Editing Post-traumatic stress disorder (section)

==== Human-made disasters ====
The [[September 11 attacks]] took the lives of nearly 3,000 people, leaving 6,000 injured.<ref name="Lowell_2018">{{cite journal |vauthors=Lowell A, Suarez-Jimenez B, Helpman L, Zhu X, Durosky A, Hilburn A, Schneier F, Gross R, Neria Y |title=9/11-related PTSD among highly exposed populations: a systematic review 15 years after the attack |journal=[[Psychological Medicine]] |volume=48 |issue=4 |pages=537–553 |date=March 2018 |pmid=28805168 |pmc=5805615 |doi=10.1017/S0033291717002033}}</ref> [[Trauma and first responders|First responders]] ([[police]], [[firefighters]], and [[emergency medical technicians]]), sanitation workers, and [[volunteering|volunteers]] were all involved in the recovery efforts. The [[prevalence]] of probable PTSD in these highly exposed populations was estimated across several studies using in-person, telephone, and online [[interview]]s and [[questionnaire]]s.<ref name="Lowell_2018" /><ref name="Perrin_2007">{{cite journal |vauthors=Perrin MA, DiGrande L, Wheeler K, Thorpe L, Farfel M, Brackbill R |title=Differences in PTSD prevalence and associated risk factors among World Trade Center disaster rescue and recovery workers |journal=The American Journal of Psychiatry |volume=164 |issue=9 |pages=1385–94 |date=September 2007 |pmid=17728424 |doi=10.1176/appi.ajp.2007.06101645 |s2cid=22476443}}</ref><ref name="Stellman_2008">{{cite journal |vauthors=Stellman JM, Smith RP, Katz CL, Sharma V, Charney DS, Herbert R, Moline J, Luft BJ, Markowitz S, Udasin I, Harrison D, Baron S, Landrigan PJ, Levin SM, Southwick S |title=Enduring mental health morbidity and social function impairment in world trade center rescue, recovery, and cleanup workers: the psychological dimension of an environmental health disaster |journal=[[Environmental Health Perspectives]] |volume=116 |issue=9 |pages=1248–53 |date=September 2008 |pmid=18795171 |pmc=2535630 |doi=10.1289/ehp.11164|bibcode=2008EnvHP.116.1248S }}</ref> Overall prevalence of PTSD was highest immediately following the attacks and decreased over time. However, disparities were found among the different types of recovery workers.<ref name="Lowell_2018" /><ref name="Perrin_2007" /> The rate of probable PTSD for first responders was lowest directly after the attacks and increased from ranges of 4.8–7.8% to 7.4–16.5% between the 5–6 year follow-up and a later assessment.<ref name="Lowell_2018" />

When comparing traditional responders to non-traditional responders (volunteers), the probable PTSD prevalence 2.5 years after the initial visit was greater in volunteers with estimates of 11.7% and 17.2% respectively.<ref name="Lowell_2018" /> Volunteer participation in tasks atypical to the defined occupational role was a significant risk factor for PTSD.<ref name="Perrin_2007" /> Other risk factors included exposure intensity, earlier start date, duration of time spent on site, and constant, negative reminders of the trauma.<ref name="Lowell_2018" /><ref name="Perrin_2007" />

Additional research has been performed to understand the social consequences of the September 11 attacks. Alcohol consumption was assessed in a cohort of [[World Trade Center (1973–2001)|World Trade Center]] workers using the [[CAGE questionnaire|cut-annoyed-guilty-eye (CAGE) questionnaire]] for [[alcohol use disorder]]. Almost 50% of World Trade Center workers who self-identified as alcohol users reported drinking more during the rescue efforts.<ref name="Stellman_2008" /> Nearly a quarter of these individuals reported drinking more following the recovery.<ref name="Stellman_2008" /> If determined to have probable PTSD status, the risk of developing an alcohol problem was double compared to those without psychological [[morbidity]].<ref name="Stellman_2008" /> Social disability was also studied in this cohort as a social consequence of the September 11 attacks. Defined by the disruption of family, work, and social life, the risk of developing social disability increased 17-fold when categorized as having probable PTSD.<ref name="Stellman_2008" />