preparedness and Response. “These courses help teach the next generation of architects and engineers about the value and importance of disaster resistant design.” For more information, go to: http://www.fema.gov/news/newsrelease.fema?id=8544
Afghanistan’s Decimated Livestock Could Take 10 Years To Regenerate – UN Report
Four years of drought and many years of civil strife have decimated livestock in Afghanistan, a major source of income and food for farmers and their families, and it could take up to 10 years for the animal herds to regenerate naturally, the United Nations Food and Agriculture Organization (FAO) reported today. For the full story, go to: http://www.un.org/apps/news/story.asp?NewsID=9066&Cr=Afghan&Cr1=livestock
UN Report Warns Small Island Developing States Increasingly Vulnerable
Small island developing states (SIDS), which rely heavily on agriculture, forestry and fisheries exports, are increasingly threatened by a combination of fluctuating commodity prices and trade regulations and the potentially disastrous results of climate change, according to a new United Nations report released today. For the full story, go to: http://www.un.org/apps/news/story.asp?NewsID=9036&Cr=small&Cr1=island
Nineteen countries pledge financial support to UN agency helping Palestinians
Nineteen countries pledged today to donate $72 million towards next year’s budget for the United Nations agency helping Palestinian refugees, but the agency says much more is needed because of the deteriorating economic situation in the Palestinian territories. For more information, go to: http://www.un.org/apps/news/story.asp?NewsID=9063&Cr=palestine&Cr1=
Sleep Apnea linked with Depression
People diagnosed with depression are five times more likely to have sleep apnea, a breathing-related sleep disorder, than non-depressed people, according to a new study at the Stanford University School. This study is the first to show a link between depression and sleep apnea along with its related disorders. It remains unclear whether depression increases the liklihood of sleep apnea, or sleep apnea contributes to depression. The relationship between the two may not be straightforward. For more information, go to: http://mentalhealth.about.com/gi/dynamic/offsite.htm?site=http://www.eurekalert.org/pub%5Freleases/2003%2D11/sumc%2Dsad110603.php
The Use of Melatonin in Children With Sleep Disturbances
The administration of exogenous melatonin has been used in a variety of clinical settings, most frequently in the management of sleep disturbances, including insomnia and jet lag. Pediatr Pharm 9(11) 2003 For the article, go to: http://www.medscape.com/viewarticle/464854
Cognitive Behavioral Therapy Useful for Bipolar Disorder in Children
After therapy, children had significant reductions in severity scores for mania, depression, aggression, ADHD, sleep, and, to a lesser extent, psychosis. For the article, go to: http://www.medscape.com/viewarticle/463224
Child and Adolescent Bipolar Disorder: An Expert Interview With Robert Kowatch, MD
An expert discusses hot topics in this area, including new pharmacologic therapies, cognitive behavioral therapy, and management differences between pediatric and adult patients. For the article, go to: http://www.medscape.com/viewarticle/463092
CERTAIN CANCERS SIGNIFICANTLY MORE COMMON IN APPALACHIAN RESIDENTS
Residents of the largely rural region of the eastern United States called Appalachia carry a heavy burden for certain cancers, a new study shows. "We've found that the occurrence, or the incidence, of new cancer of the lung, colon, rectum and cervix were significantly increased in residents of the large portion of Appalachia in Kentucky, Pennsylvania and West Virginia," said Eugene Lengerich, principal investigator and an associate professor with the Penn State Cancer Institute. "These findings support the National Cancer Institute's designation of residents of Appalachia as a population experiencing an excessive cancer burden." The study was presented Nov. 18 at an American Public Health Association meeting in San Francisco. Read the full story at http://live.psu.edu/story/4800
THE MEDICAL MINUTE: THE TROUBLE WITH THE FLU
If you have not received a flu shot yet, there is still time. According to the latest edition of the Medical Minute, a service of Penn State Milton S. Hershey Medical Center, the Centers for Disease Control have been monitoring cases of influenza to determine if this year's vaccine will protect us. The good news is that the current vaccine should work, although the protection might not be perfect. There appears to be a slight difference in the most common strain so far compared to the vaccine being used this year. There are complex reasons behind concerns over the specific strain of the flu and getting so many people immunized; and why the flu is mild one year and severe another. The fact that influenza comes in two types for humans only begins to spell out the trouble. Read the full story at http://live.psu.edu/story/4866
SEPTEMBER 11: A BRIEF REVIEW
The events of September 11th, 2001, have had long-lasting effects on our culture, interpersonal relationships, understanding of evil intent and terrorism, and approach to and treatment of trauma states. A variety of recent research studies have investigated the psychological impact on victims of the devastating events of September 11, 2001. The following are some of the ones that have recently been published.
