Dr Harbinson criticises my recent editorial in a rather defensive manner but does not provide any evidence to refute my opinion that opportunities for valuable research have been missed over the past 30 years or so.

He/she seems unhappy with my review of some of the research carried out, commenting that “it is all too easy to find fault today”. In my editorial I commented that “at the time Lyons (Reference Lyons1971) was carrying out his research the field of traumatology was in its infancy” and, in relation to Curran (Reference Curran1988), that “ more recent research in the field suggests” a different view to that of Curran regarding habituation to trauma. The whole purpose of a literature review is to examine previous research critically in the light of further developments.

In the Social Services Inspectorate document referred to in my paper (Department of Health and Social Services, 1998), the issue of confidentiality was addressed; for example, “ Another G.P. noted that ‘the individuals that are most affected in our area are of a predominantly nationalist viewpoint. There is a fundamental distrust of Government agencies [and] distrust and fear of leakage of sensitive information’ ”. Information received from the project leader in the Social Services Inspectorate has confirmed a minority, but consistent, viewpoint, mainly from those of a nationalist background, that the authorities, including those working in health and social services, are not to be trusted (J. Park, personal communication, 1999). As Dr Harbinson writes, this indeed should be a matter of concern.

Dr Harbinson is critical of me for commenting that “some people would consider terrorists incarcerated for paramilitary crimes to be victims”. It has been reported that a number of people who subsequently become involved in terrorist crime have themselves previously been victimised (Reference SmythSmyth, 1998). A study looking at 80 perpetrators of homicide found that 52% met criteria for current post-traumatic stress disorder (Reference PollockPollock, 1999). It would seem unethical to exclude anyone from being considered a victim, and therefore a potential candidate for treatment, on the basis of having been involved in criminal activity. Dr Harbinson has commented that on occasions it has not been feasible to publish research carried out. I find it difficult to understand why properly structured and anonymised research could not have been published. In order to ensure that psychiatrists maintain impartiality, it is important that such research should be published whatever the results, provided the findings are clinically relevant.

Dr Harbinson's final comment about my victimising other psychiatrists is rather emotive. He/she is correct regarding the speculative nature of some aspects of my paper. This has been necessary because of the relative lack of research. However, I am certainly not intending that criticism be directed at colleagues, a number of whom have carried out valuable research while also carrying heavy clinical workloads. It remains my view that there is a need for a detailed epidemiological community study which specifically addresses the issue of trauma.