Changes to PTSD treatment in the Wake of 9/11

By 
Nikki Novick

Prior to the attacks that happened on September 11, 2001, people only thought of post-traumatic stress disorder affecting soldiers in war zones. The terrorist attacks that took place on September 11, 2001, were unprecedented in both their immensity and aftermath. In the wake of the attacks, researchers found a wide range of mental and physical health outcomes. Post-traumatic stress disorder was one of the most commonly studied mental health outcomes of those affected by the attacks. 

A national survey in the United States says that about 15 percent of females and 19 percent of males are exposed to disasters during their lifetime. Although exposure to the trauma of disasters is common, exposure to the trauma of terrorist events is obviously much less common. Terrorist events are traumatic events that erode one’s security and safety. The terrorist attacks on the twin towers and the Pentagon on 9/11 have been life changing for countless individuals. 

After the entire nation watched the Twin Towers collapse on live television, it became clear that you didn’t need to be physically involved to feel the effects of it all. 

The World Trade Center goes up in flames as the second plane hits the tower. Chao Soi Cheong captured this photo of the North Tower of the World Trade Center. Image courtesy of breitbart.com.
The World Trade Center goes up in flames as the second plane hits the tower. Chao Soi Cheong captured this photo of the North Tower of the World Trade Center. Image courtesy of breitbart.com

Two months after 9/11, William Schlenger conducted a Web-based Study and reported a 4.3 percent prevalence of PTSD that was significantly associated with the number of hours of television coverage of the attacks watched as well as the number of 9/11-related graphic events seen on television.  This study showed strong evidence that the attacks on 9/11 affected those solely by media images or by concerns about safety in times of war and terrorism, were notably associated with PTSD symptoms in the general U.S. population. 

While countless viewers both across the nation and the globe were exposed to the awful events of 9/11 indirectly, many people were highly exposed in New York City and Washington, DC where the attacks took place that day. The tragedies that occurred in New York City alone resulted in the destruction and damage to the World Trade Center Towers and 35 surrounding buildings in which resulted in about 3,000 fatalities, over 150,000 jobs lost and $50-$100 billion in economic costs.

Firefighters, volunteers, EMT, and police officers digging through the rubble and debris of the fallen Twin Towers in hopes of recovering survivors. Image courtesy of breitbart.com.
Firefighters, volunteers, EMT, and police officers digging through the rubble and debris of the fallen Twin Towers in hopes of recovering survivors. Image courtesy of breitbart.com

As the continued health impacts of 9/11 continue to emerge even 20 years later, The World Trade Center Health Registry continues its mission of researching the long-term physical and mental health effects of the attacks, it shows that more than 21 percent of participants experienced Post-traumatic Stress Disorder five to six years after 9/11. As time went on, probable PTSD among residents increased from 13 percent 2-3 years after the attacks to more than 16 percent 5-6 years later. This shows that a significant amount of residents that experienced the attacks or the aftermath of the attacks did not start showing PTSD symptoms until several years after 9/11. 

Symptoms of post-traumatic stress disorder (PTSD) are the most common health effect of the 9/11 attacks. Up to 20% of adults directly exposed to the disaster or injured in the attack had PTSD symptoms five to six years after the attack--this is four times the rate in the general population. Risk factors included:

  • Witnessing horror
  • Intense dust cloud exposure
  • Returning to a home with a heavy layer of dust
  • Lack of social support
  • Job loss
A survivor pictured covered in white dust, trying to escape the clouds of dust. Photographer Stan Honda captured this image on September 11, 2001, of Edward Fine, who was an owner of an investment and public relations firm. Edward Fine was on the 78th floor of 1 World Trade Center when it was hit. Image courtesy of news.yahoo.com.
A survivor pictured covered in white dust, trying to escape the clouds of dust. Photographer Stan Honda captured this image on September 11, 2001, of Edward Fine, who was an owner of an investment and public relations firm. Edward Fine was on the 78th floor of 1 World Trade Center when it was hit. Image courtesy of news.yahoo.com.

Many factors were found to significantly increase the risk for Post-traumatic Stress Disorder in rescue and recovery workers.Those with the the following jobs were found to be associated with the greatest risk of PTSD:

  • Construction 
  • Sanitation
  • Unaffiliated volunteer
  • Firefighter
  • Emergency Medical Technicians
  • Engineering

The increased exposure these individuals with these jobs had to face by way of working at the World Trade Center site showed direct associations with PTSD. 

FDNY and NYPD are first responders who showed up to the scene of the World Trade Centers on the morning of September 11, 2001. Fireman shown kneeling in debris filled with emotion of the horrible scene he is witnessing of the Twin Towers collapsed. Image courtesy of irishcentral.com.
FDNY and NYPD are first responders who showed up to the scene of the World Trade Centers on the morning of September 11, 2001. Fireman shown kneeling in debris filled with emotion of the horrible scene he is witnessing of the Twin Towers collapsed. Image courtesy of irishcentral.com

A study of New Yorkers interviewed three years after 9/11 showed that those who received brief interventions at their worksites reported better mental health than those who received more extensive interventions (such as psychotherapy of 30 minutes or longer). People also stated that support from friends and neighbors was also beneficial for their recovery. 

The devastating terrorist attacks that took place on September 1, 2001, affected not only those who were highly exposed in New York City and Washington, DC, but the countless viewers both across the nation and the globe as well who witnessed the awful effects of these atrocities. The study of the overwhelming number of people affected by developing Post-traumatic Stress Disorder from these events has caused new developments to not only understand PTSD better, but to provide a better outlook for the treatment of those suffering with PTSD.

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