Blogger Note: We are in the process of verifying the author of this article. We believe Kathryn M. Franklin, Ph.D.
More than two years after the catastrophic events of September 11th, the United States remains woefully ill-prepared to face another terrorist attack. From detection to communication, to organization and restoration, advancement in applying lessons learned has been slow. Despite a current annual homeland security budget of $41 billion, financial aid is failing to effectively reach first responders, and information sharing between federal, state, and local stakeholders is limited. Public awareness and planning amongst citizens also remains low; only approximately one-fifth of Americans recognize the Department of Homeland Security’s public preparedness campaign or have indicated that their household has either an emergency supply kit or a family communications plan (Hsu, 2004).
How can we encourage greater advancement in emergency management at an individual-, organizational-, or political-level in order to minimize the impact of an actual or anticipated future event? Leveraging a long tradition of analyzing human dynamics, the field of psychology has developed significant insights into the areas of prevention, preparation, recovery, and response that will aid in the formulation of not only attitudes and behaviors in regards to terrorism, but policies.
Prevention
Perhaps the most powerful tool in emergency management is prevention. Although the elimination of all crises is idealistic, through careful forethought, improving the relations with foreign cultures, increasing the effectiveness of negotiations, enhancing knowledge management, and optimizing the identification of potential terrorists, the frequency of occurrences can be reduced.
With terrorism, the primary preventative effort is decreasing the motivation of others to respond violently against the United States. In their extensive studies of human aggression, Pyszcynski et al. (2003) postulated that one’s cultural worldview reduces the anxiety produced by the realization of one’s own mortality and that hostility, therefore, is rooted in the threat that other worldviews poses to this underlying psychological security. According to their Terror Management Theory, conditions that undermine self-esteem and faith in one’s cultural worldview, such as when one’s own culture is incapable of supporting basic psychological and physical needs, produce greater prejudice and inter-group hostility by thrusting the resulting fear and anger onto a more powerful culture that represents an opposing position. By encouraging a more tolerant and respectful society, the tendency to respond negatively to others who are different can be reduced. Intimates and members of the same culture are also highly influential in the formulation of individual attitudes and behaviors.
Hostilities can also be decreased by improving the effectiveness of the ability to negotiate with other cultures. The “Dynamic Constructivist Model” accounts for input from both the individuals involved in the negotiation and the specific negotiation situation, focusing on key variables such as cultural values and setting including appropriate negotiating techniques (Morris & Fu, 2001), characteristics of the negotiator or perceiver as magnified by the willingness to tolerate ambiguity in situations, and the social context of the negotiation such as roles and accountability (Schimel, Simon, Greenberg, Pyszczynski, Solomon, Waxmonsky, & Arndt, 1999). With this information, one could analyze the particular circumstances in order to produce a more effective negotiator. Through the “Cultural Lens Model”, a negotiator or perceiver could better view the world from another’s perspective. Utilizing research from anthropology and organizational, developmental, and cognitive psychology, this model captures cultural differences in such variables as reasoning, judgment, and authority structure and can improve an “outsider’s” ability to anticipate actions, make accurate assessments, and intervene effectively (Klein, Pongonis, & Klein, 2000).
By anticipating a breakdown in negotiations as well as more accurately estimating the probability of an attack, violence also may be averted. Communication is composed of both explicit content, which is easily manipulated, and structural characteristics, which are not. Previous historical research on the “integrative/cognitive (IC)” or implicit thoughts of “official government statements” revealed that prior to war, the IC of high-level officials dropped significantly for both parties while previous to a surprise attack, there was a decrease in the IC of the aggressor only (Baker-Brown, Ballard, Bluck, de Vries, Suedfeld, & Tetlock, 1992). In addition, several tools have been developed to improve the effectiveness of judgments culled from multiple sources. An “optimization algorithm” exists that generates an objective accuracy greater than the accuracy of the individual probability estimates from diverse judges (Batsell, Brenner, Osherson, Vardi, & Tsavachidis, 2002) while biominimetric information management systems use neural networks and other soft-computing techniques to recognize the relevance of documents based on meaning by emulating “the way biological brains work” rather than relying solely on terms or categories that are not constant across person or time (Roitblat & Henning, 1992).
