Television watching and the risk of incident probable posttraumatic stress disorder: a prospective evaluation

The impact of 24/7 news coverage on the mental health of Israelis in the 'Iron Swords' War: A cross-sectional analysis among television audience

This study aims to assess the impact of continuous 24/7 news broadcasting on the mental well-being of Jewish Israelis during the 'Iron Swords' War and compare it to findings from the 2014 Conflict. An internet-based cross-sectional panel survey was conducted on 11-12 October 2023, during the 'Iron Swords' War. The study focused on Israel's adult Jewish population, enabling comparisons with a previous 2014 study. Participants reported news consumption changes, attitudes towards newscasts (burdensome, relaxing, stressful, addictive, Fear Of Missing Out [FOMO], avoidance), opinions on 24/7 news, and anxiety symptoms. Among 802 adult Jewish participants in Israel, 83.8% increased news consumption. While more than 70% of respondents found the newscast stressing at least a medium level, more than 40% said they do not try to avoid them at all. Nearly 24% found it much addictive. Women and younger individuals reported more FOMO, stress, and addiction. More than 70% reported experiencing at least one anxiety symptom, and 21% of all four. Linear regression explained 42.9% of the variance of reported anxiety, with gender, age, news stress, addiction, and FOMO as predictors. The current study results show an increase in all measurements compared to a separate study conducted using the same tools in 2014. Jewish Israelis struggled with news consumption during the recent war, harming mental health. Heightened anxiety was observed, compared to 2014, and affected all demographics.

It matters what you see: Graphic media images of war and terror may amplify distress

Media exposure to graphic images of violence has proliferated in contemporary society, particularly with the advent of social media. Extensive exposure to media coverage immediately after the 9/11 attacks and the Boston Marathon bombings (BMB) was associated with more early traumatic stress symptoms; in fact, several hours of BMB-related daily media exposure was a stronger correlate of distress than being directly exposed to the bombings themselves. Researchers have replicated these findings across different traumatic events, extending this work to document that exposure to graphic images is independently and significantly associated with stress symptoms and poorer functioning. The media exposure-distress association also appears to be cyclical over time, with increased exposure predicting greater distress and greater distress predicting more media exposure following subsequent tragedies. The war in Israel and Gaza, which began on October 7, 2023, provides a current, real-time context to further explore these issues as journalists often share graphic images of death and destruction, making media-based graphic images once again ubiquitous and potentially challenging public well-being. For individuals sharing an identity with the victims or otherwise feeling emotionally connected to the Middle East, it may be difficult to avoid viewing these images. Through a review of research on the association between exposure to graphic images and public health, we discuss differing views on the societal implications of viewing such images and advocate for media literacy campaigns to educate the public to identify mis/disinformation and understand the risks of viewing and sharing graphic images with others.

Support for a right-wing populist party and subjective well-being: Experimental and survey evidence from Germany

With the rise of populism in many countries, including Germany, it is more important than ever to better understand the causes and consequences of populist support. Using two experiments within the context of a large panel survey, we study how support for the German right-wing populist party Alternative für Deutschland (AfD) is associated with subjective perceptions of personal and financial well-being. In both experiments, we rely on priming the identity of AfD supporters, once in a controlled manner and once in a natural setting. We document a causal relationship from AfD support to diminished well-being for new and marginal AfD supporters. Our findings challenge the prevailing assumption that causality moves unidirectionally, from life dissatisfaction to support for populist parties, and suggest that early interventions focusing on positive messages are particularly promising to win voters back into the mainstream.

COVID-19-related media consumption and posttraumatic stress symptoms in U.S. military veterans: A nationally representative, longitudinal study

PURPOSE

To examine the association between COVID-19 media consumption and pandemic-related posttraumatic stress symptoms (PTSS) in U.S. veterans.

METHODS

A population-based sample of 3,074 U.S. veterans was surveyed prior to the pandemic (fall 2019) and a year later during the height of the pandemic (fall 2020).

RESULTS

Greater COVID-19 media consumption was associated with pandemic-related PTSS, particularly in veterans with pre-existing posttraumatic stress disorder (PTSD) who were 79% more likely to report pandemic-related PTSS relative to veterans with PTSD who consumed less COVID-19 media.

CONCLUSION

COVID-19 media consumption is independently linked to a greater likelihood of pandemic-related PTSS in U.S. veterans.

Buffering the effects of bad news: Exposure to others' kindness alleviates the aversive effects of viewing others' acts of immorality

Negatively valenced news dominates the press, with stories of death and destruction gaining significant traction while also negatively impacting people's mental health and perceptions of humanity. Given that horrific acts happen and need to be reported, we examined if news stories featuring others' kindness could undo the aversive effects of news stories featuring others' immorality. In Studies 1a-d we tested whether media exposure to the acts of kindness that occurred in response to a terrorist attack could alleviate the aversive effects of media exposure to the terrorist attack. In Study 2, we examined whether, more generally, the aversive effects of news stories featuring immorality (e.g., homicide, paedophilia, bullying) could be alleviated through news stories featuring acts of kindness (e.g., volunteering, philanthropy, caring for the homeless). In Studies 1 and 2, we found that participants exposed to others' immorality and then others' kindness suffered from less aversive changes to their mood, experienced greater levels of elevation and were more inclined to believe in the goodness of others, than participants exposed only to others' immorality. Given this, we suggest there is merit in journalists shining a light on others' kindness if people's affective well-being and belief in the goodness of humanity is to remain intact.

The Impacts of Social Media Use and Online Racial Discrimination on Asian American Mental Health: Cross-sectional Survey in the United States During COVID-19

Background

During the COVID-19 pandemic, increased social media usage has led to worsened mental health outcomes for many people. Moreover, due to the sociopolitical climate during the pandemic, the prevalence of online racial discrimination has contributed to worsening psychological well-being. With increases in anti-Asian hate, Asian and Asian American social media users may experience the negative effects of online racial discrimination in addition to the reduced psychological well-being resulting from exposure to online COVID-19 content.

Objective

This study aims to investigate the impact of COVID-19–related social media use and exposure to online racial discrimination during the pandemic on the mental health outcomes (ie, anxiety, depression, and secondary traumatic stress [STS]) of Asian Americans compared with those of non-Asian Americans. In addition, this study explores the mediating role of negative affect and the moderating role of racial/ethnic identification.

Methods

An online survey was conducted through Amazon Mechanical Turk and a university-wide research portal from March 3 to March 15, 2021. A total of 1147 participants took the survey. Participants’ social media usage related to COVID-19 and exposure to 2 online forms of racial discrimination (individual and vicarious), mental health outcomes (anxiety, depression, and STS), racial/ethnic identification, negative affect, and demographics were assessed.

