Mental health status of World Trade Center tower survivors compared to other survivors a decade after the September 11, 2001 terrorist attacks

Gargano, Lisa M.; Nguyen, Angela; DiGrande, Laura; Brackbill, Robert M.

doi:10.1002/ajim.22636

Cited by 8 publications

(7 citation statements)

References 37 publications

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“…The findings of a partial increase in substance use, especially alcohol, are congruent with results from previous epidemics and pandemics, crises, and disasters, such as hurricanes ( Kishore, 2008 ; Ma & Smith, 2017 ), the global financial crisis in 2008 ( Dietze & Peacock, 2020 ; UNODC, 2020 ), and major terrorist attacks ( Gargano et al, 2016 ; Rehm et al, 2020 ). However, the COVID-19 pandemic is, in many ways, a unique and unparalleled crisis, as it can be considered a worldwide, rapidly developing disaster with unknown scale and impact on multiple dimensions of physical and mental health ( Dietze & Peacock, 2020 ).…”

Section: Introductionsupporting

confidence: 80%

No party, no drugs? Use of stimulants, dissociative drugs, and GHB/GBL during the early COVID-19 pandemic

Bendau

Viohl

Petzold

et al. 2022

International Journal of Drug Policy

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Background : The COVID-19 pandemic is presumably having an impact on the consumption of psychoactive substances. Social distancing and lockdown measures may particularly affect the use of “party drugs” (e.g., stimulants, dissociatives, and GHB/GBL) through the absence of typical use settings. We aimed to analyse the use patterns of those substances and underlying motivations before and during the pandemic. Methods : A subsample of 1,231 users of stimulants (amphetamine, methamphetamine, MDMA/ecstasy, cocaine), dissociative drugs (ketamine, dextromethorphan, PCP), and GHB/GBL was assessed from 30 th April to 4 th August 2020 as part of the Corona Drug Survey , a cross-sectional international online survey in five languages that included a total of 5,049 participants. The reported use of distinct substances and the underlying motivations were ascertained before (retrospectively) and during the pandemic. Furthermore, associations between drug use as a coping mechanism, pandemic-related stressors, and substance use were examined. Results : Regarding the reported frequency of use during the pandemic, 48.0–64.8% of the sample ceased or decreased, 11.9–25.5% maintained, and 23.6–29.1% increased their consumption. MDMA/ecstasy showed the strongest decrease and GHB/GBL and dissociatives the highest increase. Participants reported that price, quality, and supply were mostly unaffected by the pandemic. The most common motivations before and during the pandemic were mood-related factors, such as a desire to feel exhilarated, euphoric, high, or buzzed. The relevance of social purposes and mood-related motivators declined during the pandemic, whereas dealing with boredom increased. Overall, 16.4–35.6% perceived drug use as helpful for dealing with pandemic-related stressors, which were associated with an increased consumption frequency. Conclusion : The early stage of the COVID-19 pandemic was associated with major changes in the use of “party drugs”. Those who increased their level of drug use and perceived it as a coping strategy in particular might be targeted with adaptive preventive and therapeutic measures.

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Section: Introductionsupporting

confidence: 80%

No party, no drugs? Use of stimulants, dissociative drugs, and GHB/GBL during the early COVID-19 pandemic

Bendau

Viohl

Petzold

et al. 2022

International Journal of Drug Policy

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“…When parsed out by the number of PTSD symptom clusters endorsed, the enrollees who reported ISMA consistently had the highest proportions of high-frequency binge drinking compared to those who did not report ISMA, irrespective of the number of PTSD symptom clusters endorsed. This finding supports those of previous studies on binge drinking within similarly exposed populations [8,[49][50][51][52]. Given their highly robust association in our sample population, it may be that binge drinking intensity could approximate ISMA intensity.…”

Section: Discussionsupporting

confidence: 92%

The Intentional Self-Medication of 9/11-Related PTSD Symptoms with Alcohol: 15 Years after the Disaster

