OBJECTIVE: Several studies have provided prevalence estimates of posttraumatic stress disorder (PTSD) related to the September 11, 2001 (9/11) attacks in broadly affected populations, although without sufficiently addressing qualifying exposures required for assessing PTSD and estimating its prevalence. A premise that people throughout the New York City area were exposed to the attacks on the World Trade Center (WTC) towers and are thus at risk for developing PTSD has important implications for both prevalence estimates and service provision. This premise has not, however, been tested with respect to DSM-IV-TR criteria for PTSD. This study examined associations between geographic distance from the 9/11 attacks on the WTC and reported 9/11 trauma exposures, and the role of specific trauma exposures in the development of PTSD. METHODS: Approximately 3 years after the attacks, 379 surviving employees (102 with direct exposures, including 65 in the towers, and 277 with varied exposures) recruited from 8 affected organizations were interviewed using the Diagnostic Interview Schedule/Disaster Supplement and reassessed at 6 years. The estimated closest geographic distance from the WTC towers during the attacks and specific disaster exposures were compared with the development of 9/11-related PTSD as defined by the Diagnostic and Statistical Manual, Fourth Edition, Text Revision. RESULTS: The direct exposure zone was largely concentrated within a radius of 0.1 mi and completely contained within 0.75 mi of the towers. PTSD symptom criteria at any time after the disaster were met by 35% of people directly exposed to danger, 20% of those exposed only through witnessed experiences, and 35% of those exposed only through a close associate's direct exposure. Outside these exposure groups, few possible sources of exposure were evident among the few who were symptomatic, most of whom had preexisting psychiatric illness. CONCLUSIONS: Exposures deserve careful consideration among widely affected populations after large terrorist attacks when conducting clinical assessments, estimating the magnitude of population PTSD burdens, and projecting needs for specific mental health interventions.
OBJECTIVE: Several studies have provided prevalence estimates of posttraumatic stress disorder (PTSD) related to the September 11, 2001 (9/11) attacks in broadly affected populations, although without sufficiently addressing qualifying exposures required for assessing PTSD and estimating its prevalence. A premise that people throughout the New York City area were exposed to the attacks on the World Trade Center (WTC) towers and are thus at risk for developing PTSD has important implications for both prevalence estimates and service provision. This premise has not, however, been tested with respect to DSM-IV-TR criteria for PTSD. This study examined associations between geographic distance from the 9/11 attacks on the WTC and reported 9/11 trauma exposures, and the role of specific trauma exposures in the development of PTSD. METHODS: Approximately 3 years after the attacks, 379 surviving employees (102 with direct exposures, including 65 in the towers, and 277 with varied exposures) recruited from 8 affected organizations were interviewed using the Diagnostic Interview Schedule/Disaster Supplement and reassessed at 6 years. The estimated closest geographic distance from the WTC towers during the attacks and specific disaster exposures were compared with the development of 9/11-related PTSD as defined by the Diagnostic and Statistical Manual, Fourth Edition, Text Revision. RESULTS: The direct exposure zone was largely concentrated within a radius of 0.1 mi and completely contained within 0.75 mi of the towers. PTSD symptom criteria at any time after the disaster were met by 35% of people directly exposed to danger, 20% of those exposed only through witnessed experiences, and 35% of those exposed only through a close associate's direct exposure. Outside these exposure groups, few possible sources of exposure were evident among the few who were symptomatic, most of whom had preexisting psychiatric illness. CONCLUSIONS: Exposures deserve careful consideration among widely affected populations after large terrorist attacks when conducting clinical assessments, estimating the magnitude of population PTSD burdens, and projecting needs for specific mental health interventions.
Authors: Sandro Galea; Jennifer Ahern; Heidi Resnick; Dean Kilpatrick; Michael Bucuvalas; Joel Gold; David Vlahov Journal: N Engl J Med Date: 2002-03-28 Impact factor: 91.245
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Authors: M A Schuster; B D Stein; L Jaycox; R L Collins; G N Marshall; M N Elliott; A J Zhou; D E Kanouse; J L Morrison; S H Berry Journal: N Engl J Med Date: 2001-11-15 Impact factor: 91.245
Authors: Sandro Galea; Heidi Resnick; Jennifer Ahern; Joel Gold; Michael Bucuvalas; Dean Kilpatrick; Jennifer Stuber; David Vlahov Journal: J Urban Health Date: 2002-09 Impact factor: 3.671
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Authors: William E Schlenger; Juesta M Caddell; Lori Ebert; B Kathleen Jordan; Kathryn M Rourke; David Wilson; Lisa Thalji; J Michael Dennis; John A Fairbank; Richard A Kulka Journal: JAMA Date: 2002-08-07 Impact factor: 56.272
Authors: Emine R Ayvaci; David E Pollio; Jeffrey Sonis; Saira M Bhatti; Carol S North Journal: Int J Methods Psychiatr Res Date: 2019-02-11 Impact factor: 4.035
Authors: Rachel Elizabeth Zettl; Lindsay E Page; Saira M Bhatti; Karen Duong; Tulsie Patel; John R Dykema; Meagan Whitney; Emine R Ayvaci; Carol S North; Jeffrey Sonis Journal: Behav Sci Terror Polit Aggress Date: 2019-12-15
Authors: Maria E Reynolds; Josh M Raitt; Ala Üstyol; Rachel Zettl; C Robert Cloninger; Carol S North Journal: Psychiatry Date: 2021-11-15 Impact factor: 2.458