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Distant Trauma: A Prospective Study of the Effects of September 11th on Young Adults in North Carolina

In 2001, 730 young adults (aged 19-21) were given a detailed assessment as part of an ongoing longitudinal, epidemiological study of the development of psychiatric disorders across childhood and adolescence. Each participant had been interviewed up to 6 times previously, beginning in 1993. Parents were also interviewed until participants reached 16 years old. By chance in 2001, two-thirds (475) of the participants were interviewed before September 11, 2001; and one-third (255) were interviewed afterward. This provided an opportunity (a) to compare current psychopathology in those interviewed before and after September 11th, (b) to test whether September 11th acted as an additional stressor, and (c) to examine the factors from participants' earlier lives that increased the impact of September 11th. Substance use, and substance abuse disorder (SUD), were significantly more prevalent after September 11th in women. Men interviewed after September 11th were slightly more likely to have 1 or more symptoms of posttraumatic stress disorder, but rates of SUD were significantly lower. No other psychiatric disorders showed an increase after September 11th. All psychiatric disorders were more likely to occur in 2001 in those with a previous history of the same diagnosis but only substance abuse in women showed an interaction with September 11th. Overall prevalence of SUD in men was lower after September 11th in both those with and those without a previous history. Examination of a range of risk factors that might predict psychopathology following a trauma showed effects in those with relatively low levels of previous risk, but not in those at the highest levels of risk. This study of young adults living some 500 miles from the events of September 11, 2001, on whom data were available both before and after that date, suggests that the main effect was on drug abuse and dependence. Drug use and abuse increased in women and decreased in men. This finding is in line with earlier work showing that some forms of psychiatric disorder can decrease during times of civic crisis. September 11th served as an additional stressor for those under low to moderate levels of stress but did not affect those already under high stress.