Stephen J.LurieMD, PhD, Senior Editor
To the Editor: Dr Schlenger and colleagues1 found that 2 months after September 11, 2001, overall distress levels in the United States were within normal ranges, including in New York City and Washington, DC. However, the authors did not measure demoralization, which is another expression of the aftereffects of trauma in adults.2 The advantage of measuring demoralization is that it can be reliably ascertained with the use of simple scales that are brief, easy to use, and do not require a health professional to administer them.3 The practical use of this measure is that it aids primary caregivers to identify those population groups in need of psychological support whether or not they eventually will develop psychiatric disorders.
Levav I, Ponizovsky A. Psychiatric Consequences of September 11. JAMA. 2002;288(21):2683. doi:10.1001/jama.288.21.2683-JLT1204-1-2