Trajectories of PTSD risk and resilience in World Trade Center responders: an 8-year prospective cohort study

2013 ◽  
Vol 44 (1) ◽  
pp. 205-219 ◽  
Author(s):  
R. H. Pietrzak ◽  
A. Feder ◽  
R. Singh ◽  
C. B. Schechter ◽  
E. J. Bromet ◽  
...  
Keyword(s):  
Protective Factors ◽  
World Trade ◽  
World Trade Center ◽  
Risk And Protective Factors ◽  
Psychiatric History ◽  
Risk And Resilience ◽  
Ptsd Symptoms ◽  
Post Traumatic Stress ◽  
Delayed Onset ◽  
Trade Center

BackgroundLongitudinal symptoms of post-traumatic stress disorder (PTSD) are often characterized by heterogeneous trajectories, which may have unique pre-, peri- and post-trauma risk and protective factors. To date, however, no study has evaluated the nature and determinants of predominant trajectories of PTSD symptoms in World Trade Center (WTC) responders.MethodA total of 10835 WTC responders, including 4035 professional police responders and 6800 non-traditional responders (e.g. construction workers) who participated in the WTC Health Program (WTC-HP), were evaluated an average of 3, 6 and 8 years after the WTC attacks.ResultsAmong police responders, longitudinal PTSD symptoms were best characterized by four classes, with the majority (77.8%) in a resistant/resilient trajectory and the remainder exhibiting chronic (5.3%), recovering (8.4%) or delayed-onset (8.5%) symptom trajectories. Among non-traditional responders, a six-class solution was optimal, with fewer responders in a resistant/resilient trajectory (58.0%) and the remainder exhibiting recovering (12.3%), severe chronic (9.5%), subsyndromal increasing (7.3%), delayed-onset (6.7%) and moderate chronic (6.2%) trajectories. Prior psychiatric history, Hispanic ethnicity, severity of WTC exposure and WTC-related medical conditions were most strongly associated with symptomatic trajectories of PTSD symptoms in both groups of responders, whereas greater education and family and work support while working at the WTC site were protective against several of these trajectories.ConclusionsTrajectories of PTSD symptoms in WTC responders are heterogeneous and associated uniquely with pre-, peri- and post-trauma risk and protective factors. Police responders were more likely than non-traditional responders to exhibit a resistant/resilient trajectory. These results underscore the importance of prevention, screening and treatment efforts that target high-risk disaster responders, particularly those with prior psychiatric history, high levels of trauma exposure and work-related medical morbidities.

scholarly journals PTSD and Depressive Symptoms as Potential Mediators of the Association between World Trade Center Exposure and Subjective Cognitive Concerns in Rescue/Recovery Workers

2020 ◽  
Vol 17 (16) ◽  
pp. 5683 ◽  
Author(s):  
Ankura Singh ◽  
Rachel Zeig-Owens ◽  
Laura Rabin ◽  
Theresa Schwartz ◽  
Mayris P. Webber ◽  
...  
Keyword(s):  
New York ◽  
Depressive Symptoms ◽  
Cognitive Decline ◽  
World Trade ◽  
World Trade Center ◽  
Fire Department ◽  
Ptsd Symptoms ◽  
Post Traumatic Stress ◽  
Mediation Analyses ◽  
Trade Center

We observed that World Trade Center (WTC) exposure, post-traumatic stress disorder (PTSD) symptoms and depressive symptoms were associated with subjective cognitive concerns in Fire Department of the City of New York (FDNY) rescue/recovery workers. This follow-up study examined whether PTSD symptoms and/or depressive symptoms mediate the observed association between WTC exposure and subjective cognitive concerns. We included WTC-exposed FDNY workers who completed the Cognitive Function Instrument (CFI), measuring self-perceived cognitive decline (N = 9516). PTSD symptoms and depressive symptoms were assessed using the PCL-S and CES-D, respectively. Multivariable linear regression estimated the association between WTC exposure and CFI score, adjusting for confounders. Mediation analyses followed the methods of Vanderweele (2014). Participants’ average age at CFI assessment was 56.6 ± 7.6 years. Higher-intensity WTC exposure was associated with worse CFI score, an effect that was entirely mediated by PTSD symptoms (%mediated: 110.9%; 95%CI: 83.1–138.9). When substituting depressive symptoms for PTSD symptoms, the WTC exposure–CFI association was largely mediated (%mediated: 82.1%; 95%CI: 60.6–103.7). Our findings that PTSD symptoms and depressive symptoms mediate the association between WTC exposure and subjective cognitive concerns indicate that in the absence of these symptoms, WTC exposure in rescue/recovery workers would not be associated with subjective cognition. Interventions targeting PTSD and depression may have additional value in mitigating cognitive decline in WTC-exposed populations.

