Evolution over 4 years in the changes experienced by civilians exposed to the attacks of November 2015 in Paris

Abstract

Introduction: Following the attacks of November 13, 2015, Santé Publique France set up an epidemiological survey. A first phase was carried out in 2016 then repeated in 2020, in order to understand the post-traumatic impact of the attacks. The survey consisted of closed and open-ended questions. We present here the analysis of the answers to the following open-ended questions: “Would you say that the attacks that your experienced has changed you in any way? Could you explain how?” We compare the answers given in 2016 and 2020. Objective: To understand the individual impact of terrorist attacks on civilians between 2016 and 2020. Method: Based on a qualitative analysis, we compare the results at two different times and observe the evolution of these responses. The material is composed of short testimonials related to the question of interest and are processed by thematic analysis inspired by grounded theory. We analyze the responses from 2016 and 2020 independently, and then compare the emerging themes. Results: The results highlight the presence of symptoms associated with post-traumatic stress disorder, with symptoms of intrusion, persistent avoidance of stimuli associated with the traumatic event, altered cognition and mood changes in arousal and reactivity related to the traumatic event, significant suffering, and sometimes dissociative elements. Five years after the attacks, disorders are still present in some subjects. The most distressed ones present a profile with no projection into the future, living from day to day, sometimes associated with risky behaviors. The meaning of their existence eludes them. Another part of the respondents tries to find meaning in their lives. They are looking for new life projects. The process of transforming their individuality is underway. Finally, for others whose profiles appear in the 2020 testimonials, changes have been made, they have been able to mourn their past life, who they were, and overcome their trauma. They are resilient and, in some cases, show psychic functioning suggestive of post-traumatic growth. Conclusion: The psychological impact of terrorist attacks on civilians is still very much present with important suffering, but some form of adaptation in the form of resilience or even post-traumatic growth is underway for some five years after the November 2015 attacks.