As millions continue to cope with the aftermath
of September 11th's tragedy and horror, four studies in major
health and medical journals have found significant levels of increased
stress and cases of Post Traumatic Stress Disorder (PTSD) across
the nation — offering empirical evidence that the terrorist attacks
have had real and profound effects, even for those who were not
The most recent of the three studies, "Posttraumatic Stress
Disorder in Manhattan After the September 11th Terrorist Attacks,"
found that more than half of those surveyed reported at least
one PTSD symptom, including intrusive memories or loss of sleep.
The study, published in the September issue of Journal of Urban
Health, is based on interviews with more than 1,000 people living
The study found "substantial psychological symptoms in the
general population (of the area) five to eight weeks after the
September 11th attacks."
In addition, findings showed that living close to the World Trade
Center, low social support, prior life stressors, and being involved
in rescue efforts were all significant predictors of PTSD symptoms.
"Social ties, including social networks and social supports,
have been shown to play a positive role in mental health,"
the authors noted.
A second study, published in the Aug. 7 Journal of the American
Medical Association (JAMA) concluded that cases of PTSD were
significantly higher in New York City than in other major metropolitan
areas in the months after the September 11 terrorist attacks.
The web-based study, titled "Psychological Reactions to
Terrorist Attacks," found that stress levels in other areas
of the country were "within normal ranges," but that
residents of New York reported significantly higher levels of
PTSD symptoms one to two months after the attacks.
The study also found a correlation between TV viewing and PTSD,
but lead author William Schlenger says the cause-effect relationship
is complex. "We found an association between PTSD symptom
levels and the number of hours of September 11 coverage people
reported watching, but the direction of causality is unclear,"
Those findings, said Schlenger, indicate that people suffering
from PTSD symptoms may have chosen television viewing as a way
to deal with their feelings. "People who were distressed
watched the coverage as a way of trying to cope with their distress,"
said Schlenger, "However, it's probably fair to hypothesize
the causality works to some extent in both directions."
Two studies in the New England Journal of Medicine supported
the link between the terrorist attacks and increased stress levels
both in New York and nationwide. One, published in the March 28
issue, found a direct connection between witnessing the September
11 attacks and cases of PTSD in Manhattan, though the study did
not specifically address exposure to media coverage. The study,
titled "Psychological Sequelae of the September 11 Terrorist
Attacks in New York City," was conducted by researchers at
the New York Academy of Medicine.
Another New England Journal of Medicine Study, published
just two months after the tragedy, found that increased stress
was not limited to people in the geographical locations attacked.
The national telephone survey conducted within a week of the attacks
found that 90 percent of those who responded reported at least
one symptom of stress.
As in the JAMA study, findings showed that television viewing
could serve as a way to cope for some. But, the authors warned,
"for others, particularly children, watching television may
have exacerbated or caused stress, especially with repeated viewing
of terrifying images."
The most common coping mechanisms, the study found, ranged from
talking to others and participating in group activities to turning
to religion or making donations to relief agencies.
"Americans across the country, including children, had substantial
symptoms of stress," wrote the authors of the study, titled
"A National Survey of Stress Reactions After the September
11, 2001 Terrorist Attacks."
"Even clinicians who practice in regions that are far from
the… attacks should be prepared to assist people with trauma-related
symptoms of stress," they concluded.