January 1st, 2014

Impact of marathon bombing on veterans is investigated

The Boston Marathon bombing in April provided researchers at the National Center for PTSD at VA Boston Healthcare System and Boston University a rare opportunity to look at the effects of a traumatic event on combat veterans dealing with PTSD.

Researchers had already been studying a group of Boston-area veterans when the terrorist attack that killed three and injured 247 occurred. “When this happened, we knew based on our clinical experience working with these guys, that this would likely be particularly shocking for them,” says Mark Miller, Ph.D., lead author and staff clinical psychologist with the National Center for PTSD and associate professor at Boston University School of Medicine.

The group was contacted a week after the attack and asked, “Were you affected by the marathon bombing and if so, how?” Of 120 veterans in the ongoing study, 71 responded for this investigation. Of those, 42 percent reported being personally affected by the bombing and/or the manhunt that followed, according to a study published in the December issue of the Journal of Traumatic Stress.

The majority reported the bombing reminded them of their own traumas and caused other emotional distress, according to the study. As a whole, there were no changes in symptoms, but looking individually, there were increases in the hallmark symptoms of PTSD – increases in intrusion and avoidance, says Miller.

“The most interesting part of the results was some of the examples of how they said the bombing affected them in their own words,” says Miller. “There was a variety of levels of exposure to the bombing itself. Two said they actually witnessed it. Another participant was at Massachusetts General Hospital that day and saw all the casualties start coming in. A number weren’t there but they knew people there. A lot of people talked about how the news coverage brought back memories.”

A chart included as part of the study lists some of the responses of veterans. Here’s what one veteran said: “I was in the grandstands in front of the library; went into action, helped out as much as I could. After, I felt very drained and kind of fearful. Reality hits after the fact and that’s when the feelings and the physical symptoms come in. And I drank after – I’m alcoholic – had been dry for a couple [of] weeks before then.”

Miller says there are a lot of thematic similarities between the attack and the experience many combat veterans have had, especially for those involved with the conflicts in Iraq and Afghanistan, but also for Vietnam veterans, too.

The study documents something researchers have known about PTSD, Miller says. “Life events that are reminiscent of a past trauma can reactivate PTSD symptoms. That’s not news to anyone that works with PTSD,” he says. “There are very few studies that have demonstrated that empirically. It is nice to point to this study as evidence of that.”

The study also has implications for health care providers in helping them to plan how to be prepared to offer services when similar situations occur, Miller says. Patients dealing with PTSD should know that it’s normal to have a recurrence of memories when an event like this takes place, he says. “It’s helpful to normalize symptoms, not to fear them, but to understand that chronic PTSD is waxing and waning.”

By Rivkela Brodsky

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