Psychology porposed research

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POST TRAUMATIC STRESS DISORDER IN SEPTEMBER 11TH SURVIVORS

9/11 Survivors with or without Injuries and the Severity of Post Traumatic Stress Disorder

STUDENT NAME

University of Massachusetts Boston

Your N. Here

Psychology 100

Fall, 2009

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Abstract:

This is a proposal for a study to see if the severity of Post Traumatic Stress Disorder

increases in people who sustained an injury in the September 11th attacks compared to those

who did not sustain an injury. The people who participate in this study will be survivors from the

September 11th attacks on the World Trade Center and they will be asked if they had obtained an

injury during September 11th or if they did not obtain any injuries, based on their answers they

will be put into one of two groups; those with injuries and those without. Once the participants

are put into their two groups they will be allowed to go about their daily routines. On the last

friday of each month each group will be given a survey and asked questions to see how their

symptoms of Post traumatic stress disorder are developing. This will be done over the course of

three years. Previous research by Galea, Ahern, Resnick, Kilpatrick, Bucuvalas, Gold, & Vlahov

(2002) show that some exposure to the attacks was a predictor to PTSD. One study looked at a

sample of adults living in manhattan and asked them about the demographic characteristics and

exposure to the the attacks and looked at how that had affected symptoms of PTSD. They

concluded that exposure to the attacks were predictors of acute PTSD. This study hypothesizes

that the survivors who have sustained injuries from the 9/11 attacks will develop PTSD more

severely then those who did not sustain injuries.

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9/11 Survivors with or without Injuries and the Severity of Post Traumatic Stress Disorder

The purpose of this study is to see if the severity of Post Traumatic Stress Disorder is

influenced by injuries sustained from the attacks or if injuries are not sustained. The hypothesis

for this study is that people who had obtained injuries during the 9/11 attacks have PTSD on a

more severe level then those who did not sustain injuries. The people who have injuries will have

more severe uncontrollable re-experiences of the traumatic event, sleepiness, irritability, guilt,

emotional numbing and depression. These symptoms will be measured and assessed for the

severity. Prior studies have looked at the rescue and recovery workers and the experience of the

workers in the World Trade Center building and compared it to refugees.

In the article, “September 11th Survivors and the Refugee Model” by Myer, Moore, and

Hughes (2003), they compare the experience of the people who worked the Trade Center and the

experiences of refugees. Some of the people saw the first plane crash into the north tower of the

WTC; whereas many saw the second plane hit the south tower. During the escape, many

employees watched people jump from the windows of the WTC. Seeing these things lead to

employees having PTSD because there were feelings of separation and loss from their friends

and co-workers. When the survivors were able to have the possibility of returning to work they

became distressed. The refugee model provides a better description of survivors experience than

a diagnostic model.

In another article, “Virtual Reality Exposure Therapy for World Trade Center Post -

traumatic Stress Disorder: A Case Report” by Difede and Hoffman (2002) they examined PTSD

in a young man who had developed acute PTSD and did not make progress in the traditional

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imaginal exposure therapy. In this study they had re-exposed a patient to traumatic events and

and found that this imaginal imagery can lead to a reduction of PTSD symptoms. One patient

was across the street from the North Tower when the first plane hit. During her evaluation she

described with little emotion the sequence of events that she experienced September 11th. This

patient has acute PTSD, which goes along with the idea that people who have sustained injury

from the attack have more severe symptoms of PTSD then those who did sustain an injury.

In the final article “Mental Health Status of World Trade Center Rescue and Recovery

Workers and Volunteers”, it talks about the mental and physical health of rescue and recovery

workers. In this study they tested people 18-65 and over, and they were given the Patient Health

Questionnaire. The results of this experiment shows that there is a need for better tools to assess

the mental health of responders to a disaster. It also talks about how the mental health effects that

were observed in the population group suggest that there is a need for better mental health

screening, follow-up and access to mental health services for WTC rescue and recovery workers

and volunteers.

The purpose of this study is to see if the people who have injuries because of the

September 11th attacks have more severe symptoms of PTSD then those who have no injuries

from the attacks.

Method:

Participants are selected on a volunteer basis from a group of people who survived the

September 11th attack on the World Trade Center. Once there are enough volunteers, between 50

and 60, they then should be divided into two separate groups, people who have injuries i.e.

broken bones, burns, cuts etc. and those who have no injuries. Once they are divided into groups

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they can go about their daily routines. At the end of each moth they will meet at a hall and fill

out a survey. This survey will ask various questions that pertain to a list of symptoms. For

example a question could be asking if they are sleeping through the night and if not why. Then

once this survey is filled out answers will be looked at to see how severe the PTSD is in each

group. This will be done every month over a three year period. Then after the three year period

all surveys will be compared to see which group of people developed PTSD more severely.

Discussion:

This section will talk about some of the problems and limitations that may occur while

carrying out this study. The practical, methodological/design, and ethical issues will be discussed

in this section.

When conducting this study there will be many practical problems that may make

carrying out this study difficult. One problem would be other factors that play a role in

developing PTSD. If someone saw a close co-worker fall from a window and die but they

themselves suffer no injuries, that may effect the severity of the PTSD that they develop.

Another problem would be the severity of the injuries that could be sustained. Someone who

was trapped on the eighth or ninth floor who had suffered from a broken foot might develop

more severe PTSD then someone who suffered from a broken foot that was on the first floor.

Another problem would be where theses survivors were located and what they went through to

survive could also have an affect on the severity of PTSD.

This study will also have methodological/design problems. One Problem may be that we

do not how different people deal with stress and trauma. A person who did not sustain an injury

from the attack may react in the same way as a person who did sustain an injury and that can

affect the final outcome of the study.

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References:

Myer, Rick A, Hughes, Tammy L; “September 11th Survivors and the Refugee Model”, Journal

of Mental Health Counseling. Vol 25(3), Jul, 2003 pp. 245-258.

Difede, Joann, Hoffman G. Hunter; “Virtual Reality Exposure Therapy for World trade Center

Post-traumatic Stress Disorder: A Case Report”, Cyber Psychology and Behavior. Vol. 5,

Nov, 2002.

“Mental Health Status of World Trade Center Rescue and Recovery Workers and Volunteers”

Journal of the American Medical Association. Vol 293(1), Jan, 2005 pp. 30-31.