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In the Wake of National Trauma: Psychological Reactions Following the Charlie Hebdo Terror Attack

To the Editor: On Jan. 7, 2015, a terror attack targeted the satirical magazine Charlie Hebdo, leading to the death of 12 people. This attack was considered a national trauma that shook core beliefs and the French way of life (1). The association between mortality salience, reported shifts in political views, and sense of safety with psychological distress and posttraumatic stress disorder (PTSD) symptoms following national trauma is understudied.

We conducted a nationally representative online panel survey (N=1,982) in France 4 weeks after the Charlie Hebdo attack. Of 2,421 who clicked through to the survey, 1,982 (82%) responded fully.

“To what extent have the recent attacks in Paris changed how you think about your own death?” measured mortality salience, and, “The Charlie Hebdo shooting led me to change my political views,” measured shift in political views. Sense of safety was measured by the World Health Organization Quality of Life-BREF (2), psychological distress by the Kessler Psychological Distress Scale (3), and PTSD by the proposed ICD-11 PTSD criteria (4).

Two-step logistic regression (adjusted for demographic variables) showed that elevated psychological distress and endorsement of PTSD symptom criteria were significantly associated with higher mortality salience and shift in political views (odds ratios, ≥2.27, p values, ≤0.001) (Table 1). The same results were replicated for each PTSD cluster (odds ratios, ≥2.07, p values, ≤0.001).

TABLE 1. Two-Step Logistic Regression Analysis of Psychological Reactions Associated With Psychological Distress and PTSD Symptoms Following the Charlie Hebdo Shooting in Paris (N=1,982)

Elevated Psychological DistressaEndorsed PTSD Symptomsb
VariablesMeanSDN%Odds Ratio95% CIOdds Ratio95% CI
Step 1
 Age (years)41.1610.951.010.99–1.020.990.98–1.01
 Female1,03352.01.56**1.12–2.181.230.88–1.71
 Currently single69735.20.810.58–1.131.370.95–1.98
Step 2
 Age (years)1.010.99–1.031.000.98–1.02
 Female1.41*0.99–2.001.120.78–1.59
 Currently single0.830.58–1.181.49*1.01–2.18
 Mortality saliencec32316.33.86***2.71–5.513.22***2.23–4.65
 Shift in political viewd75438.02.27***1.60–3.212.81***1.96–4.02
 Sense of safetye1,02451.70.37***0.25–0.540.34***0.23–0.50

aElevated psychological distress criterion (Kessler Psychological Distress Scale score ≥13) met by 158 (8.0%) participants (Cronbach’s alpha=0.91).

bProposed ICD-11 PTSD symptom criteria endorsed by 151 (7.6%) participants on a 5-point rating scale where a score of 3 or higher represented a positive symptom rating. Note that all six symptoms must be positive for endorsement of PTSD.

cMortality salience scores range from 1 to 5, where 1=a great deal less and 5=a great deal more. A score of 4 or higher represents high mortality salience.

dShift in political view scores range from 1 to 5, where 1=not at all and 5=very much. This was measured separately for each political wing. The variables were combined and aggregated so that 0=no shift and 1=shift in political view.

eSense of safety scores range from 1 to 5, where 1=not at all and 5=extremely. The variable was aggregated so that a score of 4 or higher represented a high sense of safety.

*p<0.05. **p<0.01. ***p<0.001.

TABLE 1. Two-Step Logistic Regression Analysis of Psychological Reactions Associated With Psychological Distress and PTSD Symptoms Following the Charlie Hebdo Shooting in Paris (N=1,982)

Enlarge table

Study limitations include the use of a cross-sectional design, possible response bias, lack of premeasurement of participants with pre-existing PTSD symptoms, and potential confounders (e.g., the possibility of another traumatic event that the participant was exposed to before or concurrently with the terror attack).

In the wake of the Charlie Hebdo terror attacks, we found evidence of elevated PTSD symptoms compared with historical norms in France (7.6% compared with 4.9%). Substantial proportions of French people felt shifts in their perceptions of personal safety, thought more about their own mortality, and said they would change their voting patterns as a consequence. These results expand on previous study of 9/11 terrorist attacks (5). Clinicians should be aware that national trauma takes a toll on mental health in various ways, including mortality salience, shift in political views, and sense of safety.

From the School of Social Work, Ariel University, Ariel, Israel; and the Department of Psychology, University of Warwick, Coventry, United Kingdom.

The authors report no financial relationships with commercial interests.

References

1 Lichfield J: Charlie Hebdo: after France’s 9/11, this land will never be the same again. Independent, Jan 9, 2015. http://www.independent.co.uk/voices/comment/charlie-hebdo-after-frances-911-this-land-will-never-be-the-same-again-9969165.htmlGoogle Scholar

2 Skevington SM, Lotfy M, O’Connell KA; WHOQOL Group: The World Health Organization’s WHOQOL-BREF quality of life assessment: psychometric properties and results of the international field trial: a report from the WHOQOL group. Qual Life Res 2004; 13:299–310Crossref, MedlineGoogle Scholar

3 Kessler RC, Barker PR, Colpe LJ, et al.: Screening for serious mental illness in the general population. Arch Gen Psychiatry 2003; 60:184–189Crossref, MedlineGoogle Scholar

4 Cloitre M, Garvert DW, Brewin CR, et al.: Evidence for proposed ICD-11 PTSD and complex PTSD: a latent profile analysis. Eur J Psychotraumatol May 15, 2013; doi: 10.3402/ejpt.v4i0.20706CrossrefGoogle Scholar

5 Updegraff JA, Silver RC, Holman EA: Searching for and finding meaning in collective trauma: results from a national longitudinal study of the 9/11 terrorist attacks. J Pers Soc Psychol 2008; 95:709–722Crossref, MedlineGoogle Scholar