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Psychopathology Among New York City Public School Children 6 Months After September 11
Christina W. Hoven, DrPH;
Cristiane S. Duarte, PhD;
Christopher P. Lucas, MD, MPH;
Ping Wu, PhD;
Donald J. Mandell, PhD, MPH;
Renee D. Goodwin, PhD;
Michael Cohen, PhD;
Victor Balaban, PhD;
Bradley A. Woodruff, MD, MPH;
Fan Bin, MD;
George J. Musa, BA;
Lori Mei, PhD;
Pamela A. Cantor, MD;
J. Lawrence Aber, PhD;
Patricia Cohen, PhD;
Ezra Susser, MD, DrPH
Arch Gen Psychiatry. 2005;62:545-551.
Context Children exposed to a traumatic event may be at higher risk for developing mental disorders. The prevalence of child psychopathology, however, has not been assessed in a population-based sample exposed to different levels of mass trauma or across a range of disorders.
Objective To determine prevalence and correlates of probable mental disorders among New York City, NY, public school students 6 months following the September 11, 2001, World Trade Center attack.
Design Survey.
Setting New York City public schools.
Participants A citywide, random, representative sample of 8236 students in grades 4 through 12, including oversampling in closest proximity to the World Trade Center site (ground zero) and other high-risk areas.
Main Outcome Measure Children were screened for probable mental disorders with the Diagnostic Interview Schedule for Children Predictive Scales.
Results One or more of 6 probable anxiety/depressive disorders were identified in 28.6% of all children. The most prevalent were probable agoraphobia (14.8%), probable separation anxiety (12.3%), and probable posttraumatic stress disorder (10.6%). Higher levels of exposure correspond to higher prevalence for all probable anxiety/depressive disorders. Girls and children in grades 4 and 5 were the most affected. In logistic regression analyses, child’s exposure (adjusted odds ratio, 1.62), exposure of a child’s family member (adjusted odds ratio, 1.80), and the child’s prior trauma (adjusted odds ratio, 2.01) were related to increased likelihood of probable anxiety/depressive disorders. Results were adjusted for different types of exposure, sociodemographic characteristics, and child mental health service use.
Conclusions A high proportion of New York City public school children had a probable mental disorder 6 months after September 11, 2001. The data suggest that there is a relationship between level of exposure to trauma and likelihood of child anxiety/depressive disorders in the community. The results support the need to apply wide-area epidemiological approaches to mental health assessment after any large-scale disaster.
Author Affiliations: Department of Epidemiology, Mailman School of Public Health (Drs Hoven, Duarte, Wu, Mandell, Goodwin, P. Cohen, and Susser) and Department of Psychiatry, College of Physicians and Surgeons (Drs Hoven, Duarte, Lucas, Wu, P. Cohen, and Susser), Columbia University–New York State Psychiatric Institute (Drs Hoven, Duarte, Lucas, Wu, Mandell, P. Cohen, Bin, and Susser and Mr Musa), The Michael Cohen Group, LLC (Dr M. Cohen), New York City Department of Education (Dr Mei), Children’s Mental Health Alliance (Dr Cantor), Department of Psychology, New York University (Dr Aber), New York; National Center for Injury Prevention and Control and National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Ga (Drs Balaban and Woodruff).
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