STUDIES OF PSYCHOLOGICAL SYMPTOMS IN TRAUMA SURVIVORS

Reprinted from Pope, H.G., Oliva, P.S. & Hudson, J. I. (2002).  Scientific Status of Research on Repressed Memories.  In D.L. Faigman, D.H.Kaye, M.J. Saks & J. Sanders (Eds.) Modern Scientific Evidence. St. Paul, MN: West Group.  Posted with permission of Thomson West.

Pope et al "performed a non-selective literature search for examples of studies between 1960 and 1999 where the investigators performed psychological assessments on groups of survivors of specific, historically documented traumatic events.  There is no shortage of such studies;" the studies summarized below that assessed "victims of all manner of traumatic events, are merely representative of a larger literature."

"[I]t is striking that none of the more than 11,000 victims is reported to have repressed the memory of the traumatic event.  Admittedly, some of the survivors in some of the studies did exhibit amnesia for the trauma, but in all cases, the amnesia appears explainable for ordinary reasons, such as loss of consciousness or early childhood amnesia...  Only two fragmentary case reports in two of the studies suggest even partial amnesia in individuals over the age of three who did not lose consciousness.  Some of the studies in the table report "memory disturbances" among some trauma survivors.  However, "memory disturbances" should not be misinterpreted as evidence that the subjects forgot the trauma itself.  In fact, disturbances of memory and concentration are ubiquitous in mood and anxiety disorders, regardless of whether these disorders occur in the wake of trauma.  Indeed, impairment of concentration is one of the criteria in DSM-IV for the diagnosis of major depressive disorder."

