Steven Stellman - Trajectories of Scores on a Screening Instrument for PTSD Among World Trade Center Rescue, Recovery, and Clean-Up Workers

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      Maslow, C. B., Caramanica, K., Welch, A. E., Stellman, S. D.,   Brackbill, R. M., Farfel, M. R. 28 (3) 198-205-

      Abstract: The longitudinal course of   posttraumatic stress disorder (PTSD) over 8-9 years was examined   among 16,488 rescue and recovery workers who responded to the   events of September 11, 2001 (9/11) at the World Trade Center   (WTC; New York, NY), and were enrolled in the World Trade Center   Health Registry. Latent class growth analysis identified 5 groups   of rescue and recovery workers with similar score trajectories at   3 administrations of the PTSD Checklist (PCL): low-stable   (53.3%), moderate- stable (28.7%), moderate-increasing (6.4%),   high-decreasing (7.7%), and high-stable (4.0%). Relative to the   low-stable group, membership in higher risk groups was associated   with 9/11-related exposures including duration of WTC work, with   adjusted odds ratios ranging from 1.3 to 2.0, witnessing of   horrific events (range = 1.3 to 2.1), being injured (range = 1.4   to 2.3), perceiving threat to life or safety (range = 2.2 to   5.2), bereavement (range = 1.6 to 4.8), and job loss due to 9/11   (range = 2.4 to 15.8). Within groups, higher PCL scores were   associated with adverse social circumstances including lower   social support, with B coefficients ranging from 0.2 to 0.6,   divorce, separation, or widowhood (range = 0.4-0.7), and   unemployment (range = 0.4-0.5). Given baseline, exposure-related,   and contextual influences that affect divergent PTSD   trajectories, screening for both PTSD and adverse circumstances   should occur immediately, and at regular intervals postdisaster.

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