Intended for healthcare professionals


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 doi: (Published 15 September 2005) Cite this as: BMJ 2005;331:606
  1. G James Rubin (g.rubin{at}, research fellow1,
  2. Chris R Brewin, professor of clinical psychology2,
  3. Neil Greenberg, senior lecturer1,
  4. John Simpson, head of emergency preparedness3,
  5. Simon Wessely, professor of epidemiological and liaison psychiatry1
  1. 1 King's College London, Institute of Psychiatry, Department of Psychological Medicine, Weston Education Centre (PO62), London SE5 9RJ
  2. 2 University College London, Subdepartment of Clinical Health Psychology, London WC1E 6BT
  3. 3 Health Protection Agency, Centre for Emergency Preparedness and Response, Porton Down, Salisbury, Wiltshire SP4 0JG
  1. Correspondence to: G James Rubin
  • Accepted 18 August 2005


Objectives To assess the impact of the bombings in London on 7 July on stress levels and travel intentions in London's population.

Design A cross sectional telephone survey using random digit dialling was conducted to contact a representative sample of adults. Respondents were asked to participate in an interview enquiring about current levels of stress and travel intentions.

Setting Interviews took place between 18 and 20 July.

Participants 1010 participants (10% of the eligible people we contacted) completed the interviews.

Main outcome measures Main outcomes were presence of substantial stress, measured by using an identical tool to that used to assess the emotional impact of 11 September 2001 in the US population, and intention to travel less on tubes, trains, and buses, or into central London, once the transport network had returned to normal.

Results 31% of Londoners reported substantial stress and 32% reported an intention to travel less. Among other things, having difficulty contacting friends or family by mobile phone (odds ratio 1.7, 95% confidence interval 1.1 to 2.7), having thought you could have been injured or killed (3.8, 2.4 to 6.2), and being Muslim (4.0, 2.5 to 6.6) were associated with a greater presence of substantial stress, whereas being white (0.3, 0.2 to 0.4) and having previous experience of terrorism (0.6, 0.5 to 0.9) were associated with reduced stress. Only 12 participants (1%) felt that they needed professional help to deal with their emotional response to the attacks.

Conclusions Although the psychological needs of those intimately caught up in the attacks will require further assessment, we found no evidence of a widespread desire for professional counselling. The attacks have inflicted disproportionately high levels of distress among non-white and Muslim Londoners.


  • Contributors SW had the original idea for the study and developed the study design and interview questions with GJR, CRB, NG, and JS. We arealso grateful to Avi Bleich, Mark Gelkopf, Mark Gill, Ron Kessler, Claire Lambert, and Robert Ursano for making additional suggestions at this stage. Interviewers working for MORI collected the data. GJR performed the statistical analyses and wrote the first draft of the paper. All authors contributed to further drafts. SW is the guarantor.

  • Funding This study was funded by King's College London in advance of a grant application made to the Home Office.

  • Competing interests None declared.

  • Ethical approval South London and Maudsley NHS Trust Research Ethics Committee.

  • Accepted 18 August 2005
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