Skip to main content

Advertisement

SpringerLink
Log in

Posttraumatic stress disorder in Manhattan, New York City, after the September 11th terrorist attacks

  • Special Feature: Urban Disaster
  • Published:
Journal of Urban Health Aims and scope Submit manuscript

Abstract

Estimates of acute mental health symptoms in the general population after disasters are scarce. We assessed the prevalence and correlates of acute posttraumatic stress disorder (PTSD) in residents of Manhattan 5–8 weeks after the terrorist attacks of September 11, 2001. We used random-digit dialing to contact a representative sample of adults living in Manhattan below 110th Street. Participants were interviewed about prior life events, personal characteristics, exposure to the events of September 11th, and psychological symptoms after the attack. Among 988 eligible adults, 19.3% reported symptoms consistent with PTSD at some point in their life, and 8.8% reported symptoms consistent with a diagnosis of current (within the past 30 days) PTSD. Overall, 57.8% of respondents reported at least one PTSD symptom in the past month. The most common past-month symptoms were intrusive memories (27.4%) and insomnia (24.5%). Predictors of current PTSD in a multivariable model were residence below Canal Street, low social support, life stressors 12 months prior to September 11th, perievent panic attack, losing possessions in the attacks, and involvement in the rescue efforts. These findings can help guide resource planning for future disasters in densely populated urban areas.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. McCarthy M. USA talks of war after more than 5,000 killed in terrorist attacks. Lancet. 2001;358:939.

    Article  CAS  PubMed  Google Scholar 

  2. Dead and Missing. New York, NY. New York Times. December 26, 2001; sect B:2.

  3. Hidalgo RB, Davidson JRT. Posttraumatic stress disorder: epidemiology and health-related considerations. J Clin Psychiatry. 2000;61(suppl 7):5–13.

    PubMed  Google Scholar 

  4. Green BL, Lindy JD. Post-traumatic stress disorder in victims of disasters. Psychiatr Clin North Am. 1994;17(2):301–309.

    CAS  PubMed  Google Scholar 

  5. Galea S, Ahern J, Resnick H, et al. Psychological sequelae of the September 11 terrorist attacks in New York City. N Engl J Med. 2002;346:982–987.

    Article  PubMed  Google Scholar 

  6. Lavrakas P. Telephone Survey Methods: Sampling, Selection, and Supervision. Beverly Hills, CA: Sage; 1987.

    Google Scholar 

  7. Sherbourne CD, Stewart AL. The MOS social support survey. Soc Sci Med. 1991;32: 705–714.

    Article  CAS  PubMed  Google Scholar 

  8. Freedy JR, Kilpatrick DG, Resnick HS. Natural disasters and mental health: theory, assessment, and intervention. J Soc Behav Pers. 1993;8(special issue):49–103.

    Google Scholar 

  9. Centers for Disease Control. Diagnostic Interview Schedule (DIS). In: Health Status of Vietnam Veterans. Supplement C: Medical and Psychological Procedure Manuals and Forms. Atlanta, GA: Centers for Disease Control; 1989:405–499.

    Google Scholar 

  10. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, 4th ed. Washington, DC: APA; 1994.

    Google Scholar 

  11. Kilpatrick DG, Resnick HS, Freedy JR, et al. The posttraumatic stress disorder field trial: evaluation of the PTSD construct—criteria A through E. In: Widiger T, Frances A, Pincus H, et al., eds. DSM-IV Sourcebook. Vol 4. Washington, DC: American Psychiatric Association Press; 1998:803–844.

    Google Scholar 

  12. Resnick HS, Kilpatrick DG, Dansky BS, et al. Prevalence of civilian trauma and posttraumatic stress disorder in a representative national survey of women. J Consult Clin Psychol. 1993;61:984–991.

    Article  CAS  PubMed  Google Scholar 

  13. Shah B, Barnewll B, Bieler G. SUDAAN User's Manual. Release 7.5. Research Triangle Park, NC: Research Triangle Institute; 1997.

    Google Scholar 

  14. Bureau of the Census. Census Summary Tape, File 3A (STF3A). Washington, DC: US Dept of Commerce; 1990. Available at: www.census.gov|url. Date accessed: December 1, 2001.

