Abstract
This study assessed the impact of the World Trade Center (WTC) attacks on emotional problems, prescription drug usage, and utilization of medical and mental health services within the Chinese community in lower Manhattan. We administered a survey to 148 randomly selected Chinese workers affected by the WTC attacks in March 2003. Although nearly half of the respondents had elevated PTSD and/or elevated depression scores, only a few (4.4%) had talked to a counselor. However, nearly all (86%) reported having visited a physician at least once since September 11, 2001. Individuals with elevated PTSD scores were significantly more likely to have gone to a physician after 9/11. They were also more likely to have received prescription drugs and to indicate an interest in counseling after 9/11 than individuals with low PTSD scores. The findings highlight the role of the primary care physician as gatekeeper for mental health symptoms after a disaster. They further suggest that primary care physicians should use screening tools for depression and posttraumatic stress after a major disaster and that they should be sensitive to potential emotional problems that are associated with somatic complaints.
Similar content being viewed by others
References
American Psychiatric Association: Diagnostic and Statistical Manual of Mental Disorders, 4th ed. Washington, DC: Author; 1994:427–428
Tracy L: Posttraumatic stress disorder. In: Kramer E, Ivy S, Ying Y, eds. Immigrant Women’s Health. San Francisco: Jossey-Bass; 1999:220–231
Centers for Disease Control: Impact of September 11 attacks on workers in the vicinity of the World Trade Center—New York City. MMWR Morb Mortal Wkly Rep 2002; 51:Spec No: 8–10
Sprang G: Vicarious stress: Patterns of disturbance and use of mental health services by those indirectly affected by the Oklahoma City bombing. Psychol Rep 2001; 89:331–338
Scott RB, Brooks N, McKinlay W: Post-traumatic morbidity in a civilian community of litigants: A follow-up at 3 years. J Trauma Stress 1995; 8:403–417
Southwick SM, Morgan CA III, Darnell A, Bremner D, Nicolaou AL, Nagy LM, Chamey DS: Trauma-related symptoms in veterans of Operation Desert Storm: A 2-year follow-up. Am J Psychiatry 1995; 8:1150–1155
Bleich A, Gelkopf M, Solomon, Z: Exposure to terrorism, stress-related mental health symptoms, and coping behaviors among a nationally representative sample in Israel. JAMA 2003; 290:612–620
Vlahov D, Galea S, Resnick H, Ahern J, Boscarino JA, Bucuvalas M, Gold J, Kilpatrick D: Increased use of cigarettes, alcohol and marijuana among Manhattan, New York, residents after the September 11th terrorist attacks. Am J Epidemiol 2002; 155:988–996
Pfefferbaum, B, North, CS, Bunch, K, Wilson, TG, Tucker, P, Schorr, JK: The impact of the 1995 Oklahoma City bombing on the partners of firefighters. J Urban Health 2002; 79: 364–372
Calhoun PS, Bosworth HB, Grambow SC, Dudley TK, Beckham JC: Medical service utilization by veterans seeking help for posttraumatic stress disorder. Am J Psychiatry 2002; 159:2081–2086
Thiel de Bocanegra H, Brickman E: Mental health impact of the World Trade Center attacks on displaced Chinese workers. J Trauma Stress 2004; 17:55–62
Blanchard E, Jones-Alexander J, Buckley T, Forneris C: Psychometric properties of the PTSD checklist (PCL). Behav Res Ther 1996; 34:669–673
Blanchard EB, Hickling EJ, Taylor AE, Loos WR, Forneris CA, Jaccard J: A clinician rating scale for assessing current and lifetime PTSD: The CAPS-1. Behav Ther 1990; 18:187–188
American Psychiatric Association: Diagnostic and Statistical Manual of Mental Disorders, 3rd ed. Washington, DC: American Psychiatric Press; 1987
Beck AT, Steer RA: Manual for the Beck Depression Inventory. San Antonio, TX: The Psychological Corporation; 1987
Galea S, Ahem J, Resnick H, Kilpatrick D, Bucuvalas M, Gold J, Vlahov D: Psychological sequelae of the September 11 terrorist attacks in New York City. N Engl J Med 2002; 346:982–987
Chen H, Chung H, Chen T, Fang L, Chen JP: The emotional distress in a community after the terrorist attack on the World Trade Center. Community Ment Health J 2003; 39:157–165
Weisberg RB, Bruce SE, Machan JT, Kessler RC, Culpepper L, Keller MB: Nonpsychiatric illness among primary care patients with trauma histories and posttraumatic stress disorder. Psychiatr Serv 2002; 53:848–854
Ouimette P, Cronkite R, Henson BR, Prins A, Gima K, Moos RH: Posttraumatic stress disorder and health status among female and male medical patients. J Trauma Stress 2004; 17:1–9
Chung H: The challenges of providing behavioral treatment to Asian Americans. West J Med 2002; 176:249–253
Lin KM, Inui TS, Kleinman AM, Womack WM: Sociocultural determinants of the help-seeking behaviors of patients with mental illness. J Nerv Ment Dis 1982; 170:78–85
Chen JP, Reich L, Chung H: Anxiety disorders. West J Med 2002; 176:249–253
Chung H: Initial behavioral health assessment of Asian Americans. Putting principles into practice. West J Med 2002; 176:236–238
Beck AT, Steer RA: Manual for the Beck Depression Inventory. San Antonio, TX: The Psychological Corporation, Harcourt Brace; 1993
Randloff L: The CES-D Scale: A self-report depression scale for research in the general population. Appl Psychol Meas 1977; 1:385–401
Zung WWK: A rating instrument for anxiety disorders. Psychosomatics 1971; 12:371–379
Kroenke K, Spitzer RL, Williams JB: The PHQ-9: Validity of a brief depression severity measure. J Gen Intern Med 2001; 16;606–613
Kroenke, K, Spitzer, RL, Williams JB: The Patient Health Questionnaire—2; validity of a two-item depression screener. Med Care 2003; 41(11):1284–1292
Prins A, Ouimette P, Kimerling R, Camerond RP, Huglesofer DS, Shaw-Hegwer J, Thrailkill A, Gusman FD, Sheikh JI: The Primary Care PTSD Screen (PC-PTSD): Development and operating characteristics. Prim Care Psychiatry; 2004; 9: 9–14
United States Preventive Services Taskforce (2002). Available at http://www.ahrq.gov/clinic/uspflp/uspsdepr/.htm#top Accessed May 25, 2005
Author information
Authors and Affiliations
Corresponding author
Additional information
At the time of the study, Dr. Thiel de Bocanegra was Vice-President for Research and Evaluation at Safe Horizon
Rights and permissions
About this article
Cite this article
Bocanegra, H.T.d., Moskalenko, S. & Kramer, E.J. PTSD, Depression, Prescription Drug Use, and Health Care Utilization of Chinese Workers Affected by the WTC Attacks. J Immigrant Health 8, 203–210 (2006). https://doi.org/10.1007/s10903-006-9323-0
Issue Date:
DOI: https://doi.org/10.1007/s10903-006-9323-0