Posttraumatic Stress Disorder and the Risk of Respiratory Problems in World Trade Center Responders

Kotov, Roman; Bromet, Evelyn J.; Schechter, Clyde B.; Broihier, Julie; Feder, Adriana; Friedman‐Jiménez, George; Gonzalez, Adam; Guerrera, Kathryn M.; Kaplan, Julia; Moline, Jacqueline; Pietrzak, Robert H.; Reissman, Dori B.; Ruggero, Camilo J.; Southwick, Steven M.; Udasin, Iris; Korff, Michael Von; Luft, Benjamin J.

doi:10.1097/psy.0000000000000179

Cited by 46 publications

(44 citation statements)

References 56 publications

(83 reference statements)

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“…Emotional lability might also be associated with LRS by heightened emotions straining sympathetic nervous system responses and in turn exacerbating respiratory symptoms. This is in line with evidence that psychiatric conditions such as PTSD are a risk factor for development of LRS [47].…”

Section: Personality Facets and Initial Health Consequences Of Traumasupporting

confidence: 76%

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Maladaptive Personality Traits and 10-Year Course of Psychiatric and Medical Symptoms and Functional Impairment Following Trauma

Waszczuk

Ruggero

et al. 2018

Annals of Behavioral Medicine

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Background Personality is a major predictor of many mental and physical disorders, but its contributions to illness course are understudied. Purpose The current study aimed to explore whether personality is associated with a course of psychiatric and medical illness over 10 years following trauma. Methods World Trade Center (WTC) responders (N = 532) completed the personality inventory for DSM-5, which measures both broad domains and narrow facets. Responders' mental and physical health was assessed in the decade following the WTC disaster during annual monitoring visits at a WTC Health Program clinic. Multilevel modeling was used in an exploratory manner to chart the course of health and functioning, and examine associations of maladaptive personality domains and facets with intercepts (initial illness) and slopes (course) of illness trajectories.Results Three maladaptive personality domains-negative affectivity, detachment and psychoticism-were uniquely associated with initial posttraumatic stress disorder (PTSD); detachment and psychoticism were also associated with initial functional impairment. Five facets-emotional lability, anhedonia, callousness, distractibility and perceptual dysregulation-were uniquely associated with initial mental and physical health and functional impairment. Anxiousness and depressivity facets were associated with worse initial levels of psychiatric outcomes only. With regard to illness trajectory, callousness and perceptual dysregulation were associated with the increase in PTSD symptoms. Anxiousness was associated with greater persistence of respiratory symptoms. Conclusions Several personality domains and facets were associated with initial levels and long-term course of illness and functional impairment in a traumatized population. Results inform the role of maladaptive personality in the development and maintenance of chronic mental-physical comorbidity. Personality might constitute a transdiagnostic prognostic and treatment target.

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Section: Personality Facets and Initial Health Consequences Of Traumasupporting

confidence: 76%

“…These questions were derived from standard assessments used in previous studies of WTC responders that also validated the four-item composite [47]. Participants indicated whether or not they experienced each symptom.…”

Section: Methodsmentioning

confidence: 99%

Maladaptive Personality Traits and 10-Year Course of Psychiatric and Medical Symptoms and Functional Impairment Following Trauma

Waszczuk

Ruggero

et al. 2018

Annals of Behavioral Medicine

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“…In this cohort of WTC workers, PTSD has also been associated with self-reported incident lower respiratory symptoms during follow up (13). To our knowledge, however, this is the first report of an association between probable PTSD and either BDR or incident (new-onset) asthma.…”

Section: Discussionmentioning

confidence: 50%

Post-traumatic Stress Disorder, Bronchodilator Response, and Incident Asthma in World Trade Center Rescue and Recovery Workers

Hoz

Jeon²,

Miller

et al. 2016

Am J Respir Crit Care Med

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Rationale: Post-traumatic stress disorder (PTSD) has been associated with asthma in cross-sectional studies. Whether PTSD leads to clinically significant bronchodilator response (BDR) or new-onset asthma is unknown.Objectives: We sought to determine the relationship between probable PTSD and both BDR and incident asthma in a high-risk cohort of World Trade Center workers in New York (NY).Methods: This study was conducted on data from a high-risk cohort of 11,481 World Trade Center workers in New York, including 6,133 never smokers without a previous diagnosis of asthma. Of the 6,133 never smokers without asthma, 3,757 (61.3%) completed a follow-up visit several years later (mean = 4.95 yr, interquartile range = 3.74-5.90 yr). At the baseline visit, probable PTSD was defined as a score 44 points or greater in the PTSD Checklist questionnaire, and BDR was defined as both a change of 12% or greater and an increment of 200 ml or greater in FEV 1 after bronchodilator administration.Incident asthma was defined as a self-report of new physiciandiagnosed asthma after the baseline visit. Multivariable logistic regression was used for the analysis of probable PTSD and baseline BDR or incident asthma.Measurements and Main and Results: At baseline, probable PTSD was associated with BDR among all participants (adjusted odds ratio = 1.43; 95% confidence interval = 1.19-1.72), with similar results among never smokers without asthma. Among 3,757 never smokers, probable PTSD at baseline was associated with incident asthma, even after adjustment for baseline BDR (odds ratio = 2.41; 95% confidence interval = 1.85-3.13). This association remained significant in a confirmatory analysis after excluding 195 subjects with baseline BDR.Conclusions: In a cohort of adult workers exposed to a severe traumatic event, probable PTSD is significantly associated with BDR at baseline and predicts incident asthma.

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“…Luft et al 16 studying police and non-traditional responders (clean-up workers, building trades, transportation workers, clergy and others) suggested that PTSD mediates the association between exposure and LRS. Kotov et al 18 analysed longitudinal data on these workers to demonstrate that PTSD increased the likelihood of LRS onset and decreased the rate of LRS remission.…”

Section: Introductionmentioning

confidence: 99%

Risk factors for and consequences of persistent lower respiratory symptoms among World Trade Center Health Registrants 10 years after the disaster

et al. 2016

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Posttraumatic Stress Disorder and the Risk of Respiratory Problems in World Trade Center Responders

Cited by 46 publications

References 56 publications

Maladaptive Personality Traits and 10-Year Course of Psychiatric and Medical Symptoms and Functional Impairment Following Trauma

Maladaptive Personality Traits and 10-Year Course of Psychiatric and Medical Symptoms and Functional Impairment Following Trauma

Post-traumatic Stress Disorder, Bronchodilator Response, and Incident Asthma in World Trade Center Rescue and Recovery Workers

Risk factors for and consequences of persistent lower respiratory symptoms among World Trade Center Health Registrants 10 years after the disaster

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