Trauma survivors report more alcohol use; anxiety, depression symptoms

TORONTO — Survivors of the 1995 Oklahoma City bombing reported greater anxiety and depression symptoms and more frequent alcohol use compared with individuals unaffected by the bombing.

“As the twentieth anniversary [of the Oklahoma City bombing] is approaching, my colleagues and I really wanted to look at what happens to people long-term after they’ve been exposed to terrorism. So we looked at directly, intensely impacted individuals to assess their mental health and health status and their post traumatic growth over a period of time,” study researcher Phebe Tucker, MD, of the University of Oklahoma, said during a presentation at the American Psychiatric Association Annual Meeting.

Phebe Tucker

Tucker and colleagues conducted telephone surveys among 138 direct survivors of the bombing, of whom 80% were injured, and 171 non-exposed, demographically similar individuals to assess medical and mental health, health care utilization, depression, anxiety and PTSD symptoms. Survivors and controls had similar mean ages, 58.7 and 59.2 years, respectively.

Analysis indicated that survivors had significantly higher mean scores on anxiety (P = .02) and depression (P = 0.019) measures, compared with controls.

Twenty-three percent of survivors exceeded the PTSD threshold, according to researchers.

Alcohol use was more frequent among survivors, who had significantly higher rates of consuming at least one alcoholic beverage per week (P = .035) and per month (P = .0352) vs. controls.

Further, experiencing symptoms of depression and anxiety was significantly and positively associated with consuming at least five or more alcoholic drinks on one occasion in a given month among survivors.

“Close to 20 years after the bombing, looking at highly impacted survivors, we noted that they had more depression and anxiety symptoms than matched controls and that almost one-quarter of our survivors had enough PTSD symptoms to qualify for PTSD on one of the main rating scales. I think that’s an important point, that there is still emotional residual effects after trauma,” Tucker told Healio.com/Psychiatry. “Although they were not really using more alcohol in general, our survivors who had more anxiety and depression did binge drink more. We felt that among survivors of terrorism, even many years later, if they’re anxious, if they're depressed, we need to screen for alcohol problems and address those.”

“In contrast, looking at the post-traumatic growth inventory in which people report positive change, our survivors reported a positive sense of spirituality, feeling stronger than they originally thought and thinking others are helpful to them after the bombing. That’s important because if we can maximize their coping techniques, we can either help promote recovery or identify resilient people.” – by Amanda Oldt

Reference:

Tucker P, et al. Lasting impact of direct exposure to terrorism on health, mental health and post traumatic growth. Presented at: American Psychiatric Association Annual Meeting; May 16-20, 2015; Toronto.

Disclosure: Tucker reports no relevant financial disclosures.