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Current affairs and the public psyche: American anxiety in the post 9/11 world

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Abstract

Background

The most recent wave of interviews in a longitudinal study spanned the terrorist attacks of September 11, 2001. This unintended “natural experiment” allows examination of effects of traumatic events in ways impossible in studies conducted solely after the event and in populations not previously studied.

Methods

Participants were 610 members of the randomly selected Children in the Community cohort studied longitudinally for over 25 years and between ages 27 and 38 at the time of the current in-home interviews. Symptoms of generalized anxiety, post-traumatic stress disorder, panic disorder, agoraphobia, dissociation, and depression were assessed with an adaptation of the Structured Clinical Interview for Diagnosis. Changes in self-reported symptoms from an assessment 10 years earlier were related to the date of interview between 7/2001 and 12/2003 by polynomial regression methods, including demographic and design controls. Diagnoses based on clinical follow-up were also examined.

Results

In contrast to other data on this cohort where timing effects were absent, levels of symptoms were related to time of interview. The months following 9/11/2001 and the two anniversary periods in 2002 and 2003 showed significant elevation in anxiety symptoms (t = 2.50, df = 608, P = 0.013) with some evidence of elevated anxiety disorder as well (Fisher’s exact test P = 0.096). Similar patterns were seen for specific anxiety and depressive symptom groups. Effects of religious participation, patriotism, having offspring, and media exposure on anxiety symptoms tended to differ by season, but the effect of community involvement did not. Proximity to New York City was not significantly related to symptoms.

Conclusions

Study findings suggest that young Americans showed symptomatic and, possibly, diagnostic anxiety reactions to the events of 9/11 that persisted in response to heightened awareness of ongoing threat during anniversary periods.

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Notes

  1. For these analyses the number of aggregate symptoms of anxiety was extremely skewed. In order to comply with model assumptions data originally ranging from 0 to 48 was transformed by pulling in outliers, taking the square root of the resulting counts plus 1.0, and then subtracting 1 in order that reasonable normality characterized the resulting range from 0 to 5.4. All analyses were carried out both on transformed and original symptom counts, with no differences in substantive conclusions. Graphic presentation of overall anxiety symptoms translate the analysis of transformed values back into symptom counts. Depressive symptoms and symptoms of individual anxiety disorders were not extremely skewed and analyses are carried out on original symptom counts

  2. An alternative method of analysis would have been spectral analysis, see Kovlenko, p 107. However, this method assumes that the curves will be constant over the period of assessment. Priestly MB (1983) Spectral Analysis and Time Series. Academic Press, New York

References

  1. MacFarlane AC, de Girolamo G (1996) The nature of traumatic stressors and the epidemiology of posttraumatic reactions. In: van der  Kolk BA, Marmar AC, Weiss C, Metzler D, Delucci K (eds) Characteristics of emergency services personnel related to peritraumatic dissociation during critical incident exposure. Am J Psychiatry (Suppl) pp94–102

  2. Rubonis AV, Bickman L (1991) Psychological impairment in the wake of disaster: the disaster-psychopathology relationship. Psychol Bull 109:384–399

    Article  CAS  PubMed  Google Scholar 

  3. Yehuda R (2002) Posttraumatic stress disorder. N Engl J Med 346:108–114

    Article  CAS  PubMed  Google Scholar 

  4. North CS, Nixon S, Shariat S, Mallonee S et al. (1999) Psychiatric disorders among survivors of the Oklahoma City bombing. JAMA 282:755–763

    Article  CAS  PubMed  Google Scholar 

  5. Green B, Grace M, Lindy J, Gleser GC, Leonard AC, Kramer TL (1990) Buffalo Creek survivors in the second decade: comparison with unexposed and nonlitigant groups. J Appl Soc Psychol 20:1033–1050

    Google Scholar 

  6. Schuster MA, Stein BD, Jaycox L, Collins RL, Marshall GN, Elliot MN, Zhou AJ, Kanouse DE, Morrison JL, Berry SA (2001) A national survey of stress reactions after the September 11, 2001, terrorist attack. N Engl J Med 345:1507–1512