Emotional Responses
The aftermath of September 11th highlights the need to understand how emotion affects citizens' responses to risk. It also provides an opportunity to test current theories of such effects. For example, on the basis of appraisal-tendency theory, Lerner, Gonzalez, Small & Fischhoff (Mar 2003) predicted opposite effects for anger and fear on risk judgments and policy preferences. In a nationally representative sample of 973 Americans (aged 13-88 yrs), fear increased risk estimates and plans for precautionary measures; anger did the opposite. These patterns emerged with both experimentally induced emotions and naturally occurring ones. Males had less pessimistic risk estimates than did females with emotion differences explaining 60 to 80% of the gender difference. Emotions also predicted diverging public policy preferences.
DeLisi, Maurizio, Yost, Papparozzi, Fulchino, Katz, Altesman, Biel, Lee, & Stevens (Apr 2003) examined the prevalence of psychiatric symptoms among residents/workers in Manhattan 3-6 months after the September 11, 2001, terrorist attacks. They interviewed a total of 1,009 adults (aged 18-85 yrs) in person throughout Manhattan. Respondents answered questions about themselves before and after September 11 that included their emotional status. A total of 56.3% had at least one severe or two or more mild to moderate symptoms. Women reported significantly more symptoms than men. Loss of employment, residence, or family/friends correlated with greater and more severe symptoms. The most distressing experiences appeared to be painful memories and reminders. Dissociation was rare. Only 26.7% of individuals with severe symptoms were obtaining treatment. Over half of the individuals had some emotional sequelae 3-6 months after September 11, but the percent was decreasing. Only a small portion of those with severe responses were seeking treatment.
To assess medication use in New York after the September 11th attacks, Boscarino, Galea, Ahern, Resnick & Vlahov (2003) conducted a telephone survey in October 2001 (N=1,008). The prevalence of psychiatric medication use 30 days before the disaster was 8.9% and 11.6% 30 days after, a small but significant increase. The most important factor predicting postdisaster use was predisaster use. 92% of those who used medications postdisaster used them predisaster. Additionally, 3.3% used psychiatric medications 30 days postdisaster, but not 30 days before. Those who had panic attacks, posttraumatic stress disorder (PTSD), and insurance coverage, were the most likely medicated (26.5%). However, among those who used postdisaster medications (n=129), new users tended to be those with panic attacks (44.1%) and those with panic attacks and PTSD (69.2%).
Chen, Chung, Chen, Fang & Chen (2003) examined the psychological impact of the September 11th disaster on the immediate neighborhood of the New York World Trade Center. 555 residents (aged 8-86 yrs) from the local Chinatown community participated in the study. Ss were surveyed retrospectively on their emotional distress immediately after the tragedy and five months later. Prevalent anxiety was found in general community residents and additional depression in those who lost family members or friends. The mental health condition of the community improved tremendously five months later, with the initial 59% of general residents having four or more emotional symptoms dropping to 17%. However, more than half of the community residents had persistently shown one or more symptoms of emotional distress. Those who had lost a family member or friend in the disaster showed significantly higher distress. 90% had four or more major psychiatric symptoms during the first few weeks right after the disaster, and the rate dropped to 35% five months later. Overall, those in their 40s and 50s seemed to have had relatively higher emotional distress than both younger and older groups.
In a study about effects of memories on emotions, 54 Duke students recorded their memory of first hearing about the terrorist attacks of September 11 and of a recent everyday event (Talarico & Rubin, 2003). They initially recorded this on September 12, 2001. They were tested again either 1, 6, or 32 weeks later. Consistency for the flashbulb and everyday memories did not differ, in both cases declining over time. However, ratings of vividness, recollection, and belief in the accuracy of memory declined only for everyday memories. Initial visceral emotion ratings correlated with later belief in accuracy, but not consistency, for flashbulb memories. Initial visceral emotion ratings predicted later posttraumatic stress disorder symptoms. It was suggested that flashbulb memories are not special in their accuracy, as previously claimed, but only in their perceived accuracy.