Studies of Psychological Symptoms in Trauma Survivors

_____________________________________________________________________

Study Event No. of Subjects Data Collection Methods Amnesia? Remarks
Strom et al., 1961 Holocaust 100 Interviews No  
Chodoff, 1963 Holocaust 23 Psychiatric interviews No Subjects reported their experiences with "a vivid immediacy and wealth of detail."
Lepold et al., 1963 Marine explosion 34 Interviews No Authors note that "repression does not appear possible."
Terr, 1979, 1983 Chowchilla bus kidnapping 26 Interviews No  
Eaton et al., 1982 Holocaust 135 Interviews No Although 20 (15%) of the 135 survivors had memory problems, so did 15 (11%) of the 133 non-traumatized controls; none reported to have amnesia.
Wilkinson, 1983 Hyatt skywalk collapse 102 Questionnaire, interviews No  
Hoibert & McCaugher., 1984 Collision at sea 336 Extracted records from Naval Health Research Ctr. No 11% were hospitalized for various psychiatric difficulties following the collision. None suffered from amnesia.
Dollinger, 1985 Lightning strike disaster 38 Interviews Yes (2 cases) The 2 children that had amnesia were side flash victims.
Malmquist, 1986 Children who witnessed parental murder 16 Questionnaires (Impact of Events Scale) No "Recollection of vivid memories of the event were present in all 16 of the children."
Kinzie et al., 1986, 1989; Sack et al., 1993 Cambodian concentration camp victims 40 Interviews No  
Shore et al., 1986 Mt. St. Helens explosion 548 Interviews No  
Aveline & Fowlie., 1987 Ejection from military aircraft 175 Questionnaires No  
Earls et al., 1988 Flooding (children ages 6-17) 32 Interviews No Interviews were done with parents.
Malt, 1988 Accidental injury 107 Interviews, questionnaires No  
McFarlane (series) 1988 Australian brush fires 469 Questionnaires, interviews No After 11 months, firefighters with PTSD actually displayed better memory than those without PTSD.
Pynoos and Nader, 1988 Children who witnessed sexual assault of their mothers 10 Interviews No  
Dahl, 1989 Rape victims 55 Interviews, questionnaires No  
Ersland et al., 1989 Oil rig disaster 134 Questionnaires No  
Feinstein, 1989 Village ambushed in Namibia 14 Interviews No  
Hytten & Hasle, 1989 Fire 58 Questionnaires No Study done on non-professional rescue workers.
Maj et al., 1989 Earthquake 589 Questionnaires, interviews No  
Nadler and Ben-Shushan, 1989 Holocaust 34 Interviews No  
Pynoos & Nader, 1989 Sniper attack at elementary school 133 Interviews No Some children "remembered" the sniper although they were not actually at the scene.  None reported amnesia.
Stoddard et al., 1989 Burned children 30 Interview, review of records No  
Weisaeth, 1989 Torture victims 13 Interviews, questionnaires No  
Weisaeth, 1989 Industrial disaster (explosion) 125 Interviews No Author notes memory impairment in 20 cases but not actual amnesia for the disaster reported.
Robinson et al., 1990 Holocaust 86 Questionnaires No 82% of subjects reported hyperamnesia continuously since World War II.
Wagenaar and Groeneweg, 1990 Holocaust 78 Review of testimony in De Rijke case No Almost all witnesses remembered Camp Erika in "great detail" even after 40 years.
Green et al., 1991 Buffalo Creek Disaster (children) 179 Interviews Yes 7% unable to recall part of event, but 43 (25%) subjects were aged 2-7 at time of flood.
Nolen-Hoeksema and Morrow, 1991 Earthquake 137 Questionnaires No  
Realmuto et al., 1991 Williams Pipeline Disaster 24 Interviews ? Amnesia only briefly mentioned; no cases presented.
Stuber et al., 1991 Pediatric bone marrow transplant patients 6 Interviews and assessment through scales No  
Weissberg and Katz, 1991 Crash of Continental 1713 15 Questionnaires, interviews No Study of hospital-based personnel who worked with crash victims
Brooks & McKinlay, 1992; Scott et al., 1995 Crash of Pan Am 103 in Lockerbie 66 Interviews No  
Breton et al., 1993 Industrial disaster (PCB fire) 87 Verbal questionnaires No Study was done on children (ages 3-11) whose families were evacuated from disaster area.
Escobar et al., 1992 Flash floods, mudslides 139 Interviews No Mention amnesia in context of "pseudoneurological" but finds similar symptoms in non-traumatized comparison subjects.  No actual amnesia for the trauma reported.
Realmuto et al., 1992 Cambodian refugees (children) 47 Questionnaires No  
Rothbaum et al., 1992 Rape victims 95 Questionnaires, interviews No Many subjects had impaired concentration and memory, but none described as having amnesia.
Cardena and Spiegel, 1993 Earthquake 100 Questionnaires, interviews No "Dissociative symptoms" described, but no subject had amnesia for the earthquake.
Krell, 1993 Holocaust 25 Interviews and therapy No Results largely non-quantitative.
Lundin & Bodegard, 1993 Earthquake 49 Questionnaires No Study done on rescue workers.
Pelcovitz et al., 1994 Physical abuse 27 Interviews No One refused to answer, but none reported as having amnesia.
Bowler et al., 1994 Railroad chemical disaster 220 Questionnaires, interviews No Memory and concentration problems noted in both trauma group and non-traumatized comparison group.
Hardin et al., 1994 Hurricane Hugo (adolescents) 1482 Questionnaires No  
Jones et al., 1994 Wildfires (children and adolescents) 23 Questionnaires, interviews No  
Koopman et al., 1994 Firestorms 154     "Dissociation" reported, but no actual amnesia for traumatic event.
Carr et al., 1995 1989 Newcastle Earthquake 3007 17-page questionnaires No  
Hagstrom, 1995 Train collision (Norway) 66 Questionnaires No Avoidant behaviors noted but amnesia not mentioned.
Turner et al., 1995 Underground railroad station fire 50 Assisted completion of questionnaires No  
Lee et al., 1995 World War II combat 107 Questionnaires No Cohort assembled in 1938 as college students and studied prospectively.
Ursano et al., 1995 Explosion on USS Iowa 54 Questionnaires No Study of body handlers.
Weine et al., 1995, 1998 "Ethnic cleansing" in Bosnia 20/34 Interviews, questionnaires No  
Najarian et al., 1996 Armenian Earthquake 49 Interviews, questionnaires ? "Psychogenic amnesia" mentioned in table but was twice as common in a non-traumatized group as in Earthquake group.  No example presented of a subject who forgot the earthquake.
Savin et al., 1996 Cambodian refugees 99 Interviews, questionnaires No  
Shaw et al., 1996 Hurricane Andrew (children) 30 Questionnaires and teachers' ratings No  
Tyano, 1996 Bus-Train Collision (children) 83 Questionnaires No Nine subjects actually on the bus that crashed, while 74 students witnessed the crash.
Terr et al., 1997 Challenger explosion 153 Interviews regarding memories No Generally clear memories, though some mistakes; no amnesia for event.
LaGreca et al., 1996 Hurricane Andrew 442 Interviews, questionnaires No Multiple instruments administered at three points after exposure.  Despite elaborate analysis and details, no mention of amnesia for all or part of trauma.
Carlier et al., 1997 Bijlmermeer plane crash 136 Interviews Yes 12 (8%) of 136 victims were said to have "psychogenic amnesia" but no examples are given, nor is any case described in which a victim forgot the crash itself.
Groenjian et al., 1997 Armenian earthquake 64 Interviews No No mention of amnesia in either the 35 children receiving psychotherapy or the 29 children who did not receive psychotherapy.
DiGallo et al., 1997 Road traffic accidents 53 Interviews Yes Although amnesia is mentioned, it is also noted that 10 subjects lost consciousness during the accident.  All of these subjects had vivid memories of the time before and after losing consciousness.
Southwick et al., 1997 Operation Desert Storm 59 Questionnaires No Describes inconsistencies in reports of veterans at 1 month and at 2 years post combat.  However, the study provides no documentation that failure to report an event at either time point indicates amnesia for the event.
Engdahl et al., 1997 Prisoners of war 262 Interviews, questionnaires No Detailed follow-up of 262 victims, including case reports.  No mention of amnesia.
Mollica et al., 1997 Cambodian refugees 182 Interviews No Interviewed about various psychological parameters; no mention of memory loss or amnesia.
North et al., 1997 Mass shooting 136 Interviews ? Although "amnesia" is a symptom in about 10% of subjects, no evidence is presented that any subject actually forgot the shooting.
Jenkins et al., 1998 Rape victims 31 Questionnaires No The victims displayed poor memory of word lists, but no one is described as showing amnesia for the rape itself.
Asarnow et al., 1999 Northridge earthquake 63 Interviews No High rates of psychopathology but no mention of amnesia.
Koren et al., 1999 Traffic accidents 74 Interviews No No amnesia mentioned on the follow up
Becker et al., 1999 Bosnian War 10 Interviews No No descriptions of amnesia and no cases with scores greater than 1 on ratings of amnesia.
Favaro et al., 1999 Nazi concentration camp victims 98 Interviews No  
Sack et al., 1999 Pol Pot victims 27 Interviews No  