Results

Our results showed that COVID-19–related social media use, individual discrimination, and vicarious discrimination were predictors of negative mental health outcomes (anxiety, depression, and STS). Asian Americans reported higher vicarious discrimination than Latinx and White Americans, but Asian Americans’ mental health outcomes did not differ substantially from those of the other racial/ethnic groups. Racial/ethnic identification moderated the relationship between both types of discrimination and STS, and negative affect served as a mediator between both types of discrimination and all 3 mental health outcomes.

Conclusions

These results suggest that social media exposure continues to have a dire effect on mental health during the COVID-19 pandemic. This study helps to contextualize the rise of anti-Asian American hate and its impact on mental health outcomes in the United States.

Media exposure, risk perceptions, and fear: Americans' behavioral responses to the Ebola public health crisis

We examined media exposure, psychological fear and worry, perceptions of risk, and health protective behaviors surrounding the 2014 Ebola virus outbreak in a probability-based, representative, national sample of Americans (N = 3447). Structural equation models examined relationships between amount (hours/day) and content (e.g., graphic images of dead bodies) of media exposure and counts of self-reported health protective behaviors that participants performed or would perform if Ebola spread to their community. Ebola-related risk perceptions and fear and worry were potential mediators. Greater total hours and more graphic media exposure positively correlated with more fear and worry; greater total hours of media exposure also positively correlated with higher perceived risk. Higher risk perceptions were associated with more health protective behaviors performed and intended. Greater fear and worry were associated with more behaviors performed. Amount and content of media exposure exhibited indirect effects on behaviors performed; amount of media exposure had indirect effects on intentions. Media may help promote health protective behaviors during public health threats; the amount and content should be congruent with threat to minimize distress and maximize resources.

Media Contact and Posttraumatic Stress in Employees of New York City Area Businesses after the September 11 Attacks

Objective:

The objective of this study was to examine associations between media contact and posttraumatic stress in a sample with a large number of individuals who were directly exposed to the September 11, 2001 (9/11) attacks and to compare outcomes in exposed and unexposed participants.

Methods:

Structured interviews and questionnaires were administered to a volunteer sample of 254 employees of New York City businesses 35 months after the attacks to document disaster trauma exposures, posttraumatic stress outcomes, and media contact and reactions.

Results:

Media variables were not associated with psychopathological outcomes in exposed participants, but media contact in the first week after the attacks and feeling moderately/extremely bothered by graphic 9/11 media images were associated with re-experiencing symptoms in both the exposed and unexposed participants. Feeling moderately/extremely bothered by graphic media images was associated with hyperarousal symptoms in exposed participants.

Conclusions:

The findings suggest that media contact did not lead to psychopathology in exposed individuals, although it was associated with normative distress in both exposure groups. Because of the potential for adverse effects associated with media contact, clinicians and public health professionals are encouraged to discuss concerns about mass trauma media contact with their patients and the public at large.

Infodemic vs. Pandemic Factors Associated to Public Anxiety in the Early Stage of the COVID-19 Outbreak: A Cross-Sectional Study in China

Introduction: Every outbreak of an epidemic or pandemic disease is accompanied by the tsunami of information, which is also known as the infodemic. Infodemic makes it hard for people to find trustworthy sources and reliable guidance when they need it, and causes social panic about health, widens the gaps between races and regions, and even brings the social chaos all over the world. While most researchers and related parties made efforts to control the inaccurate information spreading online during the COVID-19 pandemic, the infodemic influence caused by the overload of accurate information were almost or completely ignored, and this will hinder the control of infodemic in future public health crises. This study aims to explore the infodemic vs. pandemic influence on people's psychological anxiety across different media sources in the early stage of the COVID-19 outbreak in China. Methods: A cross-sectional study using online survey method was conducted by a data-collection service provider in April 2020. A total of 1,117 valid samples were finally collected from 5,203 randomly invited members via webpages and WeChat. The sample distribution covered the 30 provincial administrative divisions of mainland China. Results: Hierarchical regression analysis for the potential pandemic sources and infodemic sources of psychological anxiety showed that the infodemic factors of attention to the coronavirus information (β = 0.154, p < 0.001) and commercial media exposure (β = 0.147, p < 0.001) is positively related to the level of anxiety. Statistics indicated that influence of the infodemic factors is over and above that of the pandemic factors (ΔR ² = 0.054, F = 14.199, and p < 0.001). Mediation analysis showed that information overload (B = 0.155, Boot SE = 0.022, and 95% Boot CI [0.112, 0.198]) mediates the link between attention to coronavirus information and anxiety; both information overload (B = 0.035, Boot SE = 0.014, and 95% Boot CI [0.009, 0.062]) and media vicarious traumatization (B = 0.106, Boot SE = 0.017, and 95% Boot CI [0.072, 0.140]) mediate the link between commercial media exposure and anxiety. Conclusion: This study suggested that the influence of infodemic with mixed accurate and inaccurate information on public anxiety does exist, which could possibly go beyond that of the pandemic. Information overload and vicarious traumatization explain how infodemic may be associated to public anxiety. Finally, commercial media could be a major source of infodemic in the Chinese media context. Implications for the related parties were discussed.

Addressing the "Myth" of Racial Trauma: Developmental and Ecological Considerations for Youth of Color

Trauma is prevalent among children and adolescents, with youth of color generally reporting greater exposure compared to White youth. One factor that may account for this difference is racial stress, which can manifest into trauma symptoms. Although racial stress and trauma (RST) significantly impacts youth of color, most of the research to date has focused on adult populations. In addition, little attention has been given to the impact of the ecological context in how youth encounter and cope with RST. As such, we propose the Developmental and Ecological Model of Youth Racial Trauma (DEMYth-RT), a conceptual model of how racial stressors manifest to influence the trauma symptomatology of children and adolescents of color. Within developmental periods, we explore how individual, family, and community processes influence youth's symptoms and coping. We also discuss challenges to identifying racial trauma in young populations according to clinician limitations and the post-traumatic stress disorder framework within the diagnostic and statistical manual of mental disorders-fifth edition (DSM-5). The article concludes with implications on applying DEMYth-RT in clinical and research settings to address RST for youth of color.

Media exposure predicts acute stress and probable acute stress disorder during the early COVID-19 outbreak in China

Background

The COVID-19 has led to unprecedented psychological stress on the general public. However, the associations between media exposure to COVID-19 and acute stress responses have not been explored during the early COVID-19 outbreak in China.

Methods

An online survey was conducted to investigate the relationships between media exposure to COVID-19 and acute stress responses, and to recognize associated predictors of acute stress responses on a sample of 1,450 Chinese citizens from February 3 to February 10, 2020. Media exposure questionnaire related to COVID-19 was developed to assess media exposure time, media exposure forms and media exposure content. The Stanford Acute Stress Reaction Questionnaire (SASRQ) was used to measure acute stress responses, including continuous acute stress symptom scores and the risk of probable acute stress disorder (ASD). A series of regression analyses were conducted.

