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Published in: Social Psychiatry and Psychiatric Epidemiology 2/2013

01-02-2013 | Original Paper

The course of postdisaster psychiatric disorders in directly exposed civilians after the US Embassy bombing in Nairobi, Kenya: a follow-up study

Authors: Gus Zhang, Carol S. North, Pushpa Narayanan, You-Seung Kim, Samuel Thielman, Betty Pfefferbaum

Published in: Social Psychiatry and Psychiatric Epidemiology | Issue 2/2013

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Abstract

Purpose

While disasters are common in Africa, disaster studies in Africa are underrepresented in the published literature. This study prospectively examined the longitudinal course of psychopathology, coping, and functioning among 128 directly exposed Kenyan civilian survivors of the 1998 US Embassy bombing in Nairobi.

Methods

The Diagnostic Interview Schedule/Disaster Supplement assessed predisaster and postdisaster psychiatric disorders and variables related to coping, functioning, safety, and religion near the end of the first and third postdisaster years.

Results

Total postdisaster prevalence of posttraumatic stress disorder (PTSD) at the 3-year follow-up was 49; 28 % of the sample still had active PTSD. Delayed-onset PTSD was not observed. Posttraumatic symptoms decayed more slowly in individuals with than those without PTSD. PTSD was more prevalent and chronic than major depression. Those with current PTSD or major depression reported more functioning problems than those without. The length of hospitalization for injuries after the bombing predicted major depression remission, but no predictors of PTSD remission were found.

