Posttraumatic Stress Disorder in Populations Directly Exposed to Major Terrorist Incidents

As national and international large-scale incidents of terrorism increasingly threaten populations around the world, understanding the mental health effects of terrorism becomes a pressing need. Terrorism is fueled by the potential psychological effects it is intended to exert on populations. If the population is terrorized, intimidated, demoralized, and immobilized, then terrorism has succeeded. Understanding and responding to these psychological effects of terrorism may help dismantle the power of terrorist attacks. In approaching the study of mental health effects of terrorism, it is important to examine different exposure groups separately. These groups comprise 1) those directly exposed to the event, such as people who were in the Murrah Building in Oklahoma City when the bomb detonated; 2) those indirectly exposed, such as residents of the community not present at the disaster site but whose lives were disrupted by, for example, interrupted access to their residences or loss of their job sites; and 3) remotely affected populations, such as residents of other cities in the same region or the same country. There are other relevant disaster-exposed subpopulations as well, such as rescue workers and bereaved family and friends of those killed in terrorist incidents, who also deserve separate consideration because they may have special issues, such as a history of alcohol abuse or dependence in professional firefighters (North et al,