Marshall Randall D, Galea Sandro
New York State Psychiatric Institute, New York, NY 10032, USA.
J Clin Psychiatry. 2004;65 Suppl 1:37-43.
Reactions to the September 11 attacks across the United States were pervasive, and persons throughout the country reported experiences akin to posttraumatic stress disorder (PTSD) in the first week following the attacks. In the New York area, 2 major surveys conducted 4 to 8 weeks after the attacks found that approximately 1 in 10 persons probably met full criteria for PTSD related to September 11. Although tobacco, alcohol, and marijuana use did increase, it was largely among persons already using these substances. The greatest increase, not surprisingly, occurred among persons with PTSD and major depressive disorder. Nationwide during the same time period, rates of PTSD related to September 11 were estimated at 2.7% to 4.3%, a striking finding in that the attacks were witnessed primarily on television outside the New York area. In all studies, having anxiety symptoms or meeting criteria for PTSD was strongly associated with number of hours of television watched on September 11 and in the days afterward. A number of explanations for this new finding are possible. These data can inform our understanding of trauma-related diagnoses, further the evolving diagnostic definitions of the Diagnostic and Statistical Manual of Mental Disorders, and contribute to etiologic models of PTSD. Future directions for postdisaster survey research are briefly discussed.
美国各地对9·11袭击事件的反应普遍存在，全国各地的人都报告在袭击后的第一周有类似于创伤后应激障碍（PTSD）的经历。在纽约地区，袭击发生4至8周后进行的两项主要调查发现，约十分之一的人可能完全符合与9·11事件相关的创伤后应激障碍标准。尽管烟草、酒精和大麻的使用确实有所增加，但主要是在已经使用这些物质的人群中。不出所料，增幅最大的是患有创伤后应激障碍和重度抑郁症的人群。在同一时期的全国范围内，与9·11事件相关的创伤后应激障碍发生率估计为2.7%至4.3%，这一惊人发现是因为袭击主要是在纽约地区以外通过电视目睹的。在所有研究中，出现焦虑症状或符合创伤后应激障碍标准与9月11日当天及之后观看电视的时长密切相关。对于这一新发现有多种可能的解释。这些数据可以增进我们对创伤相关诊断的理解，推动《精神疾病诊断与统计手册》不断演变的诊断定义，并为创伤后应激障碍的病因模型做出贡献。本文简要讨论了灾后调查研究的未来方向。