REFERENCES: List of 77 Studies of Psychological Symptoms in Trauma Survivors

1. A. Strom, S.B. Refsum, L. Eitenger, O. Gronvik, A. Lonnum, A. Engeset, K. Osvik, & B. Rogan, Examination of Norwegian Ex-concentration Camp Prisoners, 4 J. NEUROPSYCHIATRY 43-62 (1961);

2. P. Chodoff, Late Effects of the Concentration Camp Syndrome, 8 ARCHIVES OF GEN. PSYCHIATRY 323-33 (1963);

3. R.L. Lepopld & H. Dillon, psycho-anatomy of a Disaster: A Long Term Study of Post-traumatic Neuroses in Survivors of a Marine Explosion, 119 AM. J. PSYCHIATRY 913-21 (1963);

4. L.C. Terr, Children of Chowchilla: A Study of Psychic Trauma, 34 PSYCHOANALYTIC STUDY CHILD 552-623 (1979);

5. L.C. Terr, Chowchilla Revisited: The Effects of Psychic Trauma Four Years After a School-bus Kidnaping, 140 AM J. PSYCHIATRY 1543-50 (1983);

6. W.W. Eaton, J.J. Sigal, & M. Weinfeld, Impairment in Holocaust Survivors After 33 Years: Data from an Unbiased Community Sample, 139 AM J. PSYCHIATRY 773-77 (1982);

7. C.B. Wilkinson, Aftermath of a Disaster: The Collapse of the Hyatt Regency Hotel Skywalks, 140 AM J. PSYCHIATRY 1134-39 (1983);

8. A. Hoiberg & B.G. McCaugher, The Traumatic Aftereffects of Collision at Sea, 141 AM. J. PSYCHIATRY 70-73 (1984);

9. S.J. DOLLINGER, LIGHTNING-STRIKE DISASTER AMOUNG CHILDREN, 58 BRIT. J. MED. PSYCHOL 375-83 (1985);

10. C.P. Malmquist, Children Who Witness Parental Murder: Posttraumatic Aspects, 25 J. AM. ACAD. CHILD PSYCHIATRY 320-25 (1986);

