| Summary: | Background: This study assesses long-term physical and emotional symptoms and unmet needs in direct survivors of the 1995 Oklahoma City terrorist bombing 18 ½ years after the event. Methods: A telephone questionnaire assessed psychiatric symptoms, health problems and coping strategies in 138 terrorism survivors (of whom 80% were physically injured) from a state registry of directly exposed persons, and 171 non-exposed community controls. Structured survey questions measured psychiatric symptoms, posttraumatic growth, general health problems and health care utilization. Open-ended questions explored survivors’ most important terrorism-related problems and needs. Quantitative and qualitative data analysis methods were undertaken. Results: Survivors reported similar rates of major health problems and general health care utilization, more anxiety and depression symptoms, and more ancillary health care use than controls on structured assessments. Survivors also reported posttraumatic growth, using several positive coping skills. Open-ended questions identified survivors’ specific continuing bombing-related problems, and needs which were not disclosed on the questionnaire; these included many lasting physical injuries, health problems (especially hearing difficulties), specific posttraumatic stress disorder (PTSD) symptoms, other emotional symptoms, work and financial problems, interpersonal issues, and desires to help others. Conclusions: Results suggest that extended recovery services are needed long after terrorism exposure, and that open-ended assessment is useful to identify those requiring services.
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