TY - JOUR
T1 - Post-disaster stressful life events and WTC-related posttraumatic stress, depressive symptoms, and overall functioning among responders to the World Trade Center disaster
AU - Zvolensky, Michael J.
AU - Kotov, Roman
AU - Schechter, Clyde B.
AU - Gonzalez, Adam
AU - Vujanovic, Anka
AU - Pietrzak, Robert H.
AU - Crane, Michael
AU - Kaplan, Julia
AU - Moline, Jacqueline
AU - Southwick, Steven M.
AU - Feder, Adriana
AU - Udasin, Iris
AU - Reissman, Dori B.
AU - Luft, Benjamin J.
N1 - Funding Information:
This project was supported by National Institute of Occupational Safety and Health awards (200-2011-42057 and 200-201139410). NIOSH had no direct role in the study design, collection, analysis, or interpretation of the data, writing of the manuscript, or the decision to submit the paper for publication.
Funding Information:
This work was supported by National Institute of Occupational Safety and Health awards (200-2011-42057 and 200-2011-39410). The author(s) report no financial or other relationship relevant to the subject of this article. Please note that the content presented does not necessarily represent the official views of the National Institutes of Occupational Safety and Health, and that the funding sources had no other role other than financial support.
Publisher Copyright:
© 2014.
PY - 2015/2/1
Y1 - 2015/2/1
N2 - Background: The current study examined contributions of post-disaster stressful life events in relation to the maintenance of WTC-related posttraumatic stress, depressive symptoms, and overall functioning among rescue, recovery, and clean-up workers who responded to the September 11, 2001 World Trade Center (WTC) terrorist attacks. Methods: Participants were 18,896 WTC responders, including 8466 police officers and 10,430 non-traditional responders (85.8% male, 86.4% Caucasian; Mage=39.5, SD=8.8) participating in the WTC Health Program who completed an initial examination between July, 2002 and April, 2010 and who were reassessed, on average, 2.5 years later. Results: Path analyses were conducted to evaluate contributions of life events to the maintenance of WTC-related posttraumatic stress, depressive symptoms, and overall functioning. These analyses were stratified by police and non-traditional responder groups and adjusted for age, sex, time from 9/11 to initial visit, WTC exposures (three WTC contextual exposures: co-worker, friend, or a relative died in the disaster; co-worker, friend, or a relative injured in the disaster; and responder was exposed to the dust cloud on 9/11), and interval from initial to first follow-up visit. In both groups, WTC-related posttraumatic stress, depressive symptoms, and overall functioning were stable over the follow-up period. WTC exposures were related to these three outcomes at the initial assessment. WTC-related posttraumatic stress, depressive symptoms, and overall functioning, at the initial assessment each predicted the occurrence of post-disaster stressful life events, as measured by Disaster Supplement of the Diagnostic Interview Schedule. Post-disaster stressful life events, in turn, were associated with subsequent mental health, indicating partial mediation of the stability of observed mental health. Conclusions: The present findings suggest a dynamic interplay between exposure, post-disaster stressful life events, and WTC-related posttraumatic stress, depressive symptoms, and overall functioning among WTC disaster responders.
AB - Background: The current study examined contributions of post-disaster stressful life events in relation to the maintenance of WTC-related posttraumatic stress, depressive symptoms, and overall functioning among rescue, recovery, and clean-up workers who responded to the September 11, 2001 World Trade Center (WTC) terrorist attacks. Methods: Participants were 18,896 WTC responders, including 8466 police officers and 10,430 non-traditional responders (85.8% male, 86.4% Caucasian; Mage=39.5, SD=8.8) participating in the WTC Health Program who completed an initial examination between July, 2002 and April, 2010 and who were reassessed, on average, 2.5 years later. Results: Path analyses were conducted to evaluate contributions of life events to the maintenance of WTC-related posttraumatic stress, depressive symptoms, and overall functioning. These analyses were stratified by police and non-traditional responder groups and adjusted for age, sex, time from 9/11 to initial visit, WTC exposures (three WTC contextual exposures: co-worker, friend, or a relative died in the disaster; co-worker, friend, or a relative injured in the disaster; and responder was exposed to the dust cloud on 9/11), and interval from initial to first follow-up visit. In both groups, WTC-related posttraumatic stress, depressive symptoms, and overall functioning were stable over the follow-up period. WTC exposures were related to these three outcomes at the initial assessment. WTC-related posttraumatic stress, depressive symptoms, and overall functioning, at the initial assessment each predicted the occurrence of post-disaster stressful life events, as measured by Disaster Supplement of the Diagnostic Interview Schedule. Post-disaster stressful life events, in turn, were associated with subsequent mental health, indicating partial mediation of the stability of observed mental health. Conclusions: The present findings suggest a dynamic interplay between exposure, post-disaster stressful life events, and WTC-related posttraumatic stress, depressive symptoms, and overall functioning among WTC disaster responders.
KW - Depression
KW - Disaster
KW - Stress exposure
KW - Stress generation
KW - Trauma
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U2 - 10.1016/j.jpsychires.2014.11.010
DO - 10.1016/j.jpsychires.2014.11.010
M3 - Article
C2 - 25499737
AN - SCOPUS:84921593534
SN - 0022-3956
VL - 61
SP - 97
EP - 105
JO - Journal of Psychiatric Research
JF - Journal of Psychiatric Research
ER -