In the above studies, variables that were identified as having effects on emotional responses and on long term adjustments, including post-traumatic stress, include age, sex, proximity to the event, employment status, family/friends affected, pre-disaster use of medications and vividness of memories and/or recall of the event over time. In mitigation planning, it will be important to include these factors in planning responses.
Changes Following September 11
The tragic events of September 11, 2001 had an immediate and far-reaching impact on people in the United States and the world. Did Americans change following the September 11 terrorist attacks? Peterson & Seligman (2003) provide a tentative answer with respect to the positive traits included in the Values in Action Classification of Strengths and measured with a self-report questionnaire available on-line and completed by 4,817 respondents. When scores for individuals completing the survey in the two months immediately after September 11 were compared with scores for those individuals who completed the survey before September 11, seven character strengths showed increases: gratitude, hope, kindness, leadership, love, spirituality, and teamwork. Ten months after September 11, these character strengths were still elevated, although to a somewhat lesser degree than immediately following the attacks.
In a study of a suburban public high school near Boston, Metz & Youniss (2003) sought to determine how students viewed and reacted to the event and whether it enhanced their sense of civic engagement. Results revealed only an immediate increase in students' political interest and no changes in intended civic participation. Descriptive findings suggested that most students' view of the world was changed after 9/11. However, fewer students reported that their view of themselves had changed. The majority of students responded actively by attending memorial services or vigils, donating blood or supplies, or organizing service pertinent to the aftermath of 9/11. Analyses suggested that students who organized service had enhanced and sustained levels of intended civic participation compared to students who responded through other means or not at all. Analyses also suggested that students who attended memorials or vigils had enhanced and sustained political interest compared to others.
These two studies suggest that, following the September 11 event, young people became more involved in and interested in civic activities. In the general population, they suggest that there were increases in gratitude, hope, kindness, leadership, love, spirituality and teamwork. Longer term follow-ups with these populations (over 5, 10, 20 years) would provide some valuable insights into the long-term effects of such traumatic events on persons affected at various levels of involvement and/or exposure.
Effects on Psychiatric Patients
Stout & Farooque (2003) examined the reactions of 17 male inpatients on a secure psychiatric unit to television news coverage of the September 11 attacks. All had psychotic diagnoses. They hypothesized that self-exposure and affective response to the news coverage and use of social support would be influenced by a predominance of negative symptoms. They also examined the emergence of common stress symptoms and exacerbations of psychosis. Their results suggested a dose-response relationship between amount of viewing and the magnitude of response to the coverage. Anger was the emotion most clearly tied to coverage exposure and the other response variables. A wide range of stress symptoms was reported. Hypotheses concerning the influence of negative symptoms were partially supported. A significant minority of the patients disclosed exacerbation of psychotic symptoms in response to the attacks. Patients who reported a negative emotional reaction were more likely to talk to others about the attacks, but social contact did not predictably lead to affective relief.
Effects on Veterans
Community surveys have demonstrated significant psychological distress since the terrorist attacks of Sept. 11, 2001. Because people with posttraumatic stress disorder (PTSD) and other mental illnesses are especially vulnerable to stressful events, Rosenheck & Fontana (2003) examined the use of PTSD treatment services and other mental health services at Department of Veterans Affairs (VA) medical centers in New York City and elsewhere after the attacks. Analysis of variance was used to compare changes in average daily service use in the six months before and the six months after September 11, with changes in service use across the same months in the two previous years. Chi-square tests were used to examine differences from previous years in the proportion of new patients entering treatment after September 11. Results suggest that there was no significant increase in the use of VA services for the treatment of PTSD or other mental disorders or in visits to psychiatric or nonpsychiatric clinics in New York City after September 11 and no significant change in the pattern of service use from previous years. Additionally, there was no significant increase in PTSD treatment in the greater New York area, Washington, D.C., or Oklahoma City or in the proportion of new patients.
