This study examined the longitudinal course of psychiatric sequelae of a mass shooting incident at a courthouse. A sample of 80 individuals was examined 6-8 weeks after the incident and 77 of these were reassessed one and three years later using the Diagnostic Interview Schedule/Disaster Supplement. Only 5% of the study sample met criteria for PTSD after this incident. Universal distress, however, was evident as 96% of the respondents reported PTSD symptoms and 75% described the incident as "very upsetting." The need for intervention among symptomatic individuals not meeting diagnostic criteria should not be discounted as subdiagnostic distress may warrant specific intervention.