Terrorists can strike twice—first, by directly killing people, and second, through dangerous behaviors induced by fear in people’s minds. Previous research identified a substantial increase in U.S. traffic fatalities subsequent to the September 11 terrorist attacks, which were accounted for as due to a substitution of driving for flying, induced by fear of dread risks. Here, we show that this increase in fatalities varied widely by region, a fact that was best explained by regional variations in increased driving. Two factors, in turn, explained these variations in increased driving. The weaker factor was proximity to New York City, where stress reactions to the attacks were previously shown to be greatest. The stronger factor was driving opportunity, which was operationalized both as number of highway miles and as number of car registrations per inhabitant. Thus, terrorists’ second strike exploited both fear of dread risks and, paradoxically, an environmental structure conducive to generating increased driving, which ultimately increased fatalities.
Posttraumatic Stress in Women after the September 11 Terrorist Attacks in New York City