11. J.D. Kinzie, W. Sack, R.H. Angell, S. Manson, & R. Ben, The Psychiatric Effects of Massive Trauma on Cambodian Children: I. The Children, 25 J. AM. ACAD. CHILD PSYCHIATRY 370-76 (1986);

12. J.D. Kinzie, W. Sack, R.H. Angell, G. Clark, & R. Ben, A Three-year Follow-up of Cambodian Young People Traumatized as Children,, 28 J. AM. ACAD. CHILD ADOLESC. PSYCHIATRY 501-04 (1989);

13. W.H. Sack, G. Clarke, C. Him, D. Dickason, B. Goff, K. Lanham, J.D. Kinzie,A 6-year Follow-up Study of Cambodian Refugee Adolescents Traumatized as Children, 32 J. AM. ACAD. CHILD ADOLESC. PSYCHIATRY 431-37 (1993);

14. J.H. Shore, E.L. Tatum, W.M. Vollmer, Psychiatric Reaction to Disaster: The Mount St. Helens Experience,143 AM. J. PSYCHIATRY 590-95 (1986);

15. M.O. Aveline, D.G. Fowlie, Surviving Ejection from Military Aircraft: Psychological Reactions, Modifying Factors and Interention, 3 STRESS MED. 15-20 (1987);

16. F. Earls, E. Smith, W. Reich, K.G. Jung, Investigating Psychopathological Consequences of a Disaster in children: A Pilot Study Incorporating a Structured Diagnostic Interview, 27 J. AM. ACAD. CHILD ADOLESC. PSYCHIATRY 90-95 (1988);

17. U. Malt, The Long-term Psychiatric Consequences of Accidental Injury: A Longitudinal Study of 107 Adults, 153 BRIT. J. PSYCHIATRY 810-18 (1988);

18. A. C. McFarlane, The Phenomenology of Posttraumatic Stress Disorders Following a Natural Disaster, 176 J. NERVOUS & MENTAL DISEASE 22-29 (1988);

19. A. C. McFarlane, The Longitudinal Course of Posttraumatic Morbidity: The Range of Outcomes and Their Predictors, 176 J. NERVOUS & MENTAL DISEASE 30-39 (1988);

20. A.C. McFarlane,Relationship Between Psychiatric Impairment and a Natural Disaster: The Role of Distress, 18 PSYCHOL. MED. 129-39 (1988);

21. R. S. Pynoos & K. Nader, Children Who Witness the Sexual Assaults of Their Mothers, 27 J. AM. ACAD. CHILD ADOLESC. PSYCHIATRY 567-72 (1988);

22. S. Dahl, Acute Response to RapeŅA PTSD Variant, 80 ACTA PSYCHIATRICA SCANDINAVICA SUPP. 355, 56-62 (1989);

23. S. Ersland, L. Weisaeth, & A. Sund, The Stress upon Rescuers Involved in an Oil Rig Disaster, "Alexander L. Kielland" 1980, 80 ACTA PSYCHIATRICA SCANDINAVICA SUPPL. 355, 38-49 (1989);

24. A. Feinstein,Posttraumatic Stress Disorder: A Descriptive Study Supporting DSM-III-R Criteria, 146 AM. J. PSYCHIATRY 665-66 (1989); 25. K. Hytten & A. Hasle, Fire Fighters: A Study of Stress and Coping, 80 ACTA PSYCHIATRICA SCANDINAVICA SUPP. 355, 50-55 (1989);

26. M. Maj, F. Starace, P. Crepet, S. Lobrace, F. Veltro, F. DeMarco, & D. Kemali,Prevalence of Psychiatric Disorders Among Subjects Exposed to a Natural Disaster, 79 ACTA PSYCHIATRICA SCANDINAVICA 544-549 (1989);

27. A. Nadler & D. Ben-Shushan,Forty Years Later: Long-term Conse-quences of Massiue Traumatization as Manifested by Holocaust Survivors from the City and the Kibbutz, 57 J. CONSULTING & CLINICAL PSYCHOL. 287-93 (1989);

