Abstract
The bombing in Oklahoma City shook the entire nation from “sea to shining sea.” This tremendous collective sensation was made even worse when available evidence revealed that this act of terrorism had not been committed by some terrorist from the Middle East but one from Middle America. The blast stunned the nation's sense of collective safety, while it raised serious questions about our ability as a nation to manage violence, and the profound feelings of discontent and narcissistic injuries among distressed Americans. Was it this failure to address chronic discontents that led to this tragedy of mass violence? These larger sociocultural and political issues are being debated in public and private forums throughout the nation, an activity that is likely to continue for some time to come. As these issues are debated in the public arena, victims' levels of psychological distress are expected to rise, as they attempt to process the traumatic shock in their minds and bodies. Specifically, this article has two parts and focuses on acute and post-acute psychophysiological traumatic stress responses in victims, as well as issues pertaining to assessment, prevention, and treatment. Part I addresses the nature of disasters, with a special emphasis on the victim's subjective evaluation (meaning) of the reality of a catastrophe caused by intentional human strategy. The article, additionally, discusses issues of epidemiology of stress reactions, post-traumatic stress disorder, co-morbidity, risk factors, and assessment and diagnostic considerations. Part II, to be published in the next of issue of the Journal, will focus on issues of prevention as well as post-disaster intervention. Prevention of chronic post-traumatic stress disorder after the Oklahoma City bombing is a critical objective by debriefers and mental health professionals. A proposed four-phase model called “self-efficacy adaptational coping” will be presented in Phase II as well. The present article is probably the first major discussion on the traumatic effects of the blast on individuals, families, and the communities of Oklahoma City, and the first to offer some broad guidelines to intervention. Since it predates future empirical studies, the author relies on his almost 20 years of experience in the field of traumatic stress, and on a review and integration of pertinent disaster outcome studies in the national and international literature.
Article PDF
Similar content being viewed by others
Avoid common mistakes on your manuscript.
References
American Psychiatric Association (1994).Diagnostic and statistical manual of mental disorder, Fourth Edition. Washington, D.C.: American Psychiatric Association.
Austin-Cardona, R. (1994). Critical incident stress and the medical photographer: Its causes and effects.Journal of Biological Photography, 62, 119–122.
Barkun, M. (1974).Disaster and the millennium. New Haven, CT: Yale University Press.
Beck, A. (1972). Measurement of depression: The Depression Inventory. In A.T. Beck (Ed.),Depression: Causes and treatment. Philadelphia: University of Pennsylvania Press.
Bernstein, E., and Putnam, F. (1986). Development, reliability, and validity of a dissociation scale.Journal of Nervous and Mental Disease, 174, 727–735.
Blake, D., Albano, A., and Keane, T. (1992). Twenty years of trauma: Psychological Abstracts 1970–1989.Journal of Traumatic Stress, 5, 1–8.
Blake, D., Weathers, F., Nagy, L., Kaloupek, I., Klauminzer, G., Charney, L., and Keane, T. (1990). A Clinician Rating Scale for Assessing Current and Lifetime PTSD: The CAPS-1.The Behavior Therapist, 13, 187–188.
Blanchard, E., Hickling, E., Volmer, A., Loos, W., Buckley, T., and Jaccard, J. (1995). Short-term follow-up of post-traumatic stress symptoms in motor vehicle accident victims.Behavior: Research and Therapy, 33, 369–377.
Blanchard, E., Kolb, L., Pallmeyer, B., and Gerardi, R. (1982). A psychophysiological study of post-traumatic stress disorder in Vietnam veterans.Psychiatric Quarterly, 54, 220–229.
Bowler, R, Mergler, D., Huel, G., and Cone, E. (1994). Psychological, psychosocial and psychophysiological sequelae in a community affected by a railroad chemical disaster.Journal of Traumatic Stress, 7, 601–612.
Brende and Parson (1985).Vietnam veterans: The road to recovery. New York: Plenum.
Briggs, D. (1995, May 27). After tragedy like Oklahoma's, who cares for the caregivers?The Washington Times, p. A14.
Brom, D., and Kleber, R. (1989). Prevention of post-traumatic stress disorder.Journal of Traumatic Stress, 2, 335–351.
Cable News Network (1995, April). Sunday memorial service led by The Reverend Bill Graham., Oklahoma City, Oklahoma.
Cardena, E., and Spiegel, D. (1993). Dissociative reactions to the San Francisco bay area earthquake of 1989.American Journal of Psychiatry, 150, 474–478.
Derogitis, L. (1992).SCL-90-R administration, scoring, and procedures manual I II. Towson, MD: Clinical Psychometric Research.
Dudasik, S. (1980). Victimization in natural disasterDisasters, 4, 329–338.
