Groups for children traumatically bereaved by the attacks of September 11, 2001

The article reviews the use of debriefing and support groups for children who experienced the deaths of family members in the traumatic events of September 11, 2001. An overview of children's normal age-related responses to bereavement and of the special circumstances of trauma and grief provides the foundation for understanding the unique family and community stressors of 9/11 that impacted the children and group leaders. Stress-reduction exercises suitable for use with traumatized children in bereavement groups are presented together with specific drawing and written activities to encourage the processing of feelings.     

Linguistic markers of psychological change surrounding September 11, 2001

The diaries of 1,084 U.S. users of an on-line journaling service were downloaded for a period of 4 months spanning the 2 months prior to and after the September 11 attacks. Linguistic analyses of the journal entries revealed pronounced psychological changes in response to the attacks. In the short term, participants expressed more negative emotions, were more cognitively and socially engaged, and wrote with greater psychological distance. After 2 weeks, their moods and social referencing returned to baseline, and their use of cognitive-analytic words dropped below baseline. Over the next 6 weeks, social referencing decreased, and psychological distancing remained elevated relative to baseline. Although the effects were generally stronger for individuals highly preoccupied with September 11, even participants who hardly wrote about the events showed comparable language changes. This study bypasses many of the methodological obstacles of trauma research and provides a fine-grained analysis of the time line of human coping with upheaval.     

September 11, 2001: The Clash of Competing Worldviews

The Life Era: Cosmic Selection and Conscious Evolution Eric Chaisson New York: Atlantic Monthly Press, 1987. 259 pages.     

Responses to the September 11, 2001, terrorist attacks: experience of an indirect traumatic event and its relationship with perceived benefits

Little is known about how people might benefit from an indirectly experienced traumatic event. The authors examined the relationship between perception of benefit and trauma symptoms in response to a relatively severe, but indirectly experienced, traumatic event. The authors sampled from 2 colleges located in the southeastern United States (N = 136). Individuals responded to questionnaires that assessed perceived benefits and trauma symptoms 1-2 weeks after the terrorist attacks of September 11, 2001, and again approximately 10 weeks later. Participants did perceive benefits from witnessing this event, although their perception of benefit declined over time. Level of trauma symptoms correlated positively with perception of benefit, and experiencing a previous trauma also correlated positively with perceived benefits. Additional analysis indicated that level of trauma symptoms mediated the relationship between previous trauma and perception of benefit. These findings help to elucidate understanding of the development of perceived benefits in response to indirectly experienced events.     

Treating survivors of the World Trade Center terrorist attacks of September 11, 2001

As part of an established traumatic stress research and treatment program located in New York City, we experienced the September 11, 2001, terrorist attacks on the World Trade Center first as New Yorkers, but also as professionals with an interest in both treating the survivors and furthering scientific knowledge regarding the neurobiology and treatment of traumatic stress. This paper gives vignettes of calls to our program and the treatment of World Trade Center terrorist attack survivors.     

Psychological and health problems in a geographically proximate population time-sampled continuously for three months after the September 11th, 2001 terrorist incidents

This study assessed the mental and physical health status and psychological problems related to the September 11th terrorist incidents among a representative sample of adults living near New York City, using continuously time-sampled data collected throughout 2001. Prevalence estimates for poor mental or physical health after September 11th (October through December) were comparable to those for the entire year of 2001 (i.e. approximately 33%). Psychological problems related to the terrorist incidents were reported by more than half of the respondents, and appeared to peak in prevalence approximately two to three months following the incidents, followed by a decline in the next month and subsequent year. Poor mental health, female gender, media re-exposure, and ongoing or increased alcohol use were risk factors for psychological problems, while older age (65+ years old) and being married were protective factors. Risk factors for poor physical and mental health or psychological problems were generally stable over the three-month period following September 11th, but some changes were identified consistent with stage models of post-disaster psychological adjustment. Implications are discussed for using continuous time-sampling as a strategy to research patterns of relatively acute stress-related sequelae of terrorism in populations whose members are affected despite primarily not having been at the disaster epicenter.     

Adolescents React to the Events of September 11, 2001: Focused Versus Ambient Impact

This study examined the perceived impact of the events of September 11, 2001, on adolescents distant from the disaster sites and compared these perceptions with changes in everyday moods. A survey of reactions to September 11 was completed 2-5 months after the events by 171 adolescents participating in a longitudinal study of stress and health. Electronic diary ratings of contemporaneous moods before and after the attacks were also compared. Many adolescents distant from the disaster sites reported changes in everyday activities and signs of distress along with some positive outcomes. Elevated levels of negative affect emerged when adolescents were asked directly about the event (focused impact), but no changes were detected in their ongoing, momentary mood reports before and after September 11 (ambient impact). Trait and electronic diary measures of anxiety independently predicted posttraumatic distress. Refined assessments are needed to evaluate the degree to which self-reported traumatic symptoms reflect significant clinical distress versus an attentional focus generated by the question-asking process.     

