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PTSD after Nairobi and Oklahoma terrorist bombings - Study
By British Journal of Psychiatry,
Jun 2, 2005 - 4:23:38 PM
There were many similarities in the psychological problems found among survivors in the two cultures, following the terrorist bombings in Nairobi and Oklahoma City. However, coping responses and treatment were quite different.
Africa is poorly represented in published world research on disaster mental health. This study from the June issue of the British Journal of Psychiatry breaks new ground in using consistent methodology to provide cross-cultural comparison of diagnostic findings after two separate bomb attacks on two continents, North America and Africa.
Structured diagnostic interviews were carried out with 227 people directly exposed to the bombing of the US embassy in Nairobi in 1998, and with 182 individuals who experienced the bomb attack on the Murrah Federal Building in Oklahoma City in 1995.
Despite their geographical separation by nearly half a world, the Nairobi and Oklahoma populations and their mental health responses to the experience of bombing were remarkably similar.
The injury rate in Oklahoma City was 87% and in Nairobi 88%. Post-traumatic functional impairment, defined as interference with family, friends or work, was 39% in Oklahoma City and 40% in Nairobi.
The only difference in rates of pre-existing diagnoses before the bombing was less alcohol misuse and dependence among both men and women in Nairobi.
After the disaster, a third of the men and half of the women in Nairobi had bombing-related post-traumatic stress disorder (PTSD), and these rates were similar to those of men and women in Oklahoma City. In both locations, women's post-bombing PTSD rates were higher than men's.
Major depression also showed similar consistency between the sites in both men and women both before and after the bombings.
However, the responses to the bombings revealed important differences between the two locations. Treatment by a psychiatrist was not obtained by any Nairobi survivors in this study, whereas psychiatric treatment was more easily available in Oklahoma City.
Support and debriefing groups, and religious counselling, were used by the majority of Nairobi survivors, but not by those in Oklahoma City.
Although the majority of people in both sites coped without alcohol and medication, and most turned to family and friends for support in both settings, coping with the help of alcohol and medication was more common in Oklahoma City, and coping through social and religious supports was more often seen in Nairobi.
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