摘要：Objectives. We hypothesized that chronic stressors associated with an everyday social role (work) would interact with a traumatic macrosocial stressor (the terrorist attacks of September 11, 2001) in predicting mental health status (during the fall of 2001). Methods. We used mail surveys returned as part of wave 3 of a workplace cohort study, both before and after September 11, 2001, to assess decision latitude, sexual harassment, generalized workplace abuse, psychological distress, and alcohol use. We also used regression analyses to assess the main effect of September 11 and interactions between September 11 and stressors, after control for baseline mental health. Results. The main effect of September 11 on elevated alcohol use was significant for women but not for men. For women, work stressors significantly interacted with experiencing the events of September 11 to affect alcohol use and anxiety outcomes. Conclusions. Women experiencing chronic work stressors were most vulnerable to elevated psychological distress and alcohol use after September 11, 2001. Studies of the effects of the events of September 11, 2001, on New Yorkers and residents of surrounding communities, 1 as well as on national samples, 2– 4 have demonstrated various mental health outcomes (e.g., depression, anxiety, posttraumatic stress disorder, increased alcohol consumption). In addition, demographic risk factors for experiencing negative outcomes related to September 11 have been identified (female gender, low education level, single marital status). 5 However, much of this research has been cross-sectional in design, making the determination of causality between the experience of September 11, 2001, and mental health consequences problematic. In addition, the effects of experiencing September 11 have not been studied in conjunction with other ongoing life stressors, especially those that encompass other elements of lack of control over life experiences. We derived this report from a longitudinal workplace cohort study. The wave 3 mail survey was carried out in the fall of 2001, with some respondents returning the survey pre–September 11 and other respondents returning the survey post–September 11. We assessed the main effect of experiencing September 11–related events on men and women and examined the interaction of these events with 3 chronic stressors that could be viewed as manifestations of lack of control—in this case, with respect to an everyday social role, that of work. These aspects of lack of control over work include low decision-making latitude and sexual harassment and generalized workplace abuse. We derived this study from the stress paradigm delineating the impact of psychosocial stressors on mental health status. In particular, we addressed the combined effects on participants of a traumatic macrosocial stressor 6 and everyday stressful experiences in the workplace, which are often chronic in nature 7 and which may be viewed as being low in controllability. 8 Moreover, the events of September 11 have been viewed as constituting an apocalyptic moment, producing feelings of powerlessness and victimization on a massive scale, 9 in contrast to other feelings of powerlessness generated by everyday experiences of interpersonal victimization in the work-place, such as those generated by sexual harassment and generalized workplace abuse. 7, 10 In addition, stress researchers have depicted the negative consequences of cumulative adversity wherein acute events combine with chronic or earlier stressors to have an adverse effect on psychological well-being. 11, 12 We thus hypothesized that there would be negative mental health consequences resulting from the joint effect of experiencing September 11 and ongoing stressors involving other sources of lack of control, such as those experienced in the workplace. In particular, we hypothesized that individuals who experienced September 11 would be at greater risk for deleterious mental health outcomes if they also were subjected to everyday chronic stressors. However, given the greater vulnerability of women to psychological distress following September 11 found in previous studies, 2, 3, 5 our central interest was to explore the extent to which, for women, chronic stressors further contributed to the deleterious effects of experiencing September 11.