Endicott, J., and Spitzer, R. (1992). What? Another rating scale? The Psychiatric Evaluation Form.Journal of Nervous and Mental Disease, 154, 88–104.
Erikson, K. (1979).In wake of the flood. London: George Allen and Unwin.
Federal Emergency Management Agency (1984).Program guide, disaster assistance programs. Washington, D.C.: Government Printing Office.
Fleming, R, Baum, A. Gisriel, M., and Gatchel, R. (1982). Mediating Influences of social support on stress at Three Mile Island.Journal of Human Stress, 14–22
Folkman, S., Lazarus, R., and Dunkel-Schetter, C. DeLongis, A. and Green, R. (1986). The dynamic of a stressful disaster: Cognitive appraisal, coping, and encounter outcomes.Journal of Personality and Social Psychology, 50, 992–1003.
Fontana, A., Rosenheck, R., and Brett, E. (1992). War zone traumas and post-traumatic stress disorder symptomatology.Journal of Nervous and Mental Disease, 180, 748–755.
Frankl, V. (1966). What is meant by meaning.Journal of Existentialism, 7, 21–28.
Freedy, J. and Kilpatrick, D. (1994). Everything you ever wanted to know about disasters and mental health (well, almost!).National Center for PTSD Clinical Quarterly, 4, 6–8.
Freedy, J. and Hobfoll, S. (1994). Traumatic stress: From theory to practice. New York: Plenum.
Freedy, J., Kilpatrick, D, and Resnick, H. (1993). Natural disasters and mental health.Journal of Social Behavior and Personality, 8, 49–103.
Freedy, J., Resnick, H., Kilpatrick, D., and Saunders, B. (1993). Adult psychological functioning after earthquakes. Final Report for NIMH grant no. R03 MH 49485, submitted to the Violence and Traumatic Stress Research Branch.
Freedy, J., Resnick, H., and Kilpatrick, D. (1992). Conceptual framework for evaluating disaster impact: Implications for clinical intervention. In L. S. Austin (Ed.),Responding to disaster. A guide for mental health professionals. Washington, D.C.: American Psychiatric Association
Giel, R. (1990). Psychosocial processes in disaster.International Journal of Mental Health, 19, 7–20.
Glesser, G., Green, B., and Winget, C. (1981).Prolonged effects of disaster. New York: Academic Press.
Glesser, G., Green, B., and Winget, C. (1978). Quantifying interview data in psychic impairment of disaster survivors.Journal of Nervous and Mental Disease, 166, 209–216.
Glover, H., Silver, S., Goodnick, P., Ohlde, C., Packard, P., and Hamlin, C. (1994). Vulnerability Scale: A preliminary report of psychometric properties.Psychological Reports, 75, 1651–1668.
Goldberg, D. and Hillier, V. (1979). A scaled version of the General Health Questionnaire.Psychological Medicine, 9, 139–145.
Green, B. (1994). Psychosocial research in traumatic stress: An update.Journal of Traumatic Stress, 7, 341–362.
Green, B. (1993). Identifying survivors at risk: Trauma and stressors across events. In J. P. Wilson and B. Raphael (Eds.),International handbook of traumatic stress syndromes (pp. 135–144). New York: Plenum.
Green, B. (1990). Defining trauma: Terminology and generic stressor dimensionsJournal of Applied Social Psychology, 20, 1632–1642.
Hargreaves, A. (1980, April). Coping with disaster.American Journal of Nursing, 683.
Helzer, J., Robins, L., and McEnvoy, I. (1987). Post-traumatic stress disorder in the general population.New England Journal of Medicine, 317, 1630–1634.
Hiley-Young, B., and Gerrity, E. (1994). Critical incident stress debriefing (CISD): Value and limitations in disaster response.National Center for PTSD Clinical Quarterly, 4, 17–19.
Horowitz, M. and Wilner, N. (1981). Life events, stress and coping. In L. Poon (ed.),Aging in the 80s. Washington, DC: American Psychological Association.
Hyer, L., McCranie, E., and Peralme, L. (1993). Psychotherapeutic treatment of chronic PTSD.PTSD Research Quarterly, 4, 1–3.
Janis, I. (1951).Air war and emotional stress: Psychological studies of bombing and civilian defense. Westport, CT: Greenwood Press.
Janoff-Bulman, R. and Lang-Gunn, L. (1988). Coping with disease: The role of self-blame attributions. In L.Y. Abramson (Ed.),Social cognition and clinical psychology: A synthesis. New York: New York: Guilford.
Janoff-Bulman, R. (1985). The aftermath of victimization: Rebuilding shattered assumptions. In C.R. Figley (Ed.),Trauma and its wake. Vol 1. New York: Brunner/Mazel.
Kean, T. (1990). The epidemiology of post-traumatic stress disorder.PTSD Research Quarterly, 1, 1–7.
