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Science for the Community: Assessing Mental Health After 9/11

Randall D. Marshall, MD, and Sandro Galea, MD, MPH

Published: January 1, 2004

Article Abstract

Reactions to the September 11 attacks across the United States were pervasive, and personsthroughout the country reported experiences akin to posttraumatic stress disorder (PTSD) in the firstweek following the attacks. In the New York area, 2 major surveys conducted 4 to 8 weeks after theattacks found that approximately 1 in 10 persons probably met full criteria for PTSD related to September11. Although tobacco, alcohol, and marijuana use did increase, it was largely among personsalready using these substances. The greatest increase, not surprisingly, occurred among persons withPTSD and major depressive disorder. Nationwide during the same time period, rates of PTSD relatedto September 11 were estimated at 2.7% to 4.3%, a striking finding in that the attacks were witnessedprimarily on television outside the New York area. In all studies, having anxiety symptoms or meetingcriteria for PTSD was strongly associated with number of hours of television watched on September11 and in the days afterward. A number of explanations for this new finding are possible. These datacan inform our understanding of trauma-related diagnoses, further the evolving diagnostic definitionsof the Diagnostic and Statistical Manual of Mental Disorders, and contribute to etiologic models ofPTSD. Future directions for postdisaster survey research are briefly discussed.

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