Dimensional structure and course of post-traumatic stress symptomatology in World Trade Center responders

2013 ◽  
Vol 44 (10) ◽  
pp. 2085-2098 ◽  
Author(s):  
R. H. Pietrzak ◽  
A. Feder ◽  
C. B. Schechter ◽  
R. Singh ◽  
L. Cancelmo ◽  
...  
Keyword(s):  
Traumatic Stress ◽  
Ptsd Symptom ◽  
World Trade Center ◽  
Symptom Clusters ◽  
Post Traumatic Stress ◽  
Anxious Arousal ◽  
Trade Center ◽  
Post Traumatic ◽  
Ptsd Symptomatology ◽  
Over Time

BackgroundPost-traumatic stress disorder (PTSD) in response to the World Trade Center (WTC) disaster of 11 September 2001 (9/11) is one of the most prevalent and persistent health conditions among both professional (e.g. police) and non-traditional (e.g. construction worker) WTC responders, even several years after 9/11. However, little is known about the dimensionality and natural course of WTC-related PTSD symptomatology in these populations.MethodData were analysed from 10 835 WTC responders, including 4035 police and 6800 non-traditional responders who were evaluated as part of the WTC Health Program, a clinic network in the New York area established by the National Institute for Occupational Safety and Health. Confirmatory factor analyses (CFAs) were used to evaluate structural models of PTSD symptom dimensionality; and autoregressive cross-lagged (ARCL) panel regressions were used to examine the prospective interrelationships among PTSD symptom clusters at 3, 6 and 8 years after 9/11.ResultsCFAs suggested that five stable symptom clusters best represent PTSD symptom dimensionality in both police and non-traditional WTC responders. This five-factor model was also invariant over time with respect to factor loadings and structural parameters, thereby demonstrating its longitudinal stability. ARCL panel regression analyses revealed that hyperarousal symptoms had a prominent role in predicting other symptom clusters of PTSD, with anxious arousal symptoms primarily driving re-experiencing symptoms, and dysphoric arousal symptoms primarily driving emotional numbing symptoms over time.ConclusionsResults of this study suggest that disaster-related PTSD symptomatology in WTC responders is best represented by five symptom dimensions. Anxious arousal symptoms, which are characterized by hypervigilance and exaggerated startle, may primarily drive re-experiencing symptoms, while dysphoric arousal symptoms, which are characterized by sleep disturbance, irritability/anger and concentration difficulties, may primarily drive emotional numbing symptoms over time. These results underscore the importance of assessment, monitoring and early intervention of hyperarousal symptoms in WTC and other disaster responders.

scholarly journals BIOLOGICAL MARKERS OF AGING: CHRONIC STRESS AND COGNITIVE IMPAIRMENT IN RESPONDERS FROM THE WORLD TRADE CENTER

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S93-S94
Author(s):  
Erica D Diminich ◽  
Sean Clouston ◽  
Stacey B Scott ◽  
Nikhil Palekar ◽  
Erica D santiago ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
Post Traumatic Stress Disorder ◽  
Traumatic Stress ◽  
World Trade ◽  
Ptsd Symptom ◽  
World Trade Center ◽  
Post Traumatic Stress ◽  
The World ◽  
Trade Center ◽  
Post Traumatic

Abstract Post-traumatic Stress Disorder (PTSD) is a stress related syndrome. Chronic PTSD has increasingly been associated with poor health outcomes, neurodegeneration and risk for cognitive impairment (CI). However, the biological mechanisms underlying the development and maintenance of symptoms and potential associations in accelerating aging are not well understood. The aim of this study was to evaluate whether specific biomarkers influence functional limitations and cognitive impairment in rescue and recovery workers (i.e. responders) from the attacks on the World Trade Center (WTC) in New York. Plasma biomarkers were collected during annual health and wellness visits at the WTC responder clinic between 2012 and 2014. Short Physical Performance Battery (SPPB) and clinical data were examined with prospective PTSD symptom scores collected during participant’s initial enrollment into the parent study as early as 2002. We examined the relationship between cardiovascular (Diastolic Blood Pressure, Systolic Blood Pressure, pulse rate), metabolic (Total Cholesterol, HDL cholesterol, Triglycerides, Glucose, Body Mass Index) and inflammation markers (Albumin, White Blood Count) with Post-traumatic Stress Disorder (PTSD), cognitive functioning (Montreal Cognitive Assessment) and frailty (Short Physical Performance Battery) in responders from the World Trade Center (WTC). We first examined correlations between biomarkers, PTSD symptom severity, PTSD dimensions, cognitive functioning and frailty. We then conducted multivariate regression analyses. In models adjusted for potential confounders, among N=1,045 responders, elevated PTSD was strongly associated with increased frailty, cardiovascular dysregulation and mild cognitive impairment. Current work is ongoing to identify trajectories of change in cognition with frailty and biological factors.