Results

Longer media exposure time and social media use were associated with higher acute stress and probable ASD. Viewing the situation of infected patients was associated with higher acute stress, whereas viewing the latest news about pandemic data was associated with lower odds of probable ASD. Being females, living in Hubei Province, someone close to them diagnosed with COVID-19, history of mental illness, recent adverse life events and previous collective trauma exposure were risk factors for acute stress responses.

Conclusions

These findings confirmed the associations between indirect media exposure to pandemic events and acute stress responses. The governments should be aware of the negative impacts of disaster-related media exposure and implement appropriate interventions to promote psychological well-being following pandemic events.

Overwhelmed by the news: A longitudinal study of prior trauma, posttraumatic stress disorder trajectories, and news watching during the COVID-19 pandemic

RATIONALE

It has been recognized that exposure to mass trauma tends to increase the time spent watching television (TV) news. Yet, research on the effects of this tendency on individuals' well-being yielded inconclusive findings.

OBJECTIVE

The aim of this longitudinal study is to examine the effects of prior trauma and posttraumatic stress disorder (PTSD) on changes in the amount of TV news watching and its effect on subsequent PTSD. More specifically, we examined the interrelations of prior exposure to war captivity, long-term PTSD trajectories, and amount of change TV news watching with PTSD severity during the COVID-19 pandemic, among aging Israeli combat veterans.

METHODS

One-hundred-and-twenty Israeli ex-prisoners of war (ex-POWs) from 1973 Yom Kippur War and 65 matched controls (combat veterans from the same war) were followed up at five points of time: 1991 (T1), 2003 (T2), 2008 (T3), 2015 (T4), and in April-May 2020 (T5), during the outbreak of the COVID-19 pandemic.

RESULTS

Ex-POWs had higher odds of COVID-19 related increase in TV news watching, which, in turn, contributed to PTSD severity at T5. In addition, delayed PTSD trajectory was associated with COVID-19 related increase in TV news watching, which, in turn, contributed to more severe PTSD at T5.

CONCLUSIONS

These findings highlight the negative implications of TV news watching during a mass trauma for traumatized individuals. More specifically, they demonstrate its potential pathogenic role in exacerbating prior PTSD among trauma survivors.

Media Exposure to COVID-19 Predicted Acute Stress: A Moderated Mediation Model of Intolerance of Uncertainty and Perceived Social Support

Background: Previous studies have found that disaster-related media exposure could predict acute stress responses. However, few studies have investigated the relationship between media exposure to COVID-19 and acute stress, and less is known about the mechanisms that translate media exposure to COVID-19 into acute stress. The current study explored the impact of media exposure to COVID-19 on acute stress, and examined the mediating role of intolerance of uncertainty (IU) and the moderating role of perceived social support (PSS). Methods: A total of 1,483 Chinese participants (M age = 27.93 years, SD = 8.45) completed anonymous online questionnaires regarding media exposure to COVID-19, IU, PSS, and acute stress during the COVID-19 outbreak in China. Results: Media exposure to COVID-19 was positively related to acute stress, and IU partially mediated this relationship. The direct effect of media exposure to COVID-19 on acute stress, and the relationship between IU and acute stress, were both moderated by PSS. The impacts of both media exposure to COVID-19 and IU on acute stress were stronger for individuals with low PSS. Limitations: This study collected data in a shorter timeframe, and no assessments occurred during the follow-up, which may prevent us from detecting the changes of the relationships between variables over time. Meanwhile, the self-report method limited the validity of the data due to subjective reporting bias. Conclusions: These findings contribute to a better understanding of how and when pandemic-related media exposure affects acute stress, and provide new perspectives for the prevention to reduce psychological problems following traumatic events.

Media Exposure and Anxiety during COVID-19: The Mediation Effect of Media Vicarious Traumatization

The rapid spread and high death rates of the COVID-19 pandemic resulted in massive panic and anxiety all over the world. People rely heavily on media for information-seeking during the period of social isolation. This study aimed to explore the relationship between media exposure and anxiety, and highlighted the underlying mechanisms mediated by the media vicarious traumatization effect. A total of 1118 Chinese citizens participated in the online survey, who were from 30 provinces in mainland China. Results showed that all four types of media (official media, commercial media, social media, and overseas media) cause vicarious traumatization to their audiences to different degrees. It was also found that the impact of media exposure on anxiety was mediated by media vicarious traumatization: there were full mediation effects for commercial media exposure and overseas media exposure, while there were indirect-only mediation effects for official media exposure and social media exposure. Audiences staying in cities with a relatively severe pandemic were more susceptible to the vicarious traumatization caused by commercial media compared to those staying in Hubei. This study expanded the concept and application of vicarious traumatization to the mediated context, and the findings provided insightful advice to media practitioners in the face of major crisis.

How People Emotionally Respond to the News on COVID-19: An Online Survey

Introduction:

During the Coronavirus Disease 2019 (COVID-19) outbreak, news media has played an important role in informing people to satisfy their curiosity about this stressful condition. Regular exposure to such stressful news may elicit different emotions in people and engage them in using strategies to control their emotions. In the present study, we aimed at exploring the most common negative emotion(s) experienced by individuals, as well as the most frequent Emotion Regulation (ER) strategies used facing the COVID-19-related news. We also examined whether the variable of personal relevance can moderate these emotional responses.

Methods:

617 individuals living in Tehran who regularly read the news about the COVID-19 from the early stages of spread completed an online survey. After excluding the participants with high scores from the Beck Depression Inventory (>18), data obtained from 443 participants were analyzed in terms of the experienced negative emotions and ER strategies.

Results:

Anxiety (55.8%) was the most common negative emotion reported by participants facing COVID-19-related news and problem-solving was the most frequent strategy used to control negative emotions. Both groups with high and low personal relevance indicated a similar pattern in experiencing high and low arousal emotions, as well as using ER strategies, and no significant differences were found (X²=0.006, p=0.51; X²=0.14, p=0.39, respectively). We also found that participants with high scores in the resilience scale used an integrative rather than a single approach of the ER strategies (rbp=0.15, p=0.01).

Conclusion:

We found that during the COVID-19 outbreak, news media may have important role in triggering anxiety in people who regularly read the relevant news, and problem-solving was the most frequent strategy among them. Being directly involved with COVID-19 in personal life did not make any differences in the way that individuals emotionally respond to the news. While using an integrative approach in regulating emotion was found in more resilient individuals.

Active Shooter and Terrorist Event-Related Posttraumatic Stress and Depression: Television Viewing and Perceived Safety

OBJECTIVE

This study examined the relationship of sniper-related television viewing (TV) and perceived safety to posttraumatic stress (PTS) and depressive symptoms during the Washington, DC sniper attacks.

