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

Abstract

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.

Long-term impact of COVID-19 associated acute respiratory distress syndrome

“…However, psychiatric disorders must be analysed in the global context of the pandemic, which has led to significant changes in lifestyle, economy, work, and social relationships. In fact, the high percentage of PTSD is comparable to that described in studies conducted in survivors of wars and catastrophes ( 38 , 39 ).…”

The Bidirectional Relationship between Posttraumatic Stress Symptoms and Social Support in a 9/11-Exposed Cohort: A Longitudinal Cross-Lagged Analysis

“…The prevalence of 9/11-related PTSD has varied from 3.8% to 29.6%, depending on populations and time periods [ 1 ]. Previous studies found that exposure to the 9/11 terrorist attack was associated with elevated PTSD levels among a cohort of WTC-exposed adults years after the disaster [ 2 , 3 , 4 ]. While the prevalence of PTSD among WTC survivors has decreased over time, elevated levels of PTSD have persisted for a substantial subgroup.…”

Stroke hospitalizations, posttraumatic stress disorder, and 9/11‐related dust exposure: Results from the World Trade Center Health Registry

“…The long-term health effects of the World Trade Center (WTC) terrorist attacks on September 11, 2001 (9/11) have been acknowledged in recent literature. The frequently studied health outcomes linked to 9/11 include physical health conditions such as asthma, autoimmune diseases, cardiovascular diseases, and cancer, [1][2][3][4][5][6] mental health conditions such as posttraumatic stress disorder (PTSD) and depression, [7][8][9][10] and physical and mental health comorbidities. 11 Many studies have reported significant associations between these health outcomes and 9/11-related dust exposure, [1][2][3][4][5][6] with some studies also noting the temporal associations between mental health problems, particularly 9/11-related PTSD, and physical health outcomes.…”