High scores on the “Right Wing Authoritarianism (RWA)” and Social Dominance Orientation Scale” aid in identifying typical leaders and followers in a terrorist group. Followers submit to established/proper authorities and attack due to the fear that an increasingly disintegrating, immoral world threatens their way of life. Their powerful self-righteousness, dogmatic and steadfast personality, and markedly inconsistent and compartmentalized thinking are consistent with high RWA scores (Altemeyer, 1996). Leaders, while also high RWAs, also score highly in social dominance (Pratto, Sidanius, Stallworth, & Malle, 2001) creating high prejudice with a strong drive to dominate and little moral restraint. Terrorist leaders gravitate toward gullible groups and portray whatever image will bring power without truly believing what they espouse (Altemeyer, 1998). Profiling must be used cautiously, however. Standard profiling attempts to uncover the perpetrator’s motivation in terms of typology; terrorists, unlike most violent criminals, do not suffer from psychological disorders (Silke, 1998) and studies measuring the effectiveness of current profiling techniques indicate that it produces successful results in only less than 10% of the cases (Hazelwoord, Ressler, Depue, & Douglas, 1995.) and potentially can misdirect the investigation (e.g., the Washington, DC-area snipers).
Once identified, the ability to ascertain the veracity of intelligence information supplied by “persons of interest” either voluntarily or through confessions is vital to an effective preventative strategy. As traditional detection methods rely on biophysical responses that can be manipulated, shifting the focus to subconscious cues would produce more effective results. Through priming, semantic meaning is activated by the rapid and spontaneous presentation of a word that unbeknownst to the individual triggers associated concepts in the mind (Posner & Snyder, 1975). By employing this method, researchers have assessed intergroup stereotypes and prejudices that individuals typically might be reluctant to reveal (Fazio, Sanbonmatsu, Powell, & Kardes, 1986). Bella DePaulo, Ph.D. determined through meta-analysis that “increased vocal pitch, brief responses to difficult questions and less-compelling stories came to light more often during motivated lies. Deceptive stories also tend to be suspiciously perfect, without unusual details.” Further exploration with local law enforcement, the CIA, and the Department of Homeland Security of how these and other research findings can be applied to defense strategies is currently underway (Dingfelder, 2004).
Studies have also determined that the belief that one’s identity is unknown increases the likelihood of behaving aggressively (Rehm, Steinleitner, & Lilli, 1987), therefore efforts to reveal a terrorist’s identity beforehand or to shame him or her after the fact, taking into account cultural norms, might prove an effective deterrent to future attacks.
Preparation
Barring the ability to forestall a potential terrorist attack, insights into personnel selection, planning, and communication can help to bolster the nation’s defenses. Psychologists have significantly contributed to the assessment of appropriately qualified security and public safety positions for the federal government since the advent of World War II (Maranto & Ernesto, 2002). With refinement, the existing methodology of job evaluation – analysis, screening, selection criteria, training, evaluation, and validation – can be tailored to meet the current requirements. Actual job performance can also be improved. “Threat Image Protection (TIP)” computer software has been installed in some airports to measure the individual accuracy and establish certification procedures for luggage screeners (Deployment and Use of Security Technology, 2001) based on the theory that to optimize observancy, one must occasionally find the items one is seeking (Schroeder & Holland, 1968). By applying the existing broad range of computer-based immersive virtual technology (IVET) used in both practical and therapeutic situations (Loomis, Blascovich, & Beall, 1999; Axelsson, Abelin, Heldal, Schroeder, & Widestroem; 2001) to defense training, high-risk scenarios can be realistically simulated without endangering the participants.
Organizations can also more effectively prepare for an attack. Detailed plans involving employees that focus on stated roles, continual communication, rehearsal, and review with mechanisms for reporting information must be created. Written plans have proven successful in the past, limited employer liability after the fact, and increased a sense of personal control for employees which has the added benefit of improving productivity, an appealing business goal (“Responses to Workplace Violence Post 9/11”). Existing evacuation plans also need to be closely scrutinized as behavior under emergency conditions differs from non-emergency (Sime, 1993) and previous studies of evacuation routes and building design have uncovered unforeseen obstacles. In the 1993 bombing of the Twin Towers, the descent of evacuees with walking difficulties was actually slowed due to instructions to remain on the side of the stairs that lacked full-length handrails in order to facilitate the entrance of emergency responders (Juillet, 1993).
