Latent typologies of posttraumatic stress disorder in World Trade Center responders

Details

• Personal Author:
  Bromet EJ ; Crane M ; Feder A ; Harrison DJ ; Herbert R ; Horn SR ; Katz CL ; Kotov R ; Landrigan, Philip J. ; Luft BJ ; Moline JM ; Pietrzak RH ; Reissman, Dori B. ; Schechter C ; Southwick SM ; Stellman JM ; Udasin IG ; Zvolensky MJ
• Description:
  Posttraumatic stress disorder (PTSD) is a debilitating and often chronic psychiatric disorder. Following the 9/11/2001 World Trade Center (WTC) attacks, thousands of individuals were involved in rescue, recovery and clean-up efforts. While a growing body of literature has documented the prevalence and correlates of PTSD in WTC responders, no study has evaluated predominant typologies of PTSD in this population. Participants were 4352 WTC responders with probable WTC-related DSM-IV PTSD. Latent class analyses were conducted to identify predominant typologies of PTSD symptoms and associated correlates. A 3-class solution provided the optimal representation of latent PTSD symptom typologies. The first class, labeled "High-Symptom (n = 1,973, 45.3%)," was characterized by high probabilities of all PTSD symptoms. The second class, "Dysphoric (n = 1,371, 31.5%)," exhibited relatively high probabilities of emotional numbing and dysphoric arousal (e.g., sleep disturbance). The third class, "Threat (n = 1,008, 23.2%)," was characterized by high probabilities of re-experiencing, avoidance and anxious arousal (e.g., hypervigilance). Compared to the Threat class, the Dysphoric class reported a greater number of life stressors after 9/11/2001 (OR = 1.06). The High-Symptom class was more likely than the Threat class to have a positive psychiatric history before 9/11/2001 (OR = 1.7) and reported a greater number of life stressors after 9/11/2001 (OR = 1.1). The High-Symptom class was more likely than the Dysphoric class, which was more likely than the Threat class, to screen positive for depression (83% > 74% > 53%, respectively), and to report greater functional impairment (High-Symptom > Dysphoric [Cohen d = 0.19], Dysphoric > Threat [Cohen d = 0.24]). These results may help inform assessment, risk stratification, and treatment approaches for PTSD in WTC and disaster responders. [Description provided by NIOSH]
• Subjects:
  Emergency Responders Occupational Health Safety September 11 Terrorist Attacks
• Keywords:
  Author Keywords: Posttraumatic Stress Disorder Clinical Symptoms Disaster Recovery Emergency Responders Latent Class Analysis LCA Post-traumatic Stress Disorder Psychological Stress PTSD Rescue Workers Typologies World Trade Center WTC

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• ISSN:
  0022-3956
• Document Type:
  Text
• Funding:
  Contract
• Genre:
  Journal Article
• Place as Subject:
  Connecticut ; District of Columbia ; New Jersey ; New York ; OSHA Region 1 ; OSHA Region 2 ; OSHA Region 3 ; OSHA Region 6 ; Texas
• CIO:
  National Institute for Occupational Safety and Health (NIOSH)
• Division:
  WTCHP - World Trade Center Health Program
• Topic:
  Workplace Safety & Health
• Location:
  North America
• Pages in Document:
  151-159
• Volume:
  83
• NIOSHTIC Number:
  nn:20048663
• Citation:
  J Psychiatr Res 2016 Dec; 83:151-159
• Contact Point Address:
  Sarah R. Horn, Department of Psychiatry, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, Box 1230, New York, NY 10029, USA
• Email:
  shorn@uoregon.edu
• Federal Fiscal Year:
  2017
• Performing Organization:
  Icahn School of Medicine at Mount Sinai, New York
• Peer Reviewed:
  True
• Source Full Name:
  Journal of Psychiatric Research
• Collection(s):
  National Institute for Occupational Safety and Health
• Main Document Checksum:
  urn:sha-512:19391c882f78366cf743c3788626510a3df075dcaed2d220b0d12df78dd5160506a8f5f2149db559e85ec030e8c6a8665972ddbe159b74080a124267ae3b5e5a
• Download URL:
  https://stacks.cdc.gov/view/cdc/203370/cdc_203370_DS1.pdf
• File Type:
  [PDF - 850.88 KB ]