According to a study published recently by Columbia’s Mailman School of Public Health 95 percent of the survivors who escaped from the World Trade Center continued to exhibit symptoms of Post-Traumatic Stress Disorder two to three years after the Sept. 11 attacks.
Dr. Sandro Galea, chair of the department of epidemiology at the Mailman School, said this study is the first to specifically examine PTSD in those who barely managed to flee the crumbling towers; previous research has detailed the lingering effects on rescue workers or those who lived or worked near the towers.
Galea defined PTSD as the reoccurrence of nightmares and intrusive memories in which subjects relive the traumatic event, hypervigilance and perpetual anxiety, and avoidance of places or scenarios that trigger memories of the event.
In addition to research on the prevalence of PTSD in survivors Galea, the senior author of the study, said he and fellow researchers from the New York City Department of Health and Mental Hygiene and the federal Agency for Toxic Substances Disease Registry, uncovered “unexpectedly clear findings” on surprising risk factors for those in their sample population who developed the condition.
Notably, the researchers found a strong connection between a subject’s socioeconomic status and his or her chance of developing PTSD. Survivors with annual incomes of under $25,000 had an eight times greater likelihood of suffering from PTSD than those with annual incomes of over $100,000.
“It’s very controversial in the field whether or not socioeconomic status is associated with risk for mental illness,” Galea said. “It has not been clear, until now, that there is such a clear dose response between income and PTSD.”
Galea said this relationship could be attributed to the lack of access to mitigatory resources, like healthcare or counseling, or to “cumulative psychosocial stress” among low-income populations.
Researchers also found survivors were more likely to develop PTSD if they escaped from higher floors, sustained an injury during the attack, were caught in the dust cloud that resulted from the towers’ collapse, witnessed a traumatic incident, or took longer to evacuate the towers.
According to Dr. Galea, the study, published in the American Journal of Epidemiology, has several implications for policy makers. In addition to reinforcing the need to pay particular attention to the conditions of low-income survivors of disasters, and the need for awareness of the long-term nature of PTSD symptoms, the study also “suggests … that there should be no doubt in anybody’s mind anymore that an evacuation for no reason is much better than delayed evacuation just in case.”
The prevalence of PTSD found in the study is “pretty high,” said Dr. Galea. “But, then again, there’s never been an event like this, so it’s hard to know what to benchmark it against.”
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