28. R. S. Pynoos, K. Nader, Children's Memory and Proximity to Violence, 28 J. AM. ACAD. CHILD ADOLESC. PSYCHIATRY 236-41 (1989);

29. F. J. Stoddard, D. K. Norman, J. M. Murphy, & W. R. Beardslee, Psychiatric Outcome of Burned Children and Adolescents, 28 J. AM. J. CHILD ADOLESC. PSYCHIATRY 589-95 (1989);

30. L. Weisaeth, Torture of a Norwegian Ship's Crew: The Torture, Stress Reactions and Psychiatric After-effects, 80 ACTA PSYCHIATRICA SCANDINAVICA SUPPL. 355, 63-72 (1989);

31. L. Weisaeth, A Study of Behavioural Responses to an Industrial Disaster, 80 ACTA PSYCHIATRICA SCANDINAVICA SUPPL. 355, 13-24 (1989);

32. L. Weisaeth, The Stressors and the Post-traumatic Stress Syndrome After an Industrial Disaster, 80 ACTA PSYCHIATRICA SCANDINAVICA SUPP. 355, 25-37 (1989);

33. S. Robinson, J. Rapaport, R. Durst, M. Rapaport, P. Rosca, S. Metzer, & L. Zilberman, The Late Effects of Nazi Persecution Among Elderly Holocaust Survivors, 82 ACTA PSYCHIATRICA SCANDINAVICA 311-15 (1990);

34. W. A. Wagenaar & J. Groeneweg, The Memory of Concentration Camp Survivors, 4 APPLIED COGNITIVE PSYCHOL. 77-87 (1990);

35. B.L. Green, M. Korol, M. C. Grace, M. G. Vary, A. C. Leonard, G. C. Gleser, & S. Smitson-Cohen,Children and Disaster: Age, Gender, and Parental Effects on PTSD Symptoms, 30 J. AM. ACAD. CHILD ADOLESC. PSYCHIATRY 945-50 (1991);

36. S. Nolen-Hoeksema & J. Morrow, A Prospective Study of Depression and Posttraumatic Stress Symptoms After a Natural Disaster: The 1989 Loma Prieta Earthquake, 61 J. PERS. SOC. PSYCHOL. 115-21 (1991);

37. G.M. Realmuto, N. Wagner, & J. Bartholow, The Williams Pipeline Disaster: A Controlled Study of a Technological Accident, 4 J. TRAUMATIC STRESS 469-79 (1991);

38. M. L. Stuber, K. Nader, P. Yasuda, R. S. Pynoos, & S. Cohen, Stress Responses After Pediatric Bone Marrow Transplantation: Preliminary Results of a Prospective Longitudinal Study, 30 J. AM. ACAD. CHILD ADOLESC. PSYCHIATRY 952-57 (1991);

39. M. P. Weissberg, T. A. Katz, The Crash of Continental 1713: The Impact on Hospital-based Personnel, 9 J. EMERGENCY MED. 459-63 (1991);

40. N. Brooks & W. McKinlay, Mental Health Consequences of the Lockerbie Disaster, 5 J. TRAUMATIC STRESS 527-43 (1992);

41. J. J. Breton, J. P. Valla, J. Lambert, Industrial Disaster and Mental Health of Children and Their Parents, 32 J. AM. ACAD. CHILD ADOLESC. PSYCHIATRY 438-45 (1993);

42. R. B. Scott, N. Brooks, & W. McKinlay,Post-traumatic Morbidity in a Civilian Community of Litigants: A Follow-up at 3 Years, 8 J. TRAUMATIC STRESS 403-17 (1995);

43. J. I. Escobar, G. Canino, M. Rubio-Stipec, & M. Bravo, Somatic Symptoms After a Natural Disaster: A Prospective Study, 149 AM. J. PSYCHIATRY 965-67 ( 1992);

44. G. M. Realmuto, A. Masten, L. F. Carole, J. Hubbard, A. Groteluschen, & B. Chhun, Adolescent Survivors of Massive Childhood Trauma in Cambodia: Life Events and Current Symptoms, 5 J. TRAUMATIC STRESS 589-99 (1992);

45. B.O. Rothbaum, E. B. Foa, D. S. Riggs, T. Murdock, & W. Walsh,A Prospective Examination of Post-traumatic Stress Disorder in Rape Victims, 5 J. TRAUMATIC STRESS 455-75 (1992);

