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This chapter reviews the historical background on the construct of psychological trauma. It then considers recent empirical studies on individual differences in response to potentially traumatic events (PTEs). Most of the variability can be captured by four prototypical trajectories: chronic dysfunction, delayed reactions, resilience, and recovery. Major advances in theory and research on resilience to adversity came from developmental psychologists and psychiatrists during the 1970s. These pioneering researchers documented the large number of children who, despite growing up in harsh socioeconomic circumstances, nonetheless evidenced healthy developmental trajectories. Evidence for widespread resilience among survivors of the severe acute respiratory syndrome (SARS) epidemic has been reported. Resilience to trauma following disaster has been associated with male gender, older age, and greater education. Developmental theorists have for years argued that resilience to aversive childhood contexts results from a cumulative mix of person-centered variables and sociocontextual risk and protective factors.
The tragic events of September 11, 2001 put the resources of the American people to the test like no other event in US history. The world watched as people came together from all walks of life, from all parts of the country, to clear up the ruin that the terrorists had left behind in lower Manhattan. At the time of the attacks,we found ourselves in the unique position to lend our psychological expertise in the field of trauma to two distinct groups called upon, by profession, to respond to the devastation: the New York Fire Department (FDNY), and employees of Consolidated Edison (Con Edison), the utility company responsible for providing New York City with electricity, gas, and steam. We had a prior history with both of these groups via the primary author's role as liaison between the Weill Cornell Medical College Department of Psychiatry and the New York Presbyterian Hospital (NYPH) Burn Center for the past 15 years. Our involvement with these specific groups stems most basically from the fact that people in these positions undergo trauma via work-related accidents and injuries and require evaluation and treatment for the psychological sequelae of trauma. It was these facts that left us in a position to organize the evaluation and treatment post-disaster, on a scale we had never imagined, to two populations that had never previously been so massively traumatized.
In this chapter we share what we have learned about how these two populations were effected by their exposure to the terrorist attacks and their aftermath.
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