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PAPERS:
G James Rubin, Chris R Brewin, Neil Greenberg, John Simpson, and Simon Wessely
Psychological and behavioural reactions to the bombings in London on 7 July 2005: cross sectional survey of a representative sample of Londoners
BMJ 2005; 331: 606 [Abstract] [Full text]
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[Read Rapid Response] Fear and loathing in London
Woody Caan   (4 September 2005)

Fear and loathing in London 4 September 2005
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Woody Caan,
Professor of public health
APU, Chelmsford, Essex CM1 1SQ.

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Re: Fear and loathing in London

Thank you, BMJ, for publishing this timely population-based study on the effects of mass murder on stress and avoidant behaviours. [1] Clearly most Londoners are doing reasonably well in the short term, but some more vulnerable sub-groups are already appearing. The telephone research focused on a standard stress rating, used with adults over 18 years old.

For children faced with inexplicable 'terror', including expressions of sudden fear by their parents, 'stress' may not be the critical factor for long term health. The recent documentary Children of Beslan [2] illustrated how hatred can become the dominant response of many children who survived mass murder in their home town, a year after the events. Children can internalise their hates in ways that cause unexpected long- term damage to their health. [3]

Could I urge school health services and community services that support parenting to be vigilant for such intense and ultimately destructive emotions in some children, related to recent events. Services may already have established therapeutic resources to help identified young people at risk, to master feelings of hate. In the absence of any existing community resources, it might be worth adapting youth drama, artwork and music of the sort we found helpful with adolescent offenders who had experienced traumatic bereavements or violence. [4]

1 Rubin GJ, Brewin CR, Greenberg N, Simpson J, Wessely S. Psychological and behavioural reactions to the bombings in London on 7 July 2005: cross sectional survey of a representative sample of Londoners. BMJ 2005; 0: bmj.38583.728484.3A

2 Ewart E. Beslan children still tormented. (Summary of BBC broadcast 'Children of Beslan' 30 August 2005) http://news.bbc.co.uk/1/hi/world/europe/4187924.stm

3 Räikkönen K, Matthews KA, Salomon K. Hostility predicts metabolic syndrome risk factors in children and adolescents. Health Psychology 2003; 22: 279-286.

4 McKay I, Caan W. Free expression: tailoring health services to young offenders in Barking & Dagenham and Havering. Pp. 91-100 in Listen to Me: Consulting young people on health and health issues. London, Barnardo’s (Right Fit series), 2002.

Competing interests: None declared