Learning from Hindsight: Examining Autonomic, Inflammatory, and Endocrine Stress Biomarkers and Mental Health in Healthy Terrorism Survivors Many Years Later.

Introduction: Terrorism and trauma survivors often experience changes in biomarkers of autonomic, inflammatory and hypothalamic-pituitary-adrenal (HPA) axis assessed at various times. Research suggests interactions of these systems in chronic stress.

Study Objective: This unprecedented retrospective study explores long-term stress biomarkers in three systems in terrorism survivors.

Immediate and evolving emotions among directly exposed survivors 7 years after the Oklahoma City bombing.

The Oklahoma City bombing in 1995 was one of the most devastating incidents of terrorism in America at that time. Existing research has not examined changes in emotional responses outside of psychopathology to disaster over time. The sample for this study consisted of adult participants randomly selected from a state registry of survivors who were directly exposed to the 1995 bombing in Oklahoma City.

A longitudinal follow-up study of rescue and recovery narratives of Oklahoma City bombing responders nearly a quarter century later.

Background: Most research examining first responders of terrorist incidents has been conducted in early post-disaster periods, utilized quantitative research methods, and focused on psychopathology such as post-traumatic stress.

Methods: Longitudinal follow-up assessments of 124 workers from 181 baseline volunteer rescue and recovery workers originally studied were completed nearly a quarter century after the terrorist bombing of the Murrah Federal Building in Oklahoma City. Open-ended qualitative interviews were used in the follow-up study.

A Qualitative Narrative Study of Rescue and Recovery Workers Responding to the Terrorist Bombing of Oklahoma City's Murrah Building.

Objective: Much of disaster mental health research uses quantitative methods, focusing on numerical prevalence, services, and outcomes.

Methods: Qualitative methods can provide more detailed, rich, and spontaneous insights into personal disaster experiences, yielding important insights beyond deductive methods. This large-scale qualitative narrative study examined experiences of 181 Oklahoma City bombing rescue/recovery workers.

Tobacco and Illicit Drug Use and Drug Use Disorders Among Employees of Businesses Affected by the 9/11 Attacks on the World Trade Center in New York City.

Objective: To study the New York City area population after the September 11, 2001, 9/11 attacks, focusing on tobacco and drug use and drug use disorders. An abundance of research has identified the important mental health sequelae stemming from exposure to disasters, especially vulnerability to the development of posttraumatic stress disorder (PTSD) and major depressive disorder (MDD). There also is a body of literature on the association of disaster exposure with alcohol use/misuse, but far less research on tobacco and other drug use/disorders.

A Retrospective Matched Comparison Study of Prolonged Seizures in ECT.

Objective: This study assessed the incidence of and risk factors for prolonged seizures (>180 sec) in electroconvulsive therapy (ECT).

Method: In 611 adult patients undergoing 6697 ECT treatments administered over a 2.5-year study period, 29 individuals experienced 42 prolonged seizures.

Characteristics and experiences of professionals providing 9/11 mental health services.

Background: After disasters, mental health professionals might be called upon to help address the emotional consequences of the disaster among survivors and other affected groups, but the clinicians themselves could be affected. This exploratory study examined the experiences of 60 mental health professionals, most of whom provided mental health care to individuals affected by the September 11, 2001 terrorist attacks (9/11), and/or experienced 9/11 sequelae themselves.

Methods: Participants completed structured interviews 3 and/or 6 years after the disaster, with full diagnostic assessment of psychiatric disorders and questions specific to their personal and professional post-9/11 experience.

Addressing Mental Health Needs Among Frontline Health Care Workers During the COVID-19 Pandemic.

Frontline workers experienced inordinate stress levels during the COVID-19 pandemic, as historically high volume and acuity in our hospitals was accompanied by concerns about our safety. We suggest that supporting frontline workers is an essential part of the pandemic response plan. We propose strategies to address the emotional and mental health (MH) needs of frontline health care workers during and after a pandemic that integrates knowledge from the disaster MH literature with the lessons learned during the COVID-19 pandemic.

A prospective longitudinal study of child custody status among homeless population mothers.

Most women in homeless populations are mothers, the majority being single mothers. Retaining child custody is challenging in homeless circumstances. Prospective longitudinal studies are needed to follow the moving pieces of housing and child custody in the context carefully-assessed psychiatric and substance use disorders over time.

A longitudinal follow-up study of Oklahoma City bombing survivors in the first quarter century after the disaster.

Background: This study is one of the longest postdisaster prospective longitudinal studies of disaster-related psychopathology, completed nearly a quarter century after a terrorist bombing, and the longest follow-up study ever conducted using full diagnostic assessment in highly exposed disaster survivors.

Methods: Oklahoma City bombing survivors (87% injured) were randomly selected from a state survivor registry and interviewed approximately 6 months postdisaster (N = 182; 71% participation) and again nearly 25 years later (N = 103; 72% participation). Interviews were conducted using the Diagnostic Interview Schedule (a structured interview assessing full diagnostic criteria) for panic disorder, generalized anxiety disorder, and substance use disorder at baseline and also for posttraumatic stress disorder (PTSD) and major depressive disorder (MDD) at follow-up.

Learning and achievement characteristics of sheltered homeless population subgroups.

Background: There is little systematic information about intelligence and academic achievement among sheltered homeless adults. This study adds descriptive data on intelligence and academic achievement, examines discrepancies across these concepts, and explores the associations among demographic and psychosocial characteristics in the context of intelligence categories and discrepancies.