METHODS

Participants were 1238 Washington, DC area residents assessed using an internet survey including the Impact of Event Scale-Revised, Patient Health Questionnaire-9, hours of TV, and perceived safety.

RESULTS

Almost 40% (n = 459) of participants watched at least 2 hours of sniper-related TV daily. TV viewing was associated with lower total perceived safety. After adjusting for demographics, more TV viewing and decreased perceived safety were related to increased PTS and depressive symptoms. TV viewing modified the effect of safety on PTS and depressive symptoms. Among participants with low and high perceived safety, hours of TV were positively associated with PTS; however, the effect was stronger among those with low perceived safety. The relationship of TV to increased depressive symptoms was identified only in participants who reported low perceived safety.

CONCLUSIONS

The influence of media exposure and perceived safety have implications for intervention by community leaders and mental health care providers. Recommendations include limiting media exposure during a terrorist event, particularly among those who perceive that their safety is at risk, and targeting safety in communication strategies. (Disaster Med Public Health Preparedness. 2019;13:570-576).

Race-Related Traumatic Events Online and Mental Health Among Adolescents of Color

PURPOSE

Viral videos of the detainment of undocumented immigrants in cages and police killings of unarmed citizens are two of the most pressing traumatic events facing adolescents of color. However, little is known about whether these online experiences are linked to mental health outcomes. This study examines the association between exposure to such events online and mental health in a sample of African American and Latinx adolescents.

METHODS

Data were collected from a national sample of 302 African American and Latinx adolescents aged 11-19 years. Participants reported their exposure to traumatic events online (TEO), depressive symptoms, post-traumatic stress disorder (PTSD) symptoms, and other sociodemographics. Multiple regression analyses were conducted.

RESULTS

Analyses indicated a significant association between TEO and both PTSD symptoms and depressive symptoms, indicating that more frequent experiences of TEO were associated with higher levels of PTSD symptoms and depressive symptoms. In addition, regression analyses further indicated that girls reported higher PTSD and depressive symptoms than boys. Latinx participants also reported increased depressive symptoms.

CONCLUSIONS

This study extends recent research that suggests police killings, as well as viewing distressing news directed at members of one's own racial-ethnic group or those who share the same immigration status, are related to poor mental health outcomes. Researchers should also explore what protective factors may buffer youth against the outcomes typically associated with these events.

The Syrian refugee crisis in Jordan: a cross sectional pharmacist-led study assessing post-traumatic stress disorder

Background:

The United Nations has declared the Syrian crisis as the worst humanitarian crisis of the twenty-first century. Pharmacists play a vital role in humanitarian aid and in delivering health advices for refugees. Many Syrian refugees are in need of psychosocial assessments.

Objective:

Objective of this study was to investigate the prevalence of post-traumatic stress disorder (PTSD), assessed by pharmacists among Syrian civilian refugees residing in Amman, Jordan.

Methods:

A cross-sectional study involving Syrian civilian refugees living in Amman, Jordan, was conducted using the published and validated Arabic version of the Harvard Trauma Questionnaire (HTQ). Pharmacists recruited civilian Syrian refugees and completed the HTQ. The questionnaire included 45 questions, with the first 16 questions (HTQ-16) intended to assess the trauma symptoms felt by refugees. Assessments were done by the pharmacists and refugees were categorized to suffer PTSD if their mean item score for the HTQ-16 scale was > 2.5.

Results:

Study participants (n=186; mean age 31.5 years; 51.3% males) had a HTQ-16 mean score of 2.35 (SD=0.53), with a range of 1.19 - 3.63. Over a third of participants (38.7%) were categorized as having PTSD. Males reported significantly worse PTSD symptoms (mean=2.42, SD=0.50) compared to females (mean=2.26, SD=0.57). Correlation between the mean item score for the HTQ-16 and characteristics of the study participants showed higher mean item score correlated with being a male, older in age, a smoker, and if trauma was experienced.

Conclusions:

Many Syrian civilian refugees living in Jordan suffer from PTSD. Male participants were found to be more affected by the severity of the disorder. Pharmacists are suitably situated to identify civilian Syrian refugees suffering from PTSD in dire need of help, paving the way for much needed healthcare resources to be delivered to this particular group of refugees.

Is Viewing Mass Trauma Television Coverage Associated With Trauma Reactions in Adults and Youth? A Meta-Analytic Review

This study presents the findings of meta-analyses examining the association between viewing mass trauma television coverage and posttraumatic stress (PTS) outcomes as well as acute stress reactions (ASR) among adults and youth. A literature search identified 43 (N = 31,162) studies assessing the association between viewing mass trauma television coverage and PTS and four (N = 9,083) assessing the association with ASR. The overall size of the association between viewing television coverage and PTS, estimated using a random-effect model, was small but statistically significant, r = .17, 95% CI [.13, .22]. The moderator analysis examined eight preselected variables: man-made versus natural trauma, specific incident versus chronic stressor, adult versus youth sample, proximal versus distal event exposure, television only versus combined media form, specific content in coverage versus no specific content, quantification of media contact using numeric measurement versus subjective measurement versus a binary item, and posttraumatic stress symptoms (PTSS) versus posttraumatic stress disorder (PTSD) outcome. The analysis revealed a statistically significant moderation effect for the quantification of media contact (numeric vs. subjective vs. binary) only, which accounted for 19% of the observed heterogeneity. With a summary estimate of r = .26, 95% CI [.06, .44], the analysis of the ASR studies corroborated the PTS findings. The results suggest that clinicians and public health practitioners should discuss mass trauma television viewing with their patients and with the public. Limitations of the extant research are discussed.

Disaster awareness and coping: Impact on stress, anxiety, and depression

PURPOSE

This study examines disaster awareness and coping among college students to identify their influence on stress, anxiety, and depression.

DESIGN AND METHODS

Overall, 291 college students participated. A multiple regression analysis was conducted to analyze the influence of disaster awareness and coping on stress, anxiety, and depression.

FINDINGS

In the multiple regression model, anxiety, and depression were influenced by an awareness of natural and social disasters, level of perception of disaster response strategies, and level of information relating to disasters.

PRACTICE IMPLICATIONS

It is important to deliver effective information on disaster response and strategies to prevent disaster-related mental health issues.

Posttraumatic stress disorder symptoms and television viewing patterns in the Nurses' Health Study II: A longitudinal analysis

Introduction

The relation between TV viewing and posttraumatic stress disorder (PTSD) is controversial; prior work focused exclusively on whether TV viewing of disaster events constitutes a traumatic stressor that causes PTSD. This study evaluates a possible bidirectional relation between PTSD and TV viewing in community-dwelling women.