    Article  CAS  PubMed  Google Scholar 

  7. Galea S, Ahern J, Resnick H, Kilpatrick D, Bucuvalas M, Gold J, Vlahov D (2002) Psychological sequelae of the September 11 terrorist attacks in New York City. N Engl J Med 346:982–987

    Article  PubMed  Google Scholar 

  8. Schlenger WE, Caddell JM, Jordan BK, Rourke KM, Wilson D, Thalji L, Dennis JM, Fairbank JA, Kulka RA (2002) Psychological reactions to terrorist attacks: findings from the National Study of Americans’ reactions to September 11. J Am Med Assoc 288:581–588

    Article  Google Scholar 

  9. Lerias D, Byrne MK (2003) Vicarious traumatization: symptoms and predictors. Stress Health 19:129–138

    Google Scholar 

  10. Erikkson C, Vande Kemp H, Gorsuch R, Hoke S, Foy D (2001) Trauma exposure and PTSD symptoms in international relief and development personnel. J Trauma Stress 13:205–211

    Google Scholar 

  11. Carlier IVE, Lamberts RD, Gersons BPR (2000) The dimensionality of trauma: a multidimensional scaling comparison of police officers with and without posttraumatic stress disorder. Psychiatry Res 97:29–39

    Article  CAS  PubMed  Google Scholar 

  12. Holloway HC, Norwood AE, Fullerton ES, Engel CS, Ursano RJ (1997) The threat of biological weapons, prophylaxis and mitigation of social and psychological consequences. J Am Med Assoc 278:425–427

    Article  CAS  Google Scholar 

  13. Murphy S, Braun T, Tillery L, Cain K, Johnson L, Beaton R (1999) PTSD among bereaved parents following the violent deaths of their 12–28-year old children: a longitudinal prospective analysis. J Trauma Stress 12:273–290

    Article  CAS  PubMed  Google Scholar 

  14. Ahern J, Galea S, Resnick H, Kilpatrick D, Bucuvalas M, Gold J, Vlahov D (2002) Television images and psychological symptoms after the September 11 terrorist attacks. Psychiatry 65:289–300

    PubMed  Google Scholar 

  15. Gershuny B, Thayer J (1999) Relations among psychological trauma and dissociative phenomena and trauma-related stress. Clin Psychol Rev 19:631–657

    Article  CAS  PubMed  Google Scholar 

  16. Marmar C, Weiss D, Metzler T, Delucchi K (1996) Characteristics of emergency services personnel related to peritraumatic dissociation during critical incident exposure. Am J Psychiatry 153(Suppl):94–104

    CAS  PubMed  Google Scholar 

  17. Motta R, Joseph J, Rose R, Suozzi J, Leiderman L (1997) Secondary trauma: assessing intergenerational transmission of war experiences with a modified stroop procedure. J Clin Psychol 53:895–903

    Article  CAS  PubMed  Google Scholar 

  18. Steed L, Downing R (1998) A phenomenological study of vicarious traumatisation amongst psychologists and professional counselors working in the field of sexual abuse/assault. Aust J Disaster Trauma Stud 2:1–8

    Google Scholar 

  19. Richman JA, Wislar JS, Flaherty JA, Fendrich M, Rospenda KM (2004) Effects on alcohol use and anxiety of the September 11, 2001 attacks and chronic work stressors: a longitudinal cohort study. Am J Public Health 94:2010–2015

    PubMed  Google Scholar 

  20. Presidential Address to a Joint Session of Congress and the American Public (2001) Available at http://www.whitehouse.gov/news/releases/2001/09/20010920–8.html

  21. Kennedy GJ, Kelman HR, Thomas C, Chen J (1996) The relation of religious preference and practice to depressive symptoms among 1855 older adults. J Gerontol Ser B Psychol Sci Soc Sci 51B(6):301–308

    Google Scholar 

  22. Spitzer RL, Williams JB, Gibbon M, First MB (1992) The structured clinical interview for DSM-III-R (SCID): I. History, rationale, and description. Arch Gen Psychiatry 49:624–639

