Steven Stellman - Trajectories of PTSD Among Lower Manhattan Residents and Area Workers Following the 2001 World Trade Center Disaster, 2003-2012

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      Publication Details (including relevant citation   information):

      Welch, A. E., Caramanica, K., Maslow, C. B., Brackbill, R. M.,   Stellman, S. D., Farfel, M. R. 29 (2) 158-66-

      Abstract: Group-based trajectory modeling was   used to explore empirical trajectories of symptoms of   posttraumatic stress disorder (PTSD) among 17,062 adult area   residents/workers (nonrescue/recovery workers) enrolled in the   World Trade Center (WTC) Health Registry using 3 administrations   of the PTSD Checklist (PCL) over 9 years of observation. Six   trajectories described PTSD over time: low-stable (48.9%),   moderate-stable (28.3%), moderate-increasing (8.2%), high-stable   (6.0%), high-decreasing (6.6 %), and very high-stable (2.0%). To   examine factors associated with improving or worsening PTSD   symptoms, groups with similar intercepts, but different   trajectories were compared using bivariate analyses and logistic   regression. The adjusted odds of being in the moderate-increasing   relative to the moderate-stable group were significantly greater   among enrollees reporting low social integration (OR = 2.18), WTC   exposures (range = 1.34 to 1.53), job loss related to the   September 11, 2001 disaster (OR = 1.41), or unmet mental health   need/treatment (OR = 4.37). The odds of being in the high-stable   relative to the high-decreasing group were significantly greater   among enrollees reporting low social integration (OR = 2.23), WTC   exposures (range = 1.39 to 1.45), or unmet mental health   need/treatment (OR = 3.42). The influence of severe exposures,   scarce personal/financial resources, and treatment barriers on   PTSD trajectories suggest a need for early and ongoing PTSD   screening postdisaster.

      Address (URL): http://www.ncbi.nlm.nih.gov/pubmed/26954702