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1.  Exposure to Bioterrorism and Mental Health Response among Staff on Capitol Hill 
The October 2001 anthrax attacks heralded a new era of bioterrorism threat in the U.S. At the time, little systematic data on mental health effects were available to guide authorities' response. For this study, which was conducted 7 months after the anthrax attacks, structured diagnostic interviews were conducted with 137 Capitol Hill staff workers, including 56 who had been directly exposed to areas independently determined to have been contaminated. Postdisaster psychopathology was associated with exposure; of those with positive nasal swab tests, PTSD was diagnosed in 27% and any post-anthrax psychiatric disorder in 55%. Fewer than half of those who were prescribed antibiotics completed the entire course, and only one-fourth had flawless antibiotic adherence. Thirty percent of those not exposed believed they had been exposed; 18% of all study participants had symptoms they suspected were symptoms of anthrax infection, and most of them sought medical care. Extrapolation of raw numbers to large future disasters from proportions with incorrect belief in exposure in this limited study indicates a potential for important public health consequences, to the degree that people alter their healthcare behavior based on incorrect exposure beliefs. Incorrect belief in exposure was associated with being very upset, losing trust in health authorities, having concerns about mortality, taking antibiotics, and being male. Those who incorrectly believe they were exposed may warrant concern and potential interventions as well as those exposed. Treatment adherence and maintenance of trust for public health authorities may be areas of special concern, warranting further study to inform authorities in future disasters involving biological, chemical, and radiological agents.
doi:10.1089/bsp.2009.0031
PMCID: PMC2956562  PMID: 20028246
2.  The impact of the 1995 Oklahoma City bombing on the partners of firefighters 
This study explored the impact of the 1995 Oklahoma City, Oklahoma, bombing on the spouses and significant others of a volunteer sample of Oklahoma City firefighters who participated in the bombing rescue effort. Twenty-seven partners of Oklahoma City firefighters participated in this study, conducted 42 to 44 months after the bombing. These partners were assessed using a structured diagnostic interview and a companion interview to examine exposure, rates of psychiatric disorders and symptoms, functioning, health, and relationships. Coping and perception of the firefighter partner's response were also examined. Some of the women were exposed directly; most knew someone who had been involved in the disaster, and all reported exposure through the media. The rate of psychiatric disorders in the women following the disaster was 22%, essentially unchanged from before the incident. One developed bomb-related posttraumatic stress disorder (PTSD). Most were satisfied with their work performance; 15% reported that their health had worsened since the bombing, and more than one third reported permanent changes in relationships as a result of the bombing. Most coped by turning to friends or relatives, with less than 10% seeking professional help. Many described symptoms in their firefighter mate; all reported that their mate had been affected by the experience, and one half said their mate had fully recovered. The mates of these firefighters fared relatively well in terms of psychiatric disorders, symptoms, and ability to function. The prevalence of bomb-related post-traumatic stress disorder was considerably lower in this sample than in samples of individuals more directly exposed to the bombing, although some reported changes in relationships and health. The results suggest the need for further study of the impact of interpersonal exposure in those who provide support for rescue-and-recovery workers in major terrorist incidents.
doi:10.1093/jurban/79.3.364
PMCID: PMC3456794  PMID: 12200505

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