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Prediction of the occurrence and intensity of post-traumatic stress disorder in victims 32 months after bomb attack

Published online by Cambridge University Press:  16 April 2020

Louis Jehel*
Affiliation:
Unité de psychiatrie et psychotraumatisme, CHU Tenon (AP–HP), 4, rue de la Chine, 75970Paris cedex 20, France
Sabrina Paterniti
Affiliation:
Unité Inserm 360 (Dr. A Alpérovitch), Hôpital de la Salpêtrière, 47, boulevard de l’Hôpital, 75013Paris, France
Alain Brunet
Affiliation:
Department of Psychiatry and Douglas Hospital Research Centre, McGill University, Canada
Clara Duchet
Affiliation:
Unité de psychiatrie et psychotraumatisme, CHU Tenon (AP–HP), 4, rue de la Chine, 75970Paris cedex 20, France
Julien Daniel Guelfi
Affiliation:
Université Paris V (UFR Cochin Port-Royal), Clinique des Maladies Mentales et de l’Encéphale, 100, rue de la Santé, 75674Paris cedex 14, France
*
*E-mail address: [email protected]
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Abstract

Introduction

Our objective was to identify factors that predict occurrence and severity of post-traumatic stress disorder (PTSD) after a terrorism attack.

Population

We evaluated 32 victims of a bomb attack in a Paris subway in December 1996 at 6 and 32 months.

Methods

Sociodemographic characteristics, clinical data and physical injuries were used to predict PTSD occurrence and severity in 32 victims. The Watson’s PTSD Inventory (PTSD-I) and the Impact of Event Scale (IES) by Horowitz were used to evaluate occurrence and severity of PTSD, respectively.

Results

Thirty-nine percent of participants met PTSD criteria at 6 months, 25% still had PTSD at 32 months. Women had PTSD 32 months after the bomb attack more frequently than men. Employment predicted PTSD severity at 32 months. PTSD scores assessed by PTSD-I at 6 months were significantly and positively associated with IES scores at 32-month follow-up (r = 0.55, P = 0.004). Psychotropic drug use before the bomb attack significantly predicted PTSD occurrence and severity at 6 and 32 months. In a linear regression model, physical injuries, employment status and psychotropic drug use before the bomb attack were independent predictors of severity of PTSD at 32 months.

Conclusions

Bomb attack exposure resulted in persisting PTSD in a significant proportion of victims; the severity was predicted at 32 months by physical injuries and psychotropic drug use before the terrorism attack and by the PTSD score few months after the bomb attack.

Type
Original article
Copyright
Copyright © Éditions scientifiques et médicales Elsevier SAS 2003

