The Effects of Terrorist Attacks on Symptom Clusters of PTSD: a Comparison with Victims of Other Traumatic Events
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In the Post-Traumatic Stress Disorder (PTSD) literature, no study assessed differences in symptom clusters among victims of terrorist attacks (TA) as compared with victims of other traumatic events. Due to the intentional nature of the harm infliction, TA may be expected to produce more severe symptoms, particularly avoidance, since this cluster was found to be a severity marker and a maintenance factor of the disorder. As several patients delay treatment-seeking, duration of untreated illness (DUI) is another problem potentially influencing PTSD severity. The current study explored differences in PTSD symptom clusters as a function of the traumatic event type (TA compared with other events), DUI, and sex. One hundred-eight patients with primary PTSD were administered The Clinician Administered PTSD Scale. Mean DUI was approximately 12 years, irrespective of the event type. Patients who had experienced TA had significantly more severe Avoidance/Numbing symptoms and general PTSD severity than those who had experienced other events. No significant effects emerged for DUI and sex on all clusters. Timely recognition and intervention on PTSD may include community psychoeducation programs about its symptoms. Tailored intervention on TA-related PTSD may focus on Avoidance/Numbing by including medication and psychotherapeutic approaches for this symptom cluster.
KeywordsTerrorism Trauma Avoidance Stress Victims Numbing
Compliance with Ethical Standards
Conflict of Interest
Andrea Pozza declares that he has no conflict of interest.
Letizia Bossini declares that she has no conflict of interest.
Fabio Ferretti declares that he has no conflict of interest.
Miriam Olivola declares that she has no conflict of interest.
Laura Del Matto declares that she has no conflict of interest.
Serena Desantis declares that she has no conflict of interest.
Andrea Fagiolini declares that he has no conflict of interest.
Anna Coluccia declares that she has no conflict of interest.
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. This article does not contain any studies with animals performed by any of the authors.
Informed consent was obtained from all individual participants included in the study.
- 1.American Psychiatric Association. Diagnostic and statistical manual of mental disorders (DSM-5®). Washington, DC: American Psychiatric Publishing; 2013.Google Scholar
- 16.Wittchen HU, Gloster A, Beesdo K, Schonfeld S, Perkonigg A. Posttraumatic stress disorder: diagnostic and epidemiological perspectives. CNS Spectr. 2009;14:5–12.Google Scholar
- 20.Kessler RC. Posttraumatic stress disorder: the burden to the individual and to society. J Clin Psychiatry. 2000;61:4–12.Google Scholar
- 27.American Psychiatric Association. Diagnostic and statistical manual of mental disorders (4th ed.). Washington, DC: American Psychiatric Press; 2000.Google Scholar
- 28.General assembly of the world medical association. World medical association declaration of Helsinki: ethical principles for medical research involving human subjects. J Am Dent Assoc. 2014;81:14.Google Scholar
- 29.First MB, Spitzer RL, Gibbon M, Williams JB. Structured clinical interview for DSM-IV Axis I disorders-patient edition (SCID-I/P, version 2.0). New York, NY: Biometrics Research Department; 1995.Google Scholar
- 30.Mazzi F, Morosini P, De Girolamo G, Lussetti M, Guaraldi GP. SCID-I—structured clinical interview for DSM-IV Axis I disorders (Italian edition). Florence: Giunti OS; 2000.Google Scholar
- 31.First MB, Gibbon M, Spitzer RL, Williams JBW, Benjamin LS. Structured clinical interview for DSM-IV Axis II personality disorders (SCID-II). Washington, DC: American Psychiatric Press; 1997.Google Scholar
- 35.Cohen J. Statistical power analysis for the behavioral sciences. New York, NY: Routledge; 1988.Google Scholar
- 37.von Elm E, Altman DG, Egger M, Pocock SJ, Gøtzsche PC, Vandenbroucke JP. STROBE Initiative (2007) The strengthening the reporting of observational studies in epidemiology (STROBE) statement: guidelines for reporting observational studies. Lancet. 2007;37:1453–1457.Google Scholar
- 39.Amir M, Kaplan Z, Efroni R, Levine Y, Benjamin J, Kotler M. Coping styles in post-traumatic stress disorder (PTSD) patients. Pers Individ Dif. 1997;23:399–405.Google Scholar
- 42.Bean RC, Ong CW, Lee J, Twohig MP. Acceptance and commitment therapy for PTSD and trauma: an empirical review. Behav Ther. 2017;40:145–50.Google Scholar
- 44.Litz BT, Schlenger WE, Weathers FW, Caddell JM, Fairbank JA, LaVange LM. Predictors of emotional numbing in posttraumatic stress disorder. J Trauma Stress. 1997;10:607–18.Google Scholar
- 47.Attari A, Rajabi F, Maracy MR. D-cycloserine for treatment of numbing and avoidance in chronic post-traumatic stress disorder: a randomized, double blind, clinical trial. J Res Med Sc. 2014;19:592–8.Google Scholar
- 48.Bean RC, Ong CW, Lee J, Twohig MP. Acceptance and commitment therapy for PTSD and trauma: an empirical review. The Behav Ther. 2017;40:145–50.Google Scholar