Emotional reactions to the Oklahoma City bombing in relation to posttraumatic stress disorder in directly exposed survivors.

Existing empirical research examining PTSD related to disaster exposure has generally been limited to quantitative methods and also cross-sectional rather than over time. The purpose of this qualitative study was to retrospectively examine postdisaster emotions emerging over time in highly trauma-exposed disaster survivors, comparing individuals with and without PTSD. Survivors of the 1995 Oklahoma City bombing were interviewed approximately 17 months after the bombing, assessed for PTSD, and asked to recall their feelings at 3 different time points. The primary finding was that survivors with and without PTSD reported emotions similarly immediately following the disaster, and over time they diverged in reported emotions. Regarding both amount of emotional responses and their content such as intensity in the immediate postdisaster timeframe, some emotions differed between the groups with and without PTSD, reflecting or portending the development of psychopathology. PTSD was associated with more intense feelings of anger and fear and inability to face the reality of the bombing, indicating continuing struggles to successfully process their disaster experience that are characteristic of PTSD. Understanding similarities and differences in the expression of emotional responses over time among survivors in the context of the development and course of PTSD could aid in designing disaster relief protocols targeted to individual mental health needs over time. Further studies are needed to understand how survivors' emotional responses to catastrophic events develop and evolve over a much longer course such as a lifetime.