A Qualitative Longitudinal Study of Injuries and Medical Care, Assistance, and Losses Recounted by Oklahoma City Bombing Survivors after Nearly a Quarter Century

Abstract

Introduction: Terrorist incidents occur with alarming frequency. Much is known about acute injuries and psychopathology arising from terrorism, as well as medical care and functional status assessed in early post-disaster periods. Survivors’ memories of these experiences may change over subsequent decades, and their perspectives may evolve. Little information is available on how survivors describe these experiences decades later. Study Objective: This longitudinal qualitative study of directly-exposed survivors of the 1995 Oklahoma City bombing was conducted nearly a quarter century after the disaster. It collected systematic, open-ended descriptions of survivors’ injuries and medical care, assistance received and given, and disaster-associated losses. It sought to illuminate whether survivors recall long-term consequences of disaster exposure so long after the event, providing important details with great clarity and associated emotion, or alternatively lose memory and sharpness of recollection for these aspects of their bombing experience. Methods: A sample of 182 bombing survivors was randomly recruited from a state registry of 1,092 bombing survivors and interviewed at approximately six months after the bombing (71% participation). The sample was re-interviewed an average of 23 years after the disaster (72% follow-up participation) using an open-ended interview with survivors describing in their own words their personal experience of the bombing and its effects on their lives. The interviews were audio recorded and professionally transcribed. Themes were identified in the text of the interviews, and passages were coded using qualitative software, achieving excellent inter-rater reliability for each theme. This article covers three of twelve total themes identified. Results: Nearly a quarter century after the bombing, this highly trauma-exposed Oklahoma City bombing survivor sample had memories that were still vivid, graphic, and evocative. They described injuries and medical care, assistance given and received, and losses with great detail and intensity. Despite the continuing strong emotions expressed by these survivors in relation to the bombing, the qualitative content suggested that lasting psychopathology was not a central concern. Conclusion: This is one of the longest prospective longitudinal, qualitative studies ever conducted with highly trauma-exposed survivors of a terrorist bombing. These findings are critical to disaster emergency response and effective management of the disaster response and early care for the survivors, as the effects of the disaster may shape the rest of their lives.

A Prospective Post-disaster Longitudinal Follow-up Study of Emotional and Psychosocial Outcomes of the Oklahoma City Bombing Rescue and Recovery Workers During the First Quarter Century Afterward

“…50% or more of bombing-related PTSD and post-disaster MDD in the firefighters had not remitted at follow up. Similar to many other studies previously reviewed, few important predictors of remission were found, 13,14 especially in broader disaster-affected populations. This finding is also consistent with continuing work-related stress and hardship.…”

A qualitative longitudinal study of feelings, coping, and making meaning as recounted by Oklahoma City bombing survivors after nearly a quarter century.

“…Short-term studies do not necessarily contain all of the long-term findings collected decades later and do not necessarily reflect quantitative research findings because of conceptually different approaches to data collection. Quantitative long-term studies have generally demonstrated diminishing but some persisting postdisaster psychopathology (Bryant et al, 2021; Bui et al, 2021; Green et al, 1990; Lowe et al, 2020; van der Velden et al, 2013), including persistent PTSD or major depressive disorder in only 10%–20% of long-term survivors (North, McDonald, et al, 2022). Consistently, the longitudinal qualitative data in the current study did not reveal psychopathology to represent a major concern expressed decades after the bombing.…”

“…The large volume of the qualitative material collected necessitated the inclusion of three selected themes in this article: Thoughts and feelings , Coping , and Making meaning . Specific details of the other nine themes can be found in three other published articles from this study focused on these other themes (North et al, 2023; North, McDonald, et al, 2022; North, Suris, et al, 2022).…”