Conclusions

Despite differences in coping and social variables, longitudinal psychopathology in the Nairobi terrorism survivors appeared broadly similar to results in Western disaster populations. These findings contribute to the understanding of disaster mental health in Africa and may have implications for generalizability of psychiatric effects of terrorist attacks around the globe.
Literature
1.
go back to reference Patel V, Sumathipala A (2001) International representation in psychiatric literature: survey of six leading journals. Br J Psychiatry 178:406–409PubMedCrossRef Patel V, Sumathipala A (2001) International representation in psychiatric literature: survey of six leading journals. Br J Psychiatry 178:406–409PubMedCrossRef
2.
go back to reference Norris FH et al (2002) 60,000 disaster victims speak: part I. An empirical review of the empirical literature, 1981–2001. Psychiatry 65(3):207–239PubMedCrossRef Norris FH et al (2002) 60,000 disaster victims speak: part I. An empirical review of the empirical literature, 1981–2001. Psychiatry 65(3):207–239PubMedCrossRef
3.
go back to reference Krueger AB, Maleckova J (2009) Attitudes and action: public opinion and the occurrence of international terrorism. Science 325(5947):1534–1536PubMedCrossRef Krueger AB, Maleckova J (2009) Attitudes and action: public opinion and the occurrence of international terrorism. Science 325(5947):1534–1536PubMedCrossRef
4.
go back to reference Kim N (2011) How much more exposed are the poor to natural disasters? Global and regional measurement. Disasters 36:195–211PubMedCrossRef Kim N (2011) How much more exposed are the poor to natural disasters? Global and regional measurement. Disasters 36:195–211PubMedCrossRef
6.
go back to reference Odejide AO, Oyewunmi LK, Ohaeri JU (1989) Psychiatry in Africa: an overview. Am J Psychiatry 146(6):708–716PubMed Odejide AO, Oyewunmi LK, Ohaeri JU (1989) Psychiatry in Africa: an overview. Am J Psychiatry 146(6):708–716PubMed
7.
go back to reference North CS, Pfefferbaum B (2002) Research on the mental health effects of terrorism. JAMA 288(5):633–636PubMedCrossRef North CS, Pfefferbaum B (2002) Research on the mental health effects of terrorism. JAMA 288(5):633–636PubMedCrossRef
8.
go back to reference Carlson EB (1996) Trauma research methodology. Lutherville, Md.: Sidran. viii, p291 Carlson EB (1996) Trauma research methodology. Lutherville, Md.: Sidran. viii, p291
9.
go back to reference McFarlane AC (1988) The longitudinal course of posttraumatic morbidity. The range of outcomes and their predictors. J Nerv Ment Dis 176(1):30–39PubMedCrossRef McFarlane AC (1988) The longitudinal course of posttraumatic morbidity. The range of outcomes and their predictors. J Nerv Ment Dis 176(1):30–39PubMedCrossRef
10.
go back to reference North CS et al (2005) Comparison of post-disaster psychiatric disorders after terrorist bombings in Nairobi and Oklahoma City. Br J Psychiatry 186:487–493PubMedCrossRef North CS et al (2005) Comparison of post-disaster psychiatric disorders after terrorist bombings in Nairobi and Oklahoma City. Br J Psychiatry 186:487–493PubMedCrossRef
11.
go back to reference North CS et al (2011) Psychosocial adjustment of directly exposed survivors 7 years after the Oklahoma City bombing. Compr Psychiatry 52(1):1–8PubMedCrossRef North CS et al (2011) Psychosocial adjustment of directly exposed survivors 7 years after the Oklahoma City bombing. Compr Psychiatry 52(1):1–8PubMedCrossRef
12.
go back to reference North CS (2010) A tale of two studies of two disasters: comparing psychosocial responses to disaster among Oklahoma City bombing survivors and Hurricane Katrina evacuees. Rehabil Psychol 55(3):241–246PubMedCrossRef North CS (2010) A tale of two studies of two disasters: comparing psychosocial responses to disaster among Oklahoma City bombing survivors and Hurricane Katrina evacuees. Rehabil Psychol 55(3):241–246PubMedCrossRef
13.
go back to reference Meewisse ML et al (2011) The course of mental health disorders after a disaster: predictors and comorbidity. J Trauma Stress 24(4):405–413PubMedCrossRef Meewisse ML et al (2011) The course of mental health disorders after a disaster: predictors and comorbidity. J Trauma Stress 24(4):405–413PubMedCrossRef
14.
go back to reference Norris FH, Friedman MJ, Watson PJ (2002) 60,000 disaster victims speak: part II. Summary and implications of the disaster mental health research. Psychiatry 65(3):240–260PubMedCrossRef Norris FH, Friedman MJ, Watson PJ (2002) 60,000 disaster victims speak: part II. Summary and implications of the disaster mental health research. Psychiatry 65(3):240–260PubMedCrossRef
15.
go back to reference Onder E et al (2006) Prevalence of psychiatric disorders three years after the 1999 earthquake in Turkey: Marmara Earthquake Survey (MES). Soc Psychiatry Psychiatr Epidemiol 41(11):868–874PubMedCrossRef Onder E et al (2006) Prevalence of psychiatric disorders three years after the 1999 earthquake in Turkey: Marmara Earthquake Survey (MES). Soc Psychiatry Psychiatr Epidemiol 41(11):868–874PubMedCrossRef
16.
go back to reference North CS et al (1999) Psychiatric disorders among survivors of the Oklahoma City bombing. JAMA 282(8):755–762PubMedCrossRef North CS et al (1999) Psychiatric disorders among survivors of the Oklahoma City bombing. JAMA 282(8):755–762PubMedCrossRef
17.
go back to reference North CS et al (2004) The course of posttraumatic stress disorder in a follow-up study of survivors of the Oklahoma City bombing. Ann Clin Psychiatry 16(4):209–215PubMedCrossRef North CS et al (2004) The course of posttraumatic stress disorder in a follow-up study of survivors of the Oklahoma City bombing. Ann Clin Psychiatry 16(4):209–215PubMedCrossRef