Methods

Data are from the PTSD subsample of the Nurses’ Health II study, an ongoing prospective study of women aged 24–42 years at enrollment and who have been followed biennially (N = 50,020). Trauma exposure and PTSD symptoms (including date of onset) were assessed via the Brief Trauma Questionnaire and the Short Screening Scale for DSM-IV PTSD. Average TV viewing was reported at 5 times over 18 years of follow-up. Linear mixed models assessed differences in TV viewing patterns by trauma/PTSD status. Among women with trauma/PTSD onset during follow-up (N = 14,374), linear spline mixed models assessed differences in TV viewing patterns before and after PTSD onset.

Results

Women with high PTSD symptoms reported more TV viewing (hours/wk) compared to trauma-unexposed women at all follow-up assessments (β = 0.14, SE = 0.01, p < .001). Among the women who experienced trauma during follow-up, significant increases in TV viewing (hours/day) prior to onset of high PTSD symptom levels were evident (β = 0.15, SE = 0.02, p < .001).

Conclusions

TV viewing following trauma exposure may be a marker of vulnerability for developing PTSD and also a consequence of having PTSD. High TV viewing levels may be linked with ineffective coping strategies or social isolation, which increase risk of developing PTSD.

When Words Hurt: Affective Word Use in Daily News Coverage Impacts Mental Health

Media exposure influences mental health symptomology in response to salient aversive events, like terrorist attacks, but little has been done to explore the impact of news coverage that varies more subtly in affective content. Here, we utilized an existing data set in which participants self-reported physical symptoms, depressive symptoms, and anxiety symptoms, and completed a potentiated startle task assessing their physiological reactivity to aversive stimuli at three time points (waves) over a 9-month period. Using a computational linguistics approach, we then calculated an average ratio of words with positive vs. negative affective connotations for only articles from news sources to which each participant self-reported being exposed over the prior 2 weeks at each wave of data collection. As hypothesized, individuals exposed to news coverage with more negative affective tone over the prior 2 weeks reported significantly greater physical and depressive symptoms, and had significantly greater physiological reactivity to aversive stimuli.

Posttraumatic Stress Disorder Symptoms and Posttraumatic Growth Following Indirect Trauma from the Sewol Ferry Disaster, 2014

OBJECTIVE

The definition of psychological trauma, which was traditionally restricted to immediate and direct experience, is now expanding to include mediated or vicarious experience. So the present study aims to examine the relationship between the negative effects and the positive outcomes to a national disaster by assessing the posttraumatic stress disorder (PTSD) symptoms and posttraumatic growth of the general public.

METHODS

A nationwide survey of the Korean population (n=811) who were exposed to the Sewol ferry disaster through the media participated in this research, completing a self-report questionnaire consisting of demographic characteristics, Impact of Event Scale-Revised- Korean, and Korean-Stress-related Growth Scale-Revised. The participants were divided into three groups according to the severity of PTSD symptoms, then one-way ANOVA were conducted.

RESULTS

The results revealed 30.4% of the sampled participants reported stress symptoms equivalent to partial or full PTSD. Posttraumatic growth was significantly higher in the full and the partial PTSD symptom groups when compared to the normal group [F (2, 759)=20.534, p&lt;0.001]. At a subscale level, mature thinking showed a more significant result [F (2,759)=23.146, p&lt;0.001] than religious growth [F (2, 180.984)=4.811, p&lt;0.01].

CONCLUSION

The results indicated a general linear trend between the severity of PTSD symptoms and posttraumatic growth level, suggesting that indirect trauma also induces both PTSD symptoms and posttraumatic growth like direct trauma does. The theoretical implications based on these findings were discussed.

The 2015 and 2016 terrorist attacks in France: was there a short-term impact on hospitalizations for cardiovascular disease?

Background

The terrorist attacks in Paris and Nice in 2015 and 2016 generated widespread emotional stress in France. Given that acute emotional stress is a well-known trigger for cardiovascular disease, we investigated whether these attacks had any short-term impact on hospitalizations for acute cardiovascular disease in France.

Methods

Annual hospital discharge data from 2009 to 2016 were extracted from the French Hospital Discharge Database. All hospitalizations with a primary diagnosis of acute coronary syndrome, heart failure, or stroke were selected. Generalized additive Poisson models were used to differentiate "unusual" variations in daily hospitalization numbers in the 15 days following the attacks from the expected background hospitalization rate.

Results

The average daily number of hospitalizations was 396.4 for acute coronary syndrome, 598.6 for heart failure, and 334.6 for stroke. The daily mean number of hospitalizations for heart failure and stroke was higher in the 15 days following each attack compared with the reference periods. However, multivariate analysis showed no significant variation in the risk of hospitalization in the days following the attacks.

Interpretation

Watching events unfold on television, no matter how dramatic, was not a sufficiently potent trigger for cardiovascular disease, although it may have led to an increase in hospitalizations for stress or anxiety. The 2015 and 2016 terrorist attacks do not seem to have had any measurable short-term impact on hospitalizations for cardiovascular disease either in the Paris and Nice regions or in the rest of France.

Media use and insomnia after terror attacks in France

Direct exposure to traumatic events often precipitates sleep disorders. Sleep disturbance has also been observed amongst those indirectly exposed to trauma, via mass media. However, previous work has focused on traditional media use, rather than contemporary social media. We tested associations between both traditional and social media consumption and insomnia symptoms following 2015 terror attacks in Paris France, controlling for location and post-traumatic symptomology. 1878 respondents, selected to represent the national French population, completed an internet survey a month after the Bataclan attacks (response rate 72%). Respondents indicated different media use, post-traumatic stress and insomnia. Controlling for demographics, location and PTSD, insomnia was associated with both traditional (β 0.10, P = .001) and social media use (β 0.12, P = .001). Associations between social media and insomnia were independent of traditional media use. Interventions targeted at social media may be particularly important following mass trauma.

Aftermath of Terror: A Nationwide Longitudinal Study of Posttraumatic Stress and Worry Across the Decade Following the September 11, 2001 Terrorist Attacks

Research conducted in the early years after the September 11, 2001 (9/11) terrorist attacks in New York, Pennsylvania, and Washington, DC demonstrated adverse psychological outcomes among residents of the United States who were exposed to the attacks both directly and indirectly via the media. However, less is known about the impact of this collective trauma over time. Beginning at the end of December 2006, a longitudinal study of a nationally representative sample of U.S. residents (Cohort 2, N = 1,613) examined the long-term effects of 9/11, with annual assessments administered every year for 3 years. We assessed rates of 9/11-related posttraumatic stress (PTS) annually during the first 2 years of the study; during the second and third years of the study, we assessed fear and worry regarding future terrorism. Rates of PTS among participants were compared with those assessed annually in a nationally representative sample between 2002 and 2004 (Cohort 1); results indicated a relatively stable pattern of 9/11-related PTS symptoms for 6 years following the attacks. Five to six years after 9/11, we found an association between 9/11-related PTS and both direct, B = 8.45, 95% CI [4.32, 12.59] and media-based (live television), B = 1.78, 95% CI [0.90, 2.65] exposure to the attacks. Six to 7 years post-9/11, fear and worry regarding future terrorism were predicted by 9/11-related PTS symptoms that had been reported approximately 5 years after the attacks, B = 0.04, 95% CI [0.03, 0.05]. The psychological legacy of 9/11 was perceptible among many U.S. residents throughout the decade that followed.

