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Posted On: January 13, 2001          Updated On: April 13, 2002
© Terence T. Gorski, 2001

Incidence Of PTSD After Terrorist Attacks
By Terence T. Gorski
January 13, 2001

This article summarizes the emerging data about the incidents of Critical Incident Stress Reactions (CISR), Post Traumatic Stress Disorder (PTSD), and Grief Reactions following major terrorist events.  Although the information is preliminary, it does provide a current "best guess" for estimating the psychological causalities that could develop as a result of future terrorist attacks.

The World Trade Center Attack Of September 11th

At the end of October 2001, approximately seven weeks after the September 11th. terrorist attack, the New York City Health Department, in conjunction with the Centers for Disease Control and Prevention in Atlanta, conducted a door-to-door survey of people living in the vicinity of the World Trade Center.

According to this study, nearly 40 percent of those interviewed said they had symptoms of post-traumatic stress disorder.  The most common cluster of symptoms reported were: emotional numbness, sleep loss, depression, anxiety, feelings of intense guilt, irritability or outbursts of intense anger.  A third of those interviewed also felt they could benefit from additional counseling.  This is consistent with studies done after the Oklahoma City Terrorist bombing.  

Developing A System For "Best Guess" Projections

Although statistics related to these types of of terrorist attacks is limited, the following seems to be a general rule for the expected incidence of Critical Incident Stress Reactions (CISR) and post Traumatic Stress Disorder (PTSD) following the terror attack:

1.    Critical Incident Stress Reactions:  The incidence of Critical Incident Stress Reactions (CISR) will vary dependent upon the intensity of personal involvement with the traumatic event.  The incidence of CISR is highest (about 90%) in people who both witness and are at physical risk of death or injury during the event.  The next highest incidence rate, about 70%, is among people who are physically present to witness the event but not in immediate risk.  Those viewing the terrorist incident on television will have the lowest incidence of CISR, but this can be as high as 50%. 

2.    Post Traumatic Stress Disorder (PTSD):  Post Traumatic Stress Disorder (PTSD) will develop in about 30% of the people who develop a Critical incident Stress Reaction (CISR).  A small number of people will remain symptom free for a period of several weeks and then develop a late onset of PTSD symptoms.  The onset of delayed symptoms is often related to returning to life activities that activities memories of the trauma.

3.    Grief Reactions Related To Victim Deaths:  It is estimated that for each person killed in a terrorist act approximately 18 people will experience a normal grief reaction as the result of the loss of that person.  These grief reactions will vary from moderate to severe dependent upon the closeness and duration of the relationship.  About 5 of those 18 people can be expected to suffer from serious and prolonged grief reaction requiring some for of counseling or treatment.  These grief reactions will often coexist with Critical Incident Stress Reactions (CISR) and Post Traumatic Stress Disorders (PTSD).

References

Associated Press,  Stress Common Among WTC Neighbors, January 11, 2001

Center for the Study of Traumatic Stress, Effects of Traumatic Stress, A Web Publication of the  Henry M. Jackson Foundation for the Advancement of Military Medicine 1401 Rockville Pike, Suite 600 Rockville, Maryland 20842

Responding To Terrorism Victims - Oklahoma City and Beyond, http://www.ojp.usdoj.gov/ovc/publications/infores/respterrorism/welcome.html 

On the Net:
Post-traumatic stress: http://www.nimh.nih.gov/anxiety/ptsdmenu.cfm
New York City Health Department: http://www.ci.nyc.ny.us/html/doh/html/alerts/911.html

Stress Common Among WTC Neighbors
JANUARY 11, 2001

NEW YORK (AP) — Nearly 40 percent of the people living near the World Trade Center site have had symptoms of post-traumatic stress disorder — including emotional numbness, depression and sleep loss — since the Sept. 11 attacks, according to a city study released Friday.

Interviews with more than 400 residents of the neighborhood near the collapsed towers also indicated that about half had physical ailments, such as nose, throat and eye irritation.

The ailments, most likely short-term effects that are expected to dissipate, were linked to the fires that burned for weeks at the site. The cleanup and search for bodies there has continued around the clock since Sept. 11. 

