Resilience to post-traumatic stress among World Trade Center survivors: A mixed-methods study

Lisa M. Gargano, Sindhushree Hosakote, Qi Zhi, Kristine A. Qureshi, Robyn R. Gershon

Research output: Contribution to journalArticlepeer-review


The purpose of this study was to identify individual characteristics, behaviors, and psychosocial factors associated with symptoms of post-traumatic stress disorder (PTSD) among World Trade Center (WTC) disaster evacuation survivors. The study utilized a mixed-method design. In-depth interviews were conducted using a prepared script. PTSD was assessed using the PTSD checklist-civilian (PCL-C; a score ≥ 50 indicates probable PTSD). Thematic analysis was conducted to identify factors associated with PTSD. A purposive sample of 29 WTC evacuees was recruited using a multimodal recruitment strategy. Eligibility included: history of evacuation from the WTC (Tower 1 and/or Tower 2) on September 11, 2001, and decisional capacity for informed consent. Five participants had PCL-C scores ≥ 50. Thematic analysis identified resiliency factors (protective for PTSD), including leadership, taking action based on “gut” feelings (to evacuate), social support (staying in a group), going on “automatic survival” mode, and previous training on emergency response. Risk factors for PTSD included lack of emergency response training, lack of sense of urgency, poor physical condition, lack of communication skills, lack of direction, peri-event physical injury, peri-event traumatic exposure (horror), and moral injury (guilt and remorse). Several modifiable factors that may confer resilience were identified. In particular, the role of emergency response training in preventing disaster-related mental illness should be explored as a possible strategy for enhancing resilience to disaster events.

Original languageEnglish (US)
Pages (from-to)275-284
Number of pages10
JournalJournal of Emergency Management
Issue number5
StatePublished - Sep 1 2017


  • 9/11, World Trade Center
  • In-depth interviews
  • Mixed methods
  • Post-traumatic stress disorder
  • Resilience
  • September 11, 2001

ASJC Scopus subject areas

  • Emergency Medicine
  • Safety, Risk, Reliability and Quality
  • Safety Research


Dive into the research topics of 'Resilience to post-traumatic stress among World Trade Center survivors: A mixed-methods study'. Together they form a unique fingerprint.

Cite this