Do Direct Survivors of Terrorism Remaining in the Disaster Community Show Better Long-Term Outcome than Survivors Who Relocate?

Little is known about whether, compared to terrorism survivors who relocated to another area, better long-term outcome occurs in terrorism survivors who remain in the community, which may offer social support and formal services as well as ongoing trauma reminders and adversities. A cross-sectional telephone survey of OKC bombing survivors 19 years later assessed current symptoms of PTSD, anxiety and depression; posttraumatic growth; life satisfaction; medical conditions; alcohol use and smoking. We interviewed 138 survivors-114 (82.6%) remaining in OKC area and 24 (17.4%) relocated. Remaining survivors had higher PTS, anxiety and depression and lower posttraumatic growth scores than relocated survivors, and more remaining survivors disagreed with being satisfied with life, with differences not statistically significant. Groups did not differ in major medical problems except heart disease, not significantly different after adjusting for gender. Groups did not differ significantly in smoking or alcohol use. Contrary to expectations, remaining within the community after terrorism was not associated with better long-term psychological or medical outcome. Possible factors relevant to the literature are discussed.

Intensely Exposed Oklahoma City Terrorism Survivors: Long-term Mental Health and Health Needs and Posttraumatic Growth.

In this study, we explore directly exposed terrorism survivors' mental health and health status, healthcare utilization, alcohol and tobacco use, and posttraumatic growth 18½ years postdisaster. Telephone surveys compared terrorism survivors and nonexposed community control subjects, using Hopkins Symptom Checklist, Breslau's PTSD screen, Posttraumatic Growth Inventory, and Health Status Questionnaire 12. Statistical analyses included multivariable logistic regression and linear modeling. Survivors, more than 80% injured, reported more anxiety and depression symptoms than did control subjects, with survivors' anxiety and depression associated with heavy drinking (≥5 drinks) and worse mental health and social functioning. While survivors had continued posttraumatic stress disorder symptoms (32 [23.2%] met probable posttraumatic stress disorder threshold), they also reported posttraumatic growth. Survivors had more care from physical, speech, respiratory, and occupational therapists. In this unprecedented long-term assessment, survivors' psychiatric symptoms, alcohol use, and ancillary health service utilization suggest unmet mental health and health needs. Extended recovery efforts might benefit from maximizing positive growth and coping.