Mental health impact of 9/11 Pentagon attack: validation of a rapid assessment tool.
BACKGROUND
Following the tragic events of 9/11/2001, the Pentagon Post Disaster Health Assessment (PPDHA) survey was created to identify healthcare needs and concerns among Pentagon personnel and to assure that appropriate care and information was provided. The PPDHA was fielded from October 15, 2001, to January 15, 2002. Fundamental in this assessment was the evaluation of the mental health impact as a result of the attack.


METHODS
Although a number of standardized instruments exist for mental health domains, most are lengthy and could not be used as a rapid health assessment. Instead, a short screening instrument consisting of 17 questions was developed that covered important mental health symptom domains, mental health functioning, and possible predictive risk factors. High-risk groups for post-traumatic stress disorder (PTSD), depression, panic attacks, generalized anxiety, and alcohol abuse were assessed, and validation of risk groups was assessed across functional levels.


RESULTS
Overall, 1837 (40%) respondents met the screening criteria for any of the symptom domains of interest 1 to 4 months after the attack: PTSD (7.9%), depression (17.7%), panic attacks (23.1%), generalized anxiety (26.9%), or alcohol abuse (2.5%). Mental health risk groups were highly correlated with self-reported reduced daily functioning and use of counseling services. Additionally, risk factors known to be associated with mental health problems after traumatic events were strongly predictive of the high-risk categories identified.


CONCLUSIONS
Mental health concerns were common among Pentagon employees in the 4 months after the 9/11 attack. Data from this study suggested that the short mental health screening instrument had validity and can serve as a prototype for rapid public health assessment of the mental health impact of future traumatic events.
Jordan
Nikki N
NN
U.S. Army Center for Health Promotion and Preventive Medicine, Directorate of Epidemiology and Preventive Medicine, Aberdeen Proving Grounds, Edgewood, Maryland 21010, USA. Nikki.Jordan@apg.amedd.army.mil
Hoge
Charles W
CW
Tobler
Steven K
SK
Wells
James
J
Dydek
George J
GJ
Egerton
Walter E
WE
D000328:Adult; D000401:Aircraft; D000437:Alcoholism / Q000523:psychology; D001007:Anxiety / Q000523:psychology; D016009:Chi-Square Distribution; D003863:Depression / Q000523:psychology; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D011569:Psychiatric Status Rating Scales; D013313:Stress Disorders, Post-Traumatic / Q000523:psychology; D011795:Surveys and Questionnaires; D023481:Terrorism / Q000523:psychology*; D037041:United States Government Agencies; D014768:Virginia