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Psychological Responses to Trauma: The Impact of Terrorism Roxane Cohen Silver, Ph.D. Professor Department of Psychology and Social Behavior School of Social Ecology University of California, Irvine Presentation delivered at Western Knight Center for Specialized Journalism’s Seminar “Homeland Terrorism: A Primer for First-Responder Journalists,” sponsored by the University of Southern California, Los Angeles, CA, June 26, 2003 Characteristics of Traumatic Life Events Random Unpredictable Uncontrollable When a community-based event (e.g., natural disaster): shared experience among many victims The Unique Case of Terrorism Faceless enemy with malevolent intent Ongoing threat Political undertones and ramifications Common Responses Post-trauma Shock, Disbelief, and/or Emotional numbness (e.g., surprise and a feeling of unreality) Fear and Separation Anxiety Emotional distress (e.g., sadness, depression) Survivor guilt Somatic Symptoms (nausea, loss of appetite, headaches, nervousness, GI distress, chest pains) Ongoing memories, thoughts and mental pictures of the event (often intrusive, often avoided, often associated with anxiety) Common Responses Post-trauma (cont) Sleep disturbance (including nightmares) Difficulty concentrating, disorganized thought Desire to be close with friends, family, or similarly affected others Need to talk about one's experiences Relief and a focus on one's good fortune relative to worse-off others Altruistic behavior Possible Short and Long term Effects Psychopathological Disorders (e.g., Acute Stress Disorder, PTSD, Major Depressive Disorder, other Anxiety Disorders) Generalized distress (sadness, fear, anxiety) Intrusive ruminations Physical symptoms (somatic complaints; physical health effects of chronic stress) Increased health care utilization and cost Disruptions in functioning (e.g., work, school, domestic activities, relationships) Possible Short and Long term Effects (cont) Decreased positive affect Decreased psychological well-being Posttraumatic growth, meaning-making, construal of personal benefits (e.g., changes in personal values) Positive community effects (e.g., increased patriotism, altruism, volunteerism) The Myths of Coping with Traumatic Life Events Psychological responses are predictable; that is, there are universal reactions to traumatic events Emotional responses to traumatic events will follow a pattern, or orderly sequence of stages Individuals will respond to traumatic events with early and intense emotional distress Psychological responses will be limited to those directly exposed to the traumatic event The Myths of Coping (Cont.) Degree of emotional response will be proportional to the degree of exposure, amount of loss, or proximity to the trauma (e.g., as “objective” loss increases, so will distress) Distress is necessary, and failure to confront the experience will lead to subsequent pathology Individuals soon “recover” from traumatic events Probable Moderators of Response Pre-existing mental health history Personality dispositions Family background (learned responses; modeling) Religious orientation; philosophical perspective Lifetime or recent trauma history Chronic stress Coping strategies/responses Social context, network responses over time Media exposure? Beneficial vs. Detrimental Impact of the Media Provide useful/critical information to those who need and want it Present repeated traumatic visual images; reactivate traumatic experience and enlarge geographic range of “direct” victims Intrude on the privacy of victims Inaccurately portray range of responses to trauma vs. “normalize” variability Perpetuate the myths of coping vs. educate public Exacerbate distress and anxiety vs. assist in containing anxiety Helpful Social Responses to Victims of Trauma Provide opportunity to ventilate feelings Express concern Provide tangible support Presence ("Being there") Provide contact with similar other(s) Unhelpful Social Responses to Victims of Trauma Giving advice (unless one has special, needed expertise) Minimizing the trauma Forced cheerfulness Encouraging quick recovery Identification with feelings --"I know how you feel" (unless one has experienced a similar trauma) Providing a philosophical or religious perspective on the trauma Over-controlling behavior