To properly warn and rally people of in the event of a potential attack, messages from leadership must stimulate motivation while squelching fear. Governmental threat warnings ought to include reliable evidence presented by trusted officials with the danger clearly specified and recommended actions detailed. If the threat persists, a post-alarm debrief is needed to “correct misinformation, modify faulty recommendations, reinforce citizens for heeding the message and reassure of collaborative efforts.” In the result of no threat, a reputable authority must explain the outcome and then remove or lower the threat level (Zimbardo, 2003).
Response
Immediately following a terrorist attack, the top priorities of emergency management are to restore critical operations, promote national security, and mend public welfare. Maintaining communication amongst first responders and between officials and citizens is critical. Psychologists under sponsorship by SPAWAR Systems Center have developed a “set of interoperable communications technologies”, the “Domestic Emergency Response Information System (DERIS)” that are “designed to support emergency responses among multiple organizations under crisis conditions.” The effectiveness of this system is being tested through “relevant, realistic, and appropriate” scenarios with input from each participating agency and related stakeholders (Domestic Emergency Response Information System, SPAWAR Systems Center). In addition, SPAWAR Systems Center is also sponsoring the development of, the “Enhanced Consequence Management Planning and Support System (ENCOMPASS), a set of software tools that integrates information from various sources during a crisis. ENCOMPASS supports “multiple distributed first responder agencies” through two subsystems, one that supports the functions of incident commanders at all levels, and another that sustains medical personnel by analyzing patents for possible biochemical contamination or other epidemic disease. (ENCOMPASS, SPAWAR Systems Center). Initial testing in 2001 demonstrated several factors imperative to the system’s successful performance: 1) thorough training of the user prior to operation; 2) specific system functions tailored to particular agencies; and 3) implementation that reflects agency idiosyncrasies in operational concepts and approaches.
An effective and reliable communications channel with which to disseminate vital information to the community must also be established. As demonstrated on 9/11, the internet proved to be a popular avenue for citizens seeking and sharing advice. Based on conclusions from previous human/machine interactions studies, including major contributions to military and civilian aviation, future emergency communication campaigns that utilize screen instructions displaying prominent, easy-to-read instructions would appear both more informative and assuring (Montania & Resnick, 2002).
After handling the immediate logistical challenges of a terrorist attack, attention must be paid to alleviating the mental health consequences. According to a 2001 U.S. Surgeon General’s Report, “Mental Health: Culture, Race, and Ethnicity”, post 9-11 levels of stress and Post Traumatic Stress Disorder (PTSD) substantially increased for both adults and children across the country, not only at the target sites. Ethnic and racial groups were more susceptible to these effects due to social inequality, and higher rates of PTSD were found in these vulnerable populations as well as in veterans and those more severely exposed to the attacks (Psychological Impact on Terrorism, 2003). Walker & Chestnut (2003) concluded that ethnic background, gender, and age influenced reactions to terrorism with ethnicity and gender determining the causal explanation of the attack on 9/11, gender impacting the effects of the attack, with a strong similarity across the demographics in describing the first response of shock and disbelief. Johll & Brant concurred that women experienced more stress, but contrastingly found that they also used more coping mechanisms, and had better psychological outcomes than men who expressed a greater need for vengeance, excluding those in New York City where the general sentiment appeared to be we “wouldn’t wish what happened to us on anyone” (Clay, Daw, & Dittman, 2002). Although PTSD is difficult to detect in children, those exposed to a lot of television coverage were more likely to report symptoms common to the disorder (Smith, 2002). Even those who lived far from the incident were quite distressed. In Arizona, college students and staff who felt similar to the victims and reported feeling empathy for the survivors, were more likely to suffer from grief and anxiety about the future while those who were initially more insecure were more likely to suffer depression (Clay, 2002). Ten percent of the 50 American expatriates surveyed in Brussels demonstrated signs of acute stress disorder immediately following the event (Speckhard, 2003).
