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Title: DSM-IV post-traumatic stress disorder among World Trade Center responders 11-13 years after the disaster of 11 September 2001 (9/11)
Contributor(s): Bromet, E J (author); Hobbs, M J  (author)orcid ; Clouston, S A P (author); Gonzalez, A (author); Kotov, R (author); Luft, B J (author)
Publication Date: 2016-03
Early Online Version: 2015-11-25
Open Access: Yes
DOI: 10.1017/S0033291715002184Open Access Link
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Abstract: Background: Post-traumatic symptomatology is one of the signature effects of the pernicious exposures endured by responders to the World Trade Center (WTC) disaster of 11 September 2001 (9/11), but the long-term extent of diagnosed Diagnostic and Statistical Manual of Mental Disorders, 4th edition (DSM-IV) post-traumatic stress disorder (PTSD) and its impact on quality of life are unknown. This study examines the extent of DSM-IV PTSD 11–13 years after the disaster in WTC responders, its symptom profiles and trajectories, and associations of active, remitted and partial PTSD with exposures, physical health and psychosocial well-being. Method: Master's-level psychologists administered sections of the Structured Clinical Interview for DSM-IV and the Range of Impaired Functioning Tool to 3231 responders monitored at the Stony Brook University World Trade Center Health Program. The PTSD Checklist (PCL) and current medical symptoms were obtained at each visit. Results: In all, 9.7% had current, 7.9% remitted, and 5.9% partial WTC-PTSD. Among those with active PTSD, avoidance and hyperarousal symptoms were most commonly, and flashbacks least commonly, reported. Trajectories of symptom severity across monitoring visits showed a modestly increasing slope for active and decelerating slope for remitted PTSD. WTC exposures, especially death and human remains, were strongly associated with PTSD. After adjusting for exposure and critical risk factors, including hazardous drinking and co-morbid depression, PTSD was strongly associated with health and well-being, especially dissatisfaction with life. Conclusions: This is the first study to demonstrate the extent and correlates of long-term DSM-IV PTSD among responders. Although most proved resilient, there remains a sizable subgroup in need of continued treatment in the second decade after 9/11.
Publication Type: Journal Article
Source of Publication: Psychological Medicine, 46(4), p. 771-783
Publisher: Cambridge University Press
Place of Publication: United Kingdom
ISSN: 1469-8978
Field of Research (FoR) 2008: 110319 Psychiatry (incl. Psychotherapy)
111706 Epidemiology
170106 Health, Clinical and Counselling Psychology
Field of Research (FoR) 2020: 320221 Psychiatry (incl. psychotherapy)
520304 Health psychology
520302 Clinical psychology
520303 Counselling psychology
Socio-Economic Objective (SEO) 2008: 920410 Mental Health
920209 Mental Health Services
920204 Evaluation of Health Outcomes
Socio-Economic Objective (SEO) 2020: 200409 Mental health
200305 Mental health services
200202 Evaluation of health outcomes
Peer Reviewed: Yes
HERDC Category Description: C1 Refereed Article in a Scholarly Journal
Appears in Collections:Journal Article

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