Hansen Marianne Bang, Birkeland Marianne Skogbrott, Nissen Alexander, Blix Ines, Solberg Øivind, Heir Trond
Psychiatry. 2017 Summer;80(2):171-183. doi: 10.1080/00332747.2016.1230983.
It is well established that direct exposure to terrorism can result in posttraumatic stress disorder (PTSD). However, individuals indirectly exposed to terrorism may also develop symptoms of PTSD. This study examined the prevalence and course of symptom-defined PTSD in employees who were present and not present at the site of a workplace terror attack.
Survey data from ministerial employees were collected 10, 22, and 34 months after the 2011 bombing in the government district of Oslo. A total of 3,520 employees were initially invited to the study. Response rates of eligible participants were 56% (N = 1,974) at T1, 55% (N = 1,780) at T2, and 54% (N = 1,578) at T3. PTSD was measured using the Post-traumatic Stress Disorder Checklist-Specific (PCL-S). Symptom-defined PTSD was specified as meeting the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision (DSM-IV-TR), B, C, and D criteria.
Our findings showed a low and declining prevalence of symptom-defined PTSD in employees indirectly exposed to a workplace terror attack (4%, 3%, and 2% at the three respective times). In employees present at the site of the explosion, PTSD was six- to eightfold more prevalent (24%, 17%, and 17%).
Individuals indirectly exposed to terrorism may develop long-lasting posttraumatic stress reactions fulfilling PTSD symptom criteria. Due to the large number of individuals that may be indirectly exposed to terrorism, even a low risk of PTSD may result in high numbers of individuals with substantial posttraumatic stress. Our findings have implications for the planning and implementation of health care services beyond those directly exposed after large-scale terror events.
直接暴露于恐怖主义事件会导致创伤后应激障碍（PTSD），这一点已得到充分证实。然而，间接暴露于恐怖主义事件的个体也可能出现PTSD症状。本研究调查了在工作场所恐怖袭击现场附近和不在现场的员工中，症状定义的PTSD的患病率和病程。
收集了2011年奥斯陆政府区爆炸事件发生后10、22和34个月时，部委员工的调查数据。最初共有3520名员工受邀参与研究。符合条件的参与者在T1时的回复率为56%（N = 1974），T2时为55%（N = 1780），T3时为54%（N = 1578）。使用创伤后应激障碍检查表特定版（PCL-S）来测量PTSD。症状定义的PTSD被界定为符合《精神疾病诊断与统计手册》第四版，修订版（DSM-IV-TR）的B、C和D标准。
我们的研究结果显示，间接暴露于工作场所恐怖袭击的员工中，症状定义的PTSD患病率较低且呈下降趋势（在三个时间点分别为4%、3%和2%）。在爆炸现场的员工中，PTSD的患病率高出6至8倍（分别为24%、17%和17%）。
间接暴露于恐怖主义事件的个体可能会出现符合PTSD症状标准的长期创伤后应激反应。由于可能间接暴露于恐怖主义事件的个体数量众多，即使PTSD风险较低，也可能导致大量个体出现严重的创伤后应激反应。我们的研究结果对于大规模恐怖事件后直接暴露人群之外的医疗服务规划和实施具有启示意义。
