In the Wake of National Trauma: Psychological Reactions Following the Charlie Hebdo Terror Attack

To the Editor: On Jan. 7, 2015, a terror attack targeted the satirical magazine Charlie Hebdo, leading to the death of 12 people. This attack was considered a national trauma that shook core beliefs and the French way of life (1). The association between mortality salience, reported shifts in political views, and sense of safety with psychological distress and posttraumatic stress disorder (PTSD) symptoms following national trauma is understudied.

We conducted a nationally representative online panel survey (N=1,982) in France 4 weeks after the Charlie Hebdo attack. Of 2,421 who clicked through to the survey, 1,982 (82%) responded fully.

“To what extent have the recent attacks in Paris changed how you think about your own death?” measured mortality salience, and, “The Charlie Hebdo shooting led me to change my political views,” measured shift in political views. Sense of safety was measured by the World Health Organization Quality of Life-BREF (2), psychological distress by the Kessler Psychological Distress Scale (3), and PTSD by the proposed ICD-11 PTSD criteria (4).

Two-step logistic regression (adjusted for demographic variables) showed that elevated psychological distress and endorsement of PTSD symptom criteria were significantly associated with higher mortality salience and shift in political views (odds ratios, ≥2.27, p values, ≤0.001) (Table 1). The same results were replicated for each PTSD cluster (odds ratios, ≥2.07, p values, ≤0.001).

Study limitations include the use of a cross-sectional design, possible response bias, lack of premeasurement of participants with pre-existing PTSD symptoms, and potential confounders (e.g., the possibility of another traumatic event that the participant was exposed to before or concurrently with the terror attack).

In the wake of the Charlie Hebdo terror attacks, we found evidence of elevated PTSD symptoms compared with historical norms in France (7.6% compared with 4.9%). Substantial proportions of French people felt shifts in their perceptions of personal safety, thought more about their own mortality, and said they would change their voting patterns as a consequence. These results expand on previous study of 9/11 terrorist attacks (5). Clinicians should be aware that national trauma takes a toll on mental health in various ways, including mortality salience, shift in political views, and sense of safety.