Keane, T., Caddell, J., and Taylor, K. (1988). Mississippi scale for combat-related post-traumatic stress disorder.Journal of Consulting and Clinical Psychology, 56, 35–90.
Koopman, C., Classen, C., Cardena, E., and Spiegel, D. (1995). When disaster strikes, acute stress disorder may follow.Journal of Traumatic Stress, 8, 29–46.
Lavee and Ben-David (1993). Families under war: Stresses and strains of Israeli families during the Gulf war,Journal of Traumatic Stress, 6, 239–254.
Lifton, R. J., and Olson, E. (1976). The human meaning of total disaster: The Buffalo Creek experience.Psychiatry, 39, 1–18.
Lifton, R. J. (1970, January).Testimony before the U.S. Senate Hearings of the Subcommittee on Veterans' Affairs of the Committee on Labor and Public Welfare, 91st Congress. Washington, DC: U.S. Government Printing Office.
Lindy, J. (1993). PTSD and transference.National Center for Post-Traumatic Disorder Clinical Quarterly, 3, 1, 3–4.
Lindy, J. (1988).Vietnam: A casebook. New York: Brunner/Mazel.
Lipkin, J. O., Blank, A. S., Parson, E. R., and Smith, J. R (1982). The Vietnam veteran and post-traumatic stress disorder.Hospital and Community Psychiatry, 33, 908–912.
Marmar, C., Weiss, D., Schlenger, W., Fairbanks, J., Jordan, B., Kulka, R and Hough, R. (1994). Peritraumatic dissociation and post-traumatic stress in male Vietnam theater veterans.American Journal of Psychiatry, 151, 902–907.
McFarlane, A. (1994). Helping victims in disasters: In J.R. Freedy and S.E. Hobfoll (Eds.),Traumatic stress: From theory to practice. New York: Plenum.
McFarlane, A. (1993). PTSD—A synthesis of research studies: The Australian bushfire disaster. In J. P. Wilson and B. Raphael (Eds.),International handbook of traumatic stress syndromes (pp. 421–429). New York: Plenum.
McNair, D., Lor, M., and Droppleman, L. (1992).POMS Manual Profile of Mood States. San Diego, CA: Edits.
Meichenbaum, D. (1995).A clinical handbook/practical therapist manual. For assessing and treating adults with post-traumatic stress disorder (PTSD). Waterloo, Ontario, Canada: Institute Press.
Parson, E. R. (1995a, May).In the aftermath of the Oklahoma City Disaster of human intentional design: A brief forecasting guide to psychological integration. Presented at Congressional Seminar on PTSD, Cannon House Office Building Room 334, Washington, D.C., Washington, D.C.
Parson, E. R. (1995b). Post-traumatic stress and coping in an inner city child: Traumatogenic witnessing of interparental violence and murder.Psychoanalytic Study of the Child, 50, 272–307.
Parson, E. R. (1994a). Post-traumatic stress disorder: Its biopsychobehavioral aspects and management. In B. Wolman and G. Stricker (Eds.),Anxiety and related disorders—A handbook (pp. 226–285).
Parson, E. R. (1994b). Post-traumatic ethnotherapy (P-TET): Processes in assessment and intervention in aspects of global psychic trauma. In M. B. Williams and J. Sommers (Eds.),Handbook of post-traumatic therapy (pp. 221–239). Westport, CT: Greenwood.
Parson, E. R (1987). Transference and post-traumatic stress: Combat veterans' transference to the Veterans Administration Medical Center.The Journal of the American Academy of Psychoanalysis, 14, 349–375.
Parson, E. R. (1986). Life after death: Combat veterans' struggle for meaning and recovery.Death Studies, 10, 11–26.
Parson, E. R. (1984). The reparation of the self.Journal of Contemporary Psychotherapy, 14, 4–51.
Pynoos, R, and Nader, K. (1988). Psychological first-aid and treatment approach to children exposed to violence: Research implications.Journal of Traumatic Stress, 1, 445–473.
Pynoos, R., Frederick, C., Nader, K., Arroyo, S., Steinberg, A., Eth, S., Nunez, F., and Fairbanks (1987). Life threat and post-traumatic stress in school age children.Archives of General Psychiatry, 44, 1057–1063.
Rainie, H. (1995, May) The buried sounds of children crying.U.S. News and World Report, 10.
Raphael, B. (1986).When disaster strikes: How individuals and communities cope with catastrophe. New York: Basic Books.
Robins, L., and Smith, E. (1983).Diagnostic Interview Schedule: Disorder Supplement. St. Louis, MO: Washington University School of Medicine.
Rubin, Z., and Peplau, L. (1973). Who believes in a just world?Journal of Social Issues, 31, 65–9.
