title: The longitudinal course of PTSD among disaster workers deployed to the World Trade Center following the attacks of September 11th.
abstract: This study examined the long-term mental health outcomes of 2,960 nonrescue disaster workers deployed to the World Trade Center site in New York City following the September 11, 2001 (9/11) terrorist attacks. Semistructured interviews and standardized self-report measures were used to assess the prevalence of posttraumatic stress disorder (PTSD) and other psychopathology 4 and 6 years after the attacks. Clinician-measured rates of PTSD and partial PTSD 4-years posttrauma were 8.4% and 8.9%, respectively, in a subsample of 727 individuals. Rates decreased to 5.8% and 7.7% for full and partial PTSD 6 years posttrauma. For the larger sample, self-report scores revealed probable PTSD and partial PTSD prevalence to be 4.8% and 3.6% at 4 years, and 2.4% and 1.8% at 6 years. Approximately 70% of workers never met criteria for PTSD. Although PTSD rates decreased significantly over time, many workers remained symptomatic, with others showing delayed-onset PTSD. The strongest predictors of ongoing PTSD 6 years following 9/11 were trauma history (odds ratio (OR) = 2.27, 95% confidence interval (CI) [1.06, 4.85]); the presence of major depressive disorder 1-2 years following the trauma (OR = 2.80, 95% CI [1.17, 6.71]); and extent of occupational exposure (OR = 1.31, 95% CI [1.13, 1.51]). The implications of the findings for both screening and treatment of disaster workers are discussed.
authors.affiliation: Department of Psychiatry, Weill Cornell Medical College, New York, NY 10065, USA. juc2010@med.cornell.edu
authors.forename: Judith
authors.initials: J
authors.lastname: Cukor
authors.forename: Katarzyna
authors.initials: K
authors.lastname: Wyka
authors.forename: Brittany
authors.initials: B
authors.lastname: Mello
authors.forename: Megan
authors.initials: M
authors.lastname: Olden
authors.forename: Nimali
authors.initials: N
authors.lastname: Jayasinghe
authors.forename: Jennifer
authors.initials: J
authors.lastname: Roberts
authors.forename: Cezar
authors.initials: C
authors.lastname: Giosan
authors.forename: Michael
authors.initials: M
authors.lastname: Crane
authors.forename: Joann
authors.initials: J
authors.lastname: Difede
mesh_terms: D060731:Emergency Responders / Q000523:psychology*; D006801:Humans; D007407:Interviews as Topic; D008137:Longitudinal Studies; D009519:New York City / Q000453:epidemiology; D016017:Odds Ratio; D047851:September 11 Terrorist Attacks / Q000523:psychology*; D013313:Stress Disorders, Post-Traumatic / Q000453:epidemiology* / Q000503:physiopathology*; D011795:Surveys and Questionnaires