Those Who Viewed Disturbing Televised Images From Sept. 11 Suffered Worse PTSD, Depression

NEW YORK CITY, Jan. 23 ??? New Yorkers who were directly exposed to the Sept. 11 terrorist attacks and repeatedly viewed the most horrific televised images of that day were more likely to suffer post-traumatic stress disorder (PTSD) and/or depression than other New Yorkers, according to a new study led by researchers from The New York Academy of Medicine. The study appears in the current issue of the journal Psychiatry.

Directly-exposed New Yorkers who viewed images more than seven times of people falling or jumping from the World Trade Center (WTC) towers experienced the highest levels of both PTSD and depression, the study found. ???Directly exposed??? people include those who witnessed the attack in person, had a friend or relative killed, participated in the rescue efforts, or had been displaced from home or work as a result of the attacks. More than 22 percent of those who were directly exposed and saw the image of people falling or jumping more than seven times suffered from PTSD, and 21.3 percent suffered from depression, the survey of 1,008 Manhattan residents found.

Interestingly, New Yorkers who frequently viewed these and other disquieting images but were not directly affected by the attacks, suffered from much lower levels of PTSD/depression. The finding that image-viewing frequency affects those directly involved in the attacks, but not others, had not been previously documented, said lead author Jennifer Ahern, MPH. The results indicate that people who have experienced a direct impact of such an event should consider restricting their viewing of event coverage, said Ahern, a research analyst in the Academy???s Center for Urban Epidemiologic Studies.

???Especially for people who???ve been exposed to an event, it may make sense to limit your viewing,??? Ahern said.

The research team interviewed Manhattan adults living south of 110th St., using a random-digit-dial telephone survey between Oct. 16 and Nov. 15, 2001. Participants were asked whether and how often they had seen four televised images in the week after Sept. 11: an airplane hitting the WTC, buildings collapsing, people running from a cloud of smoke, and, people falling or jumping from the towers of the WTC. The number of times each person saw each of these images was categorized as none, one to seven, and more than seven. The researchers then identified those participants who had symptoms consistent with PTSD and depression based on their responses to diagnostic criteria questions. Finally, researchers factored in whether participants had been directly exposed to the event.

Not surprisingly, an overwhelming number of New Yorkers viewed disturbing images of the WTC attacks in the first week, Ahern and colleagues found, as follows:

Plane striking the WTC towers: 87 percent of those surveyed reported seeing this image more than seven times in the first seven days. Only 3.5 percent said they never saw it.

Buildings collapsing: 83.1 percent saw this image more than seven times in the first week. Only 5.1 percent said they never saw it.

People running from smoke cloud: 82.9 percent saw it more than seven times in the first week. Only 4.5 percent said they never saw it.

People falling or jumping from the towers: This image was viewed least frequently. Of those surveyed, 39.5 percent never saw this image. Only 19.5 percent saw it more than seven times.

PTSD and depression were more prevalent among all survey participants who frequently viewed these images, except for that of the buildings??? collapse. But the most consistent and strongest association was found for directly-affected New Yorkers who repeatedly viewed images of people falling or jumping from the towers.

Despite the strong correlation, there is no way to prove that television viewing actually contributed to psychological distress, Ahern cautions. ???Were the people who were already psychologically traumatized, watching more TV, or were they becoming more traumatized by watching TV???? Ahern said. ???We don???t know.???

The New York Academy of Medicine is a non-profit organization founded in 1847 that is dedicated to enhancing the health of the public through research, education and advocacy, with a particular focus on disadvantaged urban populations.

Posted on January 23, 2003

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