Trajectories of Psychological Risk and Resilience in World Trade Center Responders

2012 ◽  
Author(s):  
Adriana Feder ◽  
Robert Pietrzak ◽  
Ritika Singh ◽  
Clyde Schechter ◽  
Jill Barron ◽  
...  
Keyword(s):  
World Trade ◽  
World Trade Center ◽  
Risk And Resilience ◽  
Trade Center ◽  
Psychological Risk

Differential Impact of PTSD Symptoms on Psychosocial Functioning in World Trade Center Responders

2012 ◽  
Author(s):  
Jared N. Kilmer ◽  
Camilo Ruggero ◽  
Jennifer Callahan ◽  
Crystal Rodriguez ◽  
Roman Kotov ◽  
...  
Keyword(s):  
Psychosocial Functioning ◽  
World Trade ◽  
World Trade Center ◽  
Ptsd Symptoms ◽  
Differential Impact ◽  
Trade Center

scholarly journals Impact of World Trade Center-Related Health Research: An Application of the NIEHS Translational Framework

2021 ◽  
Vol 18 (5) ◽  
pp. 2659
Author(s):  
Jaime Madrigano ◽  
Thomas W. Concannon ◽  
Sean Mann ◽  
Sameer M. Siddiqi ◽  
Ramya Chari ◽  
...  
Keyword(s):  
World Trade ◽  
Grey Literature ◽  
World Trade Center ◽  
Diagnostic Procedures ◽  
Health Conditions ◽  
Future Research ◽  
Physical And Mental Health ◽  
Post Traumatic Stress ◽  
Related Research ◽  
Trade Center

The World Trade Center Health Program (WTCHP) has a research mission to identify physical and mental health conditions that may be related to the 9/11 terrorist attacks as well as effective diagnostic procedures and treatments for WTC-related health conditions. The ability of the WTCHP to serve its members and realize positive impacts on all of its stakeholders depends on effective translation of research findings. As part of an ongoing assessment of the translational impact of World Trade Center (WTC)-related research, we applied the National Institute of Environmental Health Sciences (NIEHS) translational framework to two case studies: WTC-related research on post-traumatic stress disorder (PTSD) and cancer. We conducted a review of 9/11 health-related research in the peer-reviewed literature through October 2017, grey literature, and WTCHP program documentation. We mapped peer-reviewed studies in the literature to the NIEHS framework and used WTCHP program documentation and grey literature to find evidence of translation of research into clinical practice and policy. Using the NIEHS framework, we identified numerous translational milestones and bridges, as well as areas of opportunity, within each case study. This application demonstrates the utility of the NIEHS framework for documenting progress toward public health impact and for setting future research goals.

PTSD Symptoms and Attachment Styles in World Trade Center Responders and Survivors: A Symptomics Approach

2020 ◽  
Vol 87 (9) ◽  
pp. S317-S318
Author(s):  
Danielle Torres ◽  
Mary Kowalchyk ◽  
Hannah Brinkman ◽  
Maria Zarcone ◽  
Miri Tannenbaum ◽  
...  
Keyword(s):  
World Trade ◽  
Attachment Styles ◽  
World Trade Center ◽  
Ptsd Symptoms ◽  
Trade Center

scholarly journals Exposure to the World Trade Center Disaster and 9/11-Related Post-Traumatic Stress Disorder and Household Disaster Preparedness

2015 ◽  
Vol 9 (6) ◽  
pp. 625-633 ◽  
Author(s):  
Lisa M. Gargano ◽  
Kimberly Caramanica ◽  
Sarah Sisco ◽  
Robert M. Brackbill ◽  
Steven D. Stellman
Keyword(s):  
Social Support ◽  
Post Traumatic Stress Disorder ◽  
Traumatic Stress ◽  
World Trade ◽  
World Trade Center ◽  
Hurricane Sandy ◽  
Post Traumatic Stress ◽  
World Trade Center Disaster ◽  
Trade Center ◽  
Post Traumatic

AbstractObjectiveIn a population with prior exposure to the World Trade Center disaster, this study sought to determine the subsequent level of preparedness for a new disaster and how preparedness varied with population characteristics that are both disaster-related and non-disaster-related.MethodsThe sample included 4496 World Trade Center Health Registry enrollees who completed the Wave 3 (2011-2012) and Hurricane Sandy (2013) surveys. Participants were considered prepared if they reported possessing at least 7 of 8 standard preparedness items. Logistic regression was used to determine associations between preparedness and demographic and medical factors, 9/11-related post-traumatic stress disorder (PTSD) assessed at Wave 3, 9/11 exposure, and social support.ResultsOver one-third (37.5%) of participants were prepared with 18.8% possessing all 8 items. The item most often missing was an evacuation plan (69.8%). Higher levels of social support were associated with being prepared. High levels of 9/11 exposure were associated with being prepared in both the PTSD and non-PTSD subgroups.ConclusionsOur findings indicate that prior 9/11 exposure favorably impacted Hurricane Sandy preparedness. Future preparedness messaging should target people with low social support networks. Communications should include information on evacuation zones and where to find information about how to evacuate. (Disaster Med Public Health Preparedness. 2015;9:625–633)

Post-traumatic stress disorder dimensions and asthma morbidity in World Trade Center rescue and recovery workers

2017 ◽  
Vol 54 (7) ◽  
pp. 723-731 ◽  
Author(s):  
I. Mindlis ◽  
E. Morales-Raveendran ◽  
E. Goodman ◽  
K. Xu ◽  
C. Vila-Castelar ◽  
...  
Keyword(s):  
Post Traumatic Stress Disorder ◽  
Traumatic Stress ◽  
World Trade ◽  
Stress Disorder ◽  
World Trade Center ◽  
Post Traumatic Stress ◽  
Asthma Morbidity ◽  
Trade Center ◽  
Post Traumatic
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