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Post-traumatic stress symptoms following sniper attacks: Effects of television viewing and identification with victims

Holly B. Herberman Mash, PhD, Carol S. Fullerton, PhD, Robert J. Ursano, MD

Abstract


Objective: A series of sniper attacks in the Washington, DC, area left 10 people dead and three wounded. The authors examined the relationship of sniper-related television (TV) viewing, identification with victims, and peritraumatic dissociation to posttraumatic stress symptoms.

Methods: Participants were 1,238 DC residents (ages 18-90, M = 41.7; 51 percent female; 68 percent White) who completed an online survey including items assessing identification, amount of TV, peritraumatic dissociation, and post-traumatic stress symptoms. Identification was measured by assessing to what extent participants identified victims as similar to themselves, a friend, or a family member. Peritraumatic dissociation and post-traumatic stress symptoms were assessed with the Peritraumatic Dissociative Experiences Questionnaire and Impact of Event Scale-Revised. Relationships of TV viewing, identification, and peritraumatic dissociation to post-traumatic stress symptoms were examined by univariable and multivariable regressions and variable interactions.

Results: Female gender and higher levels of TV viewing, identification, and peritraumatic dissociation were each related to greater post-traumatic stress symptoms. After adjusting for gender and the predictor variables, higher TV viewing was associated with posttraumatic stress symptoms (B = 0.72, p < 0.01, ΔR2 = 0.05). Participants with greater identification (B = 0.85, p < 0.001, ΔR2 = 0.08) and peritraumatic dissociation (B = 1.58, p < 0.001, ΔR2 = 0.39) reported more post-traumatic stress symptoms. Among those with both high (B = 1.19, p < 0.001) and low TV viewing, identification was associated with post-traumatic stress symptoms. Among those reporting low TV viewing, this association was greater for those who experienced more peritraumatic dissociation (B = −0.09, p < 0.001).

Conclusions: Trauma-related TV viewing, which may stimulate identification and peritraumatic dissociation, is an important consideration in understanding development of post-traumatic stress symptoms.


Keywords


psychological trauma, stress disorders, post-traumatic, terrorism, TV viewing, identification

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References


Busso DS, McLaughlin KA, Sheridan MA: Media exposure and sympathetic nervous system reactivity predict PTSD symptoms after the Boston Marathon bombings. Depress Anxiety. 2014; 31: 551-558. doi:10.1002/da.22282

Pfefferbaum B, Nixon SJ, Tivis RD, et al.: Television exposure in children after a terrorist incident. Psychiatry. 2001; 64: 202-211. doi:10.1521/psyc.64.3.202.18462

Silver RC, Holman EA, Andersen JP, et al.: Mental- and physical-health effects of acute exposure to media images of the September 11, 2001, attacks and the Iraq War. Psychol Sci. 2013; 24: 1623-1634. doi:10.1177/0956797612460406

Cardenas JE, Dennis M, Winkel M, et al.: A snapshot of terror: Acute posttraumatic responses to the September 11 attacks. J Trauma Dissociation. 2005; 6: 69-84. doi:10.1300/J229v06n02_07

Marshall RD, Bryant RA, Amsel A, et al.: The psychology of ongoing threat: Relative risk appraisal, the September 11 attacks, and terrorism-related fears. Am Psychol. 2007; 62: 304-316. doi:10.1037/0003-066X.62.4.304

Silver RC, Holman EA, McIntosh DN, et al.: Nationwide longitudinal study of psychological response to September 11. JAMA. 2002; 288: 1235-1244. doi:10.1001/jama.288.10.1235

Torabi MR, Seo DC: National study of behavioral and life changes since September 11. Health Educ Behav. 2004; 31: 179-192. doi:10.1177/1090198103259183

Ahern J, Galea S, Resnick H, et al.: Television images and psychological symptoms after the September 11 terrorist attacks. Psychiatry. 2002; 65: 289-300. doi:10.1521/psyc.65.4.289.20240

Ahern J, Galea S, Resnick H, et al.: Television images and probable posttraumatic stress disorder after September 11: The role of background characteristics, event exposures, and perievent panic. J Nerv Ment Dis. 2004; 192: 217-226. doi:10.1097/01. nmd.0000116465.99830.ca

Breslau N, Bohnert KM, Koenen KC: The 9/11 terrorist attack and posttraumatic stress disorder revisited. J Nerv Ment Dis. 2010; 198: 539-543. doi:10.1097/NMD.0b013e18ea1e2f

Schlenger WE, Caddell JM, Ebert L, et al.: Psychological reactions to terrorist attacks: Findings from the National Study of Americans’ Reactions to September 11. JAMA. 2002; 288: 581-588. doi:10.1001/jama.288.5.581

Schuster MA, Stein BD, Jaycox LH, et al.: A national survey of stress reactions after the September 11, 2001, terrorist attacks. N Engl J Med. 2001; 345: 1507-1512. doi:10.1056/NEJM200111153452024

Holman EA, Garfin DR, Silver RC: Media's role in broadcasting acute stress following the Boston Marathon bombings. Proc Natl Acad Sci USA. 2014; 111: 93-98. doi:10.1073/pnas.1316265110

Fullerton CS, Ursano RJ, Osuch EA, et al.: Identification and previous experience in disaster workers. In Retterstol N, Mortensen MS (eds.): Disasters and After Effects: Disaster Psychiatry in a Troubled World. Drammen, Norway: Atlantic Press, 2001.

