Trauma Exposure and Posttraumatic Stress Disorder Among Employees of New York City Companies Affected by the September 11, 2001 Attacks on the World Trade Center

North, Carol S.; Pollio, David E.; Smith, Rebecca P.; King, Richard; Pandya, Anand; Surís, Alina; Hong, Barry A.; Dean, Denis J.; Wallace, Nancy; Herman, Daniel B.; Conover, Sarah; Süsser, Ezra; Pfefferbaum, Betty

doi:10.1001/dmp.2011.50

Cited by 62 publications

(45 citation statements)

References 33 publications

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“…This finding also diminishes the probability of potential bias due to the fact that we were not able to match for urban versus rural dwelling as a proxy for access to specialised mental health services. The lower risk of post-disaster psychopathology in the low-exposure group might also show that low exposure was insufficient to produce severe psychopathology 28 while the event simultaneously resulted in an influx of beneficial factors such as social support.…”

Section: Discussionmentioning

confidence: 99%

“…Exposure severity is an important risk modifier for post-traumatic psychopathology, 28,29 and a diagnosis of PTSD is conditional on traumatic exposure. 26 Therefore, we did an analysis in tsunami survivors who had available data for exposure severity.…”

Section: Exposure Severitymentioning

confidence: 99%

“…22,28,29 We categorised survey participants to direct exposure, indirect exposure, or low exposure groups accordingly on the basis of 30 survey items that asked about their disaster experiences. 22 Participants were included in the direct exposure group if they had been caught in or chased by the tsunamis, had felt that their life was threatened, or had injuries needing immediate inpatient care.…”

Section: Exposure Severitymentioning

confidence: 99%

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Psychiatric disorders and suicide attempts in Swedish survivors of the 2004 southeast Asia tsunami: a 5 year matched cohort study

Arnberg

Guðmundsdóttir

Butwicka

et al. 2015

The Lancet Psychiatry

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Background Survivors of natural disasters are thought to be at an increased risk of psychiatric disorders, however the extent of this risk, and whether it is linked to preexisting psychopathology, is not known. We aimed to establish whether Swedish survivors of tsunamis from the 2004 Sumatra-Andaman earthquake had increased risks of psychiatric disorders and suicide attempts 5 years after repatriation. MethodsWe identified Swedish survivors repatriated from southeast Asia (8762 adults and 3742 children) and 864 088 unexposed adults and 320 828 unexposed children matched for sex, age, and socioeconomic status. We retrieved psychiatric diagnoses and suicide attempts from the Swedish patient register for the 5 years after the tsunami (from Dec 26, 2004, to Jan 31, 2010 and estimated hazard ratios (HRs), then adjusted for pre-tsunami psychiatric disorders, and, for children, for parental pretsunami disorders. 0.86-1.11), although exposed children and adolescents had a higher risk for suicide attempts with uncertain intent (1.43; 1.01-2.02) and stress-related disorders (1.79; 1.30-2.46), mainly during the first 3 months after the tsunami. FindingsInterpretation The 2004 tsunami was, independently of previous psychiatric morbidity, associated with an increased risk of severe psychopathology, mainly stress-related disorders and suicide attempts, in children and adults. Survivors of natural disasters should be targeted with early interventions and active long-term follow-up to prevent, detect, and alleviate psychiatric disorders that might follow. 3 IntroductionIn the last decade, natural disasters afflicted more than 200 million people each year, 1 resulting in loss of lives, property destruction, and psychological suffering worldwide. Literature reviews suggest that survivors are at increased risk of psychiatric disorders, particularly posttraumatic stress disorder (PTSD). [2][3][4][5] As noted previously, [6][7][8] percentile). We matched children and adolescents for sex, birth year, parental cohabitation status, disposable family income, education, and employment of both parents as defined above.The final cohort included 8762 exposed and 864088 unexposed adults and 3742 exposed and 320 828 unexposed children and adolescents. We followed the exposed and matched cohorts from Dec 26, 2004, until emigration, death, or end of follow-up (Jan 31, 2010), whichever came first. The study was approved by the Regional Ethics Committees of Karolinska Institutet and Uppsala University. After register-linkage on national identifiers, unique for every Swedish resident, data analyses were done on deidentified datasets. OutcomesOur assessed outcomes were first presentation of a psychiatric disorder (diagnostic codes F00-F99), a definite suicide attempt based on a diagnosis of intentional selfharm (X60-X84), or an uncertain suicide attempt based on a diagnosis of events of undetermined intent (Y10-Y34). For the sake of precision we report mainly diagnoses in the category of disorders related to stress and adjustment disorder...

