Long-Term Impact of World Trade Center Attacks in Primary Care

说明(申请人提供)：到目前为止，还没有一项研究审查9/11袭击等大规模恐怖事件对特别脆弱的社区的长期影响，这些社区更有可能产生长期影响--例如穷人、少数民族、文化适应程度较低的城市新移民。 这一应用程序的主要目标是确定在低收入城市初级保健人口中发展和持续发展灾后精神病理学的风险和保护因素；确定种族和文化适应在表达身体和精神症状以及寻求灾后心理健康治疗方面的作用；以及探索灾后因素，如社会支持和次生应激源，随着时间的推移在调解灾害影响方面的作用。 我们有一个独特的机会在一个由720名初级保健患者的概率样本组成的队列中进行这样的研究，其中大部分是西班牙裔患者，他们是纽约市的居民，报告说他们在9/11袭击后7-16个月接受了我们的研究团队的采访。这些目标将通过9·11袭击后4.5年的跟踪调查来实现。 这项拟议的研究将通过提供从纽约市初级保健患者的系统样本中收集的纵向数据来帮助计划未来的灾难，使用最先进的方法使我们能够测试理论指导的假设，并探索创伤事件经历、社会人口学特征、背景变量以及精神健康结果和服务利用之间的关系。

DESCRIPTION (provided by applicant): No study to date has examined the long-term impact of large scale terrorist events, such as the 9/1 1 attacks, in particularly vulnerable communities for whom long-time effects are more likely- such as the poor, minority, less acculturated, urban recent immigrants. The primary goals of this application are to identify risk and protective factors for the development and persistence of post-disaster psychopathology in a low-income, urban, primary care population; to determine the role of ethnicity and acculturation in the expression of physical and mental symptoms and in seeking post-disaster mental health treatment; and to explore the role of post disaster factors such as social support, and secondary stressors, in mediating the disaster effects over time. We have a unique opportunity to carry out such a study in a well established cohort consisting of a probability sample of 720 primary care, mostly Hispanic patients, who are residents of NYC and who have reported significant exposure to the 9/11 attacks, when they have been interviewed by our.research team 7-16 months after the 9/11attacks. These goals will be achieved through a follow up survey 4.5 years after 9/11 attacks. The proposed study will assist in planning for future disasters by providing longitudinal data collected from a systematic sample of NYC primary care patients, using state of the art measures that enable us to test theoretically guided hypotheses and to explore the relations between traumatic event experiences, sociodemographic characteristics, contextual variables, and mental health outcomes and service utilization.