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

A. Lowell, B. Suarez-Jimenez, L. Helpman, X. Zhu, A. Durosky, A. Hilburn, F. Schneier, R. Gross, Y. Neria

Research output: Contribution to journalArticlepeer-review


Background 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. Methods 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. Results 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. Conclusion Future directions for research, treatment, and healthcare policy are discussed.

Original languageEnglish
Pages (from-to)537-553
Number of pages17
JournalPsychological Medicine
Issue number4
StatePublished - 1 Mar 2018
Externally publishedYes

Bibliographical note

Publisher Copyright:
Copyright © Cambridge University Press 2017.


  • 9/11
  • post-traumatic stress disorder (PTSD)
  • trauma exposure severity
  • treatment of PTSD

ASJC Scopus subject areas

  • Psychiatry and Mental health
  • Applied Psychology


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