Overview of findings from the World Trade Center Disaster Outcome Study: recommendations for future research after exposure to psychological trauma.

In this article we review findings from the World Trade Center Disaster (WTCD) Outcomes Study, a prospective cohort study of 2,368 New York City (NYC) adults funded by the National Institutes of Health after the September 11 attacks. The findings reported were based on a baseline survey conducted one year after the disaster and a follow-up conducted two years post-disaster. One of the goals of this research was to assess the effectiveness of post-disaster treatments received by NYC residents following the attacks. Among the major findings of this study were the relatively small increase in mental health service utilization and the fact that only brief worksite interventions seemed to be an effective post-disaster treatment intervention. Specifically, those who received more conventional post-disaster interventions, such as formal psychotherapy sessions and/or psychotropic medicines, seemed to have poorer outcomes. Since this study was designed to assess treatment outcomes, use advanced measurement techniques, and incorporate propensity score matching to control for bias, these treatment findings were unexpected and raised clinical questions. Additional findings were also discussed related to minority group members, alcohol abuse, the onset and course of posttraumatic stress disorder post-disaster and other findings. Future research is recommended to resolve the issues raised by this important study, especially as this relates to treatment outcomes.