46. E. Cardena & D. Spiegel,Dissociative Reactions to the San Francisco Bay Area Earthquake of 1989, 150 AM. J. PSYCHIAATRY 474-78 (1993);

47. R. Krell,Child Survivors of the Holocaust Strategies of Adaptation, 38 CAN. J. PSYCHIATRY 384-89 (1993);

48. T. Lundin & M. Bodegard, The Psychological Impact of an Earthquake on Rescue Workers: A Follow-up Study of the Swedish Group of Rescue Workers in Armenia, 6 J. TRAUMATIC STRESS 129-39 (1993);

49. R. M. Bowler, D. Mergler, G, Huel, & J. E. Cone,Psychological, Psychosocial, and Psychophysiological Sequelae in a Community Affected by a Railroad Chemical Disaster, 7 J. TRAUMATIC STRESS 601-24 (1994);

50. S. B. Hardin, M. Weinrich, S. Weinrich, T. L. Hardin, & C. Garrison,Psychological Distress of Adolescents Exposed to Hurri-cane Hugo, 7 J. TRAUMATIC STRESS 427-40 (1994);

51. R. T. Jones, D. P. Ribbe, & P. Cunningham,Psychosocial Correlates of Fire Disaster Among Children and Adolescents, 7 J. TRAUMATIC STRESS 117-22 (1994);

52. C. Koopman, C. Classen, & D. Spiegel, Predictors of Posttraumatic Stress Symptoms Among Survivors of the Oakland/Berkeley, California Firestorm, 151 AM. J. PSYCHIATRY 888-94 (1994);

53. V. J. Carr, T. J. Lewin, R. A. Webster, P. L. Hazell, J. A. Kenardy, & G. L. Carter, Psychosocial Sequelae of the 1989 Newcastle Earthquake: I. Community Disaster Experiences and Psychological Mor-bidity 6 Months Post-disaster, 25 PSYCHOL. MED. 539-55 (1995);

54. R. Hagstrom, The Acute Psychological Impact on Survivors Following a Train Accident, 8 J. TRAUMATIC STRESS 391-402 (1995);

55. S. W. Turner, J. Thompson, & R. M. Rosser, The King's Cross Fire: Psychological Reactions, 8 J. TRAUMATIC STRESS 419-27 (1995);

56. K. A. Lee, G. E. Vaillant, W. C. Torrey, & G. H. Elder, A 50-year Prospective Study of the Psychological Sequelae of World War II Combat, 152 AM. J. PSYCHIATRY 516-22 (1995);

57. R. J. Ursano, C. S. Fullerton, T. Kao, & V. R. Bhartiya, Longitudinal Assessment of Posttraumatic Stress Disorder and Depression After Exposure to Traumatic Death, 183 J. NERVOUS & MENTAL DISEASE 36-42 (1995);

58. S. M. Weine, D. F. Becker, T. H. McGlashan, D. Laub, S. Lazrove, D. Vojvoda, & L. Hyman, Psychiatric Consequences of "Ethnic Cleansing:" Clinical Assessments and Trauma Testimonies of Newly Resettled Bosnian Refugees, 152 AM. J. PSYCHIATRY 536-42 (1995);

59. L. M. Najarian, A. K. Goenjian, D. Pelcovitz, F. Mandel, & B. Najarian,Relocation After a Disaster: Posttraumatic Stress Disorder in Armenia After the Earthquake, 35 J. AM. ACAD. CHILD ADOLESC. PSYCHIATRY 384-91 (1996);

60. D. Savin, W. H. Sack, G. N. Clarke, N. Meas, & I. M. L. Richart, The Khmer Adolescent Project: IlI A Study of Trauma from Thailand's Site II Refugee Camp, 35 J. AM. ACAD. CHILD ADOLESC. PSYCHIA-TRY 384-91 (1996);

61. J. A. Shaw, B. Applegate, & C. Schorr, Twenty-one Month Follow-up Study of School-age Children Exposed to Hurricane Andrew, 35 J. AM. ACAD. CHILD ADOLESC. PSYCHIATRY 359-64 (1996);

