Stress symptoms of two groups before and after the terrorist attacks of 9/11/01

This study investigated stress symptoms before and after the September 11, 2001 terrorist attack on the World Trade Center. Responses to the Smith Stress Symptoms Inventory were compared for Chicago area college students assessed 1 to 5 weeks after 9/11 (n=149) and a comparable sample tested up to 5 months prior to 9/11 (n=320). Post-9/11 participants scored higher on Attention Deficit. Contrary to prior research, post-9/11 participants did not score higher on distress, including Worry, Autonomic Arousal/Anxiety, Striated Muscle Tension, Depression, and Anger. It is suggested that those indirectly exposed to a terrorist attack may display traditional symptoms of distress and arousal (as suggested by previous research). Later symptoms of attention deficit and distancing may emerge. This work was based on independent pre- and post-9/11 samples and must be replicated longitudinally as a test-retest to draw conclusions regarding change over time.     

Consumerism and the Post-9/11 Paranoia: Michel Foucault on Power,Resistance, and Critical Thought

This paper intends to closely examine Michel Foucault’s take on power, resistance, and critical thought in the modern state, using the market-driven consumer economy and the paranoia-induced post-9/11 national security rhetoric as background. It will argue that on both domains, knowledge as similitude comes to be represented as part of the repressive configuration in the order of things. In retracing the technology of discipline where the individual unknowingly participates in his latent subjugation, the author thinks that critical thought—one that diverts power away from the center to the peripheries is the only effective way of resistance against forms of social control and domination.     

Political tolerance and coming to psychological closure following the September 11, 2001, terrorist attacks: an integrative approach

This study tested hypotheses generated from an integrative model of political tolerance that derived hypotheses from a number of different social psychological theories (e.g., appraisal tendency theory, intergroup emotion theory, and value protection models) to explain political tolerance following the September 11, 2001, terrorist attacks. A national field study (N = 550) found that immediate post attack anger and fear had different implications for political tolerance 4 months later. The effects of anger on political tolerance were mediated through moral outrage and outgroup derogation, whereas the effects of fear on political tolerance were mediated through personal threat, ingroup enhancement, and value affirmation. Value affirmation led to increased political tolerance, whereas moral outrage, outgroup derogation, ingroup enhancement, and personal threat led to decreased political tolerance. Value affirmation, moral outrage, and outgroup derogation also facilitated post-9/11 psychological closure and increased psychological closure led to greater political tolerance.     

Posttraumatic stress disorder following the September 11, 2001, terrorist attacks: a review of the literature among highly exposed populations

The September 11, 2001 (9/11), terrorist attacks were unprecedented in their magnitude and aftermath. In the wake of the attacks, researchers reported a wide range of mental and physical health outcomes, with posttraumatic stress disorder (PTSD) the one most commonly studied. In this review, we aim to assess the evidence about PTSD among highly exposed populations in the first 10 years after the 9/11 attacks. We performed a systematic review. Eligible studies included original reports based on the full Diagnostic and Statistical Manual of Mental Disorders (4th ed., rev.; American Psychiatric Association, 2000) criteria of PTSD among highly exposed populations such as those living or working within close proximity to the World Trade Center (WTC) and the Pentagon in New York City and Washington, DC, respectively, and first responders, including rescue, cleaning, and recovery workers. The large body of research conducted after the 9/11 attacks in the past decade suggests that the burden of PTSD among persons with high exposure to 9/11 was substantial. PTSD that was 9/11-related was associated with a wide range of correlates, including sociodemographic and background factors, event exposure characteristics, loss of life of significant others, and social support factors. Few studies used longitudinal study design or clinical assessments, and no studies reported findings beyond six years post-9/11, thus hindering documentation of the long-term course of confirmed PTSD. Future directions for research are discussed.     

New York City young adults’ psychological reactions to 9/11: findings from the Reach for Health longitudinal study

This research examines psychological distress among 955 economically disadvantaged New York City residents surveyed during high school and again after the September 11th terrorist attacks (9/11), when they were young adults. As part of the longitudinal Reach for Health study, young adult surveys were conducted from 6–19 months post-9/11 (average 8 months), providing opportunity to assess types of exposures and psychological distress, including symptoms of post-traumatic stress disorder (PTSD), depression, hopelessness, and anger. Regressions of psychological distress on 9/11 exposure were performed, controlling for high school distress, prior exposure to violence victimization, and socio-demographic characteristics. Exposure to 9/11 was positively associated with anger, hopelessness, and PTSD symptoms and a measure of global distress. The relationship was greater among women for PTSD symptoms. Although those who reported high school distress also reported more distress in young adulthood, prior psychological distress did not moderate the relationship between exposure and psychological outcomes. Greater exposure is related to distress among those who, during high school, reported lower distress, as well as among those who reported prior greater distress.     

