DSM-IV post-traumatic stress disorder among World Trade Center responders 11-13 years after the disaster of 11 September 2001 (9/11)

Details

• Personal Author:
  Bromet EJ ; Clouston SAP ; Gonzalez A ; Hobbs MJ ; Kotov R ; Luft BJ
• Description:
  Background: Post-traumatic symptomatology is one of the signature effects of the pernicious exposures endured by responders to the World Trade Center (WTC) disaster of 11 September 2001 (9/11), but the long-term extent of diagnosed Diagnostic and Statistical Manual of Mental Disorders, 4th edition (DSM-IV) post-traumatic stress disorder (PTSD) and its impact on quality of life are unknown. This study examines the extent of DSM-IV PTSD 11-13 years after the disaster in WTC responders, its symptom profiles and trajectories, and associations of active, remitted and partial PTSD with exposures, physical health and psychosocial well-being. Method: Master's-level psychologists administered sections of the Structured Clinical Interview for DSM-IV and the Range of Impaired Functioning Tool to 3231 responders monitored at the Stony Brook University World Trade Center Health Program. The PTSD Checklist (PCL) and current medical symptoms were obtained at each visit. Results: In all, 9.7% had current, 7.9% remitted, and 5.9% partial WTC-PTSD. Among those with active PTSD, avoidance and hyperarousal symptoms were most commonly, and flashbacks least commonly, reported. Trajectories of symptom severity across monitoring visits showed a modestly increasing slope for active and decelerating slope for remitted PTSD. WTC exposures, especially death and human remains, were strongly associated with PTSD. After adjusting for exposure and critical risk factors, including hazardous drinking and co-morbid depression, PTSD was strongly associated with health and well-being, especially dissatisfaction with life. Conclusions: This is the first study to demonstrate the extent and correlates of long-term DSM-IV PTSD among responders. Although most proved resilient, there remains a sizable subgroup in need of continued treatment in the second decade after 9/11. [Description provided by NIOSH]
• Subjects:
  Emergency Responders Health Care Facilities Workforce And Services Law Enforcement Mental Health Occupational Health Risk Assessment Risk Factors Safety September 11 Terrorist Attacks Stress, Psychological
• Keywords:
  Author Keywords: 9/11 Disaster Responders Emergency-responders Exposure Medical-monitoring Mental-stress Police-officers Post-traumatic Stress Disorder Psychological-stress Psychosocial Well-being Rescue-workers Risk-factors Statistical-analysis Surveillance-programs World Trade Center

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• ISSN:
  0033-2917
• Document Type:
  Text
• Funding:
  Contract
• Genre:
  Journal Article
• Place as Subject:
  New York ; OSHA Region 2
• CIO:
  National Institute for Occupational Safety and Health (NIOSH)
• Division:
  WTCHP - World Trade Center Health Program
• Topic:
  Workplace Safety & Health
• Location:
  North America
• Volume:
  46
• Issue:
  4
• NIOSHTIC Number:
  nn:20047049
• Citation:
  Psychol Med 2016 Mar; 46(4):771-783
• Contact Point Address:
  E. J. Bromet, Ph.D., Department of Psychiatry, Putnam Hall-South Campus, Stony Brook University, Stony Brook, NY 11794-8790, USA
• Email:
  evelyn.bromet@stonybrookmedicine.edu
• Federal Fiscal Year:
  2016
• Performing Organization:
  State University of New York at Stony Brook
• Peer Reviewed:
  True
• Source Full Name:
  Psychological Medicine
• Collection(s):
  National Institute for Occupational Safety and Health
• Main Document Checksum:
  urn:sha-512:c85dfc725b84da484965ca31d100d0067e3ed53e59dbd63d4667f00613aea159295cb01ff0d0f13819151461806019455ce2a0e012dac88d7f43c0f14eac53b6
• Download URL:
  https://stacks.cdc.gov/view/cdc/202279/cdc_202279_DS1.pdf
• File Type:
  [PDF - 283.26 KB ]