Abstract
BackgroundThe main aims of the study were to assess psychological morbidity among adults nine months after a car bomb explosion in the town of Omagh, Northern Ireland and to identify predictors of chronic posttraumatic stress disorder symptoms.MethodA questionnaire was sent to all adults in households in The Omagh District Council area. The questionnaire comprised established predictors of PTSD (such as pre-trauma personal characteristics, type of exposure, initial emotional response and long-term adverse physical or financial problems), predictors derived from the Ehlers and Clark (2000) cognitive model, a measure of PTSD symptoms and the General Health Questionnaire.ResultsAmong respondents (n = 3131) the highest rates of PTSD symptoms and probable casesness (58.5%) were observed among people who were present in the street when the bomb exploded but elevated rates were also observed in people who subsequently attended the scene (21.8% probable caseness) and among people for whom someone close died (11.9%). People with a near miss (left the scene before the explosion) did not show elevated rates. Exposure to the bombing increased PTSD symptoms to a greater extent than general psychiatric symptoms. Previously established predictors accounted for 42% of the variance in PTSD symptoms among people directly exposed to the bombing. Predictors derived from the cognitive model accounted for 63%.ConclusionsHigh rates of chronic PTSD were observed in individuals exposed to the bombing. Psychological variables that are in principle amenable to treatment were the best predictors of PTSD symptoms. Teams planning treatment interventions for victims of future bombings and other traumas may wish to take these results into account.
Highlights
Traumatic events trigger a wide range of emotional responses in individuals who are exposed to them
The prevalence of negative emotional responses varies with the type of trauma with rates being high when intentional harm has been inflicted by others [3,4,7,8,9]
For both PTSD and general psychiatric problems average symptom levels and numbers of individuals who met caseness criteria were significantly higher in individuals who were exposed to the trauma in any manner than in individuals with no exposure
Summary
Traumatic events trigger a wide range of emotional responses in individuals who are exposed to them. The prevalence of negative emotional responses varies with the type of trauma with rates being high when intentional harm has been inflicted by others (bombings, rape, assaults, etc) [3,4,7,8,9]. The main aims of the study were to assess psychological morbidity among adults nine months after a car bomb explosion in the town of Omagh, Northern Ireland and to identify predictors of chronic posttraumatic stress disorder symptoms. The questionnaire comprised established predictors of PTSD (such as pre-trauma personal characteristics, type of exposure, initial emotional response and long-term adverse physical or financial problems), predictors derived from the Ehlers and Clark (2000) cognitive model, a measure of PTSD symptoms and the General Health Questionnaire. Established predictors accounted for 42% of the variance in PTSD symptoms among people directly exposed to the bombing. Teams planning treatment interventions for victims of future bombings and other traumas may wish to take these results into account
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