62. S. Tyano, I. Iancu, Z. Solomon, J. Sever, I. Goldstein, Y. Touviani & A. Bleich, Seven-year Follow-up of Child Survivors of a Bus-Train Collision, 35 J..AM. ACAD. CHILD ADOLESC. PSYCHIATRY 365-72 (1996);

63. L. C. Terr, D. A. Bloch, B. A. Michel, H. Shi, J. A. Reinhardt, & S. Metayer, Children's Memories in the Wake of Challenger, 153 AM. J. PSYCHIATRY 618-25 (1996);

64. A.M. LaGreca, W.K. Silverman, E.M. Vernberg, M.J. Prinstein, Symptoms of Posttraumatic Stress in Children after Hurricane Andrew: A Prospective Study, 64 J. CONSULTING CLIN. PSYCHOLOGY 712-23 (1996);

65. I.V.E. Carlier, B.P.R. Gersons, Stress Reactions in Disaster Victims Following the Bijlmermeer Plane Crash, 10 J. TRAUMATIC STRESS 329-335 (1997);

66. A.K. Groenjian, I. Karayan, R.S. Pynoos, D. Minassian, L.M. Najarian, A.M. Steinberg, L.A. Fairbanks, Outcome of Psychotherapy Among Early Adolescents After Trauma, 154 AM. J. PSYCHIATRY 536-42 (1997);

67. A. DiGallo, J. Barton, W.L.I. Parry-Jones, Road Traffic Accidents: Early Psychological Consequences in Children and Adolescents, 170 BR. J. PSYCHIATRY 358-62 (1997);

68. S.M. Southwick, C.A. Morgan, A.L. Nicolaou, D.S. Charney, Consistency of Memory for Combat-Related Traumatic Events in Veterans of Operation Desert Storm, 154 AM. J. PSYCHIATRY 173-77 (1997);

69. B. Engdahl, T.N. Dikel, R. Eberly, A. Blank, Jr.,Posttraumatic Stress Disorder in a Community Group of Former Prisoners of War: A Normative Response to Severe Trauma, 154 AM. J. PSYCHIATRY 1576-81 (1997);

70. R.F. Mollica, M.A.R., C. Poole, L. Son, C.C. Murray, S. Tor, Effects of War Trauma on Cambodian Refugee Adolescents' Functional Health and Mental Health Status, 36 J. AM. ACAD. CHILD ADOLESC. PSYCHIATRY 1098-1106 (1997);

71. C.S. North, E.M. Smith, E.L. Spitznagel, One-Year Follow-Up of Survivors of a Mass Shooting, 154 AM. J. PSYCHIATRY 1696-1702 (1997);

72. M.A. Jenkins, P.J. Langlais, D. Delis, R. Cohen, Learning and Memory in Rape Victims with Posttraumatic Stress Disorder, 155 AM. J. PSYCHIATRY 278-9 (1998);

73. J. Asarnow, S. Glynn, R.S. Pynoos, J. Nahum, D. Guthrie, D.P. Cantwell, B. Franklin, When the Earth Stops Shaking: Earthquake Sequelae Among Children Diagnosed for Pre-Earthquake Psychopathology, 38 J. AM ACAD. CHILD ADOLESC. PSYCHIATRY 1016-23 (1999);

74. D. Koren, I. Arnon, E. Klein, Acute Stress Response and Posttraumatic Stress Disorder in Traffic Accident Victims: A One-Year Prospective, Follow-Up Study, 156 AM. J. PSYCHIATRY 367-73 (1999);

75. D.F. Becker, S.N. Weine, D. Vojvoda, T.H. McGlashan, Case Series: PTSD Sumptoms in Adolescent Survivors of "Ethnic Cleansing." Results From a 1-Year Follow-up Study, 38 J. AM. ACAD. CHILD ADOLESC. PSYCHIATRY 775-781 (1999);

76. A. Favaro, F.C. Rodella, G. Colombo, P. Santonastaso, Post-traumatic Stress Disorder and Major Depression Among Italian Nazi Concentration Camp Survivors: A Controlled Study 50 Years Later, 29 PSYCHOL. MEDICINE 87-95 (1999);

77. W.S. Sack, C. Him, D. Dickason, Twelve-Year Follow-up Study of Khmer Youths Who Suffered Massive War Trauma as Children, 38 J. AM. ACAD. CHILD ADOLESC PSYCHIATRY 1173-9 (1999).