Skip to main content

Advertisement

Log in

Association Between Feeling Threatened, Behaviour and Symptoms of Anxiety and Depression: Two and a Half Years After the Terrorist Attacks in Belgium

  • Original Paper
  • Published:
Community Mental Health Journal Aims and scope Submit manuscript

Abstract

Feeling threatened by terrorism can be associated with mental health problems and behavioural changes. However, few studies look at the association in the long-term. Using a survey, the population in Brussels, Belgium was studied using a representative database delivered by the national post service. The Patient Health Questionnaire-4 (PHQ-4) assessed mental health, and self-made questions avoidance behaviour. 170 people answered: 60% women and 50% higher educated, 28.2% between 56 and 65 years and 62.4% had a partner. 43.5% felt threatened by the terrorist attacks and 45.9% experienced no mental health problems. Both terrorist threat (p < 0.001) and avoidance behaviour (p < 0.001) significantly predicted PHQ-4 scores, while controlling for gender, age, social support, education level, and traumatic events. There is a relation between terrorist threat and anxiety/depressive symptoms 2.5 years after the last study on terrorist threat in Brussels, but it has weakened. Avoidance behaviour seems to be more present than threat.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  • Adams, S. W., Bowler, R. M., Russell, K., Brackbill, R. M., Li, J., & Cone, J. E. (2019). PTSD and comorbid depression: Social support and self-efficacy in World Trade Center tower survivors 14–15 years after 9/11. Psychological Trauma : Theory, Research, Practice and Policy, 11(2), 156–164. https://doi.org/10.1037/tra0000404

    Article  Google Scholar 

  • American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). https://doi.org/10.1176/appi.books.9780890425596

  • Bleich, A., Gelkopf, M., & Solomon, Z. (2003). Exposure to terrorism, stress-related mental health symptoms, and coping behaviors among a nationally representative sample in Israel. JAMA, 290(5), 612–620. https://doi.org/10.1001/jama.290.5.612

    Article  PubMed  Google Scholar 

  • Cohen-Louck, K., & Saka, Y. (2017). Patterns in response to chronic terrorism threats: A construct of emotional, cognitive, and behavioral responses among Israeli citizens. Stress and Health: Journal of the International Society for the Investigation of Stress, 33(4), 448–458. https://doi.org/10.1002/smi.2728

    Article  Google Scholar 

  • Deschepper, R., Six, S., Gidron, Y., Depoorter, A. M., Vandekerckhove, M., Gheysens, N., Van Overmeire, R., & Bilsen, J. (2018). Association between feeling threatened by a terrorist attack and subjective health: A web survey a week after the attacks of 22 March 2016 in Belgium. European Journal of Psychotraumatology, 9(1), 1500821. https://doi.org/10.1080/20008198.2018.1500821

    Article  PubMed  PubMed Central  Google Scholar 

  • Durodié, B., & Wainwright, D. (2019). Terrorism and post-traumatic stress disorder: A historical review. The Lancet Psychiatry, 6(1), 61–71. https://doi.org/10.1016/S2215-0366(18)30335-3

    Article  PubMed  Google Scholar 

  • Ford, J. D., Adams, M. L., & Dailey, W. F. (2007). Psychological and health problems in a geographically proximate population time-sampled continuously for three months after the September 11th, 2001 terrorist incidents. Anxiety, Stress, and Coping, 20(2), 129–146.

    Article  Google Scholar 

  • Galea, S., Ahern, J., Resnick, H., Kilpatrick, D., Bucuvalas, M., Gold, J., & Vlahov, D. (2002). Psychological sequelae of the September 11 terrorist attacks in New York City. The New England Journal of Medicine, 346(13), 982–987. https://doi.org/10.1056/NEJMsa013404

    Article  PubMed  Google Scholar 

  • Gigerenzer, G. (2006). Out of the frying pan into the fire: Behavioral reactions to terrorist attacks. Risk Analysis: An Official Publication of the Society for Risk Analysis, 26(2), 347–351. https://doi.org/10.1111/j.1539-6924.2006.00753.x

    Article  Google Scholar 

  • Gil, S., & Caspi, Y. (2006). Personality traits, coping style, and perceived threat as predictors of posttraumatic stress disorder after exposure to a terrorist attack: A prospective study. Psychosomatic Medicine, 68(6), 904–909. https://doi.org/10.1097/01.psy.0000242124.21796.f8

    Article  PubMed  Google Scholar 

  • Heir, T., Blix, I., & Knatten, C. K. (2016). Thinking that one’s life was in danger: Perceived life threat in individuals directly or indirectly exposed to terror. The British Journal of Psychiatry: THe Journal of Mental Science, 209(4), 306–310. https://doi.org/10.1192/bjp.bp.115.170167

    Article  Google Scholar 

  • Holman, E. A., Silver, R. C., Poulin, M., Andersen, J., Gil-Rivas, V., & McIntosh, D. N. (2008). Terrorism, acute stress, and cardiovascular health: A 3-year national study following the September 11th attacks. Archives of General Psychiatry, 65(1), 73–80. https://doi.org/10.1001/archgenpsychiatry.2007.6

    Article  PubMed  Google Scholar 

  • Jacobson, M. H., Norman, C., Nguyen, A., & Brackbill, R. M. (2018). Longitudinal determinants of depression among World Trade Center Health Registry enrollees, 14–15 years after the 9/11 attacks. Journal of Affective Disorders, 229, 483–490. https://doi.org/10.1016/j.jad.2017.12.105

