title: Psychosocial adjustment of directly exposed survivors 7 years after the Oklahoma City bombing.
abstract: OBJECTIVE
  The aim of this study was to prospectively examine the long-term course of psychiatric disorders, symptoms, and functioning among 113 directly exposed survivors of the Oklahoma City bombing systematically assessed at 6 months and again nearly 7 years postbombing.
  
  
  METHODS
  The Diagnostic Interview Schedule/Disaster Supplement was used to assess predisaster and postdisaster psychiatric disorders and symptoms and other variables of relevance to disaster exposure and outcomes.
  
  
  RESULTS
  Total prevalence of posttraumatic stress disorder (PTSD) was 41%. Seven years postbombing, 26% of the sample still had active PTSD. Delayed-onset PTSD and new postdisaster alcohol use disorders were not observed. PTSD nonremission was predicted by the occurrence of negative life events after the bombing. Posttraumatic symptoms among survivors without PTSD decayed more rapidly than for those with PTSD, and symptoms remained at 7 years even for many who did not develop PTSD. Those with PTSD reported more functioning problems at index than those without PTSD, but functioning improved dramatically over 7 years, regardless of PTSD or remission from PTSD. No survivors had long-term employment disability based on psychiatric problems alone.
  
  
  CONCLUSIONS
  These findings have potentially important implications for anticipation of long-term emotional and functional recovery from disaster trauma.
authors.affiliation: The North Texas VA Health Care System, Dallas, TX 75390-8828, USA. carol.north@utsouthwestern.edu
authors.forename: Carol S
authors.initials: CS
authors.lastname: North
authors.forename: Betty
authors.initials: B
authors.lastname: Pfefferbaum
authors.forename: Aya
authors.initials: A
authors.lastname: Kawasaki
authors.forename: Sungkyu
authors.initials: S
authors.lastname: Lee
authors.forename: Edward L
authors.initials: EL
authors.lastname: Spitznagel
mesh_terms: D000437:Alcoholism / Q000453:epidemiology / Q000209:etiology / Q000523:psychology; D016009:Chi-Square Distribution; D004651:Employment / Q000523:psychology; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology / Q000209:etiology / Q000523:psychology; D009825:Oklahoma / Q000453:epidemiology; D011569:Psychiatric Status Rating Scales; D012917:Social Adjustment; D013313:Stress Disorders, Post-Traumatic / Q000453:epidemiology / Q000209:etiology / Q000523:psychology; D017741:Survivors / Q000523:psychology*; D023481:Terrorism / Q000523:psychology*; D013997:Time Factors