The impact of the September 11th terrorist attacks on psychiatric patients: A review

Catholic University of America, Department of Psychology, 620 Michigan Avenue, N.E., Washington, DC 20064, USA.
Clinical psychology review (Impact Factor: 7.18). 03/2009; 29(4):339-47. DOI: 10.1016/j.cpr.2009.02.002
Source: PubMed


Studies of the general population have shown that the terrorist attacks of September 11, 2001 had a well-documented psychological effect, regardless of whether or not individuals were directly exposed to the events. In light of findings that pre-existing mental illness and prior exposure to trauma are associated with vulnerability to PTSD following a subsequent traumatic event, this article reviews research on the impact of the September 11th terrorist attacks on psychiatric patients. Findings suggest that, in general, psychiatric patients experienced immediate and long-term posttraumatic symptoms at levels greater than normal controls, although there were differential effects by diagnostic group and symptoms as observed did not always match complaints of subjective impairment. Studies sampling inpatients and outpatients, as well as research regarding service utilization, are evaluated. Assessment and treatment implications for clinicians responsible for the care of psychiatric patients following a national trauma are discussed, and recommendations for future research are presented.

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    • "Little is known about the information needs, concerns and behaviours of people with established mental illness during times of increased health threat. Research from the aftermath of September 11 indicates that the attack had detectable although variable effects on mental health patients (Franz et al., 2009), whilst natural disasters have also been shown to have negative consequences on patient groups (Hayes et al., 2009; Horan et al., 2007). To our knowledge there is no research into the effect of infectious disease outbreaks on people with pre-existing mental health problems. "
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    ABSTRACT: Electronic patient records are increasingly used in primary care research, but rarely in psychiatric research. Little is known about how people with pre-existing mental illness respond to public health threats. To outline the swine flu related concerns and behaviours of mental health patients and to determine whether marked concern was associated with any specific demographic or diagnostic groups. We searched a database containing electronic patient records from a large mental health trust for references to swine flu made between 15 April and 15 July 2009. Thematic analysis was used to code swine flu related concerns and behaviours. A case-control approach sought to determine whether there were demographic or diagnostic associations with expressing moderate/severe concern about swine flu. A range of swine flu related behaviours were noted and considerable impact was recorded for some patients. Children and patients with neurotic and somatoform disorders were over-represented amongst those expressing moderate/severe swine flu concerns. Research databases using electronic clinical records are a useful way to track responses to emerging public health threats. Children receiving mental health care and patients with neurotic and somatoform disorders may be particularly psychologically vulnerable to infectious disease epidemics.
    Full-text · Article · Feb 2011 · Journal of Mental Health
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    ABSTRACT: Disasters typically strike quickly and cause great harm. Unfortunately, because of the spontaneous and chaotic nature of disasters, the psychological consequences have proved exceedingly difficult to assess. Published reports have often overestimated a disaster's psychological cost to survivors, suggesting, for example, that many if not most survivors will develop posttraumatic stress disorder (PTSD); at the same time, these reports have underestimated the scope of the disaster's broader impact in other domains. We argue that such ambiguities can be attributed to methodological limitations. When we focus on only the most scientifically sound research-studies that use prospective designs or include multivariate analyses of predictor and outcome measures-relatively clear conclusions about the psychological parameters of disasters emerge. We summarize the major aspects of these conclusions in five key points and close with a brief review of possible implications these points suggest for disaster intervention.
    Full-text · Article · Jan 2010 · Psychological Science in the Public Interest
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    ABSTRACT: This study examined the role of several hypothesized predictors of the impact of a potentially traumatic event, the terrorist attacks of September 11, 2001 (9/11), on a sample of women experiencing intimate partner violence (IPV) and related posttraumatic stress symptoms (PTSS). We found that IPV-related PTSS mediated the relationship between IPV and 9/11-related PTSS, confirming the hypothesis that severity of symptoms related to prior trauma plays a role in the development and severity of PTSS related to subsequent potentially traumatic events. Media exposure and threat appraisal were significantly positively associated with 9/11-related PTSS, whereas social support was significantly negatively associated with 9/11-related PTSS, with none of these variables serving as moderators of the relationship between IPV-related and 9/11-related PTSS. Our results suggest that trauma-related psychiatric history is an important factor in the development of PTSS subsequent to an additional potentially traumatic event, even after adjusting for relevant variables occurring at the time of that event.
    No preview · Article · Oct 2011 · Journal of Traumatic Stress
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