Abstract
BackgroundThe effect of indirect (versus direct) exposure to a traumatic event on the quality of life of terrorist attack victims has received considerable attention in the literature. However, more research is required to examine whether the symptoms and underlying processes caused by both types of exposure are equivalent. Our main hypothesis is that well-being plays a different role depending on indirect vs. direct trauma exposure.MethodsIn this cross-sectional study, eighty direct victims of 11-M terrorist attacks (people who were traveling in trains where bombs were placed) and two-hundred indirect victims (individuals highly exposed to the 11-M terrorist attacks through communications media) voluntarily participated without compensation. To test our hypothesis regarding the mediating role of indirect exposure, we conducted a biased corrected bootstrapping procedure. To test our hypothesis regarding the moderating role of direct exposure, data were subjected to a hierarchical regression analysis.ResultsAs predicted, for indirect trauma exposure, well-being mediated the relationship between post-traumatic dysfunctional cognitions and trauma symptoms. However, for direct trauma exposure, well-being moderated the relationship between post-traumatic dysfunctional cognitions and trauma symptoms.ConclusionsThe results of our study indicate that the different role of well-being found between indirect (causal factor) and direct exposure (protective factor) should be taken into consideration in interventions designed to improve victims’ health.
Highlights
The effect of indirect exposure to a traumatic event on the quality of life of terrorist attack victims has received considerable attention in the literature
That the prevalence of Post-traumatic Stress Disorder (PTSD) is higher among people who are directly exposed to the event [1]. These findings have been taken into consideration in the revised definition of PTSD in the Diagnostic and Statistical Manual of Mental Disorders (DSM)-5, Bajo et al Health and Quality of Life Outcomes (2018) 16:96 which explicitly includes indirect exposure to trauma as a possibility to meet criterion A
Confirming expectations, post-traumatic cognitions and well-being were strongly related, when we used the same individual versus social approach (PWB-negative cognitions about the world (NCW) and Social Well-Being (SoWB)-negative cognitions about self (NCS))
Summary
The effect of indirect (versus direct) exposure to a traumatic event on the quality of life of terrorist attack victims has received considerable attention in the literature. These findings have been taken into consideration in the revised definition of PTSD in the DSM-5, Bajo et al Health and Quality of Life Outcomes (2018) 16:96 which explicitly includes indirect exposure to trauma (e.g. through a family member or close friend) as a possibility to meet criterion A. Indirect exposure to trauma is explicitly accepted as a possibility to meet PTSD criteria, more research is required to examine whether the symptoms and underlying processes caused by direct vs indirect (and through the media) exposure to trauma are equivalent
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