Psychological concomitants of the 11 September 2001 terrorist attacks: A review

This paper reviews 118 empirical studies detailing the psychological implications of the 11 September 2001 terrorist attacks. Negative outcomes are summarized under five major headings: sub-clinical distress, acute stress disorder and posttraumatic stress disorder, depression, substance abuse and suicide, and the use of health services and prescription drug use. In the immediate aftermath of the attacks, a significant minority of those residing in New York City and Washington, DC showed evidence of poor mental health. Within six months of the attacks, however, symptoms typically returned to baseline or lower levels. Within the rest of the United States, the psychological impact of the attacks was minimal; in other countries, it was almost non-existent. Important psychological and demographic moderators of these outcomes are discussed, in addition to some positive psychological outcomes of the attacks. The paper concludes with a brief review of the empirical research conducted following the 2004 Madrid and 2005 London bombings in order to assess the generalizability of the 9/11 research literature to psychological reactions to other similar events. Implications for practice and policy are discussed, along with the shortcomings of the literature and some suggestions for future research.