title: The effects of the Omagh bomb on adolescent mental health: a school-based study.
abstract: BACKGROUND
  The main objective of this study was to assess psychiatric morbidity among adolescents following the Omagh car bombing in Northern Ireland in 1998.
  
  
  METHODS
  Data was collected within schools from adolescents aged between 14 and 18 years via a self-completion booklet comprised of established predictors of PTSD; type of exposure, initial emotional response, long-term adverse physical problems, predictors derived from Ehlers and Clark's (2000) cognitive model, a PTSD symptoms measure (PDS) and the General Health Questionnaire (GHQ).
  
  
  RESULTS
  Those with more direct physical exposure were significantly more likely to meet caseness on the GHQ and the PDS. The combined pre and peri trauma risk factors highlighted in previous meta-analyses accounted for 20% of the variance in PDS scores but the amount of variance accounted for increased to 56% when the variables highlighted in Ehlers and Clark's cognitive model for PTSD were added.
  
  
  CONCLUSIONS
  High rates of chronic PTSD were observed in adolescents exposed to the bombing. Whilst increased exposure was associated with increased psychiatric morbidity, the best predictors of PTSD were specific aspects of the trauma ('seeing someone you think is dying'), what you are thinking during the event ('think you are going to die') and the cognitive mechanisms employed after the trauma. As these variables are in principle amenable to treatment the results have implications for teams planning treatment interventions after future traumas.
authors.affiliation: Queens University, Belfast, Northern Ireland, UK. michael.duffy@qub.ac.uk.
authors.forename: Michael
authors.initials: M
authors.lastname: Duffy
authors.affiliation: Western Health and Social Services Trust, Omagh, Northern Ireland, UK. Maura.mcdermott@westerntrust.hscni.net.
authors.forename: Maura
authors.initials: M
authors.lastname: McDermott
authors.affiliation: Queens University, Belfast, Northern Ireland, UK. a.percy@qub.ac.uk.
authors.forename: Andrew
authors.initials: A
authors.lastname: Percy
authors.affiliation: University of Oxford, Oxford, UK. anke.ehlers@psy.ox.ac.uk.
authors.forename: Anke
authors.initials: A
authors.lastname: Ehlers
authors.affiliation: University of Oxford, Oxford, UK. david.clark@psy.ox.ac.uk.
authors.forename: David M
authors.initials: DM
authors.lastname: Clark
authors.affiliation: Trinity College Dublin, Dublin, Ireland. Prof.m.fitzgerald@gmail.com.
authors.forename: Michael
authors.initials: M
authors.lastname: Fitzgerald
authors.affiliation: Queens University, Belfast, Northern Ireland, UK. j.moriarty@qub.ac.uk.
authors.forename: John
authors.initials: J
authors.lastname: Moriarty
mesh_terms: D000293:Adolescent; D000294:Adolescent Behavior / Q000523:psychology*; D054042:Bombs; D004190:Disasters; D005260:Female; D006801:Humans; D008297:Male; D009660:Northern Ireland / Q000453:epidemiology; D012307:Risk Factors; D012574:Schools; D013313:Stress Disorders, Post-Traumatic / Q000453:epidemiology* / Q000523:psychology*