Surprisingly, senior citizens and therapy patients proved more resilient than initially suspected. Seniors were less likely to experience PTSD or other disorders. They were, however, vulnerable to depression or confusion if they previously suffered from cognitive disorders and their routine was disrupted (Smith, 2002). Therapy patients not directly impacted by the events reported no increase in their stress levels but rather an additional layer to the chronic stress they already experienced (New APA Survey, 2003) while the “most disturbed” clients often allegedly failed to acknowledge the event at all (Daw, 2001).
Those occupations supporting the nation were particularly challenged by the dual demands of personal and professional stress. Therapists reported feeling the cumulative negative effects of their client’s discussion of the terrorist attack and related events requiring them to define new boundaries with existing clients and to extend their services to new clients all while they processed their own grief (Survey Helps Portray the Impact, 2002). Many may have had to expand their skill set to include tools for dealing with anxiety given the overwhelming incidence (Daw, 2001). In a non-random sample of psychologists surveyed on the PracticeNet website, 39% of the therapists responding reported using relaxation techniques and supportive interventions with their clients. Although Eidelson, D’Alesso, & Eidelson (2003), reported that a sample of psychologists felt more positively than negatively towards their work post-9/11, it is critical that caregivers recognize the potential strain of these demands and to extensively practice self-care throughout this period by maintaining good physical health, leveraging the support of personal relationships, not overextending professionally or sharing obligations with other therapists, maintaining a long-term perspective and possibly, personal therapy. Previous disaster research suggests that lacking similar or extensive trauma experience may render new disaster workers vulnerable to increased distress and seasoned workers to continued stress (Dougall, Herberman, Delahanty, Inslicht, & Baum, 2000). Overseas military personnel must now shoulder the conflicting responsibilities of peacekeepers and enforcers. Successfully executing “Military Operations of Other Than War (MOTTW)” requires not only technical proficiency but also the recognition of the relevant human factors in a given situation that continually changes demands and operating conditions (Joint Chiefs of Staff, 1995). Having previously tested the physical and psychological impact of these principles on a soldier’s competency through scenarios and case studies, these findings can now be used to modify future training (GAO, 1996). Individual efforts have even been made to attempt to “inoculate” against some of the mental health ramifications of such a circumstance. The behavioral sciences flight commander at the Charleston Air Force Base teaches critical incident stress management and supplies a booklet on trauma to those deployed while also familiarizing those remaining on base with mental health concepts and available resources (Clay, 2001).
These overall elevated stress levels posed a threat not only to personal welfare but also to the collective welfare of certain ethnic groups. As previously mentioned, Terror Management Theory (Pyszcynski, 2003) indicates that the fear of mortality produces hostile attitudes towards groups who hold an opposing worldview. Acts of terrorism increase the salience of mortality and as the researchers demonstrate in their 150 experiments across nine countries, this enhanced sense of vulnerability generates a more negative response to those more critical of one’s country, a greater distancing of oneself from these groups, and the amplification of a desire for justice and punishment. As a result, the Intergroup Clearinghouse reports 1,700 acts of discrimination post-9/11 while Human Rights Watch cataloged over 2,000 hate crimes against Arab and Muslim groups and the FBI stated an increase of anti-Islamic crimes from 28 in 2000 to 481 in 2001 (Psychological Impact of Terrorism, 2003).
Correspondingly, as hostility towards “outsiders” increases, the heightened sense of mortality also raises the desire to help, particularly those in one’s own culture. As a mass casualty event can quickly overwhelm first responder and healthcare resources, exploiting this natural impulse could draw additional support from the general populace. Classic bystander research also has determined that assistance increases if the bystander is female, is either alone or with one or two others, would experience a sense of shame or guilt if he/she did not act, or somehow identifies or has a personal relationship with the individual in trouble (Levine, 1999). “Apathy” is more likely to occur if in big cities due to the “diffusion of responsibility” or the belief that someone else will handle the problem (Latane & Darley, 1970), although New York City on 9/11 defied this expectation, a perceived low competency or belief that one is unable to truly be of assistance (Cramer, McMaster, Bartell, & Diagna, 1988), or if the bystander is a highly masculine male (Tice, 1985).
