Elevated C-reactive protein and posttraumatic stress pathology among survivors of the 9/11 World Trade Center attacks

Details

• Personal Author:
  Caplan-Shaw CE ; Ferri L ; Galatzer-Levy IR ; Kazeros A ; Levy-Carrick N ; Liu M ; Marmor M ; Pradhan DR ; Reibman J ; Rosen RL ; Shao Y ; Xu N
• Description:
  Background: Systemic inflammation has emerged as a promising marker and potential mechanism underlying post-traumatic stress disorder (PTSD). The relationship between posttraumatic stress pathology and systemic inflammation has not, however, been consistently replicated and is potentially confounded by comorbid illness or injury, common complications of trauma exposure. Methods: We analyzed a large naturalistic cohort sharing a discrete physical and mental health trauma from the destruction of the World Trade Center (WTC) towers on September 11, 2001 (n = 641). We evaluated the relationship between multiple physical and mental health related indices collected through routine evaluations at the WTC Environmental Health Center (WTC EHC), a treatment program for community members exposed to the disaster. C-Reactive Protein (CRP), a marker of systemic inflammation, was examined in relation to scores for PTSD, PTSD symptom clusters (re-experiencing, avoidance, negative cognitions/mood, arousal), depression and anxiety, while controlling for WTC exposures, lower respiratory symptoms, age, sex, BMI and smoking as potential risks or confounders. Results: CRP was positively associated with PTSD severity (p < 0.001), trending toward association with depression (p = 0.06), but not with anxiety (p = 0.27). CRP was positively associated with reexperiencing (p < 0.001) and avoidance (p < 0.05) symptom clusters, and trended toward associations with negative cognitions/mood (p = 0.06) and arousal (p = 0.08). Conclusions: In this large study of the relationship between CRP and posttraumatic stress pathology, we demonstrated an association between systemic inflammation and stress pathology (PTSD; trending with depression), which remained after adjusting for potentially confounding variables. These results contribute to research findings suggesting a salient relationship between inflammation and posttraumatic stress pathology. [Description provided by NIOSH]
• Subjects:
  Biomarkers Health Care Facilities Workforce And Services Immune System Mental Health Nervous System Occupational Health Pathology Safety September 11 Terrorist Attacks Stress, Psychological Stress Disorders, Post-Traumatic

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• Keywords:
  Author Keywords: C-reactive Protein Clinical Symptoms Depression Immune Reaction Immune System Medical Monitoring Medical Screening Mental Health Mental Illness Mental Processes Mental Stress Physical Agents Physiological Factors Post-traumatic Stress Disorder Proteins PTSD Stress-related Illnesses Surveillance Systemic Inflammation Trauma Traumatic Incident Stress World Trade Center WTC

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• ISSN:
  0022-3956
• Document Type:
  Text
• Funding:
  Contract ; Cooperative Agreement
• Genre:
  Journal Article
• Place as Subject:
  New York ; OSHA Region 2
• CIO:
  National Institute for Occupational Safety and Health (NIOSH)
• Topic:
  Workplace Safety & Health
• Location:
  North America
• Pages in Document:
  14-21
• Volume:
  89
• NIOSHTIC Number:
  nn:20049293
• Citation:
  J Psychiatr Res 2017 Jun; 89:14-21
• Contact Point Address:
  Rebecca L. Rosen, New York University Medical Center, 550 First Avenue, Bellevue Hospital Room 7N24, New York, NY 10016, United States
• Email:
  RebeccaLRosen@nyumc.org
• Federal Fiscal Year:
  2017
• Performing Organization:
  New York University School of Medicine
• Peer Reviewed:
  True
• Start Date:
  20130701
• Source Full Name:
  Journal of Psychiatric Research
• End Date:
  20170630
• Collection(s):
  National Institute for Occupational Safety and Health
• Main Document Checksum:
  urn:sha-512:4b7d488ef8d6f47f004d2c7bb1e4161484947215a097d322c172aa2efe79100e4d02f5c1169eaef1327d07548583b94efc5ba249037216f3987c463830072660
• Download URL:
  https://stacks.cdc.gov/view/cdc/203770/cdc_203770_DS1.pdf
• File Type:
  [PDF - 210.46 KB ]