Psychiatry 77(4) Winter 2014 374 © 2014 Washington School of Psychiatry Amit Shrira, PhD, is affiliated with the Interdisciplinary Department of Social Sciences, Faculty of Social Sciences, at Bar-Ilan University in Ramat-Gan, Israel. Yuval Palgi, PhD, is with the Department of Gerontology, Faculty of Social Welfare and Health Sciences, at the University of Haifa in Haifa, Israel. Yaira Hamama-Raz, PhD, and Men- achem Ben-Ezra, PhD, are with the School of Social Work at Ariel University in Ariel, Israel. Robin Goodwin, PhD, is with the College of Health and Life Sciences at Brunel University, London. From January 2015 he will be with the Department of Psychology, University of Warwick, UK. Address correspondence to Amit Shrira, Interdisciplinary Department of Social Sciences, Faculty of Social Sciences, Bar-Ilan University, Ramat-Gan 52900, Israel. E-mail: amit.shrira@biu.ac.il Older Adults Following Hurricane Sandy Shrira et al. Previous Exposure to the World Trade Center Terrorist Attack and Posttraumatic Symptoms Among Older Adults Following Hurricane Sandy Amit Shrira, Yuval Palgi, Yaira Hamama-Raz, Robin Goodwin, and Menachem Ben-Ezra Objective: The present study tested the maturation and inoculation hypotheses by examining whether age and previous exposure to the September 11, 2001, World Trade Center (WTC) terrorist attack moderated the relationship between degree of exposure to Hurricane Sandy and related posttraumatic stress disorder (PTSD) symptoms. Method: An online sample of 1,000 participants from affected states completed self-report questionnaires one month after Hurricane Sandy hit the East Coast. Participants reported their degree of exposure to the WTC terrorist attack and to Hurricane Sandy, and their posttraumatic stress disorder (PTSD) symptoms following Hurricane Sandy. Results: The positive relationship between degree of exposure to Hurricane Sandy and level of PTSD symptoms was weaker among older adults. An additional significant three-way interaction suggested that both age and previous exposure to the WTC terrorist attack moderated the relationship between degree of exposure to Hurricane Sandy and level of PTSD symptoms. Previous high degree of exposure to the WTC terrorist attack was related to a weaker effect of current exposure to Hurricane Sandy on PTSD symp- toms among older adults. However, among younger adults, previous high degree of exposure to the WTC terrorist attack was related to a stronger effect of cur- rent exposure on PTSD symptoms. Conclusions: When confronted by a natural disaster, American older adults are generally resilient. Supporting the inoculation hypothesis, resilience of older adults may be partly related to the strength success- fully extracted from previous exposure to adverse events. Disasters, or collectively experienced traumatic events, may have a wide range of ad- verse consequences on mental and physical functioning (Galea, Nandi, & Vlahov, 2005; Neria, Nandi, & Galea, 2008). Older adults may be at greater risk to these adverse con- sequences, due to poorer physical, social, and financial resources (Knight, Gatz, Heller, &