ABSTRACT
A sample of 481 social workers from Manhattan participated in a study of the impact of the September 11, 2001 (9/11) World Trade Center (WTC) attacks. A variety of risk factors associated with posttraumatic stress and secondary trauma were examined in relation to shared traumatic stress (STS), a supraordinate construct reflecting the dual nature of exposure to traumatic events. Risk factors included attachment style, exposure to potentially traumatic life events, and enduring distress attributed to the WTC attacks. It was expected that clinicians' resilience would mediate the relationship between these risk factors and STS. Using path analytic modeling, the findings support the study's hypotheses that insecure attachment, greater exposure to potentially traumatic life events in general, and the events of 9/11 in particular are predictive of higher levels of STS. Contrary to expectation, enduring distress attributed to 9/11 was not associated with resilience. Resilience, however, was found to be a mediator of the relationships between insecure attachment, exposure to potentially traumatic life events, and STS but did not mediate the relationship between enduring distress attributed to 9/11 and STS. Implications for theory, research, and practice are discussed.
Subject(s)
September 11 Terrorist Attacks/psychology , Stress Disorders, Post-Traumatic , Aged , Female , Humans , Male , Middle Aged , New York City/epidemiology , Resilience, Psychological , Risk Factors , Social Work , Stress Disorders, Post-Traumatic/epidemiology , Stress Disorders, Post-Traumatic/psychology , Surveys and QuestionnairesABSTRACT
Many disaster survivors suffer from postdisaster distress regardless of whether or not they meet criteria for specific psychiatric diagnoses. Cognitive Behavior Therapy for Postdisaster Distress (CBT-PD), a ten-session manualized intervention, was developed to address a range of cognitive, emotional, and behavioral reactions to disaster. Trained community-based therapists provided CBT-PD to adult survivors of Hurricane Katrina as part of InCourage, a program sponsored by the Baton Rouge Area Foundation. Participants (n = 88) who were assessed at referral, pretreatment, intermediate treatment, and posttreatment showed significant and large improvements. The overall pre-post effect size was 1.4 in intention-to-treat analyses. Improvements were comparable for persons with more severe distress and persons with moderate distress at referral. Benefits were maintained at follow-up for the 66 adults who have been assessed.
