That's not easy given the ongoing nature of the terrorist threat and the following catastrophes. "If you're afraid of something that you know what it is, you can avoid it, or diminish it in some way," explains Jeff Rosen, an associate professor of psychology at the University of Delaware. "This, there's nothing to diminish." If people find they are unable to leave their homes as a result of anthrax anxiety or credible-threat consternation, their symptoms have become disabling and professional help may be required, the doctors suggest.
Some researchers go so far as to assert that the long-term psychological ramifications of chemical or biological terrorism may be more damaging than any physical effects. Writing in an editorial in the British Medical Journal, Simon Wessely of the Guy's King's and St. Thomas' School of Medicine in London, Kenneth Craig Hyams of the Department of Veterans Affairs in Washington, D.C., and Robert Bartholomew of James Cook University in Australia caution against inappropriate reactions to presumed threats that serve to heighten the threats' impact.
"Even if the short-term consequences of an attack with chemical or biological weapons turn out to be less than some of the apocalyptic scenarios currently being aired by the media," they write, "the long-term disruptions may be worse than anticipated." Indeed, the trio suggests that the purpose of such weapons "is to wreak destruction via psychological means¿by inducing fear, confusion and uncertainty in daily life."
Studying the Response
Because the events of September 11th are so unprecedented, pertinent research literature is limited, although studies have investigated reactions to the Oklahoma City bombing and traumatic national disasters such as earthquakes. Now researchers at the Stanford University Center on Stress and Health are trying to gauge the range of possible outcomes of enduring traumatic stress. On September 22nd, they launched a study via the Internet to assess people's responses to the attacks on America.
"Although it is widely documented that natural and man-made disasters and other traumas are often associated with considerable post-event distress, little is known about normal responses to extremely abnormal situations," says lead investigator David Spiegel, a professor of psychiatry and behavioral sciences. "And even less is understood about adaptive coping in the face of traumatic stress." So far the scientists have received more than 5,000 responses from across the country and from locales as varied as Australia and Israel, says Cathleen Desjardins, a doctor and lawyer working on the project.
In the first section, the study asks participants multiple-choice questions designed to evaluate their exposure to the recent terrorist attacks and their reactions. Initially created to investigate the impact of September 11th, the study has now taken on the added complexity of addressing ongoing and broader national threats. "We're going to be looking at when participants have given their input," Desjardins says, "what has happened up to that date and what may have been happening on that day in terms of anthrax reports."
The second and third parts of the study include longer, narrative questions and will attempt to assess such things as personal experiences, physical health and social well-being, as well as coping strategies that might be particularly beneficial in dealing with terrorism anxiety. Utilizing the Internet, Desjardins explains, allows the investigators to reach a wider variety of participants both geographically and demographically in terms of background and exposure to traumatic events.
Although the idea of collecting data through a web site might raise questions regarding the veracity of the responses, Desjardins is confident that the Internet's benefits in terms of economics and reach outweigh its risks. "We don't believe that someone would take the time it takes to do the survey, about 20 minutes, to make one item of fraudulent data," she says. "Usually people who are creating fraudulent input don't want to put that kind of effort into it."