Although it's been 25 years since the World Trade Center collapsed after terrorists flew commercial airplanes into each of the center's two towers, the trauma experienced by many first responders and recovery workers is still being felt by their children.
A recent study conducted by researchers in the Department of Psychiatry at Columbia University Vagelos College of Physicians and Surgeons found that the children of responders who developed post-traumatic stress disorder (PTSD) soon after the attacks were more likely to develop PTSD, depression, anxiety, or panic symptoms themselves.
"The children did not see the tremendous amount of destruction that their parents saw, but their parents brought it home in a way. They didn't have to talk about it, but in their behavior, they somehow communicated their fear, anxiety, mistrust, and worry," says Yael Cycowicz, associate professor of clinical neurobiology, who led the study. Cycowicz directs the Neuro-Cognition and Emotion Lab, where she researches the impact of trauma on mental health across the lifespan, its spread across generations, and its influence among family members.
She recently spoke to CUIMC News about her findings.
What led you to conduct this research?
We know from studies of Holocaust survivors, Vietnam War veterans, and others who have experienced man-made atrocities that a parent's experience of trauma can impact the psychological well-being of their children, even when the children themselves were not directly exposed to the traumatic event. And we know that such impacts may be long term and persistent in children, extending into their adulthood.
9/11 is a bit different because the event itself occurred at a particular moment, but it affected a group of people-the responders and the recovery workers-for a long period of time.
Earlier studies reported that over 20% of police officers and more than 30% of relief workers reported behavioral issues with their children after the attacks. However, there was no follow-up on the lives of these children, who are now adults, and relatively little is known about the intergenerational transfer of trauma to the children of first responders and recovery workers in general.
We wanted to learn more about the transmission of 9/11-related trauma from parent to child that will aid first responders and their families.
Were you surprised by the findings?
All the children in the study were under the age of 18 on 9/11 and had a parent who had been diagnosed with PTSD soon after the attacks, representing a particularly vulnerable group. Future research is needed to see if these findings generalize to children of responders who developed other health conditions.
First of all, I would say that there was a clear psychological impact on the children, although they were less likely to develop PTSD themselves. Instead, we saw much more depression and anxiety. That makes sense because it's really the mental health of the parent affecting the mental health of the children.
But it wasn't just that. We saw that the length of the parent's exposure and the type of exposure mattered. When parents came to the site very early after the attack, spent a lot of time at the site, or were exposed to human remains, their children were more likely to have mental health issues. What surprised us is that we could detect these associations so many years later.
The specific occupation of the parent also comes into play in our study. We had two groups: the police, and the rescue and cleanup workers. Overall, the children of rescue and cleanup workers are now doing a little bit worse.
That's not surprising because the police are trained to deal with challenges, and they have their own community for support. But the rescue and cleanup workers were largely construction workers. They were not prepared in the same way. They are not trained to deal with such terrible destruction, and they don't have the same established peer-support community for coping with trauma. And unlike many first responders, they were there for months and months.
How do you think the findings could help responders and recovery workers in the future?
What we also saw in the study is what brings resilience, what can protect us. The better the social support-within the family, with friends, and with a larger community-the better the outcome was for the responders and children.
As far as treatment goes, it's probably not enough to treat the psychological symptoms of the affected individual. It's very important to include the family when we want to help those people, because that may benefit the family unit.
For me, the issue of community-what we can do, as New Yorkers, to support our responders-is really important. These responders gave their time, their lives, to make downtown livable again, and actually beautiful. And we have a responsibility to be there for them.
When we as a society provide support and engage with responders to understand their challenges and difficulties, we improve their resilience. We create resilient families.
I think that part of resilience is to know that trauma will happen. That's just the unfortunate nature of our lives, and we need to think as a society about how we prepare for it, not only by providing treatment for affected individuals and families, but also by building strong, supportive communities to create more resilience. I saw that in our data, and I think it's probably our most important finding because it gives direction. It gives hope.
