Posttraumatic Stress Disorder, Functional Impairment, and Subjective Distress in World Trade Center Disaster Workers

• Published in: Journal of traumatic stress 2018-04, Vol.31 (2), p.234-243
• Main Authors: Hunnicutt‐Ferguson, Kallio, Wyka, Katarzyna E., Peskin, Melissa, Cukor, Judith, Olden, Megan, Difede, JoAnn
• Format: Article
• Language: English
• Subjects: Disaster recovery; Post traumatic stress disorder; Quality of life; Terrorism
• ISSN: 0894-9867; 1573-6598
• DOI: 10.1002/jts.22268

Posttraumatic stress disorder (PTSD) is associated with functional deficits, poor physical health, and diminished quality of life. Limited research has examined PTSD symptom clusters and their associations with functioning and distress among disaster recovery workers, a population at high risk for PTSD due to potential for repeated trauma. The purpose of this study was to investigate associations between overall PTSD severity, as well as PTSD symptom clusters, and social and occupational functioning and subjective distress in World Trade Center (WTC) disaster workers after the terrorist attacks on September 11, 2001 (9/11). Disaster workers deployed to the site of the attacks completed assessments at three time points over approximately 5 years post‐9/11. Our sample consisted of participants who met criteria for PTSD or subthreshold PTSD at baseline (n = 514), 1‐year (n = 289), and 2‐year follow‐up (n = 179). Adjusted linear regression indicated that Clinician Administered PTSD Scale (CAPS)‐rated PTSD severity was positively associated with subjective distress, and deficits in social and occupational functioning, over time, CAPS Criterion F items; βs = .20 to .62, ps < .001. The reexperiencing and avoidance/numbing symptom clusters were associated with increased subjective distress, the avoidance/numbing and hyperarousal clusters were associated with deficits in social functioning, and the reexperiencing and hyperarousal clusters were associated with worse occupational functioning. These associations were consistent across the study period. Findings point to the importance of targeting PTSD symptom clusters associated with specific areas of functional impairment, with the goal of improving global outcomes. Resumen Spanish s by the Asociación Chilena de Estrés Traumático (ACET) Trastorno de estrés postraumático, deterioro funcional y sufrimiento subjetivo en los trabajadores de desastres del World Trade Center TEPT Y DETERIORO EN TRABAJADORES DE DESASTRES El trastorno de estrés postraumático (TEPT) se asocia con déficits funcionales, mala salud física y disminución de la calidad de vida. Limitada investigación ha examinado los dominios sintomáticos del TEPT y sus asociaciones con el funcionamiento y el sufrimiento entre los trabajadores de recuperación de desastres, una población con alto riesgo de TEPT debido al potencial de trauma repetido. El objetivo de este estudio fue investigar las asociaciones entre la gravedad general del TEPT y los dominios sintom