The Wounded Mind

Within a month of Sept. 11, David Vlahov, PhD '88, launched a telephone survey of 1,000 people to look at post-traumatic stress disorder (PTSD) and other early psychological reverberations among New Yorkers. 

"This initial rapid assessment is to provide a sense of the magnitude and scope of the psychological impact," explains Vlahov, an adjunct professor of Epidemiology and director of the New York Academy of Medicine's Center for Urban Epidemiologic Studies. "Our results will be used by the Commissioner of the New York City Department of Health to help plan services and allocation of resources when the city applies to the Federal Emergency Management Agency for assistance." 

Although PTSD has been called shell shock and battle fatigue, this common mental disorder (estimates of its prevalence range from 3 to 10 percent of the U.S. population) is by no means the exclusive province of combat veterans. Survivors of rape, domestic violence, child abuse, accidents, natural disasters — and terrorist attacks — are all susceptible to the flashbacks and nightmares, the avoidance behaviors, and the emotional numbing that mark PTSD.

Vlahov, who also plans to recruit another 2,600 adults and children in New York for long-term follow-up, is not the only person from the School interested in PTSD. Howard Chilcoat, ScD '92, MHS '91, studies the disorder as well.

"If almost 6,000 people died in the Sept. 11 catastrophes," says Chilcoat, "then every member of each of those 6,000 families, as well as those close to the deceased, are at risk of PTSD."

Asked what the signs of the disorder are, Chilcoat, an associate professor of Mental Hygiene, explains that, to be diagnosed with PTSD, a person must first have been exposed to a traumatic event and then have exhibited at least some features from each of three symptom clusters: 1) intrusive memories, fantasies, and nightmares of the trauma, as well as physiological or psychological distress when exposed to cues that remind of the event; 2) hyperarousal symptoms like insomnia and an exaggerated startle reaction; and 3) emotional numbing and avoidance of situations resembling the trauma.

What about all the millions who watched the World Trade Center towers collapse on TV? While Chilcoat is quick to note that PTSD can at times be overdiagnosed, he does think some people who watched the catastrophes unfold on television could now be at risk for the disorder. 

"There are definitely people out there not related to the victims of Sept. 11 who should be on guard for signs of PTSD," he cautions. "If after watching the catastrophes you notice yourself losing interest in people and activities, or feeling emotionally numb or hopeless or both, these are red flags for post-traumatic stress disorder."