The city Health Department, in conjunction with the Centers for Disease Control and Prevention in Atlanta, conducted the study at the end of October. Residents were questioned by workers going door to door.

According to the study, nearly 40 percent of those interviewed said they had symptoms of post-traumatic stress disorder: emotional numbness, sleep loss, depression, anxiety, feelings of intense guilt, irritability or outbursts of intense anger.

A third of those interviewed also felt they could benefit from additional counseling.

On the Net:
Post-traumatic stress: http://www.nimh.nih.gov/anxiety/ptsdmenu.cfm
New York City Health Department: http://www.ci.nyc.ny.us/html/doh/html/alerts/911.html

Other Articles Related To Terrorism, Trauma, & PTSD

Adolescents/School_Shootings/school_shootings_030713.htm
Adolescents/School_Shootings/youth_violence_surgeon_general.htm
America Is Ready For War - But Is War The Right Thing To Do
Bibliography - Managing Traumatic Stress
Coping With Catastrophe Lessons Of 9-11 For Fire Fighters
Coping With Terrorism - APA Guidelines
Could Addicts Be Legally Defined As Terrorists?
Criminal Enforcement Against Terrorism
Dawning Of A New Day - Addiction Recovery In The Age Of Terrorism
Depression & Suicide After September 11
Drug, Alcohol Abuse Up Since 9-11
Effects of Traumatic Stress
Executive Order For Military Tribunals
Exposure To Traumatic Death: The Nature Of The Stressor
Helping Children Handle Disaster-Related Anxiety
High Alert For Terrorism Can Cause Stress-induced Problems
Human Damage of 9-11 Reaches Far Beyond New York
Human Rights In the Aftermeth of Setpember 11th
Mental Health Aspects of Prolonged Combat Stress in Civilians
New York Times Reports Increase In Drinking Since September 11th
New York Trauma Symptoms- One Year Latter (09-20-02)
On Killing
Police Stress
Preventing Afghan War Syndromes
Psychic Wounds From 9-11-01
Psychological Aftermath of 9-11-01 - Scientific American
Psychological Consequences:  Natural vs.Human Disaster - NCPTSD Literature Review
Psychological Effects Of Terrorism Can Affect Firefighter Performance
Psychological Shock Of September 11 - PEWS Research Report
PTSD
PTSD & Addiction - NIAAA Bibliography Of 03-02-02
PTSD & Firefighters
PTSD & Moral Sanction
PTSD - Acute Stress Disorder As A Predictor
PTSD - Biological Factors (01-27-02)
PTSD - Effects Of Stress On The Brain
PTSD - Reliving Trauma - NIMH Web Publication
PTSD After 9-11-01 - A Literature Review 01-19-02
PTSD and Problems with Alcohol Use
PTSD Checklist Civilian Version
PTSD Checklist Military Version
PTSD In Children & Adolescents
PTSD Incidence After Terrorist Attacks
PTSD: encyclopedia.com Article (01-27-02)
PTSD: Neurobiological Research
PTSD: Sleep Disturbances After 9-11 Attacks
Public Health Strategies to Address Terrorist Threats
Stress & Alcohol Use - NIAAA Studies
Stress & Drug Addiction - Studies Show Links - NIDA Report
Stress and Substance Abuse - A NIDA Special Report
Summit MHSAT - Opening Remarks By Charles Curie
Talking Points Bulletin #1: The Psychological Effects of Terrorism
Terrorism
Terrorism & Increased Pain Problems
Terrorism - Helping Kids Cope
Terrorism - The Psychological Response
Terrorism - The Slaughter of Innocents AS A Political Strategy
Terrorism - The Slaughter of Innocents AS A Political Strategy
Terrorism and Recovery - AlcoholMD Web Conference
Terrorism Increases Demand For Drug & Alcohol Treatment
Terrorist Attack Triggering PTSD in Recovering People
Terrorist Attacks Averted Since September 11, 2001
The USA PATRIOT Act - An Analysis By The ACLU
The  Impact of September 11th on Manhattan Residents:  Participants Report Symptoms of  Post Traumatic Stress Disorder and Depression
USA PATRIOT Act - Analysis By EFF

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