Acculturation, coping, and PTSD in Hispanic 9/11 rescue and recovery workers.

Abstract

Objective: Research examining the responders of the World Trade Center terrorist attacks of 9/11 has found that Hispanic responders are at greater risk for posttraumatic stress disorder (PTSD) than non-Hispanic White responders. However, no studies have examined how acculturation may influence the relationship between coping and PTSD in Hispanic 9/11 responders. This novel study is the first to examine differences in coping and PTSD among Hispanic responders by level of acculturation. Methods: The sample is composed of 845 Hispanic 9/11 responders who were seen at the World Trade Center Health Program and participated in a web-based survey. Using logistic and multiple linear regression, we examined how acculturation is related to their coping strategies and risk for PTSD. We also tested for interaction to examine whether level of acculturation moderated the relationship between coping and PTSD symptom severity. Results: Key findings revealed that higher acculturation is associated with the use of substances, venting, and humor to cope, while lower acculturation is associated with the use of active coping and self-distraction in this sample. We also found that less acculturated responders were more likely to experience more severe PTSD. Lastly, our findings revealed that Hispanics who are more acculturated and used substances to cope had more severe PTSD than less acculturated responders. Conclusion: These findings highlight the need to consider the role of acculturation in Hispanic responders' coping and PTSD. Clinical Impact StatementThis study contributes to our understanding of sociocultural risk factors that contribute to mental health disparities among Hispanic first responders.

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“…Acculturation is defined as the process in which an individual adopts, acquires, and adjusts to a new cultural environment ( 28 ). The degree of acculturation may relate to PTSD symptoms after traumatic events, as demonstrated in one study of Hispanic 9/11 responders in whom less acculturated participants had more severe PTSD ( 29 ). Given that our study recruited Spanish-speaking and English-speaking patients, our results likely reflect the lived experiences of a range of acculturation among Hispanics.…”

Are rescue workers still at risk? A meta‐regression analysis of the worldwide prevalence of post‐traumatic stress disorder and risk factors

“…There are central moderator effects of culture, family and social networks, which buffer the impact of traumatic events on PTSD. In this view, Ciro et al (2021) report effects of culture in Hispanic rescue workers involved in 9/11 terrorist attacks, with less acculturated individuals suffering from more severe PTSD. Furthermore, meaningful differences arise regarding geographic location or occupational group, with a higher PTSD prevalence in workers from Asia and ambulance workers (Berger et al, 2012).…”

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“…The importance of resilience as an inherent ability to manage daily stresses, as well as to overcome severe trauma, has increasingly been recognized [ 7 ]. Studies of frontline health care workers during the beginning of the COVID-19 pandemic and responders to the September 11, 2001, attacks have shown that resilience is important for both risk of PTSD and the ability to overcome trauma [ 8 , 9 ]. Further, researchers have made progress modeling the neurobiological components of resilience, pointing to both physiological processes and genetic factors that shape a person’s resilience [ 10 ].…”