Media experiences and associations with mental health among the bereaved of the MH17-disaster: A latent profile analysis

Research has shown that the amount of media exposure is associated with post-event mental health problems. Whether bereaved individuals have negative experiences with media reports and whether they are associated with post-event mental health is unclear. This study evaluated these experiences and associations following the MH17-disaster. How media reports were experienced (nine topics, modified MAS), depression symptoms (QIDS-SR), functional problems (WSAS) and event-related coping-self-efficacy (CSE) were assessed about one year post-disaster (May-August 2015) among Dutch bereaved (N = 152). A substantial minority reported negative experiences such as reports made me angry (30%) and made me sad (48%). Latent profile analysis with symptoms, problems and coping self-efficacy as indicators, identified four classes of post-disaster mental health: a Well-functioning^{(class 1)} , 35.1%; a Mild-problems^{(class 2)} , 30.4%; a Sub-clinical^{(class 3)} , 27.0%; and a Clinical^{(class 4)} , 7.4%. Differences in symptoms, problems and coping self-efficacy levels between classes were large according to Cohen's ds. Multivariate logistic regression (MLR) showed that the Clinical^{(class 4)} compared to the Well-functioning^{(class 1)} , more often that felt that reports strongly "embarrassed me," "made me feel sad," "filled me with fear" and "served as a magnifying glass." Future research should assess opportunities and effects of limiting media consumption.

Post-Traumatic Stress Disorder and other mental disorders in the general population after Lorca's earthquakes, 2011 (Murcia, Spain): A cross-sectional study

AIMS

To describe the prevalence and severity of mental disorders and to examine differences in risk among those with and without a lifetime history prior to a moderate magnitude earthquake that took place in Lorca (Murcia, Spain) at roughly the mid-point (on May 11, 2011) of the time interval in which a regional epidemiological survey was already being carried out (June 2010 -May 2012).

METHODS

The PEGASUS-Murcia project is a cross-sectional face-to-face interview survey of a representative sample of non-institutionalized adults in Murcia. Main outcome measures are prevalence and severity of anxiety, mood, impulse and substance disorders in the 12 months previous to the survey, assessed using the Composite International Diagnostic Interview (CIDI 3.0). Sociodemographic variables, prior history of any mental disorder and earthquake-related stressors were entered as independent variables in a logistic regression analysis.

FINDINGS

A total number of 412 participants (response rate: 71%) were interviewed. Significant differences in 12-month prevalence of mental disorders were found in Lorca compared to the rest of Murcia for any (12.8% vs 16.8%), PTSD (3.6% vs 0.5%) and other anxiety disorders (5.3% vs 9.2%) (p≤ 0.05 for all). No differences were found for 12-month prevalence of any mood or any substance disorder. The two major predictors for developing a 12-month post-earthquake mental disorder were a prior mental disorder and the level of exposure. Other risk factors included female sex and low-average income.

CONCLUSIONS

PTSD and other mental disorders are commonly associated with earthquake disasters. Prior mental disorders and the level of exposure to the earthquakes are the most important for the development of a consequent mental disorder and this recognition may help to identify those individuals that may most benefit from specific therapeutic intervention.

Traumatic stress symptoms after the November 13th 2015 Terrorist Attacks among Young Adults: The relation to media and emotion regulation

OBJECTIVE

A major terror attack occurred in the Paris region on 13th November 2015. This event was widely showed, described, and commented in the media. Media consumption may lead to a widespread diffusion of trauma-related symptoms following a collective trauma. These effects may depend on the type of media and emotion regulation strategies used by the media consumer.

METHOD

Trauma history, traumatic symptoms, media consumption, psychological distress, and emotion regulation strategies of 451 young adults were assessed by an online survey.

RESULTS

Findings reveal the joint role of social networks use and dysfunctional emotion regulation strategies on anxiety, depression, and somatization symptoms and also on cognitive and emotional alteration among traumatic symptoms.

DISCUSSION

Consistent with the emotional contagion hypothesis, individuals who reported spending more time on social networks were also those who were experiencing more psychological distress.

Reactions of Oklahoma City bombing survivors to media coverage of the September 11, 2001, attacks

OBJECTIVE

This study explored the effects of media coverage of a terrorist incident in individuals remote from the location of a major attack who had directly experienced a prior terrorist incident.

METHOD

Directly-exposed survivors of the 1995 Oklahoma City bombing, initially studied six months after the incident, and indirectly-affected Oklahoma City community residents were assessed two to seven months after the September 11, 2001, attacks. Survivors were assessed for a diagnosis of bombing-related posttraumatic stress disorder (PTSD) at index and follow up, and emotional reactions and September 11 media behavior were assessed in all participants.

RESULTS

Among the three investigated forms of media (television, radio, and newspaper), only television viewing was associated with 9/11-related posttraumatic stress reactions. Exposure to the Oklahoma City bombing was associated with greater arousal in relation to the September 11 attacks, and among survivors, having developed bombing-related PTSD was associated with higher scores on all three September 11 posttraumatic stress response clusters (intrusion, avoidance, and arousal). Although time spent watching television coverage of the September 11 attacks and fear-related discontinuation of media contact were not associated with Oklahoma City bombing exposure, discontinuing September 11 media contact due to fear was associated with avoidance/numbing in the full sample and in the analysis restricted to the bombing survivors.

CONCLUSION

Surviving a prior terrorist incident and developing PTSD in relation to that incident may predispose individuals to adverse reactions to media coverage of a future terrorist attack.

Communal bereavement and resilience in the aftermath of a terrorist event: Evidence from a natural experiment

RATIONALE

Sociological analyses of the psychological distress experienced by persons indirectly exposed to traumatic stressors have been conceptualized as a form of communal bereavement, defined by Catalano and Hartig (2001) as the experience of distress among persons not attached to the deceased. Their theory predicts communal bereavement responses particularly in the setting of loss of essential state, religious, or economic institutions.

OBJECTIVE

To estimate the extent to which the September 11, 2001 attacks on the U.S. World Trade Center had a causal effect on psychological distress nationwide.

METHODS

We used a difference-in-differences framework applied to repeated cross-sectional data from more than 300,000 participants in the 2000 and 2001 Behavioral Risk Factor Surveillance System surveys. Psychological distress was measured using three questions eliciting days of poor mental health-related quality of life. The September 11 attacks served as our exposure of interest.

