TY - JOUR
T1 - The course of posttraumatic stress disorder in a follow-up study of survivors of the Oklahoma City bombing
AU - North, Carol S
AU - Pfefferbaum, Betty
AU - Tivis, Laura
AU - Kawasaki, Aya
AU - Reddy, Chandrashekar
AU - Spitznagel, Edward L.
PY - 2004/10/1
Y1 - 2004/10/1
N2 - Background. The course of posttraumatic stress disorder (PTSD) in populations directly exposed to terrorist attacks is of major importance in the post-9/11 era. Because no systematic diagnostic studies of the most highly exposed individuals of the 9/11 terrorist attacks have yet been done, the Oklahoma City bombing remains a unique opportunity to examine PTSD over time in high-exposure terrorist victims. Methods. This study assessed 137 survivors in the direct path of the explosion at approximately 6 and 17 months postdisaster, using the Diagnostic Interview Schedule. Results. Combined index and follow-up data yielded a higher (41%) incidence of PTSD than detected at index (32%) or follow-up (31%). All PTSD was chronic (89% unremitted at 17 months) with no delayed-onset cases. The avoidance and numbing symptom group C, unlike groups B and D alone, was pivotal to current PTSD status and was associated with indicators of functioning at index and follow-up. The findings at index were sustainable. Conclusions. This follow-up study confirmed the immediacy of onset of PTSD and its persistence over time, pointing to the need for early interventions that continue over the long term. Group C avoidance and numbing symptoms may aid in early recognition of PTSD and in predicting long-term functioning.
AB - Background. The course of posttraumatic stress disorder (PTSD) in populations directly exposed to terrorist attacks is of major importance in the post-9/11 era. Because no systematic diagnostic studies of the most highly exposed individuals of the 9/11 terrorist attacks have yet been done, the Oklahoma City bombing remains a unique opportunity to examine PTSD over time in high-exposure terrorist victims. Methods. This study assessed 137 survivors in the direct path of the explosion at approximately 6 and 17 months postdisaster, using the Diagnostic Interview Schedule. Results. Combined index and follow-up data yielded a higher (41%) incidence of PTSD than detected at index (32%) or follow-up (31%). All PTSD was chronic (89% unremitted at 17 months) with no delayed-onset cases. The avoidance and numbing symptom group C, unlike groups B and D alone, was pivotal to current PTSD status and was associated with indicators of functioning at index and follow-up. The findings at index were sustainable. Conclusions. This follow-up study confirmed the immediacy of onset of PTSD and its persistence over time, pointing to the need for early interventions that continue over the long term. Group C avoidance and numbing symptoms may aid in early recognition of PTSD and in predicting long-term functioning.
KW - Oklahoma City bombing
KW - Onset
KW - Persistence
KW - Posttraumatic stress disorder
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U2 - 10.1080/10401230490522034
DO - 10.1080/10401230490522034
M3 - Article
C2 - 15702569
AN - SCOPUS:10844282019
SN - 1040-1237
VL - 16
SP - 209
EP - 215
JO - Annals of Clinical Psychiatry
JF - Annals of Clinical Psychiatry
IS - 4
ER -