Burden of full and subsyndromal PTSD in police who responded to the World Trade Center disaster
Studies have found that police demonstrated considerable resilience to posttraumatic stress disorder (PTSD) compared to other disaster workers after the September 11, 2001 terrorist attack on the World Trade Center (WTC). This has been attributed to effective screening and extensive training in the police force. New research suggests that, despite this greater resilience to PTSD, 15.4% of police endorse symptoms of subsyndromal PTSD that do not reach the level for a formal diagnosis of PTSD, but which are nonetheless associated with elevated rates of other psychiatric disorders and functional difficulties. The study is published online in advance of publication in the July issue of the Journal of Psychiatric Research.
"The prevalence of full PTSD observed in this study (5.4%) was comparable to previous studies of police responders to the WTC disaster. However, the rate of subsyndromal PTSD was nearly 3 times greater (15.4%), suggesting that one in five police exposed to WTC rescue and recovery work may have clinically significant WTC-related PTSD symptoms," says lead investigator Robert H. Pietrzak, PhD, MPH, of the National Center for Posttraumatic Stress Disorder, VA Connecticut Healthcare System, and Department of Psychiatry, Yale University School of Medicine. "Further, subsyndromal PTSD, which is not commonly assessed as part of screening efforts, was associated with elevated rates of comorbid psychiatric disorders, functional difficulties, somatic symptoms, and perceived need for mental health care."
Researchers assessed 8,466 police who worked or volunteered as part of rescue, recovery, restoration, or cleanup in Manhattan south of Canal Street, at the barge-loading piers in Manhattan, or the Staten Island landfill between September 11 and December 31, 2001. Participants completed an initial evaluation as part of the World Trade Center Medical Monitoring and Treatment Program. An interview assessed level of WTC exposure, such as early arrival, being caught in the dust cloud, or exposure to human remains. A range of self-report psychiatric assessments were completed, including measures of depression, panic disorder, and alcohol use; impairment in work, social or family life; and somatic symptoms, such as feeling run down or having headaches. Respondents identified important sources of social support while working at the WTC site, including spouse/partner, supervisor, and co-workers. They also indicated whether they thought they would need any mental health services in the next year. The level of posttraumatic stress was measured using the PTSD Checklist.
WTC-related work exposures that were most strongly associated with full and subsyndromal PTSD were losing someone on 9/11 and knowing someone who was injured in the disaster. A greater number of stressors prior to 9/11 was also associated with both full and subsyndromal PTSD. Union membership and greater family support played a protective role. Depression, panic disorder, alcohol use problems, and somatic symptoms and functional difficulties were highest among police with full PTSD, and occurred in intermediate levels among those with subsyndromal PTSD.
Police with subsyndromal PTSD were nearly five times as likely as controls to report that they might need at least one of the mental health services assessed, such as one-on-one counseling, stress management or psychotropic medication. "This finding underscores the importance of assessing for subsyndromal PTSD in disaster-exposed police responders, as these individuals may be overlooked despite some of these responders having an increased perception of need for mental healthcare," explains Dr. Pietrzak.
Dr. Pietrzak and colleagues note that subsyndromal PTSD is not a diagnostic classification and may not be routinely identified as part of screenings in police and other disaster response personnel. "Current screening and diagnostic criteria for disaster-related PTSD may be too restrictive in identifying the full complement of police who have clinically significant psychiatric and functional difficulties after responding to a mass disaster. These findings underscore the importance of screening, monitoring, and possibly treating disaster responders with subsyndromal PTSD," he concludes, adding that additional research is needed to confirm these findings using structured diagnostic interviews, to understand the longitudinal course of subsyndromal PTSD, and to evaluate the generalizability of these results to the broader population of police WTC responders.
