Television exposure in children after a terrorist incident

This study examined the influence of bomb-related television viewing in the context of physical and emotional exposure on posttraumatic stress symptoms--intrusion, avoidance, and arousal--in middle school students following the 1995 Oklahoma City bombing. Over 2,000 middle school students in Oklahoma City were surveyed 7 weeks after the incident. The primary outcome measures were the total posttraumatic stress symptom score and symptom cluster scores at the time of assessment. Bomb-related television viewing in the aftermath of the disaster was extensive. Both emotional and television exposure were associated with posttraumatic stress at 7 weeks. Among children with no physical or emotional exposure, the degree of television exposure was directly related to posttraumatic stress symptomatology. These findings suggest that television viewing in the aftermath of a disaster may make a small contribution to subsequent posttraumatic stress symptomatology in children or that increased television viewing may be a sign of current distress and that it should be monitored. Future research should examine further whether early symptoms predict increased television viewing and/or whether television viewing predicts subsequent symptoms.

Posttraumatic stress among young children after the death of a friend or acquaintance in a terrorist bombing

The effects of traumatic loss on children who reported a friend or acquaintance killed in the 1995 Oklahoma City bombing of a federal office building were examined. Twenty-seven children who lost a friend or acquaintance and 27 demographically matched controls were assessed eight to ten months after the bombing. All but three of the children continued to experience posttraumatic stress symptoms. Those who lost a friend watched significantly more bombing-related television coverage than those without losses. Those who lost a friend had significantly more posttraumatic stress symptoms at the time of the assessment than those who lost an acquaintance. Parents and those working with children should be alert to the impact of loss even when it involves nonrelatives.

Posttraumatic stress responses in bereaved children after the Oklahoma City bombing

OBJECTIVE

To investigate the responses of middle and high school students exposed to the 1995 Oklahoma City bombing across a spectrum of loss.

METHOD

A questionnaire measuring exposure, personal consequences, initial response, and current posttraumatic stress and other symptoms was administered to 3,218 students 7 weeks after the explosion.

RESULTS

More than one third of the sample knew someone killed in the explosion. Bereaved youths were more likely than nonbereaved peers to report immediate symptoms of arousal and fear, changes in their home and school environment, and posttraumatic stress symptoms. Retrospective measures of initial arousal and fear predicted posttraumatic stress symptoms at 7 weeks.

CONCLUSIONS

The results support the literature addressing the role of initial response in posttraumatic stress symptom development. The study raises concern about the impact of television, and traumatized youths' reactivity to it, in the aftermath of disaster.

Clinical needs assessment of middle and high school students following the 1995 Oklahoma City bombing

OBJECTIVE

This clinical assessment was designed to identify middle and high school students in need of formal evaluation for posttraumatic response symptoms following the 1995 bombing of the Alfred P. Murrah Federal Building in Oklahoma City.

METHOD

A clinical needs assessment instrument was developed and administered to grade 6 through 12 students 7 weeks after the bombing (N = 3,218).

RESULTS

More than 40% of the students reported knowing someone injured, and more than one-third reported knowing someone killed in the blast. Posttraumatic stress symptoms at 7 weeks significantly correlated with gender, exposure through knowing someone injured or killed, and bomb-related television viewing.

CONCLUSIONS

This study documents the intensity of community exposure to the bombing and the lingering symptoms of stress. The assessment was used in planning for clinical service delivery, training professional responders, and supporting funding requests.

The role of exposure in posttraumatic stress in youths following the 1995 bombing

This study investigated the relative impact of various forms of exposure to the 1995 Oklahoma City bombing in middle and high school students seven weeks after the incident. We assessed 3210 youths with an instrument that probed for physical, television, and emotional exposure to the bombing and subsequent posttraumatic stress symptomatology and television reactivity. The majority of youths were exposed through physical proximity--hearing and/or feeling the blast--and through television viewing. These types of exposure, as well as emotional exposure, constituted important variables in the development of posttraumatic stress symptoms and television reactivity. Youths with immediate family casualties were more symptomatic than those without.

The impact of trauma and disaster on young children

In the past few decades, the study of the impact of trauma and disaster on children has grown; however, information about the effects on very young children is still scarce in the literature. In some regards, the characteristics of stress in young children are similar to those of older children and adults; in other ways, their reactions are unique. These characteristics, as well as mediating factors and interventions with young children, are discussed. Suggestions for future research are offered.

Behavioral assessment of narcotic detoxification fear

Recent data reveal that only a small number of opioid addicts who attempt to detoxify from methadone maintenance programs will be successful. An irrational fear of detoxification has been postulated to be one reason for detoxification not being more efficacious. The present investigation attempted to assess both self-report and psychophysiological responses to detoxification and neutral scenes in two groups of persons on methadone maintenance. The two groups (N = 8 each) were selected by two blind interviewers as either having or not having a detoxification fear. After imagery training, subjects were asked to imagine 10 scenes, alternating between neutral and detoxification scenes with random counterbalancing for order, while the psychophysiological dependent measures and self-report anxiety and clarity ratings were assessed. Some of the self-report and psychophysiological measures were significantly different for scene type, indicating a successful manipulation of scene imagery. Further, pulse volume measures indicated greater activation in the fear group than in the non-fear group to the detoxification scenes. The results are discussed in terms of providing evidence for greater activation, presumably due to greater anxiety, for the detoxification fear subjects than the non-fear subjects specific to the detoxification imagery and in terms of potential treatment implications.

Assessing pathological detoxification fear among methadone maintenance patients: the DFSS

This study assessed the reliability, validity, discriminative accuracy, and factor structure of the Detoxification Fear Survey Schedule (DFSS). Prevalence of detoxification fear and its correlates also were assessed. Random samples from three geographically, culturally, and racially disparate populations (N = 271) of treated opioid addicts were used. The DFSS had a test-retest r = .935 and demonstrated several indicants of validity. A briefer version (DFSS-14) showed superior psychometric properties and could identify correctly 81% of the detox fear subjects while it excluded 55% of nonfear subjects. The DFSS-14 had a replicated three-factor structure that accounted for 62.1% of total item variance in the validation sample. Factor two, probably best named dose reduction fear, was replicated in all populations. A cut-off score set at the nonfear mean is recommended for clinical use. A brief clinical interview of positive scorers quickly should eliminate false positives and, thus, efficiently identify most of those with detoxification fear.

Prevalence and diagnostic reliability of methadone maintenance detoxification fear

The authors identified a pathological fear of methadone detoxification in 22%, 25%, and 32% of random samples of patients in three disparate methadone maintenance programs. Patients with a pathological fear of detoxification had higher scores on the Detoxification Fear Survey Schedule, had longer histories of addiction, had been addicted for a larger percent of their life spans, and were older than patients without this fear. A greater proportion of the female patients had this fear, and a greater proportion of the patients with this fear had drug-free urinalyses. The authors recommend the use of the Detoxification Fear Survey Schedule as well as intervention to help rehabilitated opioid addicts initiate and complete detoxification.