Crupi, R., & Brondolo, E.
Posttraumatic stress disorder post 9/11: A review of the evidence and implications for
public health policy
Mass fatality incidents due to terrorism are becoming more common. Addressing the mental health needs of the general population and first responders exposed to these attacks is a pressing concern. Following the 9/11 attacks, a wide range of mental and physical health outcomes were reported, including posttraumatic stress disorder (PTSD). The aim of this paper is to provide a broad overview of the existing data on PTSD in civilian and responder samples following the 9/11 terrorist attacks on the World Trade Center and the Pentagon to provide guidance for resource planning purposes. We examine the prevalence and course of illness, including evidence on the persistence and late onset of symptoms among a proportion of the population, and review both personal and event-related risk factors across groups. We discuss brief screening instruments necessary for on-going monitoring, and review interventions focusing on building resilience, preventing symptom development, and treating PTSD symptoms. Overall, the literature suggests a substantial burden of PTSD following mass fatality incidents. The epidemiological evidence highlights the importance of managing the health risks associated with volunteering in response to terror attacks. There is relatively clear guidance for the treatment of PTSD in the general public, although there is a need for greater dissemination of treatments and better access to care. Less is known about prevention and treatment for responders. There is empirical support for several psychotherapeutic interventions for PTSD among these responders, but there is less evidence available to guide primary prevention programs for the public or responders. Planners will need to provide resources for long-term support for mental health following terror events and use a flexible approach for delivering available resources.