Recovery
Recovery from a terrorist attack is measured not in days or months but years. The extent of the impact of such an event and the rate at which one heals varies. Recent analyses suggest that a full sense of psychological security within the United States has yet to be restored.
In the first few months following 9-11, those viewed to be most vulnerable to the mental health consequences of terrorism, women, African-Americans, Hispanics, low-income, and individuals without high school diplomas, were more likely to report psychological and emotional stress symptoms, and to having a harder time recovering. Women, racial/ethnic groups, and individuals with prior physical or mental health problems, had an increased risk of depression, anxiety, or PTSD. Women, young adults, and African-Americans were more likely to feel less optimistic about the future and to attest that 9/11 changed their life (Psychological Impact of Terror, 2003). Roxanne Cohen Silver, Ph.D. found that nationwide the degree of exposure to the event (degree of proximity, direct presence, and watching it live on television) rather than the degree of loss experienced significantly predicted the extent to which a person was distressed. Using religion to cope predicted experiencing higher levels of positive affect over time whereas denial or “giving up” predicted continued distress (Dittman, 2002). In New York City, the use of alcohol, cigarettes, and marijuana significantly increased while the demand for substance abuse treatment increased in nearly half the states in the country with the greatest demand on the east coast. Cigarette/marijuana use related to PTSD while the use of alcohol related to depression only (Psychological Impact of Terror, 2003). It was also estimated that approximately 17% of Americans living outside of New York City were experiencing post-traumatic stress (People Who ‘Gave Up’, 2002). At the University of Arkansas, the students who coped most successfully after three months were those who did not let terrorism impact their worldview whereas those for whom the attacks did affect their beliefs had lower closure rates (Clay et al., 2002). Of the expatriates in Brussels, two continued to exhibit persistent signs of distress (Speckhard, 2003). Promisingly, there was also a significant increase during this time period in the self-reporting of the virtues of love, gratitude, hope, kindness, spirituality and teamwork from the responders to an online questionnaire (Chamberlin, 2002). Increased attention was paid to heroes and more reverence applied to cultural icons, such as flags, consistent with Terror Management Theory (Pyszczynski, 2003).
At approximately six months, Michael Traugott, Ph.D. reported that of the 613 Americans he surveyed, 11% reported being “more shaken” than they were the previous fall while 37% stated that they were “still shaken”. Women continued to indicate feeling more uneasiness than men, at almost twice the rate. Slightly more than two-thirds of the sample expressed concern for their safety when flying on an airplane, one-third reported feeling more concerned when attending a sporting event, and one-fifth when going to a shopping mall. Six percent of the U.S. population living outside of NYC continued to exhibit post-traumatic stress and those with pre-existing mental or physical health problems as well as those with “greater exposure” to the event were more likely to have significant problems over time (People Who ‘Gave Up’, 2002). A self-reported study of mostly minority NYC workers found that direct exposure to the attacks, worries about future attacks, and reduced confidence in self predicted PTSD even when controlling for depression and anxiety (Piotrkowski & Brannen, 2002). A joint survey commissioned by Infinite Mind public radio series and the American Psychological Association (APA) discovered that sixteen percent of Americans attributed their current depressed or anxious mood to the events of September 11th. Nearly one-half (40%) said that they were seriously affected on a personal level, even if they did not live in the areas directly attacked. Nearly all (81%) indicated that they were trying to move beyond the setbacks in their lives, while more than three-quarters (77%) stated that they were attempting to simplify their lives and focus on what really matters. People who had experienced a past trauma were significantly more likely to describe symptoms commonly associated with depression, anxiety, and post-traumatic stress. New Yorkers also continued to report stress-related symptoms, at a rate of almost twice that of others elsewhere. On the contrary, the respondents in the Washington, DC area were far less likely to report feeling depressed or anxious than either the residents of New York City or throughout the nation (Many Americans Still Feeling Effects, 2002)
Two years later, in a nationally represented and census-balanced telephone poll of 750 Americans eighteen years or older, researchers determined that most of the respondents believe that the United States will experience another terrorist attack in the near future and that “the intentional nature of terrorism and the “fear of the unknown’” are the main reasons that they are concerned about the threat of terrorism and may account for the reported strengthening of religious faith (Public Perspectives on Mental Health).