RESULTS

The September 11 attacks had a statistically significant, adverse, causal effect on psychological distress nationally. Both the magnitude and statistical significance of the estimated effects were larger in the New York City region compared to the rest of the country. Our estimates were robust to probes of the parallel trends assumption and potential sources of selection bias, as well as to falsification tests. However, these effects had largely resolved within four weeks.

CONCLUSIONS

Contrary to findings from the medical and public health literature, we conclude that the September 11 attacks did not have lasting effects on communal bereavement.

Cumulative exposure to prior collective trauma and acute stress responses to the Boston marathon bombings

The role of repeated exposure to collective trauma in explaining response to subsequent community-wide trauma is poorly understood. We examined the relationship between acute stress response to the 2013 Boston Marathon bombings and prior direct and indirect media-based exposure to three collective traumatic events: the September 11, 2001 (9/11) terrorist attacks, Superstorm Sandy, and the Sandy Hook Elementary School shooting. Representative samples of residents of metropolitan Boston (n = 846) and New York City (n = 941) completed Internet-based surveys shortly after the Boston Marathon bombings. Cumulative direct exposure and indirect exposure to prior community trauma and acute stress symptoms were assessed. Acute stress levels did not differ between Boston and New York metropolitan residents. Cumulative direct and indirect, live-media-based exposure to 9/11, Superstorm Sandy, and the Sandy Hook shooting were positively associated with acute stress responses in the covariate-adjusted model. People who experience multiple community-based traumas may be sensitized to the negative impact of subsequent events, especially in communities previously exposed to similar disasters.

Anxiety-Inducing Media: The Effect of Constant News Broadcasting on the Well-Being of Israeli Television Viewers

OBJECTIVE

The effects of televised trauma on the emotional well-being of television viewers has received some scientific attention in recent years, suggesting that the general public is placed at risk of developing distress and possibly posttraumatic psychopathology as a result of secondary exposure via mass media. At the break of a recent war in Gaza, we assessed the psychological effects of the extensive news broadcasting.

METHOD

An omnibus survey was performed two weeks into Operation Protective Edge with a sample of 500 participants representing the adult (> 18) Jewish population of Israel.

RESULTS

The results suggest that a vast majority (87.2%) of the population tuned in to the newscasts and the majority (76.7%) of viewers increased their news consumption compared to normal. Increased frequency of viewing newscasts was associated with reported anxiety reflected in uncontrolled fear, physiological hyperarousal, sleeping difficulties, and fearful thoughts. A regression model revealed that viewers watching the constant newscasts more than usual are 1.6 times more likely to report at least one anxiety symptom compared to those watching at the same frequency or less, standardized to gender and age.

CONCLUSIONS

Increased viewing patterns of televised traumatic content, as well as negative perception of such broadcasts, are associated with the report of anxiety symptoms or psychopathology. The public health implications of the findings are discussed.

Disaster media coverage and psychological outcomes: descriptive findings in the extant research

This review of the literature on disaster media coverage describes the events, samples, and forms of media coverage (television, newspapers, radio, internet) studied and examines the association between media consumption and psychological outcomes. A total of 36 studies representing both man-made and natural events met criteria for review in this analysis. Most studies examined disaster television viewing in the context of terrorism and explored a range of outcomes including posttraumatic stress disorder (PTSD) caseness and posttraumatic stress (PTS), depression, anxiety, stress reactions, and substance use. There is good evidence establishing a relationship between disaster television viewing and various psychological outcomes, especially PTSD caseness and PTS, but studies are too few to draw definitive conclusions about the other forms of media coverage that have been examined. As media technology continues to advance, future research is needed to investigate these additional media forms especially newer forms such as social media.

Witnessing images of extreme violence: a psychological study of journalists in the newsroom

OBJECTIVE

User Generated Content - photos and videos submitted to newsrooms by the public - has become a prominent source of information for news organisations. Journalists working with uncensored material can frequently witness disturbing images for prolonged periods. How this might affect their psychological health is not known and it is the focus of this study.

DESIGN

Descriptive, exploratory.

SETTING

The newsrooms of three international news organisations.

PARTICIPANTS

One hundred and sixteen journalists working with User Generated Content material.

MAIN OUTCOME MEASURES

Psychometric data included the re-experiencing, avoidance and autonomic arousal indices of posttraumatic stress disorder (Impact of Event Scale-revised), depression (Beck Depression Inventory-II; BDI-II), a measure of psychological distress (GHQ-28), the latter comprising four subscales measuring somatisation, anxiety, social dysfunction and depression, and mean weekly alcohol consumption divided according to gender.

RESULTS

Regression analyses revealed that frequent (i.e. daily) exposure to violent images independently predicted higher scores on all indices of the Impact of Event Scale-revised, the BDI-II and the somatic and anxiety subscales of the GHQ-28. Exposure per shift only predicted scores on the intrusion subscale of the Impact of Event Scale-revised.

CONCLUSIONS

The present study, the first of its kind, suggests that frequency rather than duration of exposure to images of graphic violence is more emotionally distressing to journalists working with User Generated Content material. Given that good journalism depends on healthy journalists, news organisations will need to look anew at what can be done to offset the risks inherent in viewing User Generated Content material. Our findings, in need of replication, suggest that reducing the frequency of exposure may be one way to go.

Mental- and physical-health effects of acute exposure to media images of the September 11, 2001, attacks and the Iraq War

Millions of people witnessed early, repeated television coverage of the September 11 (9/11), 2001, terrorist attacks and were subsequently exposed to graphic media images of the Iraq War. In the present study, we examined psychological- and physical-health impacts of exposure to these collective traumas. A U.S. national sample (N = 2,189) completed Web-based surveys 1 to 3 weeks after 9/11; a subsample (n = 1,322) also completed surveys at the initiation of the Iraq War. These surveys measured media exposure and acute stress responses. Posttraumatic stress symptoms related to 9/11 and physician-diagnosed health ailments were assessed annually for 3 years. Early 9/11- and Iraq War-related television exposure and frequency of exposure to war images predicted increased posttraumatic stress symptoms 2 to 3 years after 9/11. Exposure to 4 or more hr daily of early 9/11-related television and cumulative acute stress predicted increased incidence of health ailments 2 to 3 years later. These findings suggest that exposure to graphic media images may result in physical and psychological effects previously assumed to require direct trauma exposure.

The mental health consequences of student "Holocaust memorial journeys"

OBJECTIVE

Our aim was to study the mental health consequences of Israeli adolescents' 8-day "Holocaust memorial journey" to Poland.

METHOD

A survey to ascertain the experience of Israeli child and adolescent psychiatrists and residents in the specialty was conducted. Participants were asked about referrals regarding the memorial journey, and to compare these cases with referrals for other potentially traumatic events, including school "sleep-out" trips.