Living Danger: On Not Knowing What We Know

This paper contextualizes the struggle around the American Psychological Association's ethical standards regarding psychologists' participation in abusive interrogations of detainees by examining the psychological and political meanings of living in a society in which the state assumes the right to torture. To highlight the implications of authoritarian trends in America's post-9/11 political culture, I offer an interdisciplinary psychoanalytic analysis of the extreme social situation of the Argentine Dirty War, in which torture was used by the military government not as a tactic to make detainees talk but as a strategy to silence an entire population. I explore the defense mechanism of disavowal and its use by both perpetrators and victims in ways that contributed to sustaining authoritarian rule in Argentina. I suggest that it is within the legitimate arena of psychoanalysis to consider the psychological meanings of patients' experience in the larger social order. I argue for a psychoanalytic project that does not disavow the centrality of social reality in the formation of subjectivity and for a clinical model that provides a potential space in which the subject can develop a critical psyche able to co-construct a more democratic political as well as personal life.     

Online Telehealth Delivery of Group Mental Health Treatment Is Safe,Feasible, and Increases Enrollment and Attendance in Post-9/11 U.S. Veterans

Post-9/11 U.S. veterans are clinically complex with multiple co-occurring health conditions that lead to increased morbidity and mortality, risk for suicide, and decreased quality of life, but underutilization and resistance to treatment remain significant problems. Increased isolation and decreased community and social support due to coronavirus disease (COVID-19) have exacerbated mental health risk. This study evaluated the safety and feasibility of home-based telemental health group workshops to improve reintegration and social connection in post-9/11 U.S. military personnel. Seventy-four (61 males/13 females) post-9/11 U.S. military veterans were randomized to receive 12 sessions of STEP-Home cognitive-behavioral group workshop or present-centered group therapy. Treatment was delivered either in person (traditional medical center setting, treatment as usual [TAU]), or via home-based synchronous videoconferencing (VC). The change to VC occurred due to social distancing guidelines during COVID-19. Mean age was 41.0 years (SD = 11.5, range 24–65). Forty-five (36 males/9 females) participated in VC and 29 (25 males/4 females) in TAU. Demographics were similar across treatment milieu. There were no differences in therapist treatment adherence for TAU versus VC. Therapist satisfaction was higher for TAU groups (q value < .05). Veterans showed higher enrollment, attendance, group cohesion, and veteran-to-veteran support for VC compared to TAU (q values < .05). Safety procedures were successfully implemented via VC. Results demonstrate the safety, feasibility, and high satisfaction of group telemental health in U.S. veterans. Higher enrollment and treatment adherence for telemental health delivery resulted in a greater likelihood of receiving an effective treatment dose than TAU. Strong group cohesion and veteran-to-veteran support were achievable via telehealth. Telemental health offers convenient, efficient, and cost-effective care options for veterans and may be particularly helpful for patients with high psychiatric burden.     

Perceived Risk and Worry: The Effects of 9/11 on Willingness to Fly1

Most decision-making models rely on affect-free variables to understand the decisions that people make. We tested an affectively-loaded variable—worry—as a predictor of decision making in an affectively laden context: willingness to fly after 9/11. College students rated their willingness to fly to New York City or Washington, DC, in a study conducted 34 days after 9/11. They also recorded their beliefs about the likelihood that more terrorist attacks would occur, the severity of such attacks if they were to occur, and how much they worried about flying. Finally, they made these estimates for similar others. Results showed that worry was the most powerful predictor of one's own and similar others' willingness to fly. These findings suggest that models of how people make decisions may sometimes need to take feelings into account.     

Patriotism or Nationalism? Understanding Post‐September 11, 2001, Flag‐Display Behavior1

People reacted to the September 11, 2001, terrorist attacks in a number of different ways. One reaction was to display the American flag on one's home, car, or person. The goal of this research was to understand the underlying motivations that led to this widespread behavior. Specifically, to what extent was post‐9/11 flag‐display behavior motivated by patriotism (love of country and in‐group solidarity), nationalism (uncritical acceptance of national, state, and political authorities and out‐group antipathy), or a combination of both? Results of a national survey (N= 605) provided much stronger support for the hypothesis that post‐9/11 flag‐display behavior was an expression of patriotism, not nationalism. Other results supported the notion that patriotism can exist without nationalism, even in the context of people's reactions to a terrorist attack.     