Methods: We studied intelligence, academic achievement, and discrepancies between IQ and academic achievement among 188 individuals experiencing homelessness who were systematically recruited from a large, urban, 24-hour homeless recovery center.

A Prospective Post-disaster Longitudinal Follow-up Study of Emotional and Psychosocial Outcomes of the Oklahoma City Bombing Rescue and Recovery Workers During the First Quarter Century Afterward.

Objective: Little prospectively assessed post-disaster longitudinal research has been done on mental health (MH) outcomes of disaster rescue and recovery workers. This longitudinal prospective study, which is examining first responders to a terrorist bombing in Oklahoma City after nearly a quarter century, was conducted to investigate their long-term MH outcomes using full diagnostic assessments. This will most accurately inform planning for longitudinal MH care needs.

A longitudinal study of Oklahoma City bombing rescue and recovery responders providing qualitative introspections of their experience nearly a quarter century later.

Background: The 1995 terrorist bombing in Oklahoma City provided a particularly useful research opportunity. It was the most severe incident of terrorism on American soil at the time. Prior research on rescue and recovery workers responding to such events has been largely limited to early post-disaster periods, most focusing on psychopathology such as post-traumatic stress disorder.

A systematic review of alcohol consumption and disorders in relation to disasters.

Background: Excessive alcohol use and alcohol use disorders (AUDs) are serious medical problems in general populations. Alcohol use is associated with stressful events. Thus it is possible that problems with alcohol use increase in association with disasters.

City-wide study of laboratory-confirmed COVID-19 cases in San Antonio: An investigation of stressful events accompanying infection and their relation to psychosocial functioning.

Little is known about how Coronavirus Disease-2019 (COVID-19) infection is associated with stressful events (SEs) and stress-related psychological symptoms. This study examined the prevalence of SEs and incidence of stress-related symptoms accompanying COVID-19 infection. The association between these stress-related symptoms and psychosocial functioning were also examined.

Key Attributes of a Medical Learning Community Mentor at One Medical School: The Mentee Perspective.

To assess the elements necessary to be a successful learning community (ClinCalc) mentor to medical students from the mentee's perspective. Few such studies have utilized the in-depth and richness of detail obtained in qualitative studies. This qualitative study analyzed four focus group discussions lasting 45-90 min conducted at the University of Texas Southwestern Medical School, which has an established LC, in the year 2018.

Making Meaning of Surviving the Oklahoma City Bombing Seven Years Later.

: No previous studies examined how survivors made meaning (i.e. interpreted the personal significance) of a disaster experience after seven years.

Making Meaning of Disaster Experience in Highly Trauma-exposed Survivors of the Oklahoma City Bombing.

Survivors of disasters can be expected to form meaningful perspectives on their experiences that shape their trajectories of recovery; thus, these perspectives are important to study. If humans are naturally compelled to create meaning from traumatic experiences, the creation of meaning should be evident in survivors' discussion of the effects of the disaster in their lives. Therefore, the purpose of this study of highly trauma-exposed disaster survivors was to identify meaningful aspects or outcomes of their disaster experiences in their perspectives.

A Prospective Longitudinal Study of Qualitative Disaster Narratives of Highly Trauma-Exposed Survivors of the Oklahoma City Bombing Nearly a Quarter Century Later.

: To examine highly trauma-exposed survivors of the 1995 Oklahoma City Murrah Federal Building bombing nearly a quarter century later, focusing on survivors' immediate personal experiences of it through open-ended narratives. : An original sample of 182 bombing survivors, studied approximately 6 months post bombing, was randomly selected from a state registry of 1,092 bombing survivors, with 71% participation. Of the original 182 bombing survivors, 103 completed the longitudinal follow-up, conducted at a median of 23 years post bombing.

A Qualitative Longitudinal Study of Workplace Issues, Authorities and Media, and Relationships Recounted by Oklahoma City Bombing Survivors After Nearly a Quarter Century.

Objective: The aim of the study is to examine the long-term course of disaster-related experience among survivors of a terrorist bombing and the long-term recollection of initial workplace effects across nearly a quarter century.

Methods: From an initial randomly selected sample of highly trauma-exposed survivors of the 1995 Oklahoma City bombing, 103 participated in qualitative open-ended interviews about their bombing experience approximately 23 years after disaster.

Results: The survivors described their bombing experience clearly with extensive detail and expression of persistent strong emotion.

Perspectives of Survivors of the Oklahoma City Bombing with and without PTSD 17 Months Postdisaster: A Qualitative Study.

This study compared perspectives of highly trauma-exposed Oklahoma City bombing survivors (N=141) with and without PTSD. Survivors' responses to questions about the effects of the bombing on their perspectives were hand-recorded and transcribed, six themes identified, and interrater reliability established. Both diagnostic groups (with and without PTSD) expressed greater appreciation for life, greater concern with human vulnerability and mortality, and positive changes in religion/spirituality as consequences of the bombing.

Relationship between chronic obstructive pulmonary disease and cognition in an aging population.

Objectives: Chronic obstructive pulmonary disease (COPD) is a common and severe respiratory illness. Prior research suggests that COPD may be associated with depression as well as cognitive impairment and increased risk of dementia. Many studies to date have been relatively small, have largely relied on global screening measures to identify cognitive impairment, and have not examined the potential role of comorbid depression on cognition.