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Effects of Terrorism

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 11th, 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.   Societys 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,