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References

American Psychiatric Association. Diagnosis and statistical manual of mental disorders. 4th ed. Washington (DC): APA; 1994.Google Scholar
Abenhaim, L, Dab, W, Salmi, LR. Study of civilian victims of terrorist attacks (France 1982–1987). Journal of Clinical Epidemiology 1992;45:103–9.CrossRefGoogle Scholar
Bendel, RB, Afifi, AA. Comparison of stopping rules in forward regression. Journal of the American Statistical Association 1977;72:46–53.Google Scholar
Bremner, JD, Southwick, S, Brett, E, Fontana, A, RosenQeck, R, Char-ney, DS. Dissociation and post-traumatic stress disorder in Vietnam combat veterans. American Journal of Psychiatry 1992;149:328–32.Google ScholarPubMed
Breslau, N, Kessler, RC, Chilcoat, HD, et al. Trauma and post-traumatic stress disorder in the community: the 1996 Detroit Area Survey of Trauma. Archives of General Psychiatry 1998;55:626–32.CrossRefGoogle ScholarPubMed
Brewin, CR, Adrews, B, Valentine, JD. Meta-analysis of risk factors for post-traumatic stress disorder in trauma-exposed adults. Journal of Consulting and Clinical Psychology 2000;68:748–66.CrossRefGoogle ScholarPubMed
Brune, M, Haasen, C, Krausz, M, Yagdiran, O, Bustos, E, Eisenman, D. Belief systems as coping factors for traumatized refugees: a pilot study. European Psychiatry 2002;17:451–8.CrossRefGoogle ScholarPubMed
Brunet, A. Évaluation de la version française auto-administrée du PTSD-I. Communication orale in IVe Conférence Européenne sur le Stress Traumatique Paris. 1995.Google Scholar
Dougall, AL, Ursano, RJ, Posluszny, DM, Fullerton, CS, Baum, A. Predictors of post-traumatic stress among victims of motor vehicle accidents. Psychosomatic Medicine 2001;63:402–11.CrossRefGoogle ScholarPubMed
Hansenne, M, Charles, G, Phollien, P, Panzer, M, Pitchot, W, Gonzales-Moreno, A, et al. Mesure subjective de l’impact d’un événement : traduction française et validation de l’échelle d’Horowitz. Psychologie Médicale 1993;25:86–8.Google Scholar
Horowitz, MJ, Wilner Alvarez, W. Impact of event scale: a measure of subjective distress. Psychosomatic Medicine 1979;41:209–18.CrossRefGoogle Scholar
Horowitz, MJ. Stress response syndromes: character style and dynamic psychotherapy. Archives of General Psychiatry 1974;31:768–81.CrossRefGoogle ScholarPubMed
Jehel, L, Duchet, C, Paterniti, S, Louville, P. « Construction et étude de validité d’un autoquestionnaire de l’état de stress post-traumatique issu du PTSD-Interview : le QSPT ». Revue Française de Psychiatrie et de psychologie médicale 1999;24:203–5.Google Scholar
Jehel, L, Duchet, C, Paterniti, S, Consoli, SM, Guelfi, JD. Étude prospective de l’état de stress post-traumatique parmi des victimes d’un attentat terroriste. L’Encéphale 2001;27:393–100.Google Scholar
Loughrey, GC. Post-traumatic stress disorder and civil violence in Northern Ireland. British Journal of Psychiatry 1988;153:554–60.CrossRefGoogle ScholarPubMed
MacFarlane, AC. The aetiology of post-traumatic morbidity: predisposing, precipitating and perpetuating factors. British Journal of Psychiatry 1989;154:221–8.CrossRefGoogle Scholar
Marmar, CR, Weiss, DS, Schlenger, WE, et al. Peritraumatic dissociation and post traumatic stress in male Vietnam theater veterans. American Journal of Psychiatry 1994;151:902–7.Google ScholarPubMed
Mickey, J, Greenland, S. A study of the impactofconfounder-selection criteria on effect estimation. American Journal of Epidemiology 1989;129:125–37.CrossRefGoogle ScholarPubMed
North, CS, Nixon, SJ, Shariat, S, Mallonee, S, McMillen, JC, Spitznagel, EL, et al. Psychiatric disorders among survivors of the Oklahoma City bombing. Journal of the American Medical Association 1999;25 (282):755–62.CrossRefGoogle Scholar
North, CS, Smith, EM, Spitznagel, EL. One-year folIow-up of a mass shooting. American Journal of Psychiatry 1997;154:1696–702.CrossRefGoogle Scholar
Pariente, P, Lépine, JP, Ha, C, Lellouch, J. Self reported psychotropic drug use and associated factors in a French community sample. Psychological Medicine 1992;22:181–90.CrossRefGoogle Scholar
Schnyder, U, Moergeli, H, Klaghofer, R, Buddeberg, C. Incidence and prediction of post-traumatic stress disorder symptoms in severely injured accident victims. American Journal of Psychiatry 2001;158:594–9.CrossRefGoogle ScholarPubMed
Schnyder, U, Malt, UF. Acute stress response patterns to accidental injuries. Journal of Psychosomatic Research 1998;45:419–24.CrossRefGoogle ScholarPubMed
Shalev, AY, Peri, T, Canetti, L, et al. Predictors of PTSD in injured trauma survivors: a prospective study. American Journal of Psychiatry 1996;153:219–25.Google ScholarPubMed
Shalev, AY. Post-traumatic stress disorder among injured survivors of a terrorist attack. The Journal of Nervous and Mental Disease 1992(180):505–9.CrossRefGoogle ScholarPubMed
Shariat, S, Mallanee, S, Kruger, E, Former, K, North, C. A prospective studyof long-term health outcomes among Oklahoma City bombing survivors. Journal of Oklahoma State Medical Association 1999;92(4):178–86.Google Scholar
Warden, DL, Labbate, LA, Salazar, AM, Nelson, R, Sheley, E, Staudenmeier, J, et al. Post-traumatic stress disorder in patients with traumatic brain injury and amnesia for the event. Journal of Neuropsychiatry and Clinical Neuroscience 1997;9:18–22.Google ScholarPubMed
Watson, CG, Juba, MP, Manifold, V, Kucala, T, Anderson, PED, et al. The PTSD Interview: Rationale, description, reliability, and concurrent validity of a DSM III based Technique. Journal of Clinical Psychology 1991;47(3):179–88.3.0.CO;2-P>CrossRefGoogle ScholarPubMed
Yehuda, R, editor. Risk factors for Posttraumatic stress disorder. Washington, DC: American Psychiatric Press; 1999.Google ScholarPubMed
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