    Google Scholar 

  15. US Department of Health and Human Services. Mental Health: a Report of the Surgeon General. Rockville, MD: US Dept of Health and Human Services, Substance Abuse and Mental Health Services Administration, Center for Mental Health Services, National Institutes of Health, National Institute of Mental Health; 1999. Available at: www. surgeongeneral.gov/Library/MentalHealth/pdfs/front.pdf|url|. Date accessed: December 1, 2001.

    Google Scholar 

  16. Kessler RC, Sonnega A, Bromet E, et al. Posttraumatic stress disorder in the National Comorbidity Survey. Arch Gen Psychiatry. 1995;52:1048–1060.

    CAS  PubMed  Google Scholar 

  17. Carr VJ, Lewin TJ, Webster RA, Kenardy JA. A synthesis of the findings from the Quake Impact Study: a two-year investigation of the psychosocial sequelae of the 1989 Newcastle earthquake. Soc Psychiatry Psychiatr Epidemiol. 1997;32:123–136.

    CAS  PubMed  Google Scholar 

  18. Hanson RF, Kilpatrick DG, Freedy R, Saunders BE. Los Angeles County after the 1992 civil disturbances: degree of exposure and impact on mental health. J Consult Clin Psychol. 1995;63:987–996.

    Article  CAS  PubMed  Google Scholar 

  19. Smith DW, Christiansen EH, Vincent R, Hann NE. Population effects of the bombing of Oklahoma City. J Okla State Med Assoc. 1999;92(4):193–198.

    CAS  PubMed  Google Scholar 

  20. Goenjian AK, Steinberg AM, Najarian LM, et al. Prospective study of posttraumatic stress, anxiety, and depressive reactions after earthquake and political violence. Am J Psychiatry. 2000;157:911–916.

    Article  CAS  PubMed  Google Scholar 

  21. Smith EM, North CS, McCool RE, Shea JM. Acute postdisaster psychiatric disorders: identification of persons at risk. Am J Psychiatry. 1990;147:202–206.

    CAS  PubMed  Google Scholar 

  22. Ruef AM, Litz BT, Schlenger WE. Hispanic ethnicity and risk for combat-related posttraumatic stress disorder. Cultur Divers Ethni Minor Psychol. 2000;6:615–619.

    Google Scholar 

  23. Frueh BC, Brady KL, de Arellano MA. Racial differences in combat-related PTSD: empirical findings and conceptual issues. Clin Psychol Rev. 1998;18:287–305.

    Article  CAS  PubMed  Google Scholar 

  24. Fothergill A, Maestas EGM, Darlington JD. Race, ethnicity, and disasters in the United States: a review of the literature. Disasters. 1999;23:156–173.

    Article  CAS  PubMed  Google Scholar 

  25. Breslau N, Davis GC, Andreski P, et al. Sex differences in Posttraumatic Stress Disorder. Arch Gen Psychiatry. 1997;54:1044–1048.

    CAS  PubMed  Google Scholar 

  26. Kulka RA, Schlenger WE, Fairbank JA, et al.. Trauma and the Vietnam War Generation: Report of Findings From the National Vietnam Veterans Readjustment Study. New York: Brunner/Mazel; 1990. Brunner/Mazel Psychosocial Stress Series No. 18.

    Google Scholar 

  27. Pole N, Best SR, Weiss DS, et al. Effects of gender and ethnicity on duty-related posttraumatic stress symptoms among urban police officers. J Nerv Ment Dis. 2001;189: 442–448.

    Article  CAS  PubMed  Google Scholar 

  28. Caldera T, Palma L, Penayo U, Kullgren G. Psychological impact of the hurricane Mitch in Nicaragua in a one-year perspective. Soc Psychiatry Psychiatr Epidemiol. 2001;36: 108–114.

    Article  CAS  PubMed  Google Scholar 

  29. Brewin CR, Andrews B, Valentine JD. Meta-analysis of risk factors for posttraumatic stress disorder in trauma-exposed adults. J Consult Clin Psychol. 2000;68:746–766.