This is an interesting finding in as much as there are generally held beliefs that increased stress tends to exacerbate post-traumatic stress disorder. It may be that these responses (or lack of responses) are possibly specific to this population (veterans) and that they may see themselves as not being directly affected and/or the specific triggers for response were absent in their particular situations. Further follow-up with this population over time could provide valuable insight into how the specificity and proximity of exposure to traumatic events affects various populations and their relationship to previous exposures to trauma.
Effects on Children
Trauma in children can lead to the development of posttraumatic stress disorder as well as to a variety of other psychiatric disorders, including depression, generalized anxiety disorder, panic attacks, borderline personality disorder, and substance abuse in adult survivors of trauma. Research has found that early exposure to stress and trauma causes physical effects on neurodevelopment which may lead to changes in the individual's long-term response to stress and vulnerability to psychiatric disorders. Exposure to trauma also affects children's ability to regulate, identify, and express emotions, and may have a negative effect on the individual's core identity and ability to relate to others (Lubit, Rovine, Defrancisci & Eth, 2003).
Saylor, Cowart, Lipovsky, Jackson & Finch (2003) examined symptoms of Posttraumatic Stress Disorder (PTSD) in children indirectly exposed to September 11 via television, the Internet, and printed media. Approximately one month after the attacks, 179 students in Grades K-5 at four Southeastern elementary schools and their parents were surveyed about their experiences and reactions. The Pediatric Emotional Distress Scale (PEDS), the Parent Report of Post-Traumatic Symptoms (PROPS), and the Children's Report of Post-Traumatic Symptoms (CROPS) were used to assess for PTSD symptoms. More PTSD symptoms were reported in children who saw reports on the Internet (vs. television/printed media), saw images of death or injury, or feared that a loved one might have died in the attacks. There was no measurable benefit to seeing heroic or "positive" images. Older children and boys had greater media exposure and more trauma-specific PTSD symptoms.
Kirkley & Medway (2003) examined a sample of 45 emails written by adults in response to an Internet article on how to help children develop resilience and cope with hardship in the wake of the September 11, 2001 terrorist attacks on the United States. Most of the sample's recommendations for helping children achieve these goals were similar to those promoted by organizations like the National Association of School Psychologists (NASP). However, the sample responses failed to include school-based support services, suggesting that schools (and other community organizations) may need to increase parental awareness of their services.
Implications for those striving to deliver appropriate amounts and types of information to children and families following disasters are important as these studies point out. Parental education about what to potentially expect following similar events can help parents, teachers and others working directly with children better understand and respond to those exposed to critical incidents, disasters and other traumatic events.
Effects on Psychologists
It is sometime easy to overlook the effects that critical incidents, trauma and disaster may have on responders, particularly mental health responders. Eidelson, D'Alessio & Eidelson (2003) focused on the experience of caregivers through a brief survey of state psychological association members. Overall, practitioners described modest but significant changes in both their professional work and their personal lives. Not surprisingly, those respondents working closest to Ground Zero reported the greatest changes. The sample also reported more positive than negative feelings regarding their work in the post-9/11 environment. Although the survey return rate was only 15%, the findings shed light on several important professional issues related to disaster relief, including service utilization, preparedness, and vicarious traumatization.
Cross-cultural Aspects
The threat of terrorism is having a profound impact on Americans. Walker & Chestnut (2003) examined ethnocultural variables of ethnic background, gender, age, and educational background to better understand first reactions to, explanations for, and responses to what happened on September 11, 2001. Data were obtained from a sample of university students, church and civic group members, and people of the general community. Results suggest that ethnic background, gender, and age influence reactions to terrorism. Ethnic background and gender influenced causal explanations about the attacks. Strong gender differences were noted in how participants were affected by the attacks; strongest similarities were observed in reports of first reactions to news of the events, with most people experiencing shock and disbelief.
Murphy, Wismar & Freeman (2003) examined stress reactions to the events of September 11, 2001 among African-American college students not directly exposed to the attacks. Within three days of September 11, 219 undergraduates (78.3% women; aged 18-32.9 yrs) completed self-report measures assessing stress symptoms and other reactions to the attacks. The results suggested that many students experienced a variety of stress symptoms and distressing thoughts and feelings in response to the events of September 11. These included academic problems, concerns about family and friends in the military, and fear about war. Most students were highly distressed by specific attack-related news reports and images. Anger toward persons of Middle Eastern descent was not frequently reported. Later college year and having parents not currently together were predictors of overall stress symptom severity as assessed by the Posttraumatic Stress Disorder Checklist. Later college year also predicted academic problems after September 11.
