Impacts and ESPA 13-Novembre: two studies to assess the psychological impact of these attacks on the civilian population …

Following the series of attacks in January and November 2015, Santé publique France conducted two surveys: Impacts and ESPA 13 November.

Objective: to assess the psychotraumatic impact of these attacks on the civilian population and on responders involved in caring for victims, and to better understand the use of healthcare services following these events.

• The Impacts study shows that six months after the attacks, 18% of non-responding civilians exhibited post-traumatic stress disorder (PTSD)^¹ and 20% exhibited depressive or anxiety disorders without PTSD.

• The initial results of the Espa survey show that eight months after the attacks, 54% of those directly threatened and those who had lost a loved one, and 27% of bystanders, exhibited probable PTSD. Nearly half had not begun regular treatment with a psychologist or physician, a higher proportion among bystanders and those in mourning who were not directly exposed than among those directly threatened.

… and on responders involved in victim care

The Impacts and Espa surveys show that 3% of responders suffer from PTSD and 14% from an anxiety disorder. This highlights the importance of preparing responders for stress management prior to their deployment, and identifying risk factors (lack of social support, the nature of the intervention, and conditions of insecurity) to protect them from the risk of PTSD.

A profound impact of the attacks on French society

Three articles provide insights into the impact of the attacks on the French population:

• a presentation of the Sursaud syndromic surveillance system and evidence of increases in emergency room visits and SOS Médecins consultations for stress and anxiety disorders occurring in mainland France during the two weeks following the attacks

• an examination of the population’s exposure to images of the terrorist attacks through media coverage, via a study showing an association between time spent viewing images related to the attacks and the presence of post-traumatic stress symptoms six months after the events. The survey "Living Conditions and Aspirations of the French" by the Center for Research on the Study and Observation of Living Conditions (Crédoc) reveals a profound impact of the November 13 attacks on French society, seven months after they occurred.

Understanding the construction of individual and collective memory

The transdisciplinary 13-November program, led by the CNRS, Inserm, and heSam University, and involving 31 partners, is presented in this BEH. Its objective: to study the construction and evolution of individual and collective memory following the attacks. The 1000 study analyzes video testimonies from 1,000 people, ranging from those most directly affected to those furthest removed from the attack sites, with follow-ups at several-year intervals through 2026. Among them, 200 people are undergoing imaging scans and neuropsychological tests as part of the Remember study, which aims to measure memory and emotional control capabilities based on the participants’ current state. The Espa and Crédoc surveys are part of this program.

Today’s lesson is to better identify the profiles of the most vulnerable populations and raise awareness among healthcare professionals about the consequences of psychological trauma to ensure early, needs-based care. Monitoring the Impacts and Espa cohorts will allow us to assess changes over time.

BEH No. 38-39 - The 2015 attacks in France: measuring their impact on public health to better prepare the response

¹ This syndrome, defined in the DSM-5 1, can occur in people who have been exposed to death or a threat of death, serious injury, or sexual violence. It manifests as intrusive thoughts, avoidance behaviors, intense autonomic reactions, as well as cognitive and mood disturbances that last at least one month and interfere with daily life.