In this study, we expanded upon previous work on the experience of 9/11 and negative mental health outcomes in the US population in several important ways. First, we showed that level of 9/11 exposure significantly predicted latent dimensions of both internalizing and externalizing pathology in a sample who endorsed no psychiatric history prior to 9/11. These effects of the level of 9/11 exposure remained associated with these latent dimensions even after accounting for two robust risk factors for psychopathology, childhood maltreatment and parental history of mental illness. Second, post-hoc analyses revealed significant associations between indirect exposure to 9/11 as experienced through media outlets, friends or family and INT and EXT dimensions of subsequent psychiatric and substance use disorders, whereas direct exposure to 9/11 was only related to the INT dimension. Finally, childhood adversities increased the risk associated with direct and indirect 9/11 exposure for developing INT and EXT disorders following 9/11 exposure. Post-hoc analyses showed that specifically, childhood maltreatment increased the risk for developing INT and EXT disorders among those with 9/11 exposure.