Ursano RJ, Fullerton CS: Cognitive and behavioral responses to trauma. J Appl Soc Psychol. 1990; 20: 1766-1775. doi:10.1111/j.1559-1816.1990.tb01510.x

Wayment HA: It could have been me: Vicarious victims and disaster-focused distress. Pers Soc Psychol Bull. 2004; 30: 515-528. doi:10.1177/0146167203261892

Cetin M, Kose S, Ebrine S, et al.: Identification and posttraumatic stress disorder symptoms in rescue workers in the Marmara, Turkey earthquake. J Trauma Stress. 2005; 18: 485-489. doi:10.1002/jts.20056

Mash HBH, Fullerton CS, Benevides KN, et al.: Identification with terrorist victims of the Washington, D.C. sniper attacks: Posttraumatic stress, depression, and alcohol use. J Trauma Stress. 2016; 29: 41-48. doi:10.1002/jts.22069

Ursano RJ, Fullerton CS, Vance K, et al.: Posttraumatic stress disorder and identification in disaster workers. Am J Psychiatry. 1999; 156: 353-359. doi:10.1176/ajp.3.353

Westmaas JL, Silver RC: The role of perceived similarity in supportive responses to victims of negative life events. Pers Soc Psychol Bull. 2006; 32: 1537-1546. doi:10.1177/0146167206291874

Bryant RA: Does dissociation further our understanding of PTSD? J Anxiety Disord. 2007; 21: 183-191. doi:10.1016/j/ janxdis.2006.09012

Ozer EJ, Best SR, Lipsey TL, et al.: Predictors of post-traumatic stress disorder and symptoms in adults: A meta-analysis. Psychol Bull. 2003; 129: 52-73.

Fullerton CS, Gifford RK, Flynn BW, et al.: Effects of the 2002 sniper attacks on the homeless population in Washington, D.C. Disaster Med Public Health Prep. 2009; 3: 163-167. doi:10.1097/DMP.0b013e3181aa2675

Fullerton CS, Mash HBH, Benevides KN, et al.: Distress of routine activities and perceived safety associated with PTSD, depression, and alcohol use: 2002 Washington, D.C. sniper attacks. Disaster Med Public Health Prep. 2015; 9: 509-515. doi:10.1017/dmp.2015.67

Grieger TA, Fullerton CS, Ursano RJ: Posttraumatic stress disorder, alcohol use, and perceived safety after the terrorist attack on the Pentagon. Psychiatr Serv. 2003; 54: 1380-1382. doi:10.1176/appi. ps.54.10.1380

Grieger TA, Fullerton CS, Ursano RJ, et al.: Acute stress disorder, alcohol use, and perception of safety among hospital staff after the sniper attacks. Psychiatr Serv. 2003; 54: 1383-1387. doi:10.1176/appi.ps.54.10.1383

Schulden J, Chen J, Kresnow M-J, et al.: Psychological responses to the sniper attacks: Washington, D.C. area, October 2002. Am J Prev Med. 2006; 31: 324-327. doi:10.1016/j.amepre.2006.06.014

Marmar CR, Weiss DS, Metzler TJ: The peritraumatic dissociative experiences questionnaire. In Wilson JP, Keane TM (eds.): Assessing Psychological Trauma and PTSD: A Practitioner's Handbook. New York: Guilford Press, 1997: 412-428.

Weiss DS, Marmar CR: The impact of event scale-revised. In Wilson JP, Keane TM (eds.): Assessing Psychological Trauma and PTSD: A practitioner's Handbook. New York: Guilford Press, 1997: 399-411.

Creamer M, Bell R, Failla S: Psychometric properties of the impact of event scale-revised. Behav Res Ther. 2003; 41: 1489-1496. doi:10.1016/j.brat.2003.07.010

IBM Corp.: IBM SPSS Statistics for Windows, Version 22.0. Armonk, NY: IBM Corp., 2013.

Dixon P, Rehling G, Shiwach R: Peripheral victims of the Herald of Free Enterprise disaster. Br J Med Psychol. 1993; 66: 193-202. doi:10.1111/j.2044-8341.1993.tb01741.x

Fullerton CS, McCarroll JE, Ursano RJ, et al.: Psychological responses of rescue workers: Firefighters and trauma. Am J Orthopsychiatry. 1992; 62: 371-378. doi:10.1037/h0079363

Ursano RJ, McCarroll JE: The nature of the traumatic stressor: Handling dead bodies. J Nerv Ment Dis. 1990; 178: 396-398. doi:10.1097/00005053-1990006000-00010

Perrin A, Duggan M: Americans’ internet access: 2000-2015. Pew Research Center. 2015. Available at www.pewinternet.org/2015/06/26/americans-internet-access-2000-2015/. Accessed June 22, 2017.

Sax LJ, Gilmartin SK, Bryant AN: Assessing response rates and nonresponse bias in web and paper surveys. Res High Educ. 2003; 44: 409-432. doi:10.1023/A:102423915870




DOI: https://doi.org/10.5055/ajdm.2018.0285

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