The impact of the September 11th, 2001 World Trade Center attacks was expansive in nature, and so many people were deeply affected by this disaster. In the years following this attack, many researchers attempted to assess this level of impact. Data point to increased prevalence rates of posttraumatic stress and depressive symptomatology among adults and a variety of difficulties among children following trauma. Additionally, research has shown that geographic proximity to a traumatic event plays a role in identifying those with increased psychological distress. One's subjective experience of a traumatic event, and in particular, one's perception of threat to life, also appears to be important in the identification of those in need. Moreover, understanding the psychological effects of individuals who have experienced a traumatic event is essential to the effective screening and identification of those in need of mental health services. As such, the purpose of this study was to examine the ability of geographic exposure and the perceived life threat to predict psychological outcomes in parents and their young children following the World Trade Center attacks in New York City. Additionally, the moderational roles of race/ethnicity and socio-economic status were also examined. Neither maternal geographic exposure nor perception of life threat significantly predicted mental health outcomes in mothers or their young children. However, socio-economic status significantly moderated the relationship between maternal geographic exposure and children's externalizing behaviors. Finally, the effect of race/ethnicity approached significance for maternal PTSD symptoms; however, no significant moderation was found. / Master of Science

International studies of disasters indicate the risk for developing posttraumatic stress reactions among survivors is high. Modern life implicates increased traveling. During the last decades a large number of Swedish citizens were confronted with disasters taking place outside of their country. The prevalence of trauma reactions in a population that does not  normally  experience natural disasters, but are able to return to a community unaffected by the catastrophe, is not well studied. In addition, the effects of bereavement after traumatic circumstances have not been satisfactorily explored. Longitudinal studies on the effects of natural disasters are underrepresented and there are few studies investigating the course of recovery after traumatic exposure. The aim for this thesis was to examine long-term post-traumatic stress reactions, mental health, and complicated grief after disaster exposure and traumatic bereavement.  Data from returned questionnaires were analysed from bereaved Italian and Swedish relatives 18 months after the Linate airplane disaster 2001, and at 14 months and three years from Swedish travelers returning from Southeast Asia after the 2004 tsunami disaster, and from home staying bereaved relatives within the second year after the tsunami disaster. The main outcome measures were GHQ-12, IES-R and Inventory of Complicated Grief. The findings indicated many survivors were resilient and had ability to recover, but severe exposure to a disaster had considerable impact on psychological distress. Life threat was associated with higher levels of post-traumatic stress reactions, and increased the risk for affected mental health and suicidal ideation. Loss in combination with severe life threat exposure indicated a further increased risk of posttraumatic stress reactions and for complicated grief; this should be considered a substantial risk factor for general mental health. Loss of close relatives, especially loss of children, was associated with higher levels of posttraumatic stress and created a greater risk for complicated grief. Many survivors recovered over time; however, severe exposure and traumatic loss appeared to slow the recovery process. The findings have implications for government and health agencies, regarding the importance of knowledge and awareness of these risks for health, and for organizational structure, training, and accessibility of support and adequate treatment.