18.
go back to reference North CS, Smith EM, Spitznagel EL (1994) Posttraumatic stress disorder in survivors of a mass shooting. Am J Psychiatry 151(1):82–88PubMed North CS, Smith EM, Spitznagel EL (1994) Posttraumatic stress disorder in survivors of a mass shooting. Am J Psychiatry 151(1):82–88PubMed
20.
go back to reference Honig RG et al (1993) Portraits of survival. A twenty-year follow-up of the children of Buffalo Creek. Psychoanal Study Child 48:327–355PubMed Honig RG et al (1993) Portraits of survival. A twenty-year follow-up of the children of Buffalo Creek. Psychoanal Study Child 48:327–355PubMed
21.
go back to reference North CS et al (2009) Toward validation of the diagnosis of posttraumatic stress disorder. Am J Psychiatry 166(1):34–41PubMedCrossRef North CS et al (2009) Toward validation of the diagnosis of posttraumatic stress disorder. Am J Psychiatry 166(1):34–41PubMedCrossRef
22.
go back to reference Nemiah JC (1995) A few intrusive thoughts on posttraumatic stress disorder. Am J Psychiatry 152(4):501–503PubMed Nemiah JC (1995) A few intrusive thoughts on posttraumatic stress disorder. Am J Psychiatry 152(4):501–503PubMed
23.
go back to reference Yehuda R, McFarlane AC (1995) Conflict between current knowledge about posttraumatic stress disorder and its original conceptual basis. Am J Psychiatry 152(12):1705–1713PubMed Yehuda R, McFarlane AC (1995) Conflict between current knowledge about posttraumatic stress disorder and its original conceptual basis. Am J Psychiatry 152(12):1705–1713PubMed
24.
go back to reference Rosen GM, Lilienfeld SO (2008) Posttraumatic stress disorder: an empirical evaluation of core assumptions. Clin Psychol Rev 28(5):837–868PubMedCrossRef Rosen GM, Lilienfeld SO (2008) Posttraumatic stress disorder: an empirical evaluation of core assumptions. Clin Psychol Rev 28(5):837–868PubMedCrossRef
25.
go back to reference North CS, Hong BA, Pfefferbaum B (2008) P-FLASH: development of an empirically-based post-9/11 disaster mental health training program. Mo Med 105(1):62–66PubMed North CS, Hong BA, Pfefferbaum B (2008) P-FLASH: development of an empirically-based post-9/11 disaster mental health training program. Mo Med 105(1):62–66PubMed
26.
go back to reference Breslau N et al (1997) Sex differences in posttraumatic stress disorder. Arch Gen Psychiatry 54(11):1044–1048PubMedCrossRef Breslau N et al (1997) Sex differences in posttraumatic stress disorder. Arch Gen Psychiatry 54(11):1044–1048PubMedCrossRef
27.
go back to reference Kessler RC et al (1995) Posttraumatic stress disorder in the National Comorbidity Survey. Arch Gen Psychiatry 52(12):1048–1060PubMedCrossRef Kessler RC et al (1995) Posttraumatic stress disorder in the National Comorbidity Survey. Arch Gen Psychiatry 52(12):1048–1060PubMedCrossRef
28.
go back to reference Perkonigg A et al (2005) Longitudinal course of posttraumatic stress disorder and posttraumatic stress disorder symptoms in a community sample of adolescents and young adults. Am J Psychiatry 162(7):1320–1327PubMedCrossRef Perkonigg A et al (2005) Longitudinal course of posttraumatic stress disorder and posttraumatic stress disorder symptoms in a community sample of adolescents and young adults. Am J Psychiatry 162(7):1320–1327PubMedCrossRef
29.
go back to reference Galea S et al (2002) Psychological sequelae of the September 11 terrorist attacks in New York City. N Engl J Med 346(13):982–987PubMedCrossRef Galea S et al (2002) Psychological sequelae of the September 11 terrorist attacks in New York City. N Engl J Med 346(13):982–987PubMedCrossRef
30.
go back to reference Goenjian AK et al (2000) Prospective study of posttraumatic stress, anxiety, and depressive reactions after earthquake and political violence. Am J Psychiatry 157(6):911–916PubMedCrossRef Goenjian AK et al (2000) Prospective study of posttraumatic stress, anxiety, and depressive reactions after earthquake and political violence. Am J Psychiatry 157(6):911–916PubMedCrossRef
31.
go back to reference Johnson DR et al (2004) Long-term course of treatment-seeking Vietnam veterans with posttraumatic stress disorder: mortality, clinical condition, and life satisfaction. J Nerv Ment Dis 192(1):35–41PubMedCrossRef Johnson DR et al (2004) Long-term course of treatment-seeking Vietnam veterans with posttraumatic stress disorder: mortality, clinical condition, and life satisfaction. J Nerv Ment Dis 192(1):35–41PubMedCrossRef
32.
go back to reference Hussain A, Weisaeth L, Heir T (2011) Changes in religious beliefs and the relation of religiosity to posttraumatic stress and life satisfaction after a natural disaster. Soc Psychiatry Psychiatr Epidemiol 46(10):1027–1032PubMedCrossRef Hussain A, Weisaeth L, Heir T (2011) Changes in religious beliefs and the relation of religiosity to posttraumatic stress and life satisfaction after a natural disaster. Soc Psychiatry Psychiatr Epidemiol 46(10):1027–1032PubMedCrossRef
Metadata
Title
The course of postdisaster psychiatric disorders in directly exposed civilians after the US Embassy bombing in Nairobi, Kenya: a follow-up study
Authors
Gus Zhang
Carol S. North
Pushpa Narayanan
You-Seung Kim
Samuel Thielman
Betty Pfefferbaum
Publication date
01-02-2013
Publisher
Springer-Verlag
Published in
Social Psychiatry and Psychiatric Epidemiology / Issue 2/2013
Print ISSN: 0933-7954
Electronic ISSN: 1433-9285
DOI
https://doi.org/10.1007/s00127-012-0535-4

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