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Trajectories of PTSD symptoms in WTC responders are heterogeneous and associated uniquely with pre-, peri- and post-trauma risk and protective factors. Police responders were more likely than non-traditional responders to exhibit a resistant/resilient trajectory. These results underscore the importance of prevention, screening and treatment efforts that target high-risk disaster responders, particularly those with prior psychiatric history, high levels of trauma exposure and work-related medical morbidities.

BackgroundThe World Trade Center (WTC) attacks exposed thousands of workers to hazardous environmental conditions and psychological trauma. In 2002, to assess the health of these workers, Congress directed the National Institute for Occupational Safety and Health to establish the WTC Medical Monitoring and Treatment Program. This program has established a large cohort of WTC rescue, recovery, and cleanup workers. We previously documented extensive pulmonary dysfunction in this cohort related to toxic environmental exposures.ObjectivesOur objective in this study was to describe mental health outcomes, social function impairment, and psychiatric comorbidity in the WTC worker cohort, as well as perceived symptomatology in workers’ children.MethodsTen to 61 months after the WTC attack, 10,132 WTC workers completed a self-administered mental health questionnaire.ResultsOf the workers who completd the questionnaire, 11.1% met criteria for probable post-traumatic stress disorder (PTSD), 8.8% met criteria for probable depression, 5.0% met criteria for probable panic disorder, and 62% met criteria for substantial stress reaction. PTSD prevalence was comparable to that seen in returning Afghanistan war veterans and was much higher than in the U.S. general population. Point prevalence declined from 13.5% to 9.7% over the 5 years of observation. Comorbidity was extensive and included extremely high risks for impairment of social function. PTSD was significantly associated with loss of family members and friends, disruption of family, work, and social life, and higher rates of behavioral symptoms in children of workers.ConclusionsWorking in 9/11 recovery operations is associated with chronic impairment of mental health and social functioning. Psychological distress and psychopathology in WTC workers greatly exceed population norms. Surveillance and treatment programs continue to be needed.

Data for an "A-X" version of the continuous performance test (CPT) were collected from 138 7-11-year-old nonreferred boys. Most CPT measures were age-dependent, reliable, sensitive to decrements in performance over time, and resistant to practice effects. Most were unrelated to estimates of intellectual functioning, but several were significantly correlated with academic achievement. Reaction time data support the notion that CPT measures can be divided into distinct inattention, impulsivity, and dyscontrol scores. In this normal sample, correlations with behavior ratings were relatively weak. Further research is necessary before widespread clinical use of this instrument is warranted. However, it appears to be a useful research tool and may have a role in the assessment of attention and impulsivity in a wide range of psychiatrically, neurologically, and educationally impaired children.

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