Terror Distress in a New York City Primary Care Sample

摘要

As a result of the terrorist activities of September 11, 2001, the entire country has experienced increased stress. Coping with the events of 9/11 poses a unique challenge, as there have been frequent terror alerts issued by the government to the residents of New York City. It has also been shown that people with a previous history of childhood abuse are more likely to have difficulty coping with new traumatic events. The aim of this study was to describe a Brooklyn primary-care community's response to the ongoing terrorist threat around the two year anniversary of 9/11. This study further intended to explore the relationship between childhood abuse and current distress from the terror threat. Fifty patients waiting for medical appointments at an urban family practice clinic anonymously completed measures of their terror-related distress and childhood trauma. Analyses indicated substantial distress due to the ongoing terror threat and concomitant restriction of activity. People who reported a history of childhood abuse appear to be coping as well as people who do not report a history of abuse. Implications of the results are discussed. Introduction The extent of the psychological reaction to September 11, 2001 has begun to emerge in the scientific literature. A national telephone survey conducted in the days after September 11 showed that 44% of the subjects reported at least 1 stress symptom occurring “quite a bit” or “extremely”. Geographic closeness to the World Trade Center was among the predictors that were significantly associated with stress reactions (Schuster, Stein & Jaycox, 2001). An early study of Manhattan residents living below 110th street found nearly 8% of people surveyed reported symptoms of PTSD. The rate was 20% for those living below Canal Street (near the World Trade Centers) (Galea , Vlahov, & Resnick, 2002). Coping with the events of 9/11 poses a unique challenge, especially as there have been frequent terror alerts issued by the government to the residents of New York City. The current global political situation has also contributed to renewed feelings of vulnerability and increased stress (Huddy, Feldman & Capelos, 2002). This may be particularly true for the residents of Brooklyn, due to their proximity to lower Manhattan, the detection of suspected Al Qaida cells in Brooklyn, as well as a constant terror threat to the Brooklyn Bridge. It has also been shown that people with a previous history of trauma are more likely to have difficulty coping with new traumatic events (Yehuda, Halligan & Grossman, 2001 and Breslau, 2002). This finding is particularly salient to the local community, as epidemiological evidence has indicated high rates of crime, immigration and poverty (McCall, 1999). The aim of this study was to describe a Brooklyn primary-care community’s response to the ongoing terrorist threat around the two year anniversary of 9/11. This study further intended to explore the relationship between childhood abuse and current distress from the terror threat. Methods This research project and all measures were reviewed and requisite approval was provided by the Institutional Review Board prior to the recruitment of any patient. Adult patients waiting for medical appointments at an urban medical center’s family practice clinic were approached and asked if they would be interested in participating in a study about people’s reactions to 9/11. Approximately sixty-eight percent (55/80) of the people who were approached agreed to complete the survey. Of those who agreed to participate, 91% (50/55) returned the measures. In total, 50 subjects completed a measure of terror-related distress (Terror Distress Scale-See Appendix 1)) as well as a measure of child abuse (Childhood Trauma Questionnaire (Bernstein &Fink, 1998)). All of the data was collected within the 2 month span surrounding the 2 year anniversary of 9/11. Measures Terror Distress Scale – This is an unpublished measure designed to gather informat