    Article  PubMed  Google Scholar 

  • Jordan, H. T., Osahan, S., Li, J., Stein, C. R., Friedman, S. M., Brackbill, R. M., Cone, J. E., Gwynn, C., Mok, H. K., & Farfel, M. R. (2019). Persistent mental and physical health impact of exposure to the September 11, 2001 World Trade Center terrorist attacks. Environmental Health: A Global Access Science Source, 18(1), 12. https://doi.org/10.1186/s12940-019-0449-7

    Article  Google Scholar 

  • Kocalevent, R. D., Berg, L., Beutel, M. E., Hinz, A., Zenger, M., Härter, M., Nater, U., & Brähler, E. (2018). Social support in the general population: Standardization of the Oslo social support scale (OSSS-3). BMC Psychology, 6(1), 31. https://doi.org/10.1186/s40359-018-0249-9

    Article  PubMed  PubMed Central  Google Scholar 

  • Kroenke, K., Spitzer, R. L., Williams, J. B. W., & Löwe, B. (2010). The patient health questionnaire somatic, anxiety, and depressive symptom scales: A systematic review. General Hospital Psychiatry, 32(4), 345–435.

    Article  Google Scholar 

  • Lee, J. E. C., Dallaire, C., & Lemyre, L. (2009). Qualitative analysis of cognitive and contextual determinants of Canadians’ individual response to terrorism. Health, Risk & Society, 11(5), 431–450.

    Article  Google Scholar 

  • Marshall, R. D., Bryant, R. A., Amsel, L., Suh, E. J., Cook, J. M., & Neria, Y. (2007). The psychology of ongoing threat: Relative risk appraisal, the September 11 attacks, and terrorism-related fears. The American Psychologist, 62(4), 304–316. https://doi.org/10.1037/0003-066X.62.4.304

    Article  PubMed  PubMed Central  Google Scholar 

  • Nissen, A., Birkeland Nielsen, M., Solberg, Ø., Bang Hansen, M., & Heir, T. (2015). Perception of threat and safety at work among employees in the Norwegian ministries after the 2011 Oslo bombing. Anxiety, Stress, and Coping, 28(6), 650–662. https://doi.org/10.1080/10615806.2015.1009831

    Article  PubMed  Google Scholar 

  • Rubin, G. J., Brewin, C. R., Greenberg, N., Hughes, J. H., Simpson, J., & Wessely, S. (2007). Enduring consequences of terrorism: 7-month follow-up survey of reactions to the bombings in London on 7 July 2005. The British Journal of Psychiatry: THe Journal of Mental Science, 190, 350–356. https://doi.org/10.1192/bjp.bp.106.029785

    Article  Google Scholar 

  • Schuster, M. A., Stein, B. D., Jaycox, L., Collins, R. L., Marshall, G. N., Elliott, M. N., & Berry, S. H. (2001). A national survey of stress reactions after the September 11, 2001, terrorist attacks. The New England Journal of Medicine, 345(20), 1507–1512.

    Article  CAS  Google Scholar 

  • Silver, R. C., Holman, E. A., McIntosh, D. N., Poulin, M., & Gil-Rivas, V. (2002). Nationwide longitudinal study of psychological responses to September 11. JAMA, 288(10), 1235–1244. https://doi.org/10.1001/jama.288.10.1235

    Article  PubMed  Google Scholar 

  • Statbel. (2020). Bevolking naar woonplaats, nationaliteit (Belg/niet-Belg), burgerlijke staat, leeftijd en geslacht. https://bestat.statbel.fgov.be/bestat.

  • Stene, L. E., Wentzel-Larsen, T., & Dyb, G. (2016). Healthcare needs, experiences and satisfaction after terrorism: A longitudinal study of survivors from the Utøya attack. Frontiers in Psychology, 7, 1809.

    Article  Google Scholar 

  • Stevens, G., Agho, K., Taylor, M., Barr, M., Raphael, B., & Jorm, L. (2009). Terrorism in Australia: Factors associated with perceived threat and incident-critical behaviours. BMC Public Health, 9, 91. https://doi.org/10.1186/1471-2458-9-91

    Article  PubMed  PubMed Central  Google Scholar 

  • Vlahov, D., Galea, S., Resnick, H., Ahern, J., Boscarino, J. A., Bucuvalas, M., Gold, J., & Kilpatrick, D. (2002). Increased use of cigarettes, alcohol, and marijuana among Manhattan, New York, residents after the September 11th terrorist attacks. American Journal of Epidemiology, 155(11), 988–996. https://doi.org/10.1093/aje/155.11.988

    Article  PubMed  Google Scholar 

Download references

Acknowledgements

The authors wish to thank Rose-Lima Van Keer, Lara Vesentini, Stephanie Vanclooster and especially Griet Van Belleghem for their incredible help during data collection.

Funding

This work was supported by Innoviris [BRGPRO1].

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Roel Van Overmeire.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Van Overmeire, R., Six, S., Deschepper, R. et al. Association Between Feeling Threatened, Behaviour and Symptoms of Anxiety and Depression: Two and a Half Years After the Terrorist Attacks in Belgium. Community Ment Health J 58, 657–665 (2022). https://doi.org/10.1007/s10597-021-00867-w

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10597-021-00867-w

Keywords

Navigation