These consistent findings provide support for an important relationship between DT and obsessions and suggest that interventions targeting DT may have special benefit for the treatment of obsessions.

Background Each homicide leaves behind several friends and family members, or homicide survivors. However, limited information is available on the impact of homicide on adolescent survivors. The purpose of the current study was to identify the prevalence of homicide survivorship and to determine mental health outcomes within a sample of U.S. adolescent survivors. Methods A nationally representative sample of American adolescents (N=3,614) between the ages of 12–17 completed structured telephone interviews assessing homicide survivorship and mental health consequences including posttraumatic stress disorder (PTSD), depression, drug use, and alcohol abuse. Results Reported prevalence within this sample of losing a loved one to criminal homicide was 9%, losing a loved one to vehicular homicide was 7%, and losing a loved one to both types of homicide was 2%. Logistic regression analyses found that adolescents who reported being homicide survivors were significantly more likely to report depression, drug use, and alcohol abuse after controlling for demographic factors and other violence exposure. Conclusions If the results from this study are generalizable to the US population, roughly 1 in 5 American adolescents may be impacted by homicide. Further, adolescents exposed to such a loss are at increased risk for mental health sequalae. Results suggest that greater attention needs to be paid to address the needs of these often underserved victims.

The present study examined the prevalence, demographic distribution, and mental health correlates of losing a loved one to homicide. A national sample of 1753 young adults completed structured telephone interviews measuring violence exposure, mental health diagnoses, and loss of a family member or close friend to a drunk driving accident (vehicular homicide) or murder (criminal homicide). The prevalence of homicide survivorship was 15.2%. African Americans were more highly represented among criminal homicide survivors. Logistic regression analyses found that homicide survivors were at risk for past year posttraumatic stress disorder (OR = 1.88), major depressive episode (OR = 1.64), and drug abuse/dependence (OR = 1.77). These findings highlight the significant mental health needs of homicide survivors. (CDC, 2004). Each murder leaves behind 7 to 10 close relatives, in addition to friends, neighbors, and co-workers (Redmond, 1989). Therefore, the number of individuals affected is far greater than the number of direct homicide victims. "Homicide survivors," also called "co-victims" are generally defined as the friends, family, and loved ones that survive murder victims (including victims of drunk driving accidents, or vehicular homicide). While direct victims of homicide receive substantial attention in society and research reports, homicide survivors are infrequently acknowledged. However, the unexpected, violent loss of a loved one is a potentially traumatic event that can have significant psychological implications.Homicide survivors suffer from both similar and unique experiences in comparison to direct victims of crime. Similar to other crime victims, homicide survivors may contend with economic stressors, stigmatization, fear of recurrence, anxiety when encountering reminders of the event, negative beliefs about themselves and the world, and feelings of guilt and responsibility. In contrast to other crime victims, homicide survivors often face greater intrusion of the media and criminal justice systems, strained relationships with friends or family members that are suspected perpetrators, and preoccupation with revenge (see Hertz, ProthrowStith, & Chery, 2005). These stressors may contribute to the risk for mental health problems among homicide survivors. An understanding of the impact of homicide is of particular Regarding mental health problems, several descriptive studies suggest that homicide survivors are at risk for posttraumatic stress disorder (PTSD) and general psychiatric symptoms (AmickMcMullan et al., 1991;Amick-McMullan, Kilpatrick, Veronen, & Smith, 1989; Freedy, Resnick, Kilpatrick, Danksy, & Tidwell, 1994;Murphy, Johnson, Wu, Fan, & Lohan, 2003;Murphy, Johnson, & Lohan, 2002;Parkes, 1993;Thompson, Norris, & Ruback, 1998 , investigators have yet to explore whether losing a loved one to homicide represents a specific risk factor for substance use problems. Moreover, no known studies have examined whether homicide survivorship is a significant predictor of mental health outcomes in re...