Rubonis, A, and Bickman, L. (1991). Psychological impairment in the wake of disaster: the disaster-psychopathology relationship.Psychological Bulletin, 109, 384–399.
Sarason, I. (1994).Stress and social support. Paper presented at the NATO conference in Bonas, France on Stress, Coping, and Disaster in Bonas France.
Sarason, I., Sarason, F., Shearin, E., and Pierce, G. (1987). A brief measure of social support: Practical and theoretical implications.Journal of Personal Relationships, 4, 457–510.
Shalev, A. (1994). Editorial: The role of mental health professionals in mass casualty events.Israeli Journal of Psychiatry and Related Sciences, 31, 243–245.
Silver, R., Boon, C., and Stones, M. (1991). Searching for meaning in misfortune: Making sense of incest.Journal of Social Issues, 39, 81–102.
Sims, A., White, A., and Murphy, T. (1979). Aftermath neurosis: Psychological sequelae of the Birmingham Bombing in victims not seriously injured.Medical Science and the Law, 19, 78–81.
Solomon, S., and Green, B. (1992). Mental health effects of natural and human-made disasters.The National Center for PTSD Clinical Quarterly, 3, 107.
Solomon, S. and Canino, (1990). The appropriateness of DSM III-R criteria for post-traumatic stress disorder.Comprehensive Psychiatry, 31, 227–237.
Spielberger, C., Gorsuch, R., and Lushene, R. (1970).Manual of State-Trait Anxiety Inventory. Palo Alto, CA: Consulting Psychologist Press.
Spitzer, R., and William, J. (1985).Structured clinical interview for DSM (nonpatient version). New York: Biometric Research Department, New York State Psychiatric Institute.
Turner, S, and Gorst-Unsworth, C. (1990) Psychological sequelae of torture—a descriptive model.British Journal of Psychiatry, 157, 475–480.
Ursano, R., Kao, T., and Fullerton, C. (1992) Post-traumatic stress disorder and meaning: Structuring human chaos.Journal of Nervous and Mental Disease, 180, 756–759.
U.S. News and World Report (1995). Terror in the heartland: The end of innocence, p. 34, 39.
Van der Kolk, B., Van der Hart, O. (1991). The intrusive past: The flexibility of memory and the engraving of trauma.American Images, 48, 425–454.
Van der Kolk, B. (1987).Psychological trauma. Washington, DC: American Psychiatric Press.
Vogel, J. and Vernberg, E. (1994). Children's psychological responses to disasters.Journal of Clinical and Child Psychology, 22, 464–484.
Vrna, S., and Lauterback, O. (1994). Prevalence of traumatic events and post-traumatic psychological symptoms in a nonclinical sample of college students.Journal of Traumatic Stress, 7, 289–302.
Weine, S., Becker, D., McGlashan, T., Laub, D., Lazrove, S. Vojvoda, D., and Hyman, L. (1995). Psychiatric consequences of “ethnic cleansing”: Clinical assessments and trauma testimonies of newly resettled Bosnian refugees,American Journal of Psychiatry, 152, 536–542.
Weiss, D., Marmar, C., Metzler, T., and Ronfeldt, H. (1995). Predicting symptomatic distress in emergency services.Journal of Consulting and Clinical Psychology, 63, 361–368.
Weiss, D. (1993, October).The Impact of Event Scale-Revised. Paper presented at the Eighth Annual of the International Society for Traumatic Stress Studies. San Antonio, Texas.
Whittow, J. (1980).Disasters: The anatomy of environmental hazards. London: Allen Land.
Williams, R., Moore, C., Pettibone, T., and Thomas, S. (1992). Construction and validation of a brief self-report scale of self-management practices.Journal of Research in Personality, 26, 216–234.
World Health Organization (1993).The ICD-10 classification of mental and behavioural disorders: Diagnostic criteria for research. Geneva: World Health Organization.
Yalom, I. (1980).Existential psychotherapy. New York: Basic Books.
Yehuda, R., Resnick, H., Kahana, B., and Giller, (1993). Long-standing hormonal alterations to extreme stress in humans: Normative or maladaptive?Psychosomatic Medicine, 55, 287–297.
Zilberg, N., Weiss, D., and Horowitz, M. (1982). Impact of Event Scale: A cross-validation study and some empirical evidence supporting a conceptual model of stress response syndromes.Journal of Consulting and clinical Psychology, 50, 407–414.
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Parson, E.R. Mass traumatic terror in Oklahoma City and the phases of adaptational coping, part I: Possible effects of intentional injury/harm on victims' post-traumatic responses. J Contemp Psychother 25, 155–184 (1995). https://doi.org/10.1007/BF02306627
Issue Date:
DOI: https://doi.org/10.1007/BF02306627