September 11th, 2001 : acute stress and coping in a New York City metropolitan college sample

Ph.D. University of Hawaii at Manoa 2013.Includes bibliographical references.The events of September 11th 2001 (9/11) provided a unique opportunity to investigate the psychological effects of terrorism in the United States. Although terrorist attacks occurred in the United States previously, the events of 9/11 marked the most devastating terrorist attack in recent U.S. History. Numerous studies have investigated the effects of 9/11 events in populations that were either directly or indirectly exposed. Despite numerous investigations, my literature review yielded only two studies examining the psychological effects of these events within the first month after the 9/11 attacks (Schuster et al., 2001; Silver, Holman, McIntosh, Poulin, & Gil-Riva, 2002). In this study, using an archived data set, some of the immediate psychological effects of 9/11 in a New York City metropolitan college sample (n = 99) were investigated 10-30 days after the attacks using a self-report survey. The survey included demographic questions, physical and social proximities to the attacks, trauma symptoms as measured by the Impact of Events Scale (IES; Horowitz, Wilmer, & Alavarez, 1979), the Posttraumatic Check List (PCL; Weathers, Litz, Herman, Huska & Keane, 1993), and stressful information coping strategies (i.e., Monitoring and Blunting) using the Miller Behavioral Style Scale (MBSS; Miller, 1987). First, missing data were analyzed to determine if data were missing completely at random using "Little" Missing Completely at Random (LMCAR). After no significant differences were found using LMCAR, Expectation-Maximum algorithm was used to calculate single imputation. Eight multiple regression analyses were conducted to determine if six predictors per regression (e.g., age, gender, physical proximity, social proximity, or media [live or multiple replay]) predicted acute stress reactions as measured by the IES and PCL as continuous variables. Moderation effects were also investigated (i.e., gender, race, Monitoring and Blunting coping strategies). Third, cutoff scores were determined for the IES and PCL to calculate what percentage of the sample met or scored higher than cutoff scores recommended by the instrument developers and prior research. Finally, a secondary analysis was performed using the Diagnostic Statistical Manual, Fourth Edition Text Revision (DSMIV-TR) to determine if individuals meeting cutoff criteria on the PCL also met the nontemporal criteria B, C, and D for PTSD-like (subclinical) symptoms (American Psychiatric Association, 1987). Demographic, proximity and media exposure results are discussed. The IES, MBSS and PCL demonstrated adequate reliabilities. Factor analysis using maximum likelihood with Promax indicated a one-factor solution for the PCL and a two-factor solution for the IES. For the IES regressions, Monitoring coping style was consistently a significant predictor of higher IES scores. Younger age was also a significant predictor in one regression using the IES as the dependent variable. For the PCL, white-Hispanic was a significant predictor in three of four regressions using the PCL as a dependent variable. No other main effects or interactions were found. For the IES, using a cutoff score of 35, 26.3% of the sample scored a 35 or higher. For the PCL, using a cutoff score of 44, 32 (32.3%) scored 44 or higher. When using DSM-IV-TR criteria B, C and D and a cutoff score of 44 or higher, 27 (27.3%) achieved both. Conclusion: Based on prior research, this sample scored high on two widely used stress measurements. Consistent with prior PTSD terror research, Hispanic ethnicity (Neria, DiGrande, & Adams, 2011) and using a Monitoring coping style (Keinan, Sadeh, & Rosen, 2003) appeared to increase risk for higher scores on the IES and PCL. The results and implications are discussed