The pivotal role of perceived emotional synchrony in the context of terrorism: Challenges and lessons learned from the March 2016 attack in Belgium

Since the September 11, 2001 terrorist attack against the World Trade Center in New York City, terrorism has become one of the most distressing large‐scale societal threats. The March 22, 2016 terrorist attack in Brussels, the capital of Belgium undermined the collective sense of perceived security and social cohesion. The present research investigates Belgian civilians’ (N = 202) terrorist threat perception, personal emotions, and the role of perceived emotional synchrony in the construction of the perceived socioemotional climate in Belgium. The main purpose of the current study was to examine the role of perceived emotional synchrony emerging in collective gatherings as a regulatory mechanism improving the perceived socioemotional climate of the country. Additionally, the precise components (personal vs. collective) shaping the perceptions of terrorist threat were also examined. This study was conducted by a questionnaire during the collective gatherings in Brussels 1 week after the terrorist attack. The main results suggest that the terrorist threat has been perceived at the collective level rather than at the personal level. Furthermore, the perceived emotional synchrony with others mediated specifically the relationship between positive personal emotions and the perceived positive socioemotional climate in Belgium. Such findings point to the importance of considering the perceived emotional synchrony in order to provide a better understanding of lay people's psychosocial responses to terrorism and the subsequent construction of collective macro‐social phenomena in post‐terrorist contexts.     

Searching for and finding meaning in collective trauma: results from a national longitudinal study of the 9/11 terrorist attacks

The ability to make sense of events in one's life has held a central role in theories of adaptation to adversity. However, there are few rigorous studies on the role of meaning in adjustment, and those that have been conducted have focused predominantly on direct personal trauma. The authors examined the predictors and long-term consequences of Americans' searching for and finding meaning in a widespread cultural upheaval--the terrorist attacks of September 11, 2001--among a national probability sample of U.S. adults (N=931). Searching for meaning at 2 months post-9/11 was predicted by demographics and high acute stress response. In contrast, finding meaning was predicted primarily by demographics and specific early coping strategies. Whereas searching for meaning predicted greater posttraumatic stress (PTS) symptoms across the following 2 years, finding meaning predicted lower PTS symptoms, even after controlling for pre-9/11 mental health, exposure to 9/11, and acute stress response. Mediation analyses suggest that finding meaning supported adjustment by reducing fears of future terrorism. Results highlight the role of meaning in adjustment following collective traumas that shatter people's fundamental assumptions about security and invulnerability.     

Growing up in the shadow of terrorism: youth in America after 9/11

Research conducted in the aftermath of the September 11th terrorist attacks (9/11) suggests that, except for those who directly witnessed or suffered loss from the attacks, for most children the emotional impact was relatively transitory. We review this literature as well as consider other ways in which the attacks may have played a role in the development of adolescents and young adults as they came of age in the shadow of 9/11 in the United States. Specifically, we discuss the potential impact of the collective trauma of 9/11 on children's coping and emotional regulation, their sociopolitical attitudes, and their general beliefs about the world. Developmental issues and the role of parents in shaping their children's responses to 9/11 are also addressed. Researchers interested in children's social, emotional, and psychological development have much to learn about children's reactions to events like 9/11 and factors that might mitigate the negative consequences of such events on children's development.     

How Discrimination Impacts Sociopolitical Behavior: A Multidimensional Perspective

The conventional wisdom regarding the impact of discrimination on political behavior is that the perception of prejudiced treatment motivates individuals to take political action. This study challenges this common conception by demonstrating that the source of discrimination can play a significant role in whether perceived or experienced injustice leads to activism or withdrawal from sociopolitical life. Drawing from political science and social psychology literature, this study provides a new perspective on the potential effects of discrimination on a relatively new marginalized group in the United States. Specifically, an important distinction is drawn between political (systematic) and societal (interpersonal) discrimination in analyzing the sociopolitical behavior of American Muslims in the aftermath of the 9/11 terrorist attacks. The results will hopefully encourage scholars to take a deeper look at the nexus between discrimination and democratic engagement, which is an important, complex, multidimensional, and understudied topic.     

Terrorist Suspect Religious Identity and Public Support for Harsh Interrogation and Detention Practices

Does the U.S. public's support for the use of harsh interrogation and detention practices against terrorism suspects depend upon the religious identity of the alleged perpetrators? Some scholarly research indicates greater public acceptance for abridging the rights of Muslims after 9/11. This is consistent with literature suggesting that heightened perception of threat decreases popular tolerance for racial, ethnic, and religious outgroups. This study executes a survey experiment and finds respondents to be more permissive of the use of extraordinary detention practices, such as indefinite detention and denying suspects access to legal counsel and civilian criminal courts, against terror suspects identified as Muslims. Furthermore, the study reveals that respondents are significantly less likely to treat domestic, right‐wing terrorist suspects with extraordinary detention, suggesting ingroup leniency.     

