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Psychiatric Disorders More Common in Children Directly Exposed to Sept. 11 Attacks

May 21, 2019

SAN FRANCISCO—People directly exposed as children to the Sept. 11, 2001 attacks in New York City have higher rates of psychiatric and physical disorders, compared with people not directly exposed to the mass trauma event in childhood, according to a study presented at the American Psychiatric Association’s annual meeting.

“This finding calls for a public health response that identifies vulnerable children soon after a mass trauma exposure and offers prevention and treatment in a timely fashion to avoid lifelong negative consequences,” wrote poster presenter Lawrence Amsel, MD, MPH, of the Global Psychiatric Epidemiology Group at Columbia University in New York City and the New York State Psychiatric Institute, and coauthors.

The investigation used data from the Stress and Well-Being study, an ongoing longitudinal, epidemiologic study following 942 people who were between 0 and 17 years old when they were directly exposed to the 9/11 attacks. Children who were below Canal Street in Manhattan during the attacks and/or personally witnessed the Twin Towers fall were considered to have direct exposure. They were compared with control group of 563 people from the nearby New York City borough of Queens without childhood direct exposure to the event. Information was gathered through face-to-face assessments.

When the study participants were assessed 12 to 15 years after the attacks, past-year psychiatric disorders were more prevalent among those with direct exposure to 9/11, compared with controls (35.5% vs. 27.9%), researchers reported, as were any lifetime physical health condition (26.5% vs. 10.6%). Physical and psychiatric comorbidities affected 13.6% of participants with direct childhood exposure, compared with 3.9% of controls.

People who had experienced direct exposure were more likely to have developed separation anxiety, panic disorder, marijuana abuse, any anxiety disorder, and any internalizing disorder, compared with the control subjects. They were also about half as likely to be living with a spouse or partner or living independently than controls were.

The researchers are now conducting a follow-up study of the same cohort including psychiatric assessments as well as objective measures of physical health.

“Our findings highlight the need to develop and implement a comprehensive intervention with trauma exposed children immediately following the event, and to monitor their physical and mental health across the lifespan,” they wrote.

—Terri Airov and Jolynn Tumolo


“The broad impact of childhood trauma: physical-psychiatric comorbidity in a cohort of individuals exposed to 9/11 in childhood.” Abstract presented at: the American Psychiatric Association Annual Meeting; May 21, 2019; San Francisco, CA.

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