Pantin, Schwartz, Prado, Feaster, Szapocznik (2003) examined posttraumatic stress disorder (PTSD) symptom severity in Hispanic immigrants exposed to September 11th attacks through television, ascertained the relationship between previous traumatic exposure and September 11th-related symptoms, and investigated the effect of television exposure of the attacks on symptoms. A total of 110 Hispanic immigrant 41-67-year-olds living more than 1,000 miles from the attacks completed measures of natural disaster exposure, war violence exposure, and September 11th-related PTSD symptoms. Of the sample, 14% self-reported September 11th-related PTSD symptoms consistent with a Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) diagnosis. Previous exposure to natural disasters and war violence was significantly related to September 11th-related PTSD symptomatology. Individuals with symptoms consistent with a DSM-IV PTSD diagnosis reported twice as much war violence exposure and one-and-a-half times as much natural disaster exposure as those not meeting criteria.
Future mental health interventions and research should give strong consideration to ethnocultural variables when dealing with victims of terrorism. The psychosocial dimension of terrorism is one important component deserving attention. The term psychosocial refers to the close and interactive relationship between the human psyche and the diverse social contexts in which we live (Moghaddam & Marsella 2004).
A common commitment to the importance of understanding cultural variations in worldview and orientations is necessary. This commitment is a recognition that unless we understand the perspectives of different cultures around the world, we, as individual human beings and as societies, will be limited and constrained in our ability to live successfully in a global community.
Vicarious Trauma and Distance
Can expatriates witnessing the attack of their country from afar develop acute and posttraumatic stress reactions? In Brussels, Speckhard (2003) surveyed 50 expatriate Americans in the 10 weeks following September 11. Of the sample, 10% (n=5) showed acute stress disorder in the 1st week, and 4% (n=2) persisted with traumatic stress indications in the following weeks. All participants showed symptoms of distress, including derealization, reexperiencing the event, avoidance, heightened arousal, trouble working, and assault on world assumptions. For most, symptoms diminished over time. Increased psychological readiness in terms of assessment, prevention, and treatment methods in response to mass terrorism is suggested as one method of planning mitigation.
The negative effects of vicarious traumatic exposure are well known. However, less is known about potential positive changes following vicarious exposure. Respondents living in Britain (n=108) were surveyed about their vicarious exposure to the terrorist attacks of September 11 (Linley, Joseph, Cooper, Harris & Meyer, 2003). They also completed measures of their perceptions of the events of September 11, and positive (valuing friends and family more) and negative changes (loss of meaning, greater anxiety). Results suggested that respondents who perceived the terrorist attacks to be an attack on their own values and beliefs, or the work of religious fanatics, were more likely to report positive changes. Negative and positive psychological changes were positively associated.
PTSD, Depression and Substance Abuse
Cardenas, Williams, Wilson, Fanouraki & Singh (2003) investigated the prevalence of Posttraumatic Stress Disorder (PTSD), Major Depressive Disorder (MDD) and substance abuse in a midwestern university population following the terrorist attacks on September 11, 2001, in New York City and Washington, DC. 305 subjects volunteered to complete a questionnaire which measured nine areas of psychosocial functioning which included demographics, personality, PTSD, MDD, prior traumatic experiences, alcohol and drug use, psychiatric history and treatment, and current attitudes towards government, religion, the economy, and how children were affected by the events. The participants lived in a large urban city over which United Flight 93 circled before crashing in Pennsylvania due to terrorist attacks. The subjects were forced to evacuate their university and city due to attacks on New York and errant United Flight 93. The study also replicated the first two national studies on PTSD prevalence (Schuster, et al., 2002; Galea, et al., 2002). The results found a prevalence rate of 5.9% for probable PTSD, matching identically pervious national surveys. There were higher levels of PTSD and MDD for females, those with less education and who were single or unmarried, and those who had a prior history of mental health problems.
