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  • Print publication year: 2006
  • Online publication date: October 2009

16 - PTSD in urban primary care patients following 9/11

from Part IV A - New York area



Mass violence disasters, especially terrorist events in urban areas, are hypothesized to have greater impact on mental health than either natural or technological disasters due to their intentional nature (Norris et al., 2002). The density of the urban environment, its ethnic diversity, and expected support deterioration, might exacerbate the disaster effects (Norris, 2002). Studies focused on the exposure to terrorist events in recent years: the 2001 World Trade Center (WTC) disaster (Schuster et al., 2001; Galea et al., 2002; Schlenger et al., 2002; Silver et al., 2002; Vlahov et al., 2002), and the 2000–2002 terrorist attacks in Israel (Bleich et al., 2003), have documented significant psychological problems, in the short term, in both directly and indirectly exposed individuals.

A recent review concluded that the health effects of disasters are wide and adversely affect several aspects of health including generalized distress, psychiatric disorders, physical illness, and interpersonal problems (Norris et al., 2002). Mass violence was found to have greater psychosocial impact than natural or technological disasters, due to its intentional character (Norris et al., 2002). For example, 6 months following the Oklahoma bombing (North et al., 1999) adults injured in that event had markedly elevated rates of post-disaster mental health disorders (45%), including post-traumatic stress disorder (PTSD, 34%).

Political terrorism, and especially suicide terrorism, has emerged as a highly detrimental international problem. As a well planned and executed violent event, suicide terrorism is deliberately intended to cause massive destruction and gruesome death; induce fear and helplessness; diminish safety and stability; weaken crucial social bonds; and disrupt the economic, political, and social order (Kaniasty & Norris, 2004; Neria et al., 2005).

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