Association between feeling threatened by a terrorist attack and subjective health: a web survey a week after the attacks of 22 March 2016 in Belgium

Threat through the Screen? Association between Proximity and/or Watching Media Coverage of a Terrorist Attack and Health

INTRODUCTION

After terrorist attacks, media coverage of the attacks is extensive. There are some indications that there is an association between watching the media coverage and certain health reactions, both mental and somatic. Most studies occur in the United States and often months after the initial attack. In the current study, we investigated the terrorist attacks in Belgium on 22 March 2016.

METHODS

An online cross-sectional survey was conducted one week after the attacks among the general population of Belgium. We measured hours of media watching of the terrorist attacks (hereafter media watching), adjusted scales of the Patient Health Questionaire-4 (PHQ-4) to measure mental symptoms and the Patient Health Questionaire-15 (PHQ-15) to measure somatic symptoms, proximity to Brussels (home, work and overall proximity) and background factors such as gender, age and level of education. Respondents were included if they answered the survey between 29 March 2016 and 5 April 2016.

RESULTS

A total of 2972 respondents were included. Overall, media watching was significantly associated with both mental symptoms (p < 0.001) and somatic symptoms (p < 0.001), while controlling for age, gender, level of education and proximity. Watching more than three hours of media was associated with more mental and somatic symptoms (p < 0.001). Compared to proximity, media watching was, in general, a better association. For geographical factors, watching more than three hours of media indicated equally high scores for mental symptoms and somatic symptoms as work proximity (p = 0.015) and overall proximity to the attacks (p = 0.024).

CONCLUSION

Media-watching is associated with acute health reactions after terrorist attacks. However, the direction of the relationship is unclear, as it might also be that people with health issues seek out more media.

Association Between Feeling Threatened, Behaviour and Symptoms of Anxiety and Depression: Two and a Half Years After the Terrorist Attacks in Belgium

Feeling threatened by terrorism can be associated with mental health problems and behavioural changes. However, few studies look at the association in the long-term. Using a survey, the population in Brussels, Belgium was studied using a representative database delivered by the national post service. The Patient Health Questionnaire-4 (PHQ-4) assessed mental health, and self-made questions avoidance behaviour. 170 people answered: 60% women and 50% higher educated, 28.2% between 56 and 65 years and 62.4% had a partner. 43.5% felt threatened by the terrorist attacks and 45.9% experienced no mental health problems. Both terrorist threat (p < 0.001) and avoidance behaviour (p < 0.001) significantly predicted PHQ-4 scores, while controlling for gender, age, social support, education level, and traumatic events. There is a relation between terrorist threat and anxiety/depressive symptoms 2.5 years after the last study on terrorist threat in Brussels, but it has weakened. Avoidance behaviour seems to be more present than threat.

Psychological impact of far-right terrorism against Muslim minorities on national distress, community, and wellbeing

The Christchurch mosque shootings on March 15th, 2019 was the deadliest incident of mass violence in New Zealand for over a century. The present study investigated the psychological impact of these terrorist attacks targeting a specific minority community on the psychological functioning of the wider New Zealand population by examining changes in terrorism anxiety, sense of community, psychological distress, and wellbeing. Data from the New Zealand Attitudes and Values Survey (N = 47,951; age range 18–99 years, M = 48.59, SD = 13.86; 62% female) collected across a year, including approximately 6 months following the terrorist attack, was used. Regression discontinuity analyses found a statistically significant increase in terrorism anxiety and sense of community following the attacks, yet counterintuitively, no significant change in psychological distress or wellbeing. These findings provide unique insight into the psychological implications of politically motivated violence for the wider population when terrorism is directed toward a specific minority group.

Suicide in Flanders, Belgium, after terrorist attacks

Little is known about the association between terrorism and suicide. This study investigates suicide numbers in Flanders, Belgium before and after the Paris-attacks (13/11/2015) and Brussels-attacks (22/03/2016). Population mortality data for suicide were gathered from the Agency for healthcare. Suicides in Flanders, Belgium, were higher after both attacks. The increase was higher after the Paris-attacks, compared to the attacks in Brussels, Belgium. The effect of a close-by, but still foreign attack (the Paris-attacks in France) on suicide numbers is larger than that of an attack inside the country (the Brussels-attacks), possibly due to a difference in threat experience and coping possibilities.

Questions and Emotions of Minors After Terrorist Attacks: A Qualitative Study Using Data from a Belgian Youth-Helpline

Until now, there is little research on the experiences of indirectly exposed minors after terrorist attacks. This study sheds light on the emotions and questions of such indirectly exposed minors. A qualitative content analysis of secondary data gained from Awel, a youth-helpline, was performed until saturation. Data contained emotions and questions in chat conversations, with 30 minors (8-18 years old). Emotions included guilt, sadness, and especially fear of attacks on themselves, their family, or at school. Questions mostly focused on making sense of the attacks, and how to distinguish fantasy from reality. After an attack children and adolescents experienced a wide range of emotions, and seem to have difficulty to make sense of what happened. Teachers and parents can play an important role in buffering fears, and in offering contextual information and concrete answers.

A decennial review of psychotraumatology: what did we learn and where are we going?

On 6 December 2019 we start the 10th year of the European Journal of Psychotraumatogy (EJPT), a full Open Access journal on psychotrauma. This editorial is part of a special issue/collection celebrating the 10 years anniversary of the journal where we will acknowledge some of our most impactful articles of the past decade (also discussed below and marked with * in the reference list). In this editorial the editors present a decennial review of the field addressing a range of topics that are core to both the journal and to psychotraumatology as a discipline. These include neurobiological developments (genomics, neuroimaging and neuroendocrine research), forms of trauma exposure and impact across the lifespan, mass trauma and early interventions, work-related trauma, trauma in refugee populations, and the potential consequences of trauma such as PTSD or Complex PTSD, but also resilience. We address innovations in psychological, medication (enhanced) and technology-assisted treatments, mediators and moderators like social support and finally how new research methods help us to gain insights in symptom structures or to better predict symptom development or treatment success. We aimed to answer three questions 1. Where did we stand in 2010? 2. What did we learn in the past 10 years? 3. What are our knowledge gaps? We conclude with a number of recommendations concerning top priorities for the future direction of the field of psychotraumatology and correspondingly the journal.

Trauma and trauma care in Europe

The European countries have a long history of exposure to large-scale trauma. In the early 1990s the increasing awareness of the consequences of trauma within the mental health community led to the foundation of local societies for psychotraumatology across Europe and the European Society of Traumatic Stress Studies (ESTSS), which celebrated its 25th anniversary in 2018. The focus of this article is to describe the current state of care for survivors of trauma in the 15 European countries where ESTSS member societies have been established. Brief descriptions on the historical burden of trauma in each country are followed by an overview of the care system for trauma survivors in the countries, the state-of-the-art of interventions, current challenges in caring for survivors and the topics that need to be most urgently addressed in the future. The reports from the different countries demonstrate how important steps towards a better provision of care for survivors of trauma have been made in Europe. Given the cultural and economic diversity of the continent, there are also differences between the European countries, for instance with regard to the use of evidence-based treatments. Strategies to overcome these differences, like the new ESTSS training curricula for care-providers across Europe, are briefly discussed.