Garrey

Welch

Jacobson

et al. 2020

IJERPH

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The self-medication hypothesis may explain the co-morbidity of affective and substance use disorders. Research shows increased prevalence, frequency, and intensity of binge drinking and post-traumatic stress disorder (PTSD) among those directly exposed to the 9/11 terrorist attacks on the World Trade Center (WTC), however, little is known about PTSD symptomology and intentional self-medication with alcohol (ISMA) among this group. We used WTC Health Registry data (N = 28,935) to describe the relationship between ISMA and specific symptom clusters of probable 9/11-related PTSD, the number of PTSD symptom clusters endorsed, and binge drinking intensity. Multivariable logistic regression models were used to estimate the adjusted odds ratios (AORs) and 95% confidence intervals (CI). ISMA was most strongly associated with the hyperarousal PTSD symptom cluster (AOR = 2.04 [1.88, 2.21]) and the endorsement of one (AOR = 1.80 CI [1.65, 1.95]), two (AOR = 2.51 CI [2.28, 2.77]), or three (AOR = 2.84 CI [2.55, 3.17]) PTSD symptom clusters, indicating a clear dose–response relationship. A significant number of 9/11-exposed persons continue to experience PTSD symptoms and engage in ISMA as a potential coping mechanism. Repeated screenings for self-medicative alcohol use among survivors of mass traumas with PTSD symptoms is of public health importance.

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“…In a separate analysis of Registry data which focused on WTC tower survivors two to three years post-disaster, there was an overall PTSD prevalence of 15% [28]. A follow-up paper on tower survivors found late onset PTSD (i.e., first reported at Wave 3) prevalence for tower survivors in 2010 and 2011 to be 4.5% and 4.3% for survivors overall, respectively [29]. However, the prevalence of chronic PTSD was 13.6% among those in Tower 1 and Tower 2, compared to 10.3% for enrollees in other buildings, and 9.3% for passersby [29].…”

Section: Cross-sectional Findings Pertaining To Survivorsmentioning

confidence: 99%

“…A follow-up paper on tower survivors found late onset PTSD (i.e., first reported at Wave 3) prevalence for tower survivors in 2010 and 2011 to be 4.5% and 4.3% for survivors overall, respectively [29]. However, the prevalence of chronic PTSD was 13.6% among those in Tower 1 and Tower 2, compared to 10.3% for enrollees in other buildings, and 9.3% for passersby [29]. One study focused on the Asian community using Registry data collected two to three years post-9/11 found a PTSD prevalence of 14.6% [30], while another study of Asian Americans 11 to 12 years post-9/11 found a prevalence of 15.2% among non-Rescue/Recovery workers [31].…”

Section: Cross-sectional Findings Pertaining To Survivorsmentioning

confidence: 99%

Post-Traumatic Stress Disorder among Survivors of the September 11, 2001 World Trade Center Attacks: A Review of the Literature

Hamwey

Gargano

Friedman

et al. 2020

IJERPH

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Prior reviews of 9/11-related post-traumatic stress disorder (PTSD) have not focused on the civilian survivors most directly exposed to the attacks. Survivors include those individuals who were occupants of buildings in or near the World Trade Center (WTC) towers, those whose primary residence or workplace was in the vicinity, and persons who were on the street passing through the area. This review reports published information on the prevalence of and risk factors for PTSD, as well as comorbidities associated with PTSD among 9/11 survivors. Articles selected for inclusion met the following criteria: (1) full-length, original peer-reviewed empirical articles; (2) published in English from 2002–2019; (3) collected data from persons directly exposed; (4) adult populations; and (5) focused on non-rescue or recovery workers (i.e., survivors). Data were extracted with focus on study design, sample size, time frame of data collection post-9/11, PTSD assessment instrument, and PTSD prevalence, risk factors, and comorbidities. Our review identified the use of cross-sectional and longitudinal designs, finding multiple direct comorbidities with PTSD, as well as the prevalence and persistence of PTSD. Future research would benefit from incorporating more mixed methods designs, and exploring the mediating mechanisms and protective factors of the known associations of PTSD among the 9/11 survivor population.

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Mental health status of World Trade Center tower survivors compared to other survivors a decade after the September 11, 2001 terrorist attacks

Cited by 8 publications

References 37 publications

No party, no drugs? Use of stimulants, dissociative drugs, and GHB/GBL during the early COVID-19 pandemic

No party, no drugs? Use of stimulants, dissociative drugs, and GHB/GBL during the early COVID-19 pandemic

The Intentional Self-Medication of 9/11-Related PTSD Symptoms with Alcohol: 15 Years after the Disaster

Post-Traumatic Stress Disorder among Survivors of the September 11, 2001 World Trade Center Attacks: A Review of the Literature

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