TY - JOUR
T1 - The burden of full and subsyndromal posttraumatic stress disorder among police involved in the World Trade Center rescue and recovery effort
AU - Pietrzak, Robert H.
AU - Schechter, Clyde B.
AU - Bromet, Evelyn J.
AU - Katz, Craig L.
AU - Reissman, Dori B.
AU - Ozbay, Fatih
AU - Sharma, Vansh
AU - Crane, Michael
AU - Harrison, Denise
AU - Herbert, Robin
AU - Levin, Stephen M.
AU - Luft, Benjamin J.
AU - Moline, Jacqueline M.
AU - Stellman, Jeanne M.
AU - Udasin, Iris G.
AU - Landrigan, Philip J.
AU - Southwick, Steven M.
N1 - Funding Information:
This work was supported by the Centers for Disease Control and Prevention, National Institute of Occupational Safety and Health (contract 200-2002-0038 and grant 5U1O 0H008232), the American Red Cross Liberty Fund, The September 11th Recovery Program, The Bear Stearns Charitable Foundation, The September 11th Fund, The Robin Hood Foundation The findings and conclusions of this report are those of the authors and do not necessarily represent the views of the National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, the U.S. Public Health Service, or the Department of Veterans Affairs National Center for Posttraumatic Stress Disorder. The sponsors of this study had no role in the study design, data collection, data analysis, data interpretation, or writing of the report.
PY - 2012/7
Y1 - 2012/7
N2 - Background: This study examined the prevalence, correlates, and perceived mental healthcare needs associated with subsyndromal PTSD in police involved in the World Trade Center (WTC) rescue and recovery effort. Methods: A total of 8466 police completed an interview/survey as part of the WTC Medical monitoring and Treatment Program an average of four years after 9/11/2001. Results: The past month prevalence of full and subsyndromal WTC-related PTSD was 5.4% and 15.4%, respectively. Loss of someone or knowing someone injured on 9/11 (odds ratios [ORs] = 1.56-1.86), pre-9/11 stressors (ORs = 1.30-1.50), family support (ORs = 0.83-0.94), and union membership (ORs = 0.50-0.52) were associated with both full and subsyndromal PTSD. Exposure to the dust cloud (OR = 1.36), performing search and rescue work (OR = 1.29), and work support (OR = 0.89) were additionally associated with subsyndromal PTSD. Rates of comorbid depression, panic disorder, and alcohol use problems (ORs = 3.82-41.74), and somatic symptoms and functional difficulties (ORs = 1.30-1.95) were highest among police with full PTSD, with intermediate rates among police with subsyndromal PTSD (ORs = 2.93-7.02; and ORs = 1.18-1.60, respectively). Police with full and subsyndromal PTSD were significantly more likely than controls to report needing mental healthcare (41.1% and 19.8%, respectively, versus 6.8% in trauma controls). Conclusions: These results underscore the importance of a more inclusive and dimensional conceptualization of PTSD, particularly in professions such as police, as operational definitions and conventional screening cut-points may underestimate the psychological burden for this population. Accordingly, psychiatric clinicians should assess for disaster-related subsyndromal PTSD symptoms in disaster response personnel.
AB - Background: This study examined the prevalence, correlates, and perceived mental healthcare needs associated with subsyndromal PTSD in police involved in the World Trade Center (WTC) rescue and recovery effort. Methods: A total of 8466 police completed an interview/survey as part of the WTC Medical monitoring and Treatment Program an average of four years after 9/11/2001. Results: The past month prevalence of full and subsyndromal WTC-related PTSD was 5.4% and 15.4%, respectively. Loss of someone or knowing someone injured on 9/11 (odds ratios [ORs] = 1.56-1.86), pre-9/11 stressors (ORs = 1.30-1.50), family support (ORs = 0.83-0.94), and union membership (ORs = 0.50-0.52) were associated with both full and subsyndromal PTSD. Exposure to the dust cloud (OR = 1.36), performing search and rescue work (OR = 1.29), and work support (OR = 0.89) were additionally associated with subsyndromal PTSD. Rates of comorbid depression, panic disorder, and alcohol use problems (ORs = 3.82-41.74), and somatic symptoms and functional difficulties (ORs = 1.30-1.95) were highest among police with full PTSD, with intermediate rates among police with subsyndromal PTSD (ORs = 2.93-7.02; and ORs = 1.18-1.60, respectively). Police with full and subsyndromal PTSD were significantly more likely than controls to report needing mental healthcare (41.1% and 19.8%, respectively, versus 6.8% in trauma controls). Conclusions: These results underscore the importance of a more inclusive and dimensional conceptualization of PTSD, particularly in professions such as police, as operational definitions and conventional screening cut-points may underestimate the psychological burden for this population. Accordingly, psychiatric clinicians should assess for disaster-related subsyndromal PTSD symptoms in disaster response personnel.
KW - Depression
KW - Healthcare needs
KW - Police
KW - Posttraumatic stress disorder
KW - World Trade Center
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U2 - 10.1016/j.jpsychires.2012.03.011
DO - 10.1016/j.jpsychires.2012.03.011
M3 - Article
C2 - 22464942
AN - SCOPUS:84862007988
SN - 0022-3956
VL - 46
SP - 835
EP - 842
JO - Journal of Psychiatric Research
JF - Journal of Psychiatric Research
IS - 7
ER -
