Researchers at the Stanford University Center on Stress and Health are asking people from throughout the world to participate in a confidential Internet study to assess the psychological impact of the terrorist attacks that took place on Sept. 11.

"People have been deeply affected by these events, even if they were far away," said David Spiegel, MD, professor of psychiatry and behavioral sciences and lead investigator for the study. "We have all lost something and we need to come to terms with that."

Understanding what helps and what hinders people in coping with the stress of such traumatic events is one goal of the study, said Spiegel. Another goal is to better understand people's resilience and their ability to turn such events into opportunities for growth.

Participants can access the survey via the Internet at http://coping.stanford.edu. The first part of the survey is a series of multiple-choice questions that takes approximately 15-20 minutes to complete. The questions are designed to evaluate individuals' reactions to the terrorist attacks -- from emotional distress to resilience -- in addition to assessing the degree of trauma exposure they experienced. The questions are also meant to help researchers assess an individual's personality features, coping styles, social support and general outlook on life. The study is designed to determine which factors are associated with various aspects of psychological adjustment over the short term as well as the long term.

The second part of the survey, which will be available at the end of October, is optional and involves additional questions on different aspects of distress and coping, physical health, psychological and social well being, and the participant's own experience of the terrorist attacks. Both portions of the survey are located on a secure Internet site. Participants must be age 18 or older. In addition, study participants will be contacted in six months and invited to participate in an additional online assessment to determine which coping strategies and other factors are most beneficial or least beneficial in the long term.

"By conducting our study on the Internet we hope to reach a broad range or people from across the country and even around the world. The more diverse the sample we are able to gather, both in background and in experience of the trauma, the more informative our findings will be," said Lisa Butler, PhD, senior research scholar and co-investigator on the study.

Researchers believe the attacks that took place on Sept. 11 represent a unique opportunity to better understand the range of possible consequences of enduring dramatic, traumatic stress. "Although it is widely documented that natural and man-made disasters and other traumas are often associated with considerable post-event distress, little is known about normal responses to extremely abnormal situations, and even less is understood about adaptive coping in the face of traumatic stress," Spiegel said. "There is also little consensus in the mental health community about how best to help individuals in the aftermath of acute broad-scale trauma, although anecdotal reports from around the country suggest that many individuals are exhibiting remarkable resilience in the face of this disaster."

Over the last two decades, Spiegel and his colleagues have become widely known for their research on responses to traumatic and medical stress and the means of providing emotional support. They have conducted research on acute and chronic stress responses to such incidents as the Loma Prieta earthquake, the Oakland-Berkeley fires, and the shootings at 101 California St. in San Francisco, and among those who have witnessed executions and those living with life-threatening medical conditions.

The online survey has been endorsed by the National Mental Health Association. A link to the survey is also available through the organization's website.