A National Survey of Stress Reactions after the September 11, 2001, Terrorist Attacks
Mark A. Schuster, M.D., Ph.D., Bradley D. Stein, M.D., M.P.H., Lisa H. Jaycox, Ph.D., Rebecca L. Collins, Ph.D., Grant N. Marshall, Ph.D., Marc N. Elliott, Ph.D., Annie J. Zhou, M.S., David E. Kanouse, Ph.D., Janina L. Morrison, A.B., and Sandra H. Berry, M.A.
Background People who are not present at a traumatic event mayexperience stress reactions. We assessed the immediate mentalhealth effects of the terrorist attacks on September 11, 2001.
Methods Using random-digit dialing three to five days afterSeptember 11, we interviewed a nationally representative sampleof 560 U.S. adults about their reactions to the terrorist attacksand their perceptions of their children's reactions.
Results Forty-four percent of the adults reported one or moresubstantial symptoms of stress; 90 percent had one or more symptomsto at least some degree. Respondents throughout the countryreported stress symptoms. They coped by talking with others(98 percent), turning to religion (90 percent), participatingin group activities (60 percent), and making donations (36 percent).Eighty-four percent of parents reported that they or other adultsin the household had talked to their children about the attacksfor an hour or more; 34 percent restricted their children'stelevision viewing. Thirty-five percent of children had oneor more stress symptoms, and 47 percent were worried about theirown safety or the safety of loved ones.
Conclusions After the September 11 terrorist attacks, Americansacross the country, including children, had substantial symptomsof stress. Even clinicians who practice in regions that arefar from the recent attacks should be prepared to assist peoplewith trauma-related symptoms of stress.
Source Information
From RAND, Santa Monica, Calif. (M.A.S., B.D.S., L.H.J., R.L.C., G.N.M., M.N.E., A.J.Z., D.E.K., S.H.B.); and the Departments of Pediatrics (M.A.S., J.L.M.), Health Services (M.A.S.), and Medicine (M.N.E.), University of California, Los Angeles (J.T.W.).
Address reprint requests to Dr. Schuster at RAND, 1700 Main St., Santa Monica, CA 90407-2138, or at schuster{at}rand.org.
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