In a study of Dutch dairy farmers [10] around half of those whose animals were culled suffered from severe post-traumatic distress, (identified as a clinical level of distress (> 25) using the 15-item Impact of Events Scale), with this reducing to one in five for those where severe restrictions were imposed (but where no culling took place). Higher levels of symptoms were reported for older respondents and those with lower levels of education. In this same study differences in stress, psychological marginalization, and depression were reported for different disease control areas, i.e. culled-area, buffer-area, FMD-free area [11] .