Home > Public Resources > Trauma Blog > 2020 - May > Worst life events and media exposure to terrorism Worst life events and media exposure to terrorism Rebecca R. Thompson, PhD; E. Alison Holman, PhD, FNP; & Roxane Cohen Silver, PhD May 9, 2020 Unfortunately, all people are likely to have something bad happen to them over the course of their lifetimes. This includes both individually-experienced events, such as the loss of a loved one or experience of a physical assault, as well as collective traumas, or events that are shared across an entire community, such as a natural disaster or terrorist attack. The September 11, 2001 (9/11) terrorist attacks were one such collective trauma that was shared across the United States – millions of Americans watched on their television sets in horror as planes crashed into both towers of the World Trade Center and the Pentagon, events which marked a shift in many individuals’ views of the world as a safe and benevolent place to live (Updegraff, Silver, & Holman, 2008). Exposure to 9/11 via the media, especially to graphic imagery of this event, was associated with negative mental health outcomes among viewers (Ahern, Galea, Resnick, & Vlahov, 2004; Silver et al., 2013), including people living very far away from the attacks (Holmes, Creswell, & O’Connor, 2007). Our team of researchers at the University of California, Irvine was interested in how people consider and catalog their various life events, including both direct, individually-experienced events and indirect, collectively-experienced ones, to determine which is their “worst” life event. In our study, we assessed how 9/11 factored into people’s assessments of their worst life events, given that most people across the United States only experienced it via the news media. We administered two surveys to a nationally representative panel of U.S. residents who reported no direct exposure to the 9/11 attacks (N=1,609; at least 75% participation rate at each wave); the first survey was fielded 9-22 days after the attacks, and the second was fielded approximately one year later. In the second survey, participants were asked to complete an inventory of their negative life experiences and to indicate which event they considered to be the worst of their lives. In our nationally representative sample, the most commonly cited worst life events were those characterized by loss (e.g., death of a spouse or child; 42%). Violent traumas were cited by 11.4% of the sample (e.g., physical assault, combat exposure). Most surprisingly, 22% of our nationally representative sample indicated that 9/11 was their worst life event, even though none of our participants had any direct exposure to the attacks or knew anyone who died that day. Individuals who selected 9/11 as their worst life event were on average younger (M=46.28 vs. M=50.43 years), had experienced fewer overall life events (M=6.22 vs. M=9.81 events), and reported more distress in the weeks after 9/11 (M=5.55 vs. M=4.97 acute stress symptoms). Using logistic regression, we sought to test the predictors of selecting 9/11 as one’s worst life event. Analyses revealed that individuals who reported fewer violence and loss events in their past were less likely to select 9/11 as their worst life event. However, having consumed a daily average of four or more hours of 9/11-related television in the weeks following the attacks was associated with an increased likelihood of selecting 9/11 as a person’s worst life event, even when accounting for the other events in their lives. These results held when accounting for other potential explanatory variables, including demographics, past mental health diagnoses, anniversary-related television exposure, neuroticism, the experience of a 9/11-related “near miss” event, and television watching habits. These findings have important implications for clinical practice and for the news media. In the most recent version of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), which contains the criteria for the diagnosis of posttraumatic stress disorder, exposure to trauma via the media is explicitly excluded from consideration as a potentially traumatic stressor (American Psychiatric Association, 2013). Our results demonstrate that this exclusion might be unnecessary, and that the impact of exposure to collective trauma through television and other media outlets (e.g., online news or social media) should be acknowledged by mental health professionals. Further consideration by the news media regarding how traumatic content is broadcast and marketed to viewers so as not to create undue distress is also warranted. Given that coverage of mass violence events is more accessible to consumers than ever before due to the proliferation of smartphones, researchers should work to identify those who are most vulnerable to media coverage of violence and create strategies for early intervention to prevent distress among these individuals. References: Ahern, J., Galea, S., Resnick, H., & Vlahov, D. (2004). Television images and probable posttraumatic stress disorder after September 11. The Journal of Nervous and Mental Disease, 192, 217–226. https://doi.org/10.1097/01.nmd.0000116465.99830.ca American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: American Psychiatric Publishing. https://doi.org/10.1176/appi.books.9780890425596.744053 Holmes, E. A., Creswell, C., & O’Connor, T. G. (2007). Posttraumatic stress symptoms in London school children following September 11, 2001: An exploratory investigation of peri-traumatic reactions and intrusive imagery. Journal of Behavior Therapy and Experimental Psychiatry, 38, 474–490. https://doi.org/10.1016/j.jbtep.2007.10.003 Silver, R. C., Holman, E. A., Andersen, J. P., Poulin, M. J., Mcintosh, D. N., & Gil-Rivas, V. (2013). Mental- and physical-health effects of acute exposure to media images of the September 11, 2001, attacks and the Iraq War. Psychological Science, 24, 1623–1634. https://doi.org/10.1177/0956797612460406 Updegraff, J. A., Silver, R. C., & Holman, E. A. (2008). Searching for and finding meaning in collective trauma: Results from a national longitudinal study of the 9/11 terrorist attacks. Journal of Personality and Social Psychology, 95, 709–722. https://doi.org/10.1037/0022-35220.127.116.119 Reference Article Thompson, R. R., Holman, E. A., & Silver, R. C. (2020). Worst life events and media exposure to terrorism in a representative U.S. sample. Journal of Traumatic Stress. Published online ahead of print April 20, 2020. http://www.doi.org/10.1002/jts.22534 About the Authors: Rebecca R. Thompson, PhD is a postdoctoral scholar in the Department of Psychological Science at the University of California, Irvine (UCI). She received her PhD in social psychology from UCI in 2018. Her research focuses on psychological responses to direct and indirect exposure to collective traumas, including the 2013 Boston Marathon bombings, the 2014 Ebola public health crisis, and the 2018 Atlantic hurricane season. E. Alison Holman, PhD, FNP is Associate Professor in the Sue & Bill Gross School of Nursing at the University of California, Irvine. She received her PhD in Health Psychology and Family Nurse Practitioner Certificate from the University of California, Irvine. Her research is focused on identifying early predictors of trauma-related health problems that can be targeted for early interventions to prevent the morbidity and mortality associated with trauma exposure in populations who have experienced a variety of traumatic life events (e.g., terrorism, war, disaster). Most recently, she has focused on indirect, media-based trauma exposure and genetic susceptibilities as potential risk factors for subsequent mental and physical health problems. Roxane Cohen Silver, PhD is professor in the Department of Psychological Science, the Department of Medicine, and the Program in Public Health at the University of California, Irvine. She has spent almost four decades studying acute and long-term psychological and physical reactions to stressful life experiences, including personal traumas and larger collective events such as war, firestorms, school shootings, terrorist attacks, and other international community disasters. In 2018, she received the ISTSS Robert S. Laufer Ph.D. Memorial Award for Outstanding Scientific Achievement and in 2011, she received the APA Award for Distinguished Contributions to Psychology in the Public Interest (Senior Career). She received her PhD in social psychology from Northwestern University. Discussion Questions: How might psychologists, public health professionals, and media organizations collaborate to ensure that media coverage and messaging surrounding collective traumas is informative and engaging without inciting undue distress among viewers? What role should social media platforms play in monitoring content on their sites that might be potentially traumatizing to users? In light of these findings and those by other researchers (e.g., Ahern et al., 2004) suggesting that exposure to media coverage of collective traumas might be psychologically harmful, should we as psychologists reconceptualize our definition of trauma?