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Trajectories of Scores on a Screening Instrument for PTSD Among World Trade Center Rescue, Recovery, and Clean‐Up Workers
Author(s) -
Maslow Carey B.,
Caramanica Kimberly,
Welch Alice E.,
Stellman Steven D.,
Brackbill Robert M.,
Farfel Mark R.
Publication year - 2015
Publication title -
journal of traumatic stress
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.259
H-Index - 134
eISSN - 1573-6598
pISSN - 0894-9867
DOI - 10.1002/jts.22011
Subject(s) - demography , injury prevention , poison control , odds ratio , occupational safety and health , confidence interval , trauma center , psychiatry , psychology , suicide prevention , unemployment , affect (linguistics) , mental health , medicine , gerontology , environmental health , surgery , retrospective cohort study , communication , pathology , sociology , economics , economic growth
The longitudinal course of posttraumatic stress disorder (PTSD) over 8–9 years was examined among 16,488 rescue and recovery workers who responded to the events of September 11, 2001 (9/11) at the World Trade Center (WTC; New York, NY), and were enrolled in the World Trade Center Health Registry. Latent class growth analysis identified 5 groups of rescue and recovery workers with similar score trajectories at 3 administrations of the PTSD Checklist (PCL): low‐stable (53.3%), moderate‐ stable (28.7%), moderate‐increasing (6.4%), high‐decreasing (7.7%), and high‐stable (4.0%). Relative to the low‐stable group, membership in higher risk groups was associated with 9/11‐related exposures including duration of WTC work, with adjusted odds ratios ranging from 1.3 to 2.0, witnessing of horrific events (range = 1.3 to 2.1), being injured (range = 1.4 to 2.3), perceiving threat to life or safety (range = 2.2 to 5.2), bereavement (range = 1.6 to 4.8), and job loss due to 9/11 (range = 2.4 to 15.8). Within groups, higher PCL scores were associated with adverse social circumstances including lower social support, with B coefficients ranging from 0.2 to 0.6, divorce, separation, or widowhood (range = 0.4–0.7), and unemployment (range = 0.4–0.5). Given baseline, exposure‐related, and contextual influences that affect divergent PTSD trajectories, screening for both PTSD and adverse circumstances should occur immediately, and at regular intervals postdisaster.