Probable Posttraumatic Stress Disorder and Lower Respiratory Symptoms Among Rescue/Recovery Workers and Community Members After the 9/11 World Trade Center Attacks-A Longitudinal Mediation Analysis
| Autor: | Stephen Friedman, Katarzyna Wyka, Hannah T. Jordan |
|---|---|
| Rok vydání: | 2019 |
| Předmět: |
Adult
Male Respiratory Tract Diseases Comorbidity Psychological Trauma Stress Disorders Post-Traumatic 03 medical and health sciences 0302 clinical medicine medicine Rescue Work Humans Longitudinal Studies Registries Respiratory system Short duration Applied Psychology Inhalation Exposure Mediation Analysis business.industry World trade center Emergency Responders Ptsd checklist Middle Aged medicine.disease 030227 psychiatry Psychiatry and Mental health Posttraumatic stress Stress disorders Female New York City September 11 Terrorist Attacks business 030217 neurology & neurosurgery Clinical psychology |
| Zdroj: | Psychosomatic medicine. 82(1) |
| ISSN: | 1534-7796 |
| Popis: | OBJECTIVE Posttraumatic stress disorder (PTSD) and lower respiratory symptoms (LRS) often coexist among survivors of the September 11, 2001 (9/11) World Trade Center (WTC) attacks. Research in police and nontraditional responders suggests that PTSD mediates the relationship between 9/11 physical exposures and LRS, but not vice versa. We replicated these findings in WTC rescue/recovery workers (R/R workers), extended them to exposed community members, and explored the interplay between both physical and psychological 9/11 exposures, probable PTSD, and LRS over a 10-year follow-up. METHODS Participants were 12,398 R/R workers and 12,745 community members assessed in three WTC Health Registry surveys (2003-2004, 2006-2007, and 2011-2012). LRS and 9/11 exposures were self-reported. Probable PTSD was defined as a PTSD Checklist score ≥44. RESULTS Probable PTSD predicted LRS (R/R workers: β = 0.88-0.98, p < .001; community members: β = 0.67-0.86, p < .001) and LRS predicted PTSD (R/R workers: β = 0.83-0.91, p < .001; community members: β = 0.68-0.75, p < .001) at follow-ups, adjusting for prior symptoms and covariates. In both R/R workers and community members, probable PTSD mediated the relationship between 9/11 physical exposures (dust cloud, long duration of work) and LRS (indirect effects, p = .001-.006), and LRS mediated the physical exposure-PTSD relationship (indirect effects, p = .001-.006). In R/R workers, probable PTSD mediated the psychological exposure (losing friends or loved ones, witnessing horrific events)-LRS relationship (indirect effect, p < .001), but LRS did not mediate the psychological exposure-PTSD relationship (indirect effect, p = .332). In community members, high 9/11 psychological exposure predicted both probable PTSD and LRS at follow-ups; probable PTSD mediated the psychological exposure-LRS relationship (indirect effect, p < .001), and LRS mediated the psychological exposure-PTSD relationship (indirect effect, p = .001). CONCLUSIONS Probable PTSD and LRS each mediated the other, with subtle differences between R/R workers and community members. A diagnosis of either should trigger assessment for the other; treatment should be carefully coordinated. |
| Databáze: | OpenAIRE |
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