An investigation of the psychological effects of the September 11, 2001, attacks on New York City: developing and implementing research in the acute postdisaster period

The September 11, 2001, attack on New York City was the largest human-made disaster in United States history. In the first few days after the attack, it became clear that the scope of the attacks (including loss of life, property damage, and financial strain) was unprecedented and that the attacks could result in substantial psychological sequelae in the city population. Researchers at the Center for Urban Epidemiologic Studies at the New York Academy of Medicine designed and implemented an assessment of the mental health of New Yorkers 5-8 weeks after the attacks. To implement this research in the immediate postdisaster period, researchers at the center had to develop, in a compressed time interval, new academic collaborations, links with potential funders, and unique safeguards for study respondents who may have been suffering from acute psychological distress. Results of the assessment contributed to a New York state mental health needs assessment that secured Federal Emergency Management Agency funding for mental health programs in New York City. This experience suggests that mechanisms should be in place for rapid implementation of mental health assessments after disasters.     

Toward an Analysis of the September 11, 2001 Terrorist Event from the Holistic, Developmental, Systems-Oriented Perspective

The holistic, developmental, systems-oriented perspective, an extension of some aspects of the theoretical perspective of Heinz Werner and his associates, is briefly characterized with respect to its assumptions, methodological approach, and its analysis of a variety of research on critical person-in-environment transitions. The theoretical perspective is applied in an analysis of the far-reaching critical person-in-environment transition that began with the catastrophic events of September 11, 2001.     

The social dynamics of a cultural upheaval: social interactions surrounding September 11, 2001

Using the Electronically Activated Recorder (EAR), a new methodology for sampling behavioral data in naturalistic settings, we tracked the social lives of 11 people by recording 30-s snippets of ambient sounds in their environment approximately every 12 min. Participants wore the EAR continuously for 10 days from September 11, 2001. Pre-September 11 baseline data were available for all participants. Analyses of the coded sound information showed that although participants did not change in their overall amount of interactions, they gradually shifted from group conversations to dyadic interactions. Exploratory analyses revealed that a relative increase in dyadic interactions over the first 10 days after September 11 was marginally related to better psychological adjustment at follow-up. The findings have relevance for the understanding of stress and affiliation and normal psychological reactions to emergencies.     

An imperfect relationship between prospective memory and the prospective interference effect

Three experiments examined the functional relationship between the frequency of prospective responding and the prospective interference effect within the context of a task switching paradigm. Prospective responding was less frequent across the experiments when prospective cues appeared in switch blocks than when they appeared in pure blocks. The magnitude of the prospective interference effect for response time (RT) was similar for pure and switch blocks when exogenous task cuing was used, and was greater for switch blocks than for pure blocks when endogenous task cuing was used. These data reveal a dissociation between the effect of task switching on the frequency of prospective responding and the prospective interference effect, and indicate that the functional relationship between these two measures is dependent on task demands.     

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.     

School Entry After a Community-Wide Trauma: Challenges and Lessons Learned from September 11th, 2001

The purpose of this paper is to describe the implementation of a school-based trauma-specific mental health program in New York City following the terrorist attacks on September 11, 2001. This program aimed to serve children most at risk for developing mental health problems as a result of physical proximity (e.g., evacuation from schools surrounding the World Trade Center) to the trauma. As we present the components of the program, we will review the literature that guided our decision making. The ongoing struggle between searching for answers from established science and immediate needs in a crisis is highlighted. Lastly, a discussion of the lessons learned and recommended next steps is presented.     

The Association Between Strength of Religious Faith and Coping with American Terrorism Regarding the Events of September 11, 2001

This study examined the association between strength of religious faith and coping with the terrorist attacks in New York City, Washington DC, and Pennsylvania on September 11, 2001, the resulting war in Afghanistan, and subsequent anthrax attacks. The participants included 97 students from a West Coast Catholic university. Measures included the Santa Clara Strength of Religious Faith Questionnaire, the Marlowe-Crowne Social Desirability Scale, the Symptom Check List-90-Revised, the Impact of Event Scale, a 10-point stress, coping, and importance of faith scale, and an author-developed questionnaire assessing demographic as well as qualitative questions regarding coping with terrorism. Results suggest that strength of religious faith was not associated with coping with terrorism.     

Memories of the terrorist attacks of September 11, 2001: a study of the consistency and phenomenal characteristics of flashbulb memories

In this study, I investigated students' memories of the terrorist attacks of September 11, 2001, carried out by Al Qaeda terrorists against the World Trade Center in New York and the Pentagon in Washington. Participants completed on two occasions (2 weeks and 8 months after the events took place) a memory questionnaire that included an assessment of the phenomenal richness of their memories. The results showed that the participants remembered very well the circumstances in which they first heard about the terrorist attacks, that they were very confident about this information, and that these memories were characterized by a high phenomenal richness. Over time, there was a decrease in all of these variables, but people's ratings of phenomenology and confidence were still very high.     

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.