Posttraumatic Stress Disorder in Daily Life Among World Trade Center Responders: Temporal Symptom Cascades

Details

• Personal Author:
  Bennett CB ; Callahan JL ; Contractor AA ; Kotov R ; Luft BJ ; Ruggero CJ ; Schuler K ; Waszczuk MA
• Description:
  Background: Posttraumatic stress disorder (PTSD) symptoms are common in the immediate aftermath of a trauma, but it is their persistence over time that leads to a diagnosis. This pattern highlights the critical role of symptom maintenance to understanding and treating the disorder. Relatively few studies have explored whether PTSD symptoms may be interacting or triggering one another to worsen and maintain the disorder, a dynamic we refer to as "symptom cascades." Additionally, little work has tested in real-time how other maintenance factors, such as stress, contribute to such events in daily life. Methods: The present study in a group (N = 202) of World Trade Center (WTC) responders oversampled for PTSD tested day-to-day temporal associations among PTSD symptom dimensions (i.e., intrusions, avoidance, numbing, and hyperarousal) and stress across one week. Results: Longitudinal models found hyperarousal on a given day predicted increased PTSD symptoms the next day, with the effect sizes almost double compared to other symptom dimensions or daily stress. Intrusions, in contrast, showed little prospective predictive effects, but instead were most susceptible to the effects from other symptoms the day before. Avoidance and numbing showed weaker bidirectional effects. Limitations: Findings are from a unique population and based on naturalistic observation. Conclusions: Results are consistent with the idea of symptom cascades, they underscore hyperarousal's strong role in forecasting short-term increases in PTSD (even more than stress per se) and they raise the prospect of highly specific ecological momentary interventions to potentially disrupt PTSD maintenance in daily life. [Description provided by NIOSH]
• Subjects:
  Occupational Health Safety Stress Disorders, Post-Traumatic
• Keywords:
  Author Keywords: Ecological Momentary Assessment Models Post-traumatic Stress Disorder Psychological Responses Psychological Testing PTSD Trauma Traumatic Incident Stress
• ISSN:
  0022-3956
• Document Type:
  Text
• Funding:
  Cooperative Agreement
• Genre:
  Journal Article
• Place as Subject:
  Illinois ; New York ; OSHA Region 2 ; OSHA Region 5 ; OSHA Region 6 ; Texas
• CIO:
  National Institute for Occupational Safety and Health (NIOSH)
• Topic:
  Workplace Safety & Health
• Location:
  North America
• Pages in Document:
  240-245
• Volume:
  138
• NIOSHTIC Number:
  nn:20063050
• Citation:
  J Psychiatr Res 2021 Jun; 138:240-245
• Contact Point Address:
  Camilo J. Ruggero, Department of Psychology, University of North Texas, 1155 Union Circle #311280, Denton, TX, 76203, USA
• Email:
  Camilo.Ruggero@unt.edu
• Federal Fiscal Year:
  2021
• Performing Organization:
  State University New York Stony Brook
• Peer Reviewed:
  True
• Start Date:
  20140701
• Source Full Name:
  Journal of Psychiatric Research
• End Date:
  20170630
• Collection(s):
  National Institute for Occupational Safety and Health
• Main Document Checksum:
  urn:sha-512:6883277225bf0a731105c7ef887217d07d0750dfb7353e6899849098659c2f47f8a4bebf2457ed6968642362d98741f76b987883d9c28f96464b96eab4f2f6e4
• Download URL:
  https://stacks.cdc.gov/view/cdc/226179/cdc_226179_DS1.pdf
• File Type:
  [PDF - 1.90 MB ]