PTSD and Comorbid Depression: Social Support and Self-Efficacy in World Trade Center Tower Survivors 14–15 Years After 9/11

Details

• Personal Author:
  Adams SW ; Bowler RM ; Brackbill RM ; Cone, James E. ; Li J ; Russell K
• Description:
  Objective: Following the World Trade Center (WTC) terrorist attack in New York City, prevalence rates of posttraumatic stress disorder (PTSD) and depression remain elevated. Although social support and self-efficacy have been associated with PTSD, little is known about their differential effect on PTSD and depressive comorbidity. Method: WTC tower survivors (n = 1,304) were assessed at Wave 1 (2003-2004), Wave 2 (2006-2007), Wave 3 (2011-2012), and Wave 4 (2015-2016). Results: At Wave 4, 13.0% of participants had probable PTSD, a decrease from 16.5% at Wave 1. In addition, 4.1% (54) were identified as having PTSD alone, 6.8% (89) had depression alone, and 8.9% (116) had comorbid PTSD and depression. Of those with PTSD, 68.2% also had comorbid depression. WTC tower survivors with PTSD and comorbid depression reported greater PTSD symptom severity and were more likely to have had greater exposure to the events of 9/11 (adjusted odds ratio [aOR] = 1.14) and lower self-efficacy (aOR = 0.85) than those with depression alone. Less perceived social support predicted only depression and not PTSD, whereas less perceived self-efficacy equally predicted having PTSD or depression (aOR = 0.76). Conclusions: Findings indicate that self-efficacy may be more important to the severity and chronicity of PTSD symptoms than social support. Multivariate comparisons suggest that PTSD with comorbid depression is a presentation of trauma-dependent psychopathologies, as opposed to depression alone following trauma, which was independent of trauma exposure and may be secondary to the traumatic event and posttraumatic response. Implications for assessment and treatment are discussed. [Description provided by NIOSH]
• Subjects:
  Mental Health Occupational Health Safety September 11 Terrorist Attacks Stress Disorders, Post-Traumatic
• Keywords:
  Author Keywords: Posttraumatic Stress Disorder Comorbidity Post-traumatic Stress Disorder Psychological Effects PTSD Self-efficacy Social Support Traumatic Incident Stress World Trade Center WTC
• ISSN:
  1942-9681
• Document Type:
  Text
• Funding:
  Cooperative Agreement ; Grant
• Genre:
  Journal Article
• Place as Subject:
  California ; New York ; OSHA Region 2 ; OSHA Region 9
• CIO:
  National Institute for Occupational Safety and Health (NIOSH)
• Topic:
  Workplace Safety & Health
• Location:
  North America
• Pages in Document:
  156-164
• Volume:
  11
• Issue:
  2
• NIOSHTIC Number:
  nn:20054533
• Citation:
  Psychol Trauma 2019 Feb; 11(2):156-164
• Contact Point Address:
  Shane W. Adams, John Jay College of Criminal Justice and Graduate Center of the City University of New York, 524 West 59th Street, Room 10.67.01, New York, NY 10019
• Email:
  shadams@jjay.cuny.edu
• Federal Fiscal Year:
  2019
• Performing Organization:
  New York City Health/Mental Hygiene
• Peer Reviewed:
  True
• Start Date:
  20090430
• Source Full Name:
  Psychological Trauma: Theory, Research, Practice, and Policy
• End Date:
  20260630
• Collection(s):
  National Institute for Occupational Safety and Health
• Main Document Checksum:
  urn:sha-512:34d0f542b4f470670fb5f03a891b7391ade45d470bd29e94ea124a8035d0afcc8ebcdeda6f4522c90f58d22193d9b707a24bfa945fd20666bf4e726ce5726ad6
• Download URL:
  https://stacks.cdc.gov/view/cdc/217064/cdc_217064_DS1.pdf
• File Type:
  [PDF - 227.24 KB ]