Anniversaries
Anniversaries present varying degrees of concern following traumatic events. Jordan (2003) discusses how counselors can assist individuals, families, and communities to prepare and deal effectively with first-year anniversaries of traumatic events. These anniversaries represent psychological importance to traumatic events. Therefore, the effects need to be addressed preventively rather than reactively. Counselors can become important resources for helping individuals, families, and communities in this process. Jordan provides specific guidelines in what needs to be considered when dealing with survivors, victims, their families and friends, communities, and the country at large to prepare and deal more effectively with the one-year anniversary of traumatic events that influence not just a community but the whole nation. More specifically, she emphasizes five areas for counselors to consider: (a) expected anniversary reactions, (b) education that can help prepare for the one-year anniversary, (c) mental health services, (d) how counselors can help schools with the one-year anniversary, and (e) what counselors should remember.
Some Conclusions
Myer, Moore & Hughes (2003) compare the experience of people working in the area of the World Trade Centers (WTC) on September 11th to the experience of refugees. They contend that the refugee model provides a better description of survivors' experience than a diagnostic model. Their service provision for an organization adjacent to the WTC after September 11th serves as a basis for suggesting this alternative perspective.
Extrapolating from B. L. Fredrickson's (1998, 2001) broaden-and-build theory of positive emotions, Fredrickson, Tugade, Waugh & Larkin (2003) hypothesized that positive emotions are active ingredients within trait resilience. U.S. college students (18 men and 28 women) were tested in early 2001 and again in the weeks following the September 11th terrorist attacks. Mediational analyses showed that positive emotions experienced in the wake of the attacks--gratitude, interest, love, and so forth--fully accounted for the relations between (a) precrisis resilience and later development of depressive symptoms and (b) precrisis resilience and postcrisis growth in psychological resources. Findings suggest that positive emotions in the aftermath of crises buffer resilient people against depression and fuel thriving, consistent with the broaden-and-build theory.
There is much to be learned from how people have dealt with the impact and aftermath of the September 11 event. These studies have provided some in-depth insights. Further analyses and long-term follow-up will be needed to give more information about the resilience and coping of people affected individually by being in close proximity, by having friends or relatives who were victims, who experienced the event vicariously and those who were away from the country at the time.
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REFERENCES Danieli, Yael, Engdahl, Brian & Schlenger, William E. (2004). The psychosocial aftermath of terrorism. In Moghaddam, Fathali M. (Ed); Marsella, Anthony J. (Ed); Understanding terrorism: Psychosocial roots, consequences, and interventions. Washington, DC, US: American Psychological Association. pp. 223-246
Moghaddam, Fathali M. & Marsella, Anthony J. (2004). Understanding terrorism: Psychosocial roots, consequences, and interventions. Washington, DC, US: American Psychological Association. xiii, 343 pp.
Cardenas, Jessica, Williams, Kimberly, Wilson, John P., Fanouraki, Gianna & Singh, Arvin (Win 2003). PSTD, major depressive symptoms, and substance abuse following September 11, 2001, in a midwestern university population. International Journal of Emergency Mental Health , Vol 5(1), pp. 15-28.
