Post-disaster stressful life events and WTC-related posttraumatic stress, depressive symptoms, and overall functioning among responders to the World Trade Center disaster

Michael J. Zvolensky, Roman Kotov, Clyde B. Schechter, Adam Gonzalez, Anka Vujanovic, Robert H. Pietrzak, Michael Crane, Julia Kaplan, Jacqueline Moline, Steven M. Southwick, Adriana Feder, Iris Udasin, Dori B. Reissman, Benjamin J. Luft

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Abstract

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.

Original languageEnglish (US)
Pages (from-to)97-105
Number of pages9
JournalJournal of Psychiatric Research
Volume61
DOIs
StatePublished - Feb 1 2015

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Keywords

  • Depression
  • Disaster
  • Stress exposure
  • Stress generation
  • Trauma

ASJC Scopus subject areas

  • Psychiatry and Mental health
  • Biological Psychiatry

Cite this

Zvolensky, M. J., Kotov, R., Schechter, C. B., Gonzalez, A., Vujanovic, A., Pietrzak, R. H., Crane, M., Kaplan, J., Moline, J., Southwick, S. M., Feder, A., Udasin, I., Reissman, D. B., & Luft, B. J. (2015). Post-disaster stressful life events and WTC-related posttraumatic stress, depressive symptoms, and overall functioning among responders to the World Trade Center disaster. Journal of Psychiatric Research, 61, 97-105. https://doi.org/10.1016/j.jpsychires.2014.11.010