
doi: 10.1002/jts.22407
pmid: 31206211
AbstractStudies of terrorism‐related deaths are few and mostly focus on short‐term effects. To characterize long‐term bereavement outcomes, including resilience/recovery and patterns of comorbidity, following the September 11, 2001 (9/11), terrorist attacks, we report mental health conditions and grief‐related impairment in 454 9/11 bereaved family members. In addition, the contribution of non‐9/11 lifetime traumas, pre‐9/11 mental health conditions, post‐9/11 interim life events, grief services, income adequacy, and social support were examined. Latent class analyses yielded three groups: healthy, comorbid without PTSD (comorbid/noPTSD), and comorbid with PTSD and impaired (comorbid/PTSD+I). Participants in the healthy group (66.1%) were least likely to meet thresholds for mental conditions, whereas those in the comorbid/noPTSD (21.3%) and comorbid/PTSD+I (12.6%) groups had higher probabilities of meeting depression, grief, and anxiety thresholds. These groups also endorsed more negatively valenced post‐9/11 interim life events than the healthy group: comorbid/noPTSD vs. healthy, odds ratio (OR) = 0.84, 95% CI [0.76, 0.94]; comorbid/PTSD+I vs. healthy, OR = 0.85, 95% CI [0.76, 0.96]. Comorbid/PTSD+I was the only group with elevated probabilities of meeting clinical thresholds for PTSD (.64) and grief‐related impairment (.94). This group was also more likely to include bereaved parents: comorbid/PTSD+I vs. healthy, OR = 12.96, 95% CI [1.97, 85.41]; comorbid/PTSD+I vs. comorbid/noPTSD, OR = 15.55, 95% CI [1.63, 148.41]); and to experience more non‐9/11 lifetime traumas: comorbid/PTSD+I vs. healthy, OR = 4.34, 95% CI [1.28, 14.70]; comorbid/PTSD+I vs. comorbid/noPTSD, OR = 6.54, 95% CI [1.53, 27.95]. Clinical and community programs should target this high‐risk group to identify individuals in need of services.
Male, Depression, Comorbidity, Anxiety, Middle Aged, Severity of Illness Index, Life Change Events, Stress Disorders, Post-Traumatic, Latent Class Analysis, Case-Control Studies, Humans, Family, Female, Longitudinal Studies, September 11 Terrorist Attacks, Aged, Bereavement
Male, Depression, Comorbidity, Anxiety, Middle Aged, Severity of Illness Index, Life Change Events, Stress Disorders, Post-Traumatic, Latent Class Analysis, Case-Control Studies, Humans, Family, Female, Longitudinal Studies, September 11 Terrorist Attacks, Aged, Bereavement
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