RESULTS

Fifty child and adolescent psychiatrists and residents participated. According to their collective experience, the adolescents' memorial journey triggered a variety of mental health problems, including psychosis, but only one case of post-traumatic stress disorder (PTSD). Judging by the number of referrals, there was a higher rate of mental health problems following the memorial journey than after the annual sleep-out school trip.

CONCLUSIONS

Although it may seldom lead to PTSD, the Holocaust memorial journey can be a major stressor for some participating teenagers. Evaluating "high risk" adolescents prior to their planned exposure to likely stressors and conducting large, prospective studies that examine the impact of pre-planned stressors on the lives of adolescents are warranted. Providing support to all adolescents before, during and after exposure to anticipated stressors is important.

Disordered eating following exposure to television and internet coverage of the March 2011 Japan earthquake

OBJECTIVE

To prospectively explore the relationship between exposure to potentially distressing news content and disordered eating.

METHOD

Within 2 weeks of the March 3, 2011 Japan earthquake, an online survey was conducted among non-Japanese adults in distant countries (N = 698) assessing time spent on TV and the internet watching the news as well as peritraumatic reactions to the news and sleep disturbance. Participants were invited to complete a followup survey two months later [n = 113, mean age (SD) = 38.8 (11.91), 73% female] reporting on eating disorder symptoms.

RESULTS

Exposure to TV and, to a lesser extent, internet coverage of the Japan disaster were associated with disordered eating, in particular dieting and oral control, as measured by the eating attitudes test. Peritraumatic reactions and sleep disturbance displayed specific patterns of association with disordered eating.

DISCUSSION

Exposure to media coverage of distant disasters may be associated with increased disordered eating.

Psychological Consequences of Indirect Exposure to Disaster Due to the Haiti Earthquake

Introduction

Few studies have focused on the mental health consequences of indirect exposure to disasters caused by naturally occurring hazards. The present study assessed indirect exposure to the 2010 earthquake in Haiti among Haitian-Americans now living in Miami; these subjects had no direct exposure to the earthquake, but retained their cultural identity, language, and connection to family and friends in Haiti.

Methods

Two months following the earthquake a sample of Haitian-Americans was surveyed inquiring about: (1) their psychological reactions to the quake; (2) types of exposures experienced by their family members and friends in Haiti; and (3) symptom levels of (a) major depression, (b) generalized anxiety disorder, (c) complicated grief, (d) mental health status, and (e) physical health status.

Results

Haitian-Americans living in Miami experienced a broad spectrum of indirect exposures to the 2010 earthquake in Haiti. These exposures were strongly associated with psychological distress, trauma-related mental health consequences, and diminished health status. Most notable was the multiplicity of indirect exposures to the on-scene experiences of multiple family members and friends in Haiti.

Conclusions

Consideration should be given to the psychological impact and needs for support among indirectly-exposed populations with strong affiliation to directly-impacted victims.

Shultz JM, Besser A, Kelly F, Allen A, Schmitz S, Hausmann V, Marcelin LH, Neria Y. Psychological consequences of indirect exposure to disaster due to the Haiti earthquake.Prehosp Disaster Med.2012;27(4):1-10.

"Warriors": impact of a powerful television drama on the psychological health of U.K. Bosnia peacekeepers

PURPOSE

The impact of secondary trauma, such as watching powerful images on television, on the etiology of posttraumatic stress disorder in adults remains controversial. We explored the impact of a powerful TV drama ("Warriors") on the psychological health of U.K. peacekeeping troops compared with other military personnel who also saw the program but did not deploy on the same mission.

METHODS

Psychological health (health perception, fatigue, posttraumatic stress reactions and common mental disorders) was assessed via questionnaire in a group of 1463 U.K. Armed Forces personnel before and after the televising of an award-winning dramatic reconstruction ("Warriors") of events in Former Yugoslavia, a deployment in which some of the respondents had participated (Bosnia group) and some who had not (Era group). Information was also collected on whether participants had seen Warriors.

RESULTS

Those who had deployed to Bosnia were more likely to have watched the drama, and viewers were more likely to be posttraumatic stress reactions and common mental disorders cases before transmission of the program. There were few health differences between viewers and nonviewers, and Bosnia viewers and Era viewers, posttransmission. Viewing status and group status (Bosnia/Era) restricted to viewers only did not predict posttransmission health outcomes, with one exception. Group status (viewers only) was a significant predictor of posttransmission fatigue, with Bosnia viewers more likely to be cases. Additional analyses, however, revealed the same finding for nonviewers.

CONCLUSIONS

We found no evidence that those with symptoms of traumatic distress avoided watching a drama relevant to their experiences and no evidence of adverse effects on mental health.

Effects of media exposure on adolescents traumatized in a school shooting

This study analyzes the impact of the media on adolescents traumatized in a school shooting. Participants were trauma-exposed students (n = 231) and comparison students (n = 526), aged 13-19 years. A questionnaire that included the Impact of Event Scale and a 36-item General Health Questionnaire was administered 4 months after the shooting. Being interviewed was associated with higher scores on the Impact of Event Scale (p = .005), but posttraumatic symptoms did not differ between those who refused to be interviewed and those not approached by reporters. Following a higher number of media outlets did not affect symptoms.

Timing crisis information release via television

When and how often to release information on television are important issues in crisis and emergency risk communication. There is a lot of crisis information, including warnings and news, to which people should have access, but most of it is not significantly urgent to interrupt the broadcasting of television programmes. Hence, the right timing for the release of crisis information should be selected based on the importance of the crisis and any associated communication requirements. Using recursive methods, this paper builds an audience coverage model of crisis information release. Based on 2007 Household Using TV (HUT) data for Hefei City, China, the optimal combination of broadcasting sequence (with frequencies between one and eight times) is obtained using the implicit enumeration method. The developed model is applicable to effective transmission of crisis information, with the aim of reducing interference with the normal television transmission process and decreasing the psychological effect on audiences. The same model can be employed for other purposes, such as news coverage and weather and road information.

Witnessing trauma in the newsroom: posttraumatic symptoms in television journalists exposed to violent news clips

Employees working in television newsrooms are exposed to video footage of violent events on a daily basis. It is yet unknown whether they subsequently develop symptoms of posttraumatic stress disorder as has been shown for other populations exposed to trauma through television. We conducted an internet-based survey with 81 employees. Nearly 80% of the sample reported being familiar with recurring intrusive memories. However, the sample's overall posttraumatic stress disorder symptoms were low, although participants with a prior trauma, more general work stress, and a greater exposure to footage had a tendency to show more severe symptoms. Regarding general mental health, there were no differences compared with a journalistic control group. Results suggest that the population as such is not at a particular risk of developing mental problems.