Linley, P. Alex, Joseph, Stephen, Cooper, Rachel, Harris, Sophie & Meyer, Caroline (Oct 2003). Positive and Negative Changes Following Vicarious Exposure to the September 11 Terrorist Attacks. Journal of Traumatic Stress , Vol 16(5), pp. 481-485. Journal URL: http://www.wkap.nl/journalhome.htm/0894-9867
Rosenheck, Robert & Fontana, Alan (Sep 2003). Use of Mental Health Services by Veterans With PTSD After the Terrorist Attacks of September 11. American Journal of Psychiatry , Vol 160(9), pp. 1684-1690. Journal URL: http://ajp.psychiatryonline.org/
Stout, Ronnie G. & Farooque, Rokeya S. (Fal 2003). Negative Symptoms, Anger, and Social Support: Response of an Inpatient Sample to News Coverage of the September 11 Terrorist Attacks. Psychiatric Quarterly , Vol 74(3), pp. 237-250. Journal URL: http://www.wkap.nl/journalhome.htm/0033-2720
Talarico, Jennifer M. & Rubin, David C. (Sep 2003). Confidence, not consistency, characterizes flashbulb memories. Psychological Science , Vol 14(5), pp. 455-461. Journal URL: http://www.blackwellpublishers.co.uk/asp/journal.asp?ref=0956-7976
Saylor, Conway F., Cowart, Brian L., Lipovsky, Julie A., Jackson, Crystal & Finch, A. J. Jr. (Aug 2003). Media exposure to September 11: Elementary school students' experiences and posttraumatic symptoms. American Behavioral Scientist , Vol 46(12), pp. 1622-1642. Publisher URL: http://www.sagepub.com
Walker, Katrina L. & Chestnut, Dennis (Aug 2003). The role of ethnocultural variables in response to terrorism. Cultural Diversity & Ethnic Minority Psychology , Vol 9(3), pp. 251-262. Journal URL: http://www.apa.org/journals/cdp.html
Myer, Rick A., Moore, Holly & Hughes, Tammy L. (Jul 2003). September 11th survivors and the refugee model. Journal of Mental Health Counseling , Vol 25(3), pp. 245-258. Publisher URL: http://www.amhca.org
Peterson, Christopher & Seligman, Martin E. P. (Jul 2003). Character strengths before and after September 11. Psychological Science , Vol 14(4), pp. 381-384. Journal URL: http://www.blackwellpublishers.co.uk/asp/journal.asp?ref=0956-7976
Boscarino, Joseph A., Galea, Sandro, Ahern, Jennifer, Resnick, Heidi & Vlahov, David (Jun 2003). Psychiatric medication use among Manhattan residents following the World Trade Center disaster. Journal of Traumatic Stress , Vol 16(3), pp. 301-306. Journal URL: http://www.wkap.nl/journalhome.htm/0894-9867 Publisher URL: http://www.wkap.nl
Kirkley, Kevin O. & Medway, Frederic J. (May 2003). Promoting children's resilience and coping following September 11, 2001: An email analysis. School Psychology International , Vol 24(2), pp. 166-181. Publisher: US: Sage Publications. Publisher URL: http://www.sagepub.com
DeLisi, Lynn E., Maurizio, Andrea, Yost, Marla, Papparozzi, Carey F., Fulchino, Cindy, Katz, Craig L., Altesman, Josh, Biel, Mathew, Lee, Jennifer & Stevens, Pilar (Apr 2003). A survey of New Yorkers after the Sept. 11, 2001, terrorist attacks. American Journal of Psychiatry , Vol 160(4), pp. 780-783. Journal URL: http://ajp.psychiatryonline.org/
Chen, Hongtu, Chung, Henry, Chen, Teddy, Fang, Lin & Chen, Jian-Ping (Apr 2003). The emotional distress in a community after the terrorist attack on the World Trade Center. Community Mental Health Journal , Vol 39(2), pp. 157-165. Journal URL: http://www.wkap.nl/journalhome.htm/0010-3853
Jordan, Karin (Apr 2003). What we learned from the 9/11 first anniversary. Family Journal-Counseling & Therapy for Couples & Families , Vol 11(2), pp. 110-116. Publisher URL: http://www.sagepub.com
Eidelson, Roy J., D'Alessio, Gerard R. & Eidelson, Judy I. (Apr 2003). The impact of September 11 on psychologists. Professional Psychology: Research & Practice , Vol 34(2), pp. 144-150. Journal URL: http://www.apa.org/journals/pro.html
Speckhard, Anne (Apr 2003). Acute stress disorder in diplomats, military, and civilian Americans living abroad following the September 11 terrorist attacks on America. Professional Psychology: Research & Practice , Vol 34(2), pp. 151-158. Journal URL: http://www.apa.org/journals/pro.html
McAfee, Scot G. (Mar 2003). Ground One. Bulletin of the Menninger Clinic , Vol 67(1), pp. 1-4. Journal URL: http://www.guilford.com/cartscript.cgi?page=periodicals/jnme.htm&cart_id=547216.21319
Lubit, Roy, Rovine, Deborah, Defrancisci, Lea & Eth, Spencer (Mar 2003). Impact of trauma on children. Journal of Psychiatric Practice , Vol 9(2), pp. 128-138. Publisher URL: http://www.lww.com