More information: The burden of full and subsyndromal posttraumatic stress disorder among police involved in the World Trade Center rescue and recovery effort, by R.H. Pietrzak, C.B. Schechter, E.J. Bromet, et al. DOI:10.1016/j.psychires.2012.03.011. Journal of Psychiatric Research, Volume 46, Issue 7 (July 2012)
Journal reference: Journal of Psychiatric Research
Provided by Elsevier
- Anxiety, mood disorders put cancer patients at risk for PTSD May 05, 2008 | not rated yet | 0
- Study of WTC responders: PTSD and respiratory illness linked Dec 23, 2011 | not rated yet | 0
- First long-term study of WTC workers shows widespread health problems Sep 02, 2011 | not rated yet | 0
- More than 3,000 survivors of the WTC attacks experience long-term post-traumatic stress disorder Jan 07, 2011 | not rated yet | 0
- Intense, prolonged exposure to WTC attack linked to new health problems years later Aug 04, 2009 | not rated yet | 0
- Motion perception revisited: High Phi effect challenges established motion perception assumptions Apr 23, 2013 | 3 / 5 (2) | 2
- Anything you can do I can do better: Neuromolecular foundations of the superiority illusion (Update) Apr 02, 2013 | 4.5 / 5 (11) | 5
- The visual system as economist: Neural resource allocation in visual adaptation Mar 30, 2013 | 5 / 5 (2) | 9
- Separate lives: Neuronal and organismal lifespans decoupled Mar 27, 2013 | 4.9 / 5 (8) | 0
- Sizing things up: The evolutionary neurobiology of scale invariance Feb 28, 2013 | 4.8 / 5 (10) | 14
How can there be villous adenoma in colon, if there are no villi there
15 hours ago As title suggest. Thanks :smile:
How can there be a term called "intestinal metaplasia" of stomach
May 21, 2013 Hello everyone, Ok Stomach's normal epithelium is simple columnar, now in intestinal type of adenocarcinoma of stomach it undergoes "intestinal...
Pressure-volume curve: Elastic Recoil Pressure don't make sense
May 18, 2013 From pressure-volume curve of the lung and chest wall (attached photo), I don't understand why would the elastic recoil pressure of the lung is...
If you became brain-dead, would you want them to pull the plug?
May 17, 2013 I'd want the rest of me to stay alive. Sure it's a lousy way to live but it beats being all-the-way dead. Maybe if I make it 20 years they'll...
MRI bill question
May 15, 2013 Dear PFers, The hospital gave us a $12k bill for one MRI (head with contrast). The people I talked to at the hospital tell me that they do not...
Ratio of Hydrogen of Oxygen in Dessicated Animal Protein
May 13, 2013 As an experiment, for the past few months I've been consuming at least one portion of Jell-O or unflavored Knox gelatin per day. I'm 64, in very...
- More from Physics Forums - Medical Sciences
More news stories
A new study shows there is a gender gap when it comes to behavior and self-control in American young children – one that does not appear to exist in children in Asia.
Psychology & Psychiatry 6 hours ago | not rated yet | 0
Until now, little was scientifically known about the human potential to cultivate compassion—the emotional state of caring for people who are suffering in a way that motivates altruistic behavior.
Psychology & Psychiatry 7 hours ago | 5 / 5 (2) | 2 |
What effect does a father's depression have on his young son or daughter? When fathers report a high level of emotional intimacy in their marriage, their children benefit, said a University of Illinois study.
Psychology & Psychiatry 7 hours ago | not rated yet | 0
(Medical Xpress)—Preschoolers universally recognize that one's choices are not always free – that our decisions may be constrained by social obligations to be nice to others or follow rules set by parents ...
Psychology & Psychiatry 15 hours ago | not rated yet | 0
(Medical Xpress)—Do ethicists engage in better moral behavior than other professors? The answer is no. Nor are they more likely than nonethicists to act according to values they espouse, according to researchers from the ...
Psychology & Psychiatry 15 hours ago | 5 / 5 (1) | 0
Swiss scientists reveal the mechanism responsible for aging hidden deep within mitochondria—and dramatically slow it down in worms by administering antibiotics to the young.
10 hours ago | 4.8 / 5 (5) | 0 |
Researchers from Queen Mary, University of London have led the largest sequencing study of human disease to date, investigating the genetic basis of six autoimmune diseases.
10 hours ago | 4 / 5 (1) | 0 |
(HealthDay)—Migraines and depression can each cause a great deal of suffering, but new research indicates the combination of the two may be linked to something else entirely—a smaller brain.
6 hours ago | 5 / 5 (1) | 0 |
A new approach for immunizing against influenza elicited a more potent immune response and broader protection than the currently licensed seasonal influenza vaccines when tested in mice and ferrets. The vaccine ...
7 hours ago | not rated yet | 0 |
In a series of lab experiments designed to unravel the workings of a key enzyme widely considered a possible trigger of rheumatoid arthritis, researchers at Johns Hopkins have found that in the most severe ...
9 hours ago | 5 / 5 (1) | 0 |
Researchers have developed a new drug delivery system that allows inhalation of chemotherapeutic drugs to help treat lung cancer, and in laboratory and animal tests it appears to reduce the systemic damage ...
9 hours ago | not rated yet | 0 |