Sept. 11: US changed psychologically

(Part of UPI's Special Package on Sept. 11)

WASHINGTON (UPI) -- Americans feel a lingering sense of fear triggered by the Sept. 11 terror attacks, say academics and mental health authorities interviewed by United Press International.

The attacks on the World Trade Center and the Pentagon changed the United States psychologically and politically, a distinguished professor of American Culture at the State University of New York at Buffalo said.

"It's a huge psychic wound to us," Bruce Jackson told United Press International. A "palpable fear" remains among Americans that is "small and fleeting at times, large and overwhelming at other times," he said.

Jackson's daughter, an executive in New York, saw the north tower of the World Trade Center collapse.

"Part of the brilliance of this act was the second hit," the professor said, "because everybody was watching the flames of the first one. So I don't know how many people actually saw those buildings go down. ... You don't forget something like that."

His daughter told him that now at big meetings of her firm, when one person looks out the window for more than a second or two, everyone pauses and looks.

He said before Sept. 11 there had been "nuts" such as Oklahoma City bomber Timothy McVeigh, but "this time the kind of things that happen in scary movies really happened."

"There's a real feeling of vulnerability in public spaces. During World War II, Hawaii was an abstraction," he said. "Americans did not experience their country as being attacked until Sept. 11."

It was suggested that worse could come.

"In a way, this is a taste of a potential future that's really frightening," Jackson replied.

"America is a different place than it was a year ago," the professor said. "The main areas where I see change are nervousness about being in public spaces and a fear of not knowing what's going to happen next."

Jackson said business on the ferry boat that goes from lower Manhattan to the Jersey shore has "expanded hugely" because people don't want to use the Lincoln and Holland tunnels.

Parents are doing things differently that affect children, he said.

While Jackson's daughter was at work in New York on Sept. 11, his granddaughters, 8 and 5, saw the buildings collapse on television. They had a lot of questions for their mother: "Were there children in that building too? What happened to the children whose parents were in that building? What is the building you work in like? Is a plane going to hit your building?"

Jackson said the girls don't talk about it as much now. "But those images appear on television again and again, and they're aware of it. My daughter is much less likely to take her children for excursions into New York than she was."

The attacks have affected U.S. social psychology as well.

"I cannot picture (President) Bush so easily rattling the saber of an Iraq war were it not for the World Trade Center," Jackson said. "Saddam in theory would be just as much a threat. ... There's no uproar over this. We should be terrified about going into a major land war on another continent. That is very serious business.

"There's also the change in security. We have many more people looking into a lot more aspects of our lives than we did a year ago, and we accept it," he said.

Formerly, Americans "were fiends for privacy."

"And the stuff (Attorney General John) Ashcroft has done -- locking people up with no trial, no attorney, no charges. ... It wouldn't have been just civil liberties groups talking about this a year ago," Jackson said. "People would have gone crazy."

Child psychologist Robin F. Goodman of the Child Study Center, New York University School of Medicine, has been working with the bereaved families of uniformed personnel killed in the World Trade Center attacks.

Goodman said "half to three-quarters" of all the children in the New York City area had problems immediately after the attacks but now the effects are "much lower."

She cited surveys showing that the 66 percent of children who were worried about the safety of adults in their lives is now down to 39 percent. The 41 percent who were anxious about leaving home are now down to 21 percent. Thirty-four percent of children had trouble sleeping right after the attacks, but now only 16 percent experience such disturbance, she said.

Goodman estimated that, six months after the attacks, between 10 percent and 15 percent of New York City schoolchildren had "some kind of an anxiety disorder," or agoraphobia (fear of going outside the home), or depression, or symptoms of post-traumatic stress disorder.

Goodman said "we don't have any specific results" on the 500 children of the uniformed personnel killed. Anecdotally, "a tremendous number of the kids we've seen have gotten better. They're dealing with how to remember the person who died as well as how to deal with how the rest of the world is remembering this. And that's a tough, tough, thing for these families, because their grief is played out publicly everywhere they go."

Some of those children are angry and having trouble in school. She predicted that after this week "it will get harder for them, when everybody thinks it was supposed to get better. ... We will not be surprised at all if in the next year we see some of these kids either starting to have problems for the first time or are finally getting recognized as needing extra help to get through it all."

Academic studies have been undertaken to assess the long-term psychological consequences of the attacks. One, published in the March 28 issue of the New England Journal of Medicine, investigated the prevalence of acute post-traumatic stress disorder and depression among Manhattan residents five to eight weeks after Sept. 11. Researchers interviewed a random sample of 1,008 adults living south of 110th Street and found that 7.5 percent reported symptoms consistent with a diagnosis of PTSD, and 9.7 percent reported symptoms consistent with depression within the previous 30 days.

Among those who lived south of Canal Street -- that is, near the World Trade Center -- the prevalence of PTSD was 20 percent.

"In the aftermath of terrorist attacks, there may be substantial psychological morbidity in the population," the study stated.

A study published in the June 1 issue of the American Journal of Epidemiology showed that substance abuse increased in New York City in the aftermath of Sept. 11. In a random-digit telephone survey of 988 persons five to eight weeks after the attacks, 28.8 percent of respondents reported an increased use of either cigarettes, alcohol or marijuana: 9.7 percent reported an increase in smoking, 24.6 percent reported an increase in alcohol consumption, and 3.2 percent reported an increase in marijuana use.

Symptoms of PTSD and depression were higher for those who reported increased substance use than for those who did not.

A Maryland psychiatrist said he has seen "a substantial increase" in anxiety disorders among children in his practice.

"Every child got affected, period, normal or otherwise," said Gustavo Goldstein, psychiatrist of the Child and Adolescent Forensic Evaluation Service of Montgomery County, Md.

He said a phase of acute distress was widespread after the attacks.

"Now we are seeing the fallout, the persistence of the more chronic states that were triggered but not caused by 9-11," Goldstein said. "Some children probably were genetically or environmentally predisposed to anxiety, and we are still dealing with them."

Patricia Webbink, a Maryland psychologist, said children are more fearful.

"Americans, children and adults, have been sheltered. And all of a sudden this thing happened. And the children not only saw the effects on the world, and watched the twin towers go down in the media, but they saw the effects on their families. They saw people to whom they looked up for guidance frightened, perhaps for the first time. The whole atmosphere of fear is something that has affected children greatly. Some have nightmares, and some are afraid to fly on planes who never had that fear before."

Children pick up fear whether we know it or not, she said.

"It's affected the whole country," Webbink said. "It's affected their parents, their schoolmates, and their teachers."