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9/11-related PTSD among highly exposed populations: a systematic review 15 years after the attack

  • A. Lowell (a1) (a2), B. Suarez-Jimenez (a1) (a2), L. Helpman (a1) (a2), X. Zhu (a1) (a2), A. Durosky (a2), A. Hilburn (a2), F. Schneier (a1) (a2), R. Gross (a3) (a4) (a5) and Y. Neria (a1) (a2) (a3)...

The 11 September 2001 (9/11) attacks were unprecedented in magnitude and mental health impact. While a large body of research has emerged since the attacks, published reviews are few, and are limited by an emphasis on cross-sectional research, short time frame, and exclusion of treatment studies. Additionally, to date, there has been no systematic review of available longitudinal information as a unique data set. Consequently, knowledge regarding long-term trajectories of 9/11-related post-traumatic stress disorder (PTSD) among highly exposed populations, and whether available treatment approaches effectively address PTSD within the context of mass, man-made disaster, remains limited.


The present review aimed to address these gaps using a systematic review of peer-reviewed reports from October 2001 to May 2016. Eligible reports were of longitudinal studies of PTSD among highly exposed populations. We identified 20 reports of 9/11-related PTSD, including 13 longitudinal prevalence studies and seven treatment studies.


Findings suggest a substantial burden of 9/11-related PTSD among those highly exposed to the attack, associated with a range of sociodemographic and back-ground factors, and characteristics of peri-event exposure. While most longitudinal studies show declining rates of prevalence of PTSD, studies of rescue/recovery workers have documented an increase over time. Treatment studies were few, and generally limited by methodological shortcomings, but support exposure-based therapies.


Future directions for research, treatment, and healthcare policy are discussed.

Corresponding author
*Address for correspondence: Y. Neria, Ph.D., Department of Psychiatry, New York State Psychiatric Institute, College of Physicians and Surgeons, Columbia University, Unit #69,1051 Riverside Drive, New York, NY 10032, USA. (Email:
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