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September 2008, Vol 98, No. Supplement_1 | American Journal of Public Health S113-S119
© 2008 American Public Health Association


MENTAL HEALTH CARE: RESEARCH AND PRACTICE

Macrolevel Stressors, Terrorism, and Mental Health Outcomes: Broadening the Stress Paradigm

Judith A. Richman, PhD, Lea Cloninger, PhD and Kathleen M. Rospenda, PhD

The authors are with the Department of Psychiatry, University of Illinois at Chicago.

Correspondence: Requests for reprints should be sent to Judith A. Richman, PhD, University of Illinois at Chicago, Department of Psychiatry, Room 469, 1601 W Taylor St (M/C 912), Chicago, IL 60612 (e-mail: jrichman{at}uic.edu.).

ABSTRACT

Objectives. We examined the extent to which the stress paradigm linking psychosocial stressors to mental health status has focused disproportionate attention on microlevel social stressors to the detriment of macrolevel stressors. Also, we assessed the effects of the terrorist attacks of September 11, 2001, on subsequent mental health among participants in a Midwestern cohort study.

Methods. Respondents in a 6-wave longitudinal mail survey completed questionnaires before September 11, 2001, and again in 2003 and 2005. Regression analyses focused on measures of negative terrorism-related beliefs and fears, as well as psychological distress and deleterious alcohol use outcomes measured both before and after September 11.

Results. Negative terrorism-related beliefs and fears assessed in 2003 predicted distress and drinking outcomes in 2005 after control for sociodemographic characteristics and pre–September 11 distress and drinking.

Conclusions. The events of September 11 continue to negatively affect the mental health of the American population. Our results support the utility of according greater attention to the effects of such macrolevel social stressors in population studies embracing the stress paradigm.







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