Although each individual processes grief in his or her own way and time, research suggests several coping strategies that may facilitate healing. To restore a sense of security in the home and community, Terror Management Theory proposes increasing the value of one’s own culture and self-esteem through developing and maintaining personal relationships with intimates and those who share similar beliefs and values (Pyszczynski et al., 2003). APA’s “Road to Resilience” campaign (http://helping.apa.org) also recommends getting involved in the community and helping others while Wayment’s research further discovered that those with the strongest survivor reaction were more likely to respond by valuing family and friends more, getting involved in the community, and expressing a positive form of patriotism (Clay, 2002). It is hypothesized that senior citizens prove to be more resilient than most due to a good support network of friends and family as well as a generally positive outlook and a sense of personal mastery derived from life experience (Kersting, 2004). Florian, Mikulincer, & Hirschberger, (2002) confirmed the anxiety-buffering function of romantic relationships to thoughts of death while Frederickson et. al (2003) found that positive emotions such as gratitude, interest, and love help to buffer resilient people against depression and to fuel thriving.
In addition, the APA advises adults “to take a step back to problem solve before addressing problems” and “to seek help from others”. Knowing where to go for help and counseling is a major factor in helping Americans become more resilient (Public Perspectives on Mental Health) although those suffering from serious mental illness may already struggle with high levels of trauma and unstable support systems (Kersting, 2004). Most therapists emphasize a return to a routine rather than normalcy. “Normal” is a relative term and as long as the chosen actions are not debilitating, individuals should pursue the activities with which they are most comfortable. Establishing routines are particularly beneficial for reassuring children as well as providing age-appropriate information while also assuring them they are safe, monitoring one’s own reactions and theirs, communicating positive values, and not over-worrying (DeAngelis, 2002). Despite previous studies indicating that many children suffered from moderate to severe post-stress symptoms several months after catastrophes like Hurricane Andrew, due to the concerted efforts of their families and communities to reassure them after the attacks, children ages 6-11 reported that everyday fears such as television violence and bullies were of greater concern than terrorism (Smith, 2003).
To restore a sense of safety in the workplace, immediately after the attack effective leaders need to be visible, convey a sense of realistic hope and optimism, be calm and calming, and communicate both what is known and unknown. They must continue to create contingencies for future major events by again involving employees in developing disaster and recovery plans, ensuring that organizational supports are in place and making themselves accessible, as well as offering training/development to leaders at all levels to utilize the best resources. Although Ryan et al. (2003) in a study of a multinational corporation found only negligible differences in job satisfaction, supervisor evaluation, and stress amongst its U.S. and worldwide employees post-9/11, uncertainty is linked to poor employee and organizational performance, therefore leaders are pressed to convey timely and useful information to all employees, including the unknown, in order to reduce ambiguity and avoid panic. Good communication and good work support reduces work stress (Responses to Workplace Violence). After 9-11 in situations where employees were displaced, emotional support from loved ones and practical support, such as housing, from the employer mitigated the lost sense of security (Smith, 2002).
Terrorist attacks also increase the need for information and understanding with a shifting of the desire for security over freedom (Pyszczynski, 2003). To restore a sense of national security, the government must respond to the nationwide demand for informational programs. Strong sentiment exists that public officials could do a better job of communicating with the public about the threat of terrorism, and that the nation’s public health, medical, and emergency response systems are not meeting the mental health demands that result from the threat of terrorism. Americans want access to programs that will help them cope with fear and distress and believe that the federal government should take responsibility for the establishment of such programs with the mental health professionals delivering of the curriculum at a community level (Public Perspectives on Mental Health).
It is evident that the field of psychology has much to contribute to the theory and practice of emergency management. In order to best serve the nation’s need for prevention, preparation, response, and recovery, the government should not only welcome but seek out the behavioral science perspective for creating homeland security policies, particularly mental health first aid training for both the public and first responders.
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(1) A number of the studies cited in this paper were drawn from an excellent review on the American Psychological Association’s “Combating Terrorism” website. The original references are included to encourage further exploration of these topics.
