A Web-based survey of adults who experienced loss during the September 11, 2001, terrorist attacks was conducted to examine the prevalence and correlates of complicated grief (CG) 2.5-3.5 years after the attacks. Forty-three percent of a study group of 704 bereaved adults across the United States screened positive for CG. In multivariate analyses, CG was associated with female gender, loss of a child, death of deceased at the World Trade Center, and live exposure to coverage of the attacks on television. Posttraumatic stress disorder, major depression, anxiety, suicidal ideation, and increase in post-9/11 smoking were common among participants with CG. A majority of the participants with CG reported receiving grief counseling and psychiatric medication after 9/11. Clinical and policy implications are discussed.

This cross-sectional retrospective study examined self-perceived changes in importance of religious beliefs (RBs) following the attacks of September 11, 2001, and assessed their associations with complicated grief (CG), posttraumatic stress disorder (PTSD), and major depressive disorder (MDD). Data were collected from 608 participants 2.5 to 3.5 years after the attacks. Whereas the majority of the participants reported no change in importance of RBs, 11% reported increased importance and 10% reported decreased importance of RBs after 9/11. Decreased, but no increased, importance of RBs was found to be associated with severity of loss and trauma (i.e., loss of a child, direct exposure to the attacks, watching the attacks unfold live on TV). In addition, decreased RBs after 9/11, as compared with no change, was significantly associated with all mental health outcomes, namely CG, PTSD, and MDD. Theoretical and clinical implications are discussed.

Risk factors identified in this study should be assessed in replication studies. Psychiatric clinicians can use such risk factors to create evidence-based fall prevention programs.

I n 1996 the Joint Commission onAccreditation of Health Care Organizations began monitoring sentinel events of patient falls. An analysis of fatal falls indicated that, of 22 fatal falls, four (18%) involved psychiatric patients in various psychiatric facilities and the rest occurred in general hospitals and long-term-care facilities (1). However, 17 (77%) of the 22 patients had an impaired mental