Post-September 11 Admission Symptoms and Treatment Response Among Veterans With Posttraumatic Stress Disorder

OBJECTIVE: Evidence has been found of significant psychological distress after the terrorist attacks of September 11, 2001, even in communities that were not directly affected. Persons with preexisting posttraumatic stress disorder (PTSD) may be especially vulnerable to such distress. The authors examined clinical data on veterans who had a diagnosis of PTSD to determine whether the attacks exacerbated their symptoms. METHODS: Outcome-monitoring data were analyzed from a national sample of more than 9,000 veterans who were treated in specialized intensive PTSD programs of the Department of Veterans Affairs (VA) from March 11, 1999, to March 11, 2002. Analysis of variance was used to compare symptom levels at admission and clinical improvement during the six months before and six months after September 11 and in comparison with the same periods in 1999 and 2000. RESULTS: Veterans who were admitted after September 11, 2001, had less severe symptoms than those admitted before September 11, a pattern that was significantly different from previous years. Veterans who were followed up after September 11 showed significantly more improvement in PTSD symptoms than those who were followed up before then, which also represented a significant difference from previous years. CONCLUSIONS: VA patients with preexisting PTSD were, unexpectedly, less symptomatic at admission after September 11 than veterans admitted before September 11, and patients who had follow-up assessments after September 11 showed more improvement. It is possible that these veterans benefited from the shared feelings of national unity, pride, and patriotism in the months after September 11 as well as from the normalization of PTSD-like reactions by the news media and a sense of mastery at having past experience in coping with trauma.