Towards an exposure-dependent model of post-traumatic stress: longitudinal course of post-traumatic stress symptomatology and functional impairment after the 2011 Oslo bombing

2016 ◽  
Vol 46 (15) ◽  
pp. 3241-3254 ◽  
Author(s):  
Ø. Solberg ◽  
M. S. Birkeland ◽  
I. Blix ◽  
M. B. Hansen ◽  
T. Heir
Keyword(s):  
Social Adjustment ◽  
Functional Impairment ◽  
Traumatic Stress ◽  
Exposed Group ◽  
Symptom Clusters ◽  
Emotional Numbing ◽  
Post Traumatic Stress ◽  
Main Driver ◽  
Post Traumatic ◽  
Over Time

BackgroundOur understanding of the dynamics of post-traumatic stress symptomatology and its link to functional impairment over time is limited.MethodPost-traumatic stress symptomatology (Post-traumatic Checklist, PCL) was assessed three times in 1-year increments (T1, T2, T3) following the Oslo bombing of 22 July, 2011, in directly (n = 257) and indirectly exposed (n = 2223) government employees, together with demographics, measures of exposure and work and social adjustment. The dynamics of post-traumatic stress disorder symptom cluster interplay were examined within a structural equation modelling framework using a cross-lagged autoregressive panel model.ResultsIntrusions at T1 played a prominent role in predicting all symptom clusters at T2 for the directly exposed group, exhibiting especially strong cross-lagged relationships with avoidance and anxious arousal. For the indirectly exposed group, dysphoric arousal at T1 played the most prominent role in predicting all symptom clusters at T2, exhibiting a strong relationship with emotional numbing. Emotional numbing seemed to be the main driver behind prolonged stress at T3 for both groups. Functional impairment was predominately associated with dysphoric arousal and emotional numbing in both groups.ConclusionsFor directly exposed individuals, memories of the traumatic incident and the following intrusions seem to drive their post-traumatic stress symptomatology. However, as these memories lose their potency over time, a sequela of dysphoric arousal and emotional numbing similar to the one reported by the indirectly exposed individuals seems to be the main driver for prolonged post-traumatic stress and functional impairment. Findings are discussed using contemporary models within an exposure-dependent perspective of post-traumatic stress.

Post-traumatic stress disorder and the association with overweight, obesity, and weight change among individuals exposed to the World Trade Center disaster, 2003–2016

2020 ◽  
pp. 1-10
Author(s):  
Erin Takemoto ◽  
Katherine R. Van Oss ◽  
Shadi Chamany ◽  
Jennifer Brite ◽  
Robert Brackbill
Keyword(s):  
Post Traumatic Stress Disorder ◽  
Traumatic Stress ◽  
Weight Change ◽  
Stress Disorder ◽  
World Trade Center ◽  
Post Traumatic Stress ◽  
The World ◽  
Trade Center ◽  
Post Traumatic ◽  
The Impact

Abstract Background Among Veterans, post-traumatic stress disorder (PTSD) has been shown to be associated with obesity and accelerated weight gain. Less is known among the general population. We sought to determine the impact of PTSD on body mass index (BMI) and weight change among individuals with exposure to the World Trade Center (WTC) disaster. Methods We examined individuals from the WTC Health Registry. PTSD symptoms were assessed on multiple surveys (Waves 1–4) using the PTSD Checklist-Specific. Three categories of post-9/11 PTSD were derived: no, intermittent, and persistent. We examined two outcomes: (1) Wave 3 BMI (normal, overweight, and obese) and (2) weight change between Waves 3 and 4. We used multivariable logistic regression to assess the association between PTSD and BMI (N = 34 958) and generalized estimating equations to assess the impact of PTSD on weight change (N = 26 532). Sex- and age-stratified analyses were adjusted for a priori confounders. Results At Wave 3, the observed prevalence of obesity was highest among the persistent (39.5%) and intermittent PTSD (36.6%) groups, compared to the no PTSD group (29.3%). In adjusted models, persistent and intermittent PTSD were consistently associated with a higher odds of obesity. Weight gain was similar across all groups, but those with persistent and intermittent PTSD had higher estimated group-specific mean weights across time. Conclusions Our findings that those with a history of PTSD post-9/11 were more likely to have obesity is consistent with existing literature. These findings reaffirm the need for an interdisciplinary focus on physical and mental health to improve health outcomes.

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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