Effects of the 9/11 Terrorist Attacks on Family Narratives and Family Systems

Background: Disaster mental health outcomes of individuals may be affected by the families they inhabit, with effects rippling through the entire family system. Existing research on the experience of children in disasters has typically been limited to examining single individuals or, at most, family dyads. Research is needed to explore interactions within families as a whole, including interactions among multiple family members, as well as with community entities in a broad systems approach with dynamic analysis of family systems over time. The purpose of this study was to combine quantitative and qualitative data using structured diagnostic interviews and accompanying open-ended narratives of family members (spouses and children) of survivors of the 9/11 attacks. Methods: This study examined 60 members in 25 families of employees affected by the 9/11 attacks on New York City’s World Trade Center, using a mixed methods approach, collecting quantitative data using full assessments of psychiatric disorders and qualitative data from detailed personal disaster narratives. The employees were a highly 9/11 trauma-exposed group, with about one-fourth developing posttraumatic stress disorder (PTSD). The employees’ exposures and PTSD did not regularly appear to propagate straightforwardly to psychopathology in their spouses or children. Based on the impact of disaster experience, 4 illustrative families were selected for narrative and family systems analyses. Results: Qualitative analysis of their narratives suggested distinct family system patterns or archetypes that may reflect different ways that families cope with disaster. Conclusion: Findings suggest that family systems and family dynamics may influence not only disaster trauma-exposed members but also other family members in supporting one another and coping with the disaster, with interactions with outside community influences adding further complexity. This information may help guide disaster response efforts to provide psychosocial support targeted to specific family patterns.