Social integration buffers stress in New York police after the 9/11 terrorist attack

Being socially integrated is regarded as a protective factor enabling people to cope with adversity. The stress-buffering effect reflects an interaction between stress and a social coping resource factor on subsequent outcomes. This study, based on 2943 police officers, examines mental health outcomes among officers who responded to the 9/11 terrorist attack on the World Trade Center. The Wave 1 data collection took place between September 2003 and November 2004 with a follow-up study (Wave 2) conducted from November 2006 through December 2007. A moderated mediation model was specified that uses event exposure as a distal predictor, earlier stress response as a mediator, and later stress response as an outcome, and social integration as a moderator of this relationship. The mediation hypothesis was confirmed, and moderation occurred at two stages. First, there was a multiplicative relationship between exposure levels and social integration: The higher the exposure level, the more stress responses occur, but this effect was buffered by a high level of social integration. Second, Wave 1 stress interacted with social integration on Wave 2 stress: The more the police officers were socially integrated, the lower the Wave 2 stress, which happened in a synergistic manner. The findings contribute to the understanding of mediating and moderating mechanisms that result in health outcomes such as posttraumatic stress disorder or resilience.     

Reactions to 9/11 as a function of terror management and perspective taking

The authors used terror management theory to investigate people's reactions to the terrorist attacks of 09/11/01. According to the theory, people have a primary need to eliminate or reduce existential terror in response to such horrific events as 9/11. The authors obtained people's reactions to 9/11, an event in which the threat to one's existence was more authentic than those of previous events that were imagined. The authors of the present study collected data two weeks after 9/11 from young adults on a large university campus in the U.S. Midwest. The authors asked participants about their proximal and distal reactions to 9/11 and their reasons or motives for those reactions. The results indicated that the vast majority of participants' proximal reactions to 9/11 were shock and/or disbelief, whereas their distal reactions included performing altruistic or prosocial behavior, searching for meaning or value in life, seeking or sharing information, spending time in talking to others, and making bigoted remarks about Arab Muslims. The main finding was that interpersonal communication is an important means of eliminating or reducing existential terror.     

PSYCHOANALYTIC CONTROVERSIES: The relevance of psychoanalysis to an understanding of terrorism

Psychoanalysis has much to offer an understanding of terrorism, in two primary domains: fi rst, the social context and group dynamics of terrorism, and, second, the understanding of the individual psychopathology of the terrorist. My argument is anchored in several givens (Akhtar, 1999; Twemlow and Sacco, 2002): 1. The terrorist label is always assigned to the other person; it is never a self-assigned role. 2. The term is applicable to individuals. For example, the FBI has classifi ed the school shooters as domestic or anarchic terrorists. Terrorists usually consider themselves the victims of humiliation by the enemy with incompatible political, religious or personal ideologies. 4. The defi nition of terrorism is infl uenced by the political and social mores of the time. Yesterday's terrorist may be tomorrow's hero, as in the case of members of the French Revolution like Robespierre, and other revolutionary leaders. These givens are empirically observable, with the unique potential contribution of psychoanalysis being to understand the dynamics of the processes as they play themselves out in the social context much as an individual plays out his confl icts in interpersonal relationships. These contributions can be grouped into the following four main areas.     

The impact of pretrauma analogue GAD and posttraumatic emotional reactivity following exposure to the September 11 terrorist attacks: a longitudinal study

The relation between analogue generalized anxiety disorder (GAD) assessed the day before the events of September 11, 2001 (9/11) and long-term outcome was examined in 44 young adults who were directly exposed the following day to the terrorist attacks in New York City. After controlling for high exposure to the attacks, preattack analogue GAD was associated with greater social and work disability, loss of psychosocial resources, anxiety and mood symptoms, and worry, but not symptoms of posttraumatic stress, assessed 12 months after 9/11. Fear and avoidance of emotions assessed 4 months after 9/11 statistically mediated the relation between preattack analogue GAD and social and work disability, loss of psychosocial support, mood and anxiety symptoms, and worry at 12-month follow-up. Avoidance of emotions 4 months after 9/11 also mediated the relation between preattack analogue GAD and posttraumatic stress symptoms 12 months after 9/11.     

After 9/11 at Ground Zero: The Anxiety-Buffering Effects of Worldview Support on the First Anniversary of 9/11

A field experiment adjacent to the former World Trade Center in New York City on the anniversary of the 9/11 terrorist attacks examined the prediction of terror management theory (TMT; Greenberg, Pyszcznyski, & Solomon, 1986) that individuals validate their cultural beliefs when exposed to subtle rather than overt death reminders. Participants (N = 410) who were exposed to a subtle reminder of 9/11 perceived more social consensus for their belief than those who were exposed to an overt one. Consistent with TMT, the pattern was especially strong for participants with the minority belief. The effect abated once the anniversary ended. The implications of this research and future directions are discussed.