A longitudinal study of Oklahoma City bombing rescue and recovery responders providing qualitative introspections of their experience nearly a quarter century later





terrorism, rescue and recovery workers, longitudinal study, qualitative methods, personal narratives


Background: The 1995 terrorist bombing in Oklahoma City provided a particularly useful research opportunity. It was the most severe incident of terrorism on American soil at the time. Prior research on rescue and recovery workers responding to such events has been largely limited to early post-disaster periods, most focusing on psychopathology such as post-traumatic stress disorder. This incident provided a unique unrealized opportunity to examine long-term psychosocial effects on first responders studied longitudinally over decades after the event, using qualitative methods to yield rich, in-depth observations.

Methods: A volunteer sample of 181 volunteer first responders for the Oklahoma City bombing was initially assessed 3 years after the bombing, and 124 (70 percent of those documented to still be alive) participated in longitudinal follow-up interviews an average of 23-24 years after the incident. The follow-up study included open-ended, nondirected qualitative interviews of the workers’ personal disaster narratives.

Results: The experience of providing rescue and recovery efforts after the Oklahoma City bombing had lasting effects on these first responders’ personal and professional relationships. It taxed their coping skills, elicited an enduring resilience, and permanently altered their outlook on life. Unlike the directly exposed survivors, these first responders found meaning and affirmation in their professional service, reaffirming their original motivations to be part of a helping profession that in today’s world now requires recovery and rescue work in major terrorist incidents. Even though the work was very gruesome and taxing, more than two decades later, these workers expressed pride in their participation and had no regrets about it.

Conclusions: The Oklahoma City bombing experience was life-changing for first responders, setting a standard for those who will follow in their footsteps. Continuing to conduct this line of work in the decades to follow reflected a conviction that their continued service honored both survivors and members of their profession. Despite the positive aspects of their perspectives on their experience, the attention they received to their emotional and psychological processing and recovery was limited, implying the importance of additional development and research on assistance to these needs.

Author Biographies

Carol S. North, MD, MPE, DLFAPA

Medical Director, The Altshuler Center for Education & Research; Professor of Psychiatry, The Nancy and Ray L. Hunt Chair in Crisis Psychiatry; Director, Division of Trauma & Disaster, The University of Texas Southwestern Medical Center, Dallas, Texas

Katy McDonald, LPC

The Altshuler Center for Education and Research at Metrocare Services; The Department of Psychiatry at the University of Texas Southwestern Medical Center, Dallas, Texas

Alina Surís, PhD, ABPP

The Department of Psychiatry at the University of Texas Southwestern Medical Center, Dallas, Texas

Barry A. Hong, PhD

The Altshuler Center for Education and Research at Metrocare Services, Dallas, Texas; Department of Psychiatry, Washington University School of Medicine, St. Louis, Missouri


Garbern SC, Ebbeling LG, Bartels SA: A systematic review of health outcomes among disaster and humanitarian responders. Prehosp Disaster Med. 2016; 31(6): 635-642. DOI: 10.1017/S1049023X16000832.

Wilson LC: A systematic review of probable posttraumatic stress disorder in first responders following man-made mass violence. Psychiatr Res. 2015; 229: 21-26. DOI: 10.1016/j.psychres.2015.06.015.

Zhang G, Pfefferbaum B, Narayanan P, et al.: Psychiatric disorders after terrorist bombings among rescue workers and bombing survivors in Nairobi and rescue workers in Oklahoma city. Ann Clin Psychiatry. 2016; 28(1): 22-30.

North CS, Tivis L, McMillen JC, et al.: Psychiatric disorders in rescue workers after the Oklahoma city bombing. Am J Psychiatry. 2002; 159(5): 857-859.

Bromet EJ, Hobbs MJ, Clouston SA, et al.: DSM-IV post-traumatic stress disorder among world trade center responders 11-13 years after the disaster of 11 September 2001 (9/11). Psychol Med. 2016; 46(4): 771-783. DOI: 10.1017/S0033291715002184.

Smith E, Holmes L, Larkin B: Health trends among 9/11 responders from 2011-2021: A review of world trade center health program statistics. Prehosp Disaster Med. 2021; 36(5): 621-626. DOI: 10.1017/S1049023X21000881.

Clouston SAP, Guralnik JM, Kotov R, et al.: Functional limitations among responders to the world trade center attacks 14 years after the disaster: Implications of chronic posttraumatic stress disorder. J Traum Stress. 2017; 30(5): 443-452. DOI: 10.1002/jts.22219.

Feder A, Mota N, Salim R, et al.: Risk, coping and PTSD symptom trajectories in world trade center responders. J Psychiatr Res. 2016; 82: 68-79. DOI: 10.1016/j.jpsychires.2016.07.003.

Zvolensky MJ, Kotov R, Schechter CB, et al.: Post-disaster stressful life events and WTC-related posttraumatic stress, depressive symptoms, and overall functioning among responders to the world trade center disaster. J Psychiatr Res. 2015; 61: 97-105. DOI: 10.1016/j.jpsychires.2014.11.010.

Zvolensky MJ, Farris SG, Kotov R, et al.: World trade center disaster and sensitization to subsequent life stress: A longitudinal study of disaster responders. Preventive Med. 2015; 75: 70-74. DOI: 10.1016/j.ypmed.2015.03.017.

North CS, McMillen JC, Pfefferbaum B, et al.: Coping, functioning, and adjustment of rescue workers after the Oklahoma city bombing. J Traum Stress. 2002; 15(3): 171-175.

Robins LN, Cottler LB, Compton WM, et al.: Diagnostic Interview Schedule for the DSM-IV (DIS-IV). St. Louis, MO: Washington University, 2000.

North CS, Pfefferbaum B, Robins LN, et al.: The Disaster Supplement to the Diagnostic Interview Schedule for DSM-IV (DIS-IV/DS). St. Louis, MO: Washington University, 2001.

Cohen JA: A coefficient of agreement for nominal scales. Educ Psychol Meas. 1960; 20: 37-46.

McHugh ML: Interrater reliability: The kappa statistic. Biochem Med. 2012; 22(3): 276-282.

Fleiss J: Statistics for Rates of Proportions. 2nd ed. Hoboken, NJ: John Wiley & Sons, 1981.

van Emmerik AA, Kamphuis JH, Hulsbosch AM, et al.: Single session debriefing after psychological trauma: A meta-analysis. Lancet. 2002; 360(9335): 766-771. DOI: 10.1016/S0140-6736(02)09897-5.

Tran DV, North CS: The association between dissatisfaction with debriefing and post-traumatic stress disorder (PTSD) in rescue and recovery workers for the Oklahoma city bombing. Disaster Med Public Health Prep. 2018; 12(6): 718-722. DOI: PM10.1017/dmp.2017.153.



How to Cite

North, MD, MPE, DLFAPA, C. S., K. McDonald, LPC, A. Surís, PhD, ABPP, and B. A. Hong, PhD. “A Longitudinal Study of Oklahoma City Bombing Rescue and Recovery Responders Providing Qualitative Introspections of Their Experience Nearly a Quarter Century Later”. Journal of Emergency Management, vol. 21, no. 1, Jan. 2023, pp. 23-36, doi:10.5055/jem.0740.