Psychological sequelae of the September 11 terrorist attacks in New York City

Background: The terrorist attacks of September 11, 2001, were unprecedented in scope in the United States. In this study, the prevalence and correlates of acute posttraumatic stress disorder (PTSD) were assessed in residents of Manhattan 5 to 8 weeks after the attacks. Method: A representative sample of adults living south of 110th street in Manhattan (the part of Manhattan closest to the World Trade Center) was contacted for interview by telephone via random-digit dialing. The interview included questions about demographic characteristics, exposure to the events of September 11, and psychological symptoms after the attacks. PTSD was assessed using the PTSD questionnaire from the National Women's Study, and major depressive disorder, using a modified, validated version of the Structured Clinical Interview for DSM-IV. Result: A total of 7.5% of the study sample (N = 1008) reported symptoms consistent with a current (i.e., within the previous 30 days) PTSD diagnosis related to the attacks, and 9.7% reported symptoms consistent with a current depression diagnosis. The prevalence of PTSD was 20.0% among those living in the immediate vicinity of the World Trade Center (i.e., south of Canal Street). In a multivariate model, predictors of PTSD were Hispanic ethnicity, 2 or more prior stressors, a panic attack during or soon after the events, residence south of Canal Street, and loss of possessions due to the events. Depression was predicted by Hispanic ethnicity, 2 or more prior stressors, a panic attack, a low level of social support, the death of a relative or friend during the attacks, and loss of a job due to the attacks. Conclusions: The attacks of September 11 were followed by a substantial burden of acute PTSD and depression in Manhattan. Current PTSD was predicted by experiences involving exposure to the attacks, and current depression was predicted by losses resulting from the events. Substantial psychological morbidity in the population may be found in the aftermath of terrorist attacks.