    CAS  PubMed  Google Scholar 

  23. Rogler LH, Malgady RG, Tryon WW (1992) Evaluation of mental health: issues of memory in the Diagnostic Interview Schedule. J Nerv Ment Dis 180:215–222

    CAS  PubMed  Google Scholar 

  24. Bradburn NM, Rips LJ, Shevell SK (1987) Answering autobiographical questions: the impact of memory and inference on surveys. Science 236:157–161

    CAS  PubMed  Google Scholar 

  25. Kessler RC (1990–1992) National Comorbidity Survey. http://webappi.icpsr.umich.edu/cocoon/SAMHDA-STUDY/06693.xml

  26. Cohen P, Cohen J (1996) Life values and adolescent mental health. Lawrence Erlbaum Associates, Hillsdale, NJ

    Google Scholar 

  27. Cohen J, Cohen P, West S, Aiken L (2003) Applied multiple regression/correlation analysis for the behavioral sciences, 3rd edn. Lawrence Erlbaum Associates, Mahwah, NJ

    Google Scholar 

  28. Source of data, on-line analysis: National Comorbidity Survey (ICPSR SDA edition 2004) Analysis conducted January 2, 2004. http://www.icpsr.umich.edu/

  29. Schlager D, Schwartz JE, Bromet EJ (1993) Seasonal variation of current symptoms in a healthy population. Br J Psychiatry 163:322–326

    CAS  PubMed  Google Scholar 

  30. Kovlenko PA, Hoven CW, Wicks J, Moore RE, Mandell DJ, Liu H (2000) Seasonal variations in internalizing, externalizing, and substance use disorders in youth. Psychiatry Res 94:103–119

    Google Scholar 

  31. Fossey E, Shapiro C (1992) Seasonality in psychiatry—a review. Can J Psychiatry 37:299–308

    CAS  PubMed  Google Scholar 

  32. Blazer DG, Kessler RC, Swartz MS (1998) Epidemiology of recurrent major and minor depression with a seasonal pattern: the National Comorbidity Study. Br J Psychiatry 172:164–167

    CAS  PubMed  Google Scholar 

  33. Bromet EJ, Dunn LO, Connell MM, Dew MA, Schulberg HC (1986) Long-term reliability of diagnosing lifetime major depression in a community sample. Arch Gen Psychiatry 43:435–440

    CAS  PubMed  Google Scholar 

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Authors and Affiliations

  1. New York State Psychiatric Institute, Columbia University College of Physicians and Surgeons, New York, NY, USA

    Patricia Cohen PhD, Stephanie Kasen PhD & Henian Chen MD, PhD

  2. Unit 47, New York State Psychiatric Institute, 1051 Riverside Drive, New York, NY, 10032, USA

    Patricia Cohen PhD

  3. New York State Psychiatric Institute, New York, NY, USA

    Kathy Gordon & Kathy Berenson PhD

  4. Mt. Sinai School of Medicine, New York University Medical School, New York, NY, USA

    Judith Brook Ed D

  5. Unit of Psychiatric Informatics, New York State Office of Mental Health, New York, NY, USA

    Thomas White MD, PhD

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  1. Patricia Cohen PhD
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  2. Stephanie Kasen PhD
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  3. Henian Chen MD, PhD
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Corresponding author

Correspondence to Patricia Cohen PhD.

Additional information

Funding/Support: This study was supported by NIMH grant MH-60911, Patricia Cohen, P.I., NIDA 03188, Judith Brook, P.I. and by the New York State Office of Mental Health.

Role of sponsor: NIMH and NIDA did not contribute in any way to the design and conduct of the study, to the collection, analysis and interpretation of data, or to the preparation, review or approval of the manuscript.

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Cohen, P., Kasen, S., Chen, H. et al. Current affairs and the public psyche: American anxiety in the post 9/11 world. Soc Psychiat Epidemiol 41, 251–260 (2006). https://doi.org/10.1007/s00127-006-0033-7

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