    Google Scholar 

  30. Kawachi I, Berkman LF. Social ties and mental health. J Urban Health. 2001;78:458–446.

    CAS  PubMed  Google Scholar 

  31. Madakasira S, O'Brien KF. Acute posttraumatic stress disorder in victims of a natural disaster. J Nerv Ment Dis. 1987;175:286–290.

    Article  CAS  PubMed  Google Scholar 

  32. Boscarino JA. Post-traumatic stress and associated disorders among Vietnam veterans: the significance of combat exposure and social support. J Trauma Stress. 1995;8:317–336.

    Article  CAS  PubMed  Google Scholar 

  33. Regehr C, Hill J, Glancy GD. Individual predictors of traumatic reactions in firefighters. J Nerv Ment Dis. 2000;188:333–339.

    Article  CAS  PubMed  Google Scholar 

  34. Bromet EJ, Parkinson DK, Schulberg HC, Dunn LO, Gondek PC. Mental health of residents near the Three Mile Island reactor: a comparative study of selected groups. J Prev Psychiatr. 1982;1:225–274.

    Google Scholar 

  35. Harvey AG, Bryant RA. The relationship between acute stress disorder and posttraumatic stress disorder: a two-year prospective evaluation. J Consult Clin Psychol. 1999; 67:985–988.

    Article  CAS  PubMed  Google Scholar 

  36. Resnick H, Acierno R, Holmes M, Kilpatrick DG, Jager N. Prevention of post-rape psychopathology: preliminary findings of a controlled acute rape treatment study. J Anxiety Disord. 1999;13:359–370.

    Article  CAS  PubMed  Google Scholar 

  37. Bryant RA, Panasetis P. Panic symptoms during trauma and acute stress disorder. Behav Res Ther. 2001;39:961–966.

    Article  CAS  PubMed  Google Scholar 

  38. Schuster MA, Stein BD, Jaycox LH, et al. A national survey of stress reactions after the September 11, 2001, terrorist attacks. N Engl J Med. 345:1507–1512.

  39. Vlahov D, Galea S, Resnick H, et al. Increased consumption of cigarettes, alcohol, and marijuana among Manhattan residents after the September 11th terrorist attacks. Am J Epidemiol. 2002;155:988–996.

    Article  PubMed  Google Scholar 

  40. Rothbaum BO, Foa EB, Riggs DS, et al. A prospective examination of post-traumatic stress disorder in rape victims. J Trauma Stress. 1992;5:455–475.

    Article  Google Scholar 

  41. McFarlane AC. Posttraumatic stress disorder: a model of the longitudinal course and the role of risk factors. J Clin Psychiatry. 2000;61(suppl 5):15–20.

    PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Center for Urban Epidemiologic Studies, New York Academy of Medicine, 1216 Fifth Avenue, 10029, New York, NY

    Sandro Galea MD, MPH,  Jennifer Ahern,  Jennifer Stuber &  David Vlahov

  2. Department of Epidemiology, Columbia University Mailman School of Public Health, New York, New York

    Sandro Galea MD, MPH &  David Vlahov

  3. National Crime Victims' Research and Treatment Center, Medical University of South Carolina, Charleston, South Carolina

    Heidi Resnick &  Dean Kilpatrick

  4. Bellevue Hospital Center, New York, New York

    Joel Gold

  5. Schulman, Ronca, and Bucuvalas, Incorporated, New York, New York

    Michael Bucuvalas

  6. Division of Health and Science Policy, New York Academy of Medicine, New York, New York

    Jennifer Stuber

Authors
  1. Sandro Galea MD, MPH
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Heidi Resnick
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Jennifer Ahern
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Joel Gold
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Michael Bucuvalas
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Dean Kilpatrick
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Jennifer Stuber
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. David Vlahov
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Sandro Galea MD, MPH.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Galea, S., Resnick, H., Ahern, J. et al. Posttraumatic stress disorder in Manhattan, New York City, after the September 11th terrorist attacks. J Urban Health 79, 340–353 (2002). https://doi.org/10.1093/jurban/79.3.340

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1093/jurban/79.3.340

Keywords

Search

Navigation