title: Intensely Exposed Oklahoma City Terrorism Survivors: Long-term Mental Health and Health Needs and Posttraumatic Growth.
abstract: In this study, we explore directly exposed terrorism survivors' mental health and health status, healthcare utilization, alcohol and tobacco use, and posttraumatic growth 18½ years postdisaster. Telephone surveys compared terrorism survivors and nonexposed community control subjects, using Hopkins Symptom Checklist, Breslau's PTSD screen, Posttraumatic Growth Inventory, and Health Status Questionnaire 12. Statistical analyses included multivariable logistic regression and linear modeling. Survivors, more than 80% injured, reported more anxiety and depression symptoms than did control subjects, with survivors' anxiety and depression associated with heavy drinking (≥5 drinks) and worse mental health and social functioning. While survivors had continued posttraumatic stress disorder symptoms (32 [23.2%] met probable posttraumatic stress disorder threshold), they also reported posttraumatic growth. Survivors had more care from physical, speech, respiratory, and occupational therapists. In this unprecedented long-term assessment, survivors' psychiatric symptoms, alcohol use, and ancillary health service utilization suggest unmet mental health and health needs. Extended recovery efforts might benefit from maximizing positive growth and coping.
authors.affiliation: *Department of Psychiatry, University of Oklahoma Health Sciences Center; and †Oklahoma State Department of Health, Oklahoma City, OK.
authors.forename: Phebe
authors.initials: P
authors.lastname: Tucker
authors.forename: Betty
authors.initials: B
authors.lastname: Pfefferbaum
authors.forename: Pascal
authors.initials: P
authors.lastname: Nitiéma
authors.forename: Tracy L
authors.initials: TL
authors.lastname: Wendling
authors.forename: Sheryll
authors.initials: S
authors.lastname: Brown
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000428:Alcohol Drinking / Q000523:psychology*; D001007:Anxiety / Q000523:psychology*; D003863:Depression / Q000523:psychology*; D005260:Female; D005500:Follow-Up Studies; D006301:Health Services Needs and Demand; D006304:Health Status; D006801:Humans; D008297:Male; D008875:Middle Aged; D009825:Oklahoma; D010342:Patient Acceptance of Health Care; D013313:Stress Disorders, Post-Traumatic / Q000523:psychology*; D017741:Survivors / Q000523:psychology*; D023481:Terrorism / Q000523:psychology*; D055815:Young Adult