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    Anxiety in America -- Terror's Aftermath

    How Bad Is It, When Will It Go Away, and What Can We Do to Cope?

    Beyond Our Personal Control continued...

    While we have all confronted risk and danger in our daily lives, even before Sept. 11, certain aspects of this disaster tend to keep us all on edge, explains Scott Geller, PhD, a professor and director of the Center for Applied Behavior Systems at Virginia Tech in Blacksburg.

    This tragedy was catastrophic, unusual, and beyond our personal control, unlike the familiar risks we experience every day, such as driving in our cars or working in dangerous job environments. We did not choose to take the risks involved in exposure to terrorist attacks, anthrax in the mail, or future bioterrorist, chemical, or nuclear threats. This makes them far more frightening and stressful.

    "Situations where we perceive personal control, like driving, do not seem risky," Geller says. "People take risks everyday from driving to skiing down steep slopes without feeling at risk because they chose to take those risks and they felt in control of the situation."

    While more people have died in motor vehicle accidents since Sept. 11 than were killed on that tragic day by terrorists, media coverage of individuals losing loved ones or narrowly escaping death has much greater emotional impact than do statistics, Geller explains.

    "Traumatic events of this magnitude typically increase the anxiety of all and will consequently have an effect on the behavior of many," says Michele M. Carter, PhD, a psychologist at American University in Washington, DC. "As long as another attack doesn't occur, and as time passes we all have a tendency to return to a reasonable approximation of our normal routines."


    The experts agree that for most of us, anxiety should begin to subside within a few months. But Gibbs points out that those more directly exposed to the trauma -- who were in or near Ground Zero or who lost loved ones in the attacks -- are more vulnerable to persistent problems.

    The symptoms of post-traumatic stress disorder are normal during the first few weeks following trauma, says Karestan C. Koenen, PhD, a psychiatric epidemiologist at the Columbia School of Public Health in New York City. These may include nightmares, jumpiness, brooding over what happened, avoiding reminders of the event, and difficulty sleeping. Children may refuse to go to sleep, cry when going to school, or regress to thumb sucking or bed wetting. Adults may have angry outbursts, or resort to alcohol or drug abuse, or domestic violence.

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