Long-Term Impact of WTC Attacks in Primary Care

描述（由申请人提供）：迄今为止，没有研究检查大规模恐怖事件（如9/11袭击）对特别脆弱的社区的长期影响，这些社区更有可能受到长期影响，如穷人、少数民族、文化适应程度较低的城市新移民。 该应用程序的主要目标是确定低收入城市初级保健人群中灾后精神病理学发展和持续的风险和保护因素;确定种族和文化适应在身心症状表达和寻求灾后精神健康治疗中的作用;探讨灾后社会支持、次级压力源等因素在灾害影响中的作用。 我们有一个独特的机会在一个成熟的队列中进行这样的研究，该队列由720名初级保健患者组成的概率样本组成，其中大部分是西班牙裔患者，他们是纽约市居民，在接受我们的采访时报告了严重接触过9/11袭击。研究团队在9/11袭击后7-16个月。这些目标将通过9/11袭击后4.5年的随访调查来实现。 拟议的研究将有助于规划未来的灾难，提供纵向数据收集从纽约市初级保健患者的系统样本，使用最先进的措施，使我们能够测试理论指导的假设，并探讨创伤性事件的经验，社会人口特征，上下文变量之间的关系，心理健康结果和服务利用。

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.