Lerner, Jennifer S., Gonzalez, Roxana M., Small, Deborah A., Fischhoff, Baruch (Mar 2003). Effects of fear and anger on perceived risks of terrorism: A national field experiment. Psychological Science , Vol 14(2), pp. 144-150. Journal URL: http://www.blackwellpublishers.co.uk/asp/journal.asp?ref=0956-7976
Pantin, Hilda M., Schwartz, Seth J., Prado, Guillermo, Feaster, Daniel J., Szapocznik, Jose (Feb 2003). Posttraumatic stress disorder symptoms in Hispanic immigrants after the September 11th attacks: Severity and relationship to previous traumatic exposure. Hispanic Journal of Behavioral Sciences , Vol 25(1), pp. 56-72. Publisher URL: http://www.sagepub.com
Murphy, Ronald T., Wismar, Keith, Freeman, Kassie (Feb 2003). Stress symptoms among African-American college students after the September 11, 2001 terrorist attacks. Journal of Nervous & Mental Disease , Vol 191(2), pp. 108-114. Journal URL: http://www.jonmd.com/
Fredrickson, Barbara L., Tugade, Michele M., Waugh, Christian E., Larkin, Gregory R. (Feb 2003). What good are positive emotions in crisis? A prospective study of resilience and emotions following the terrorist attacks on the United States on September 11th, 2001. Journal of Personality & Social Psychology , Vol 84(2), pp. 365-376. Journal URL: http://www.apa.org/journals/psp.html
Metz, Edward & Youniss, James (2003). September 11 and service: A longitudinal study of high school students' views and responses. Applied Developmental Science , Vol 7(3), pp. 148-155. Journal URL: http://www.catchword.com/erlbaum/10888691/contp1-1.htm
To search for books on TRAUMA, disasters and disaster mental
health topics, leaders, leadership, orgainizations,
crisis intervention, leaders and crises, and related
topics and purchase them online, go to the following url:
https://www.angelfire.com/biz/odochartaigh/searchbooks.html
RECOMMENDED READING
Trauma at Home: After 9/11
by Judith Greenberg (Editor)
Book Description
The terrorist attacks of September 11 brought the effects of trauma home to millions in America and throughout the world. Initially the attacks created a sense of paralysis and a narrative void. Now we find ourselves struggling as a nation to remember and rebuild. The distinguished writers in Trauma at Home confront September 11 from a variety of personal, cultural, scholarly, and clinical perspectives. Bringing together wide-ranging reflections on understanding, representing, and surviving trauma, the book offers readers an array of analyses of the overwhelming events. Through the lenses of cultural studies, trauma studies, feminism, film and literary criticism, psychoanalytic theory, and through poetic and photographic images, the contributors use their disciplines to help make sense of the incomprehensible. These essays and reflections address loss and examine our changed modes of perception, relations with others, and sense of home. Trauma at Home contains meditations on the personal and cultural aftereffects of trauma and provides analyses of the historical echoes of Hiroshima, the Holocaust, and Vietnam that the attacks evoked. Collectively these essays replace the silence of shock and disbelief with the possibility of dialogue—even as they also recognize the impossibility of providing a single cohesive narrative for the trauma of September 11.
Judith Greenberg has served as a visiting assistant professor at Williams College and Dartmouth College.
Contributors: Elizabeth Baer, Donna Bassin, Jill Bennett, James Berger, Peter Brooks, Ann Cvetkovich, Suheir Hammad, Geoffrey Hartman, Marianne Hirsch, Irene Kacandes, Claire Kahane, E. Ann Kaplan, Dori Laub, Orly Lubin, Nancy K. Miller, Toni Morrison, Lorie Novak, Susannah Radstone, Michael Rothberg, Richard Stamelman, Patricia Yaeger, and James Young.
Additional Readings at:
Also try looking here for September 11, 2001: A Simple Account for Children.
Videos on Terrorism
Other videos about terrorism
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Contact your local Mental Health Center or
check the yellow pages for counselors, psychologists,
therapists, and other Mental health Professionals in
your area for further information.
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George W. Doherty
Rocky Mountain Region
Disaster Mental Health Institute
Box 786
Laramie, WY 82073-0786
MENTAL HEALTH MOMENT Online: https://www.angelfire.com/biz3/news
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