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Evaluating the Lasting Impact of Direct Exposure to Terrorism

Tuesday, July 21, 2015 - Campus News -
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Oklahoma City  ̶   As terrorism and terrorist attacks make headlines worldwide, researchers at the University of Oklahoma Health Sciences Center work to better understand the lasting exposure of terrorism on those directly impacted by it and their work has uncovered some positive consequences for survivors.
 
The research involved evaluation of two groups of individuals from the Oklahoma City community. About half, 138 people, were direct survivors of the April 1995 bombing of the Alfred P. Murrah Federal Building and 80 percent of them were injured by the blast. 
 
“What we were really interested in finding out is how people who were directly impacted, compared with those not directly impacted, cope in the aftermath of terrorism, and what mechanisms they use to do so,” said researcher Phebe Tucker, M.D. Dr. Tucker is a psychiatrist with OU Physicians who, along with her colleagues, has treated survivors of the Oklahoma City bombing since it happened 20 years ago.
 
Researchers found direct survivors had significantly more symptoms of depression and anxiety almost 20 years later than did those without direct exposure. However, they also found there were some positive consequences for survivors. 
 
“We used the post-traumatic growth inventory to evaluate change. That inventory is designed to look at positive coping in individuals after a crisis,” she explained.   
 
The inventory involves 10 parameters for positive coping skills. It looks at things like social support, spirituality and positive life changes.
 
“Many survivors noted that they experienced  post-traumatic growth in areas such as learning about “how wonderful people are,” having a “greater appreciation for the value of my own life,”  discovering that “I’m stronger than I thought I was, changing life priorities and having a “stronger religious faith,” Tucker said. “Post-traumatic growth may be a sign of resilience. We are still learning a lot about resilience in the mental health field.”
 
There were some differences among survivors and those seemed to center on posttraumatic stress symptoms, gender and education.
 
“Post-traumatic growth was endorsed more by survivors with higher posttraumatic stress scores and by women than by men. In general, women are more likely to experience post-traumatic stress disorder after trauma. The thought is that perhaps those who most needed to use positive coping skills actually used them accordingly,” Tucker said. “However, at 20 years, we did not see any difference in the current use of mental health treatment between those directly impacted by terrorism and those who were not.”
 
Survivors who were college graduates were also more likely to score high on the post-traumatic growth index, reflecting more use of positive coping mechanisms.
 
“What it all seems to point to is that while a group of individuals directly impacted by terrorism will be negatively impacted for many years, it is not the majority of survivors,” she explained.
 
Tucker added that she is extremely grateful to the many survivors who have participated in this ongoing research for two decades now.
 
“The thing that is a little unique about this study is that a lot of the people have stayed in the community. In 1996, this group became part of a registry created and maintained by the Oklahoma Department of Health.  And many agreed to participate in research later on. They felt it was important to learn from their experiences,” Tucker said.  
 
She added the results may point to what one survivor described as  learning to “forgive, but not necessarily to forget.” 
 
Next, Tucker and fellow researchers at the OU Health Sciences Center will begin evaluating the results of a series of open-ended questions they asked. 
 
“Scales are important, but letting people tell their stories and listening to them tell how the bombing has affected them in their own words is also important,” Tucker said.
 
Tucker presented the findings recently at the Annual Meeting of the American Psychiatric Association in Toronto. The research was supported in part by the Arnold and Bess Ungerman Endowed Chair.in Psychiatry. 

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