Get Alert
Please Wait... Processing your request... Please Wait.
You must sign in to sign-up for alerts.

Please confirm that your email address is correct, so you can successfully receive this alert.

Brief Reports   |    
Extended Mental Health Service Utilization Among Survivors of the Oklahoma City Bombing
Phebe Tucker, M.D.; Betty Pfefferbaum, M.D., J.D.; Haekyung Jeon-Slaughter, Ph.D.; Theresa S. Garton, M.D.; Carol S. North, M.D., M.P.E.
Psychiatric Services 2014; doi: 10.1176/appi.ps.201200579
View Author and Article Information

Dr. Tucker, Dr. Pfefferbaum, and Dr. Garton are with the Department of Psychiatry and Behavioral Sciences, University of Oklahoma College of Medicine, Oklahoma City (e-mail: phebe-tucker@ouhsc.edu). Dr. Jeon-Slaughter and Dr. North are with the Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, where Dr. North is also with the Department of Surgery, Division of Emergency Medicine.

Copyright © 2014 by the American Psychiatric Association


Objective  The study assessed survivors of Oklahoma City’s 1995 bombing seven years postdisaster to identify long-term mental health service use.

Methods  Psychiatric disorders and disaster-related variables were assessed for 99 survivors at seven years postdisaster with the Diagnostic Interview Schedule for DSM-IV and its Disaster Supplement.

Results  Of the 99 survivors, 86% received services during the seven years. Use was associated with female sex, injury or hospitalization, and posttraumatic stress disorder (PTSD) or major depression. Informal interventions were usually initiated in the first six months. Treatment by psychiatrists, other professionals, and family doctors increased after the first month. Half the survivors with PTSD or depression received treatment from a psychiatrist. Only 15% of survivors took psychotropic medications. Although 33% received treatment for more than one year, only 7% were receiving services at seven years.

Conclusions  Although service needs decreased over time, results support provision of diverse services adapted to changing needs.

Abstract Teaser
Figures in this Article

Your Session has timed out. Please sign back in to continue.
Sign In Your Session has timed out. Please sign back in to continue.
Sign In to Access Full Content
Sign in via Athens (What is this?)
Athens is a service for single sign-on which enables access to all of an institution's subscriptions on- or off-site.
Not a subscriber?

Subscribe Now/Learn More

PsychiatryOnline subscription options offer access to the DSM-5 library, books, journals, CME, and patient resources. This all-in-one virtual library provides psychiatrists and mental health professionals with key resources for diagnosis, treatment, research, and professional development.

Need more help? PsychiatryOnline Customer Service may be reached by emailing PsychiatryOnline@psych.org or by calling 800-368-5777 (in the U.S.) or 703-907-7322 (outside the U.S.).

Anchor for Jump
Table 1Service use patterns of 99 survivors of the 1995 Oklahoma City bombing, by demographic characteristics


North  CS;  Nixon  SJ;  Shariat  S  et al:  Psychiatric disorders among survivors of the Oklahoma City bombing.  JAMA 282:755–762, 1999
[CrossRef] | [PubMed]
North  CS;  Pfefferbaum  B;  Tivis  L  et al:  The course of posttraumatic stress disorder in a follow-up study of survivors of the Oklahoma City bombing.  Annals of Clinical Psychiatry 16:209–215, 2004
[CrossRef] | [PubMed]
North  CS;  Pfefferbaum  B;  Kawasaki  A  et al:  Psychosocial adjustment of directly exposed survivors 7 years after the Oklahoma City bombing.  Comprehensive Psychiatry 52:1–8, 2011
[CrossRef] | [PubMed]
Boscarino  JA;  Adams  RE;  Figley  CR:  Mental health service use 1-year after the World Trade Center disaster: implications for mental health care.  General Hospital Psychiatry 26:346–358, 2004
[CrossRef] | [PubMed]
Boscarino  JA;  Galea  S;  Ahern  J  et al:  Utilization of mental health services following the September 11th terrorist attacks in Manhattan, New York City.  International Journal of Emergency Mental Health 4:143–155, 2002
Boscarino  JA;  Galea  S;  Ahern  J  et al:  Psychiatric medication use among Manhattan residents following the World Trade Center disaster.  Journal of Traumatic Stress 16:301–306, 2003
[CrossRef] | [PubMed]
Covell  NH;  Donahue  SA;  Allen  G  et al:  Use of Project Liberty counseling services over time by individuals in various risk categories.  Psychiatric Services 57:1268–1270, 2006
[CrossRef] | [PubMed]
Robins  L;  Cottler  L;  Bucholz  K  et al:  The Diagnostic Interview Schedule for DSM-IV (DIS-IV) .  St Louis, Mo,  Washington University, 2000
North  CS;  Pfefferbaum  B;  Robins  LN  et al:  The Diagnostic Interview Schedule/Disaster Supplement (DIS-IV/DS) .  St Louis,  Washington University, 2001
Amaya-Jackson  L;  Davidson  JR;  Hughes  DC  et al:  Functional impairment and utilization of services associated with posttraumatic stress in the community.  Journal of Traumatic Stress 12:709–724, 1999
[CrossRef] | [PubMed]
Lindy  JD;  Grace  MC;  Green  BL:  Survivors: outreach to a reluctant population.  American Journal of Orthopsychiatry 51:468–478, 1981
[CrossRef] | [PubMed]
Schwarz  ED;  Kowalski  JM:  Malignant memories: reluctance to utilize mental health services after a disaster.  Journal of Nervous and Mental Disease 180:767–772, 1992
[CrossRef] | [PubMed]
Koenen  KC;  Goodwin  R;  Struening  E  et al:  Posttraumatic stress disorder and treatment seeking in a national screening sample.  Journal of Traumatic Stress 16:5–16, 2003
[CrossRef] | [PubMed]
McFarlane  AC:  The longitudinal course of posttraumatic morbidity: the range of outcomes and their predictors.  Journal of Nervous and Mental Disease 176:30–39, 1988
[CrossRef] | [PubMed]
North  CS;  Hong  BA;  Pfefferbaum  B:  P-FLASH: development of an empirically-based post-9/11 disaster mental health training program.  Missouri Medicine 105:62–66, 2008
References Container

CME Activity

There is currently no quiz available for this resource. Please click here to go to the CME page to find another.
Submit a Comments
Please read the other comments before you post yours. Contributors must reveal any conflict of interest.
Comments are moderated and will appear on the site at the discertion of APA editorial staff.

* = Required Field
(if multiple authors, separate names by comma)
Example: John Doe

Related Content
The American Psychiatric Publishing Textbook of Psychopharmacology, 4th Edition > Chapter 7.  >
The American Psychiatric Publishing Textbook of Psychopharmacology, 4th Edition > Chapter 7.  >
The American Psychiatric Publishing Textbook of Psychopharmacology, 4th Edition > Chapter 7.  >
The American Psychiatric Publishing Textbook of Psychiatry, 5th Edition > Chapter 12.  >
Textbook of Traumatic Brain Injury, 2nd Edition > Chapter 32.  >
Topic Collections
Psychiatric News
APA Guidelines
PubMed Articles