Coping and posttraumatic stress disorder symptoms following the World Trade Center attacks

This study examined the association between exposure to and coping with the World Trade Center attacks of September 11, 2001 and PTSD symptoms. Participants were Pace University students from both the Pleasantville and New York City campuses. Participants were assessed on all three variables during the initial survey (6 months post event) using and Internet survey. PTSD ratings were additionally obtained during follow-up surveys at 8, 13, and 18 months post event. A total of 177 participants completed at least one follow-up and were therefore included in the final analysis. Results indicated that those with greater physical exposure (i.e., physical proximity) and those who used greater maladaptive coping (i.e., high levels of avoidance coping and use of drugs or alcohol) reported higher initial (at 6 months post event) and overall levels of PTSD symptoms. Moreover, high exposure/high maladaptive coping individuals, compared to others, showed relatively smaller decreases in PTSD symptoms over time. These findings, which are consistent with models of PTSD, suggest that use of denial and drugs and alcohol as means of coping might prevent assimilation of traumatic information with previous knowledge, prevent the extinction of a fear response to a previously neutral stimulus, and reinforce shattered assumptions that the world is benevolent, the world is meaningful, and the self is worthy, thereby leading to the maintenance of symptoms over time. Limitations and clinical implications are discussed