Effectiveness of trauma-focused cognitive behavioral therapy for terrorism victims with very long-term emotional disorders

There are no published studies on the clinical utility of psychotherapy in victims of terrorism who suffer emotional disorders many years after the attacks. A course of trauma-focused cognitive behavioral therapy was administered to 50 victims of terrorist attacks that occurred an average of 23 years previously and who presented isolated or concurrent posttraumatic stress disorder (PTSD; 74%), major depressive disorder (54%), panic disorder (38%), or other anxiety disorders (38%). According to an intention-to-treat analysis (N=50), these percentages decreased significantly to 24% (PTSD and major depression), 16% (panic disorder) and 14% (other anxiety disorders) at 1-year follow-up. According to a complete data analysis, at posttreatment no victims (n=31) still presented major depressive or panic disorder, only 3.2% presented PTSD and 9.7% presented other anxiety disorders, whereas at 1-year follow-up, no victims presented any disorders (n=22). At posttreatment and at the 1-, 3-, 6-month, and 1-year follow-ups, large statistically and clinically significant decreases in PTSD, depression, and anxiety symptomatology were found (d=1.26 to 2.52 at 1-year follow-up). These results suggest that efficacious treatments for recent victims are also useful in the usual clinical practice for victims with very long-term emotional disorders.