All of us at Posit Science are thinking of Boston today, and this week, in the aftermath of the explosions at the Boston Marathon on Monday and the related events unfolding today. Our hearts go out to everyone in the area and all those affected. After the headlines are gone and people not directly affected by the tragedy begin to move on, many Bostonians and marathon attendees will likely struggle from post-traumatic stress disorder (PTSD) and long-term trauma related to the bombing. Another tragic explosion at a West, Texas fertilizer plant also claimed lives and will undoubtedly lead to long-term psychological trauma for survivors of that incident. While no two incidents are exactly alike, research on similar tragedies can offer clues to what bomb survivors might expect–and how to protect children, especially, from psychological trauma related to terror attacks.
A large body of research involving survivors of the 1995 Oklahoma City bombing is a good place to start. Of the many findings, some are particularly jarring. For example, one study found that the prevalence of PTSD was 41% after the bombing, and seven years later, 26% of people still had active PTSD. Another study showed that those who also suffered a head trauma were more at-risk for concurrent PTSD, while another found that the traumatic brain injury (TBI) victims also experienced “life-long medical, emotional, vocational and residential needs… beyond their own anticipation and that of their families and healthcare professionals.” One study even found that the spouses of survivors experienced long-term effects of the bombing, and exhibited heightened stress biomarkers seven years after the attack.
There are countless other senseless bombings that have occurred in the last few decades, and aspects of their effects have also been studied. In some cases, they have been used to illustrate the similarities in human response to terror attacks despite cultural, economic, and social differences. For instance, research on Kenyan civilian survivors of the 1998 bombing at the U.S. Embassy in Nairobi found that three years post-bombing, 49% of survivors had PTSD with 28% still experiencing active PTSD–numbers that are similar to those found outside of Africa. A 2010 study that looked at survivors of the 2002 bombing in Bali found that eight years out, survivors were mostly in good physical health but that many suffered psychologically.
Perhaps most tragically of all, this body of research clearly shows that children are most strongly affected by these events, as they may not have yet developed the resilience and understanding necessary for strong mental health following a cataclysmic attack. In a study on the 2009 explosion in Mbagala, Tanzania, an appalling 93% of children who survived experienced PTSD. Oklahoma City research found that even though children may not have acknowledged or expressed PTSD initially, they showed heightened psychological reactivity (as measured by heart rate and blood pressure) seven years later, while another study found that those who lost a friend in the attack were extremely at risk for long-term PTSD.
One of the most important takeaways from this body of research, from the standpoint of the general public, are the several studies that have shown that even kids who are geographically distant from a bombing or terror attack can experience lasting trauma from media exposure to the event. For that reason, most experts recommend assiduously keeping children away from the TV, newspapers, Internet news, and radio broadcasts following a tragedy of this scale.
Research gleaned from survivors of previous events can hopefully help us to more appropriately and effectively care for those affected by current events. An Israeli study noted that teens who had social support from friends were more protected from terrorism-related stress. The 2010 Bali study previously cited found that positive family and marital relationships greatly lessened the psychological distress of bomb survivors. All of this research can help both mental health professionals and family and friends of survivors as they support those directly affected. Still, the road ahead may be long and challenging for survivors, and they will need all the help they can get.
Our heartfelt sympathies go out to everyone affected by the Boston Marathon bombings and the West, Texas fertilizer plant explosion. But more than that, we want to continue to bring attention to the issues of PTSD and long-term trauma following tragic events like these, so the survivors’ mental health needs and recovery processes are not forgotten or discounted in the aftermath.