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Section: Discussionmentioning

confidence: 99%

Section: Exposure Severitymentioning

confidence: 99%

Section: Exposure Severitymentioning

confidence: 99%

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Psychiatric disorders and suicide attempts in Swedish survivors of the 2004 southeast Asia tsunami: a 5 year matched cohort study

Arnberg

Guðmundsdóttir

Butwicka

et al. 2015

The Lancet Psychiatry

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“…Future studies of mental health consequences of disasters should utilise measures that fully assess diagnostic criteria for psychiatric disorders and carefully assess exposures to the disaster trauma, such as in studies of survivors of the Oklahoma City bombing3 and the 9/11 attacks4 using the fully structured Diagnostic Interview Schedule and assessing qualifying exposures to traumatic events. Determination of qualifying exposures to trauma, as defined by established diagnostic criteria (in DSM-V, eg, direct exposure to trauma, defined as threat to life or limb; directly witnessing trauma; or indirect exposure through close associates directly exposed to trauma) is necessary for identification of cases and estimation of the prevalence of PTSD.…”

Section: What Next In Researchmentioning

confidence: 99%

Studying the prevalence and predictors of psychiatric disorders among adolescent disaster survivors

North

2015

Evid Based Mental Health

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“…Most exposures to 9/11 trauma in the attacks on the World Trade Center (“Ground Zero”) in New York City occurred very close to the Ground Zero site, within about a one-block radius. [7] The majority of people who were either in the World Trade Center (WTC) towers or nearby during the attacks, however, did not develop PTSD [7–9]. These individuals without PTSD and the very large numbers of people in the New York City area who were not exposed to trauma in the disaster were nevertheless profoundly affected.…”

Section: Introductionmentioning

confidence: 99%

A focus group study of the impact of trauma exposure in the 9/11 terrorist attacks

North

Barney²,

Pollio

2014

Soc Psychiatry Psychiatr Epidemiol

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Purpose Much of the mental health research that has emerged from the September 11 (9/11) attacks has been focused on posttraumatic stress disorder and its symptoms. To better understand the broader experience of individuals following a disaster, focus groups were conducted with individuals from affected companies both at Ground Zero and elsewhere. Methods Twenty-one focus groups with a total of 140 participants were conducted in the second post-9/11 year. Areas of identified concern were coded into the following themes: Disaster Experience, Emotional Responses, Workplace Issues, Coping, and Issues of Public Concern. Results Discussions of focus groups included material represented in all five themes in companies both at Ground Zero and elsewhere. The emphasis and the content within these themes varied between the Ground Zero and other companies. Content suggesting symptoms of PTSD represented only a minority of the material, especially in the company groups not at Ground Zero. Conclusions This study’s findings revealed an array of psychosocial concerns following the 9/11 attacks among employees of companies in New York City that extended far beyond PTSD. This study’s results provide further evidence that trauma exposure is central to individuals’ post-disaster experience and focus, and to individuals’ adjustment and experience after disaster.

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Trauma Exposure and Posttraumatic Stress Disorder Among Employees of New York City Companies Affected by the September 11, 2001 Attacks on the World Trade Center

Cited by 62 publications

References 33 publications

Psychiatric disorders and suicide attempts in Swedish survivors of the 2004 southeast Asia tsunami: a 5 year matched cohort study

Psychiatric disorders and suicide attempts in Swedish survivors of the 2004 southeast Asia tsunami: a 5 year matched cohort study

Studying the prevalence and predictors of psychiatric disorders among adolescent disaster survivors

A